Fewer Michigan Women Getting Prenatal Care

The odd thing about this story is that women in the cluster of wealthiest (and whitest) Michigan counties (Antrim, Benzie, Grand Traverse and Leelanau) have among the lowest rates of first trimester prenatal care.  The overall infant mortality rate in Michigan is approximately 6.3 deaths per 1,000 live births.  This puts us just below the U.S. national average (5.5 deaths per 1,000 live births) and near the median for G20 countries (4.9 deaths per 1,000 live births).  It would be interesting to see the Michigan maternal death rate as a function of prenatal care, by county, to determine whether the claimed correlation is incidental, or causation:

https://www.woodtv.com/news/michigan/fewer-women-are-getting-prenatal-care-michigan-doctors-want-to-know-why/

Fewer women are getting prenatal care. Michigan doctors want to know why
By Katherine Connolly - April 25, 2026

GRAND RAPIDS, Mich. (WOOD) — From the closure of rural hospitals to Medicaid policy changes and physician shortages, prenatal care is becoming more difficult to access across the country, including Michigan, a new federal report shows.

According to statistics from the Centers for Disease Control and Prevention, the percentage of pregnant women across the country forgoing prenatal care until the after the first trimester grew in 36 states between 2021 and 2024. That includes Michigan, where more than 20% of women did not receive early prenatal care. About 6.5% of women — more than 26,000 — reported not receiving prenatal medical care until the third trimester, if at all.

The report doesn’t identify why these women didn’t get care — whether it was an issue of access or whether she simply didn’t know she was pregnant until after the first trimester. News 8 spoke with health care experts across the state to understand the barriers their patients face.

“This kind of decline in prenatal care use is also consistent with other worsening trends in the nation in regard to maternal infant health outcomes,” Dr. Mona Hanna, a pediatrician and the founder and director of Rx Kids, said. “We have some of the worst maternal health outcomes in the world, especially compared to peer countries.”

A 2024 report from the Commonwealth Fund found that the U.S. “continues to have the highest rate of maternal deaths of any high-income nation.” In 2022, the U.S. maternal mortality rate, a measure how many women died during pregnancy or within 42 days of the end of pregnancy, was 22.3 per 100,000. Michigan saw a slightly below-average rate of 19.1. In Canada, that number was 8.4.

Up to 80% of U.S. maternal deaths may have been preventable, the nonprofit reported.

Dangerous birth outcomes, including death, are substantially more common for women of color, studies have repeatedly found — especially for Black mothers, who see deaths at a rate of 49.5 per 100,000, more than double that of the average U.S. population.

Kalamazoo County touts lowest infant mortality rate in Michigan

“Black moms are two to three times as likely to die during pregnancy and postpartum and to have other serious complications. When you control for mom’s prenatal health and a lot of other things, including mom’s own health behavior, that difference is still there. So there are some things that are going on in the health system,” Dr. Jessica E. Johnson, a clinical psychologist who works with high-risk pre- and postnatal women around Flint, said.

While several factors influence those disproportionately negative outcomes, Johnson and Hanna explained, access to high quality, local prenatal care is a critical factor in improving Black maternal health.

Prenatal visits are important for the well-being of both moms and their babies, experts who spoke with News 8 said. Early visits can lead to early detection of pregnancy complications like preeclampsia or gestational diabetes that, if left untreated, can lead to death among expectant and new mothers.

“Starting prenatal care before that 10-week mark is incredibly imperative. We know that that’s been also something that’s been shown to help reduce prematurity and very low birth weight outcomes, as well,” said Dr. Karen Garcia, a newborn hospitalist and the system director for health transformation with Bronson Healthcare in Kalamazoo. “The earlier that we can get people in (and) really start trying to see what it is that we can support physically, mentally, emotionally, the better outcomes that we tend to have.”

Numerous studies have found that infant mortality is strongly tied to prenatal care access. The harder it is to find or get to prenatal care, the more likely it is that mom or baby will suffer complications, including death.

Prenatal visits also allow providers to assess the social needs of families and connect them with community resources, local parenting groups and social services, like WIC food benefits and Medicaid, Garcia said.

“We know that there’s a direct correlation between infant mortality and early or prenatal care,” Berrien County Health Officer Guy Miller said. “The mortality rate we had in 2023 was higher than the state’s average. We lost 20 children that year, and we were way higher than the state average of what they typically see for infant mortality in a community.”

In 2023, Michigan saw an average of more than 6 infant deaths per 1,000 live births. In Berrien County, deaths were more than twice that at a rate of 14.4 per 1,000. Over the same period, nearly 25% of the county’s pregnant woman did not receive prenatal care during the first trimester.

Miller said transportation is one of the greatest challenges facing expecting parents in Berrien County. Much of the county is rural, with limited access to public transportation or rideshare services like Uber. For pregnant women without reliable access to a car a 20- or 30-mile journey to the OB-GYN can become an all-day endeavor, requiring them to take time off work or find child care for their other kids.

“If you don’t have transportation, if you are busy trying to work two jobs to support your family, if you just have all the other complications going on that relate to poverty and trying to hold a family together, that can make (getting prenatal care) more complicated,” Johnson explained.

In six Michigan counties, primarily in the Traverse City-Cadillac area, an average of fewer than 60% of pregnant women received prenatal care during their first trimester between 2021 and 2024. In Kalkaska County, only half of women received care during their first trimester, according to county-level data provided by the March of Dimes.

In rural areas, like Branch County where just over half of pregnant women received early prenatal care between 2021 and 2024, care is becoming increasingly difficult to access as hospitals and clinics close. At least 10 birthing hospitals have closed since 2018, eight of which served primarily rural patients, according to a Michigan Senate Fiscal Agency report. In 2023, the ProMedica Coldwater Regional Hospital shuttered its OB-GYN department amid a pending sale. Sturgis Hospital closed its birthing center in 2018.

“There’s been this consistent decline in people in pregnant people’s ability to get health care access. … We’re seeing that, for example, in a lot of rural communities — the Upper Peninsula of Michigan — lots of places have less access to care because these safety net hospitals can’t stay in business,” Hanna said.

As of 2024, nearly 22% Michigan counties were considered maternity care deserts with zero hospitals or birth centers offering obstetric care, and zero obstetric providers. This is up from 18% the year before, the Senate Fiscal Agency report found.

Grants support maternal health equity in Southwest Michigan

The uncertainty of prenatal care access adds another layer of stress to lives already complicated by the daily realities of poverty. In Berrien County, where the median per capita income was just over $38,000 in 2024, parents-to-be are tasked with balancing daily expenses, saving for a new baby and managing and paying for medical care.

“It’s no wonder those families are having a hard time getting to their provider’s appointments because they’re lacking so many other resources,” Miller said. “If you’re worried about paying rent, you’re worried about keeping the lights on, you’re worried about putting food on the table, going to a doctor’s appointment for yourself might fall quickly to the bottom of that list.”

The experts acknowledged that, from the outside, it can be easy to judge these women, but they encouraged the public to put themselves in these expectant mothers’ shoes.

“I think it’s easy to blame moms for not coming in, but that contributes to the problems that lead them to not come in, which is worrying about feeling understood or respected,” Johnson said. “There are still things that we can do to ensure systems meet the needs of moms where they are.”