The emergency department and first-touch encounters among pregnant individuals: An examination of births from a single delivery Hospital in a Large Healthcare System in Indiana

This study compared pregnant individuals whose first contact with the healthcare system during pregnancy occurred in the emergency department to those whose first contact occurred in non-emergency department settings. We sampled the electronic health records of pregnant individuals who had a live birth in a single urban hospital in Indiana in 2022 ( N = 1680). All encounters that occurred in the healthcare system of delivery during the pregnancy were evaluated. Descriptive statistics and bivariate logistic regressions were examined. Among all deliveries, 13.8% of individuals had their first touch with the healthcare system in the emergency department. A significantly larger proportion of that population were insured by Medicaid (82.3%) and were Non-Hispanic Black (54.3%) or Hispanic (13.8%) compared to the population whose first touch was not in the emergency department (51.5% insured by Medicaid; 30.4% Non-Hispanic Black and 10.7% Hispanic). Individuals with a first trimester prenatal care encounter had significantly reduced odds of a first touch in the emergency department (Odds Ratio = 0.44; 95% Confidence Interval:0.29,0.66). Pregnant individuals whose first touch occurred in the emergency department may be at risk for inadequate prenatal care. Improving referrals and connection to care could improve receipt of prenatal care in the first trimester.