What Are Some Socioeconomic Factors That Influence the Rates of Pregnancy Loss in the U.S.?

Several socioeconomic factors influence the rates of pregnancy loss in the United States. These socioeconomic factors include: 

• Low socioeconomic status or position
• Educational attainment
• Insurance coverage 
• Race
• Ethnicity 

Socioeconomic status is often a key determinant in pregnancy loss rates. Low socioeconomic status can result in disparities in access to education, quality healthcare and resources. This often correlates with higher pregnancy loss rates among low-income and poverty-level populations. Pregnant women with low socioeconomic status also have significantly more depressive symptoms and higher stress levels, particularly during the third trimester. Low socioeconomic status is often associated with limited access to prenatal care, food insecurity or inadequate nutrition, and increased environmental exposure to hazards in disadvantaged communities. 

Insurance coverage can also significantly affect access, quality, and level of care received during pregnancy. Interrupted care and delayed access to services through Medicaid can result in adverse health and birth outcomes. Unfortunately, many women with Medicaid are less likely to start prenatal care during their first trimester of pregnancy and less likely to receive suitable prenatal care when compared to women with private insurance. While this does not result in noticeable differences in birth outcomes or pregnancy loss, it demonstrates how access to care can vary significantly for low-income people. 

Numerous studies have documented increased maternal death in women with lower education levels, public or no insurance coverage, or minority race and ethnicity. Racial and ethnic disparities often have a prominent influence on pregnancy loss and maternal and infant health. For example, the pregnancy-related mortality rate for Black women who have completed a college education or beyond is 5.2 times higher than that for white women with the same level of educational attainment. Similarly, Black women who receive adequate prenatal care have higher rates of infant mortality even when compared to white women who receive little or no prenatal care, suggesting that issues such as structural racism influence pregnancy loss even in the absence of socioeconomic factors.

Sources 

“Fact Sheet: Women & Socioeconomic Status”. American Psychological Association. https://www.apa.org/pi/ses/resources/publications/women 

“Access in Brief: Pregnant Women and Medicaid”. Medicaid and CHIP Payment and Access Commission. https://www.macpac.gov/wp-content/uploads/2018/11/Pregnant-Women-and-Medicaid.pdf 

“Social Determinants of Pregnancy-Related Mortality and Morbidity in the United States: A Systematic Review”. National Library of Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC7104722/ 

“Racial Disparities in Maternal and Infant Health: Current Status and Efforts to Address Them”. KFF. https://www.kff.org/racial-equity-and-health-policy/issue-brief/racial-disparities-in-maternal-and-infant-health-current-status-and-efforts-to-address-them/ 

“Why Are Black Mothers at Higher Risk for Miscarriage?” WebMD. https://www.webmd.com/baby/features/why-black-mothers-higher-risk-miscarriage