Background: A continuum of maternal healthcare before, during, and after pregnancy, influences optimal health of mothers and infants. However, limited population-based research examined risk factors of neglected maternal care across its spectrum. This study explored patterns and disparities of preconception, prenatal, and postpartum care utilization among women in Virginia.

Methods: We used data from the 2016 - 2020 Virginia Pregnancy Risk Assessment Monitoring System (VA-PRAMS), representative sample surveys of women recruited 4-6 months postpartum (N = 4,843). The maternal care spectrum was assessed in relation to receiving a primary care visit (PCV) within a year of conception, timing of the first prenatal care visit (PNCV), and having a postpartum visit (PPV) 4-6 weeks after delivery. Multivariable logistic regression was employed to examine factors related to missing or delayed maternal care visits, adjusting for sociodemographic characteristics.

Results: Over one-third of women had no preconception PCV (37.14%), one in ten had delayed PNCV (11.92%), and missed their PPV check-up (11.50%). Missed or delayed care was significantly associated with younger age, lower income, and no insurance coverage (p <0.001). Relative to White women, minority women had significantly increased odds of no PCV (African-American AOR: 1.57, 95% CI: 1.17–2.18); Hispanic AOR: 1:71, 95% CI: 1.23 – 2.37); Asian and other AOR: 2.41, 95% CI: 1.68-3.45).

Conclusion: The study highlighted disparities of care across the spectrum of maternity among minority and socioeconomically disadvantaged Virginia women, which highlighted the need for better-equipped healthcare services for expecting mothers, and eventually policy implementation to improve maternal healthcare utilization.