women who
were eligible for assistance ceased to qualify for and receive Medicaid
automatically. The Temporary Assistance for Needy Families (TANF)
denied Medicaid benefits at a relatively low income eligibility level,
consequently penalizing low-income working mothers.28 Restoring
Medicaid eligibility will not, in itself, be sufficient to increase the
number of women who seek prenatal care. Even when women do
qualify, they may still experience prohibitive barriers to access and
availability. More than 29% of obstetrical services in the United States
refuse to accept Medicaid.28 This is especially a problem in the urban
and rural areas because high numbers of black women live in these
geographical areas. Data from the 2005 National Vital Statistics Report
shows that only 76% of black women seek prenatal care in the first
trimester and of the remaining 24% only 5.4% receive late prenatal
care (third-trimester). Black women had the highest percentage of
very preterm (b32 weeks) and low birthweight (b1500 g) infants as
compared to women of other races.30,31 A better understanding of
factors associated with the lack of prenatal care can lead to
development of interventions for the populations most at risk. Efforts