Racial and Ethnic Disparities in Preconception Care Utilization: Findings from the Los Angeles Mommy and Baby (LAMB) Survey

OBJECTIVE: To examine racial and ethnic disparities in preconception care utilization. METHODS: We used data from the first wave of 2007 Los Angeles Mommy and Baby (LAMB) Survey. LAMB is a mail sample survey with telephone follow-up for non-respondents based on multistage clustered design. Our preliminary analyses were based on the responses of 721 women with a live birth in 2007 in Los Angeles County. The relationship between race and ethnicity and preconception care utilization was examined using Pearson's chi square tests, stratified by preconception insurance status and other sociodemographic characteristics. RESULTS: More than two-thirds (69.6%) of women surveyed did not receive a checkup in the 6 months prior to their most recent pregnancy. Latina and African American women were significantly less likely to receive care (p<0.0001); 78% of Latina women and 72% of African American women did not receive care, as compared to 63.3% of Asian and Pacific Islander women and 57% of white women. Uninsured women were significantly less likely to receive preconception care than insured women (p<0.001); 89% of uninsured women had no prepregnancy checkup compared to 61% of women with private insurance. However, racial-ethnic disparities in preconception care utilization persisted even when the analyses were stratified by insurance status. Among privately insured women; 69% of Latinas, 65% of African Americans, and 62% of API women compared to 49% of white women, did not receive preconception care. DISCUSSION: Significant racial-ethnic disparities in preconception care utilization exist even among women with health insurance.