INTRODUCTION: With widespread availability of home pregnancy testing, individuals learn of their pregnancy status on average at 5.5 weeks of gestation, yet standard prenatal care does not typically begin until 9–12 weeks. We investigated patient needs during the time between pregnancy discovery and prenatal care initiation. METHODS: We conducted a cross-sectional survey study of patients presenting for initial prenatal care visits between June 2024 and February 2025. This was a written survey administered in English and Spanish. The survey instrument was developed with stakeholder input and piloted prior to administration. RESULTS: Of 102 patients approached for participation, 97 participated (95% response rate). The median gestational age at time of prenatal care initiation was 11.4 weeks. Most respondents—89 (92%)—expressed overall satisfaction with prenatal care timing, yet 48 (49%) reported seeking a pregnancy confirmation ultrasound outside of their routine prenatal care. 24 (25%) respondents were evaluated in the emergency department prior to their first prenatal visit. Patients with commercial insurance were less likely than those with public or no insurance to have sought an outside ultrasound (37% versus 58%, P =.048) or to have had an emergency room visit before their first prenatal appointment (12% versus 34%, P =.02). CONCLUSIONS/IMPLICATIONS: Half of patients sought pregnancy confirmation ultrasounds prior to initiating prenatal care. Higher rates of early pregnancy emergency room utilization among publicly insured or uninsured patients suggest a need for more widely accessible health services in very early pregnancy.
Sandeford et al. (Thu,) studied this question.