Prenatal Care (Inadequate, Late or No Care, Few Visits)

Limitaciones

OASIS's percent of births with inadequate prenatal care (Kotelchuck), late or no care, or under 5 visits, among births with care recorded (not num_births). The measures overlap: never add them. None published 2008-2014 (2007: visits only); never compare 2000-2007 with 2015-2025 (new birth certificate). Artifacts (our reading): late or no care jumps in 2016 and 2019; Catoosa, Dade and Walker 2024-2025 (late over 90%; Kotelchuck known for 10-18%, masked); Glynn 2015-2021 (visits, Kotelchuck). Live births to mothers who live in Georgia, placed by the mother's county of residence (not where the birth happened); OASIS counts births, not pregnancies, so twins are two births. The certificate change: OASIS reports too many records missing (its code -4: over 20% of the year's records lack the field) for every measure in 2008-2014 and for late or no care and the Kotelchuck index in 2007, the year the revised (2003) birth certificate came in, which records the date of the first prenatal visit instead of the month care began; num_births is kept on those rows. Georgia's percents were 13.2% inadequate (Kotelchuck), 4.1% late or no care and 5.7% under 5 visits in 2006, and 19.4%, 5.7% and 7.7% in 2015: the two series are not comparable (2007's visits figure mixes both certificates). The denominator: OASIS divides by the group's births whose prenatal care is recorded for the measure (its definitions exclude unknown values), never by num_births, and every published year leaves some out: Georgia 0.5% (fewer_than_5_visits, 2025) to 14.7% (inadequate_kotelchuck, 2015) of its births, so the percent runs up to 2.85 percentage points above num_births_with_measure / num_births for Georgia and up to 17 points in small groups (on the rows served: our 20% mask, below, NULLs those with wider gaps). 18 county rows (all breakdowns at 'all') leave out over half their births (masked, below). OASIS does not publish the denominator, so there is no exact pooled figure. Recording breaks (our reading; caveated, not masked): Georgia's late or no care percent was 5.7% in 2015, 8.8% in 2016, 5.6% in 2017, 5.6% in 2018 and 9.5% in 2019, while the Kotelchuck percent held at 19.0%-19.6%, and in the jump years far fewer births had unknown timing (Georgia: 19,045 in 2015, 6,444 in 2016; 9,024 in 2018, 3,188 in 2019): records with no recorded start of care were probably counted as no care in some years and as unknown in others. In Catoosa, Dade and Walker late or no care is 90.7%-96.1% in 2024-2025 (7.3% in 2023; Dade and Walker NULL here, over 20% unknown timing), while OASIS has a Kotelchuck status for only 10%-18% of their births (probably records of births in Tennessee hospitals), so OASIS's Kotelchuck percents for them, the highest of any county in those years, rest on a handful of births: NULL here (our 20% mask, below). In Glynn in 2015-2021 the under-5-visits percent is 22.3%-43.2% and the Kotelchuck percent 31.2%-49.4% (from 2023: 5.2%-6.1% and 19.1%-22.5%), the highest Kotelchuck percent of any county with 200+ births in 2016-2021, and its late or no care is 31.6%-44.5% where served (NULL in 2015, 2017 and 2018: over 20% of its births of unknown timing, OASIS's own figures as low as 3.8%). In 2024 every measure rises statewide (Kotelchuck 18.8% to 23.1%, under 5 visits 8.3% to 10.8%), led by a few counties (Chatham's under-5-visits percent 12.1%, 22.2% and 10.9% in 2023-2025; Richmond's 5.8% to 17.1%): check a county's own series before comparing years. Each percent divides by the group's own births of known prenatal care status: a mother's age group, race group or payer by its births, not by all births in the place. demographic, mother_age and payer are never crossed: a row breaks down by one of them, the others at 'all' (OASIS's requests never cross them). OASIS publishes every count, however small, and withholds the percent on 1-4 births with the measure (NULL here); the platform adds no small-cell suppression of its own (its masks, below, are quality masks) and never recomputes a withheld percent. 35% of rows with births and a published year have no percent (withheld on 1-4 births, or NULLed by our masks), mostly small counties and groups. Where a group had no births in a place (num_births 0) the percent is NULL: OASIS shows 0, but a percent of no births is undefined (our mask; the counts stay 0). That covers 35,890 rows over all measures, mostly small race and age groups and payers. OASIS shows 0% wherever a group has births but none with the measure, even when none had a known care status. Where OASIS's other rows prove that none had (the place's births of known status are all in the breakdown's other groups), the percent and its count are NULL: 0 of 0 is undefined, and every one of those births is of unknown status (our masks, 73 rows, most of them payers). Where more than 20% of a row's births have an unknown value for the measure (OASIS leaves them out of its denominator), the percent and its count are NULL (our mask: OASIS's own 20% threshold, which it applies only to whole years); num_births is kept. That covers 1,530 rows (154 county totals); 374 of them are 0% or withheld rows (101 at 0% and 273 withheld), whose percent implies no denominator but whose births of known status OASIS's other rows bound: at most the place's known-status births (count / percent of its total row) less the breakdown's other groups'. A 0% or a withheld percent implies no denominator, so it can't be tested unless OASIS's other rows bound it; unbounded, it stays as published. Georgia's own unknown-payer rows are among them every year from 2015. The race groups' series break in 2007-2008, which looks like a change in how the mother's race was recorded (our reading; OASIS documents none): multiracial births rose from 648 in 2006 to 3,538 in 2007 and 6,961 in 2008, then held between 2,487 and 3,499 a year from 2010, so multiracial figures of 2007-2009 are not comparable with other years; white births fell from 66,940 to 57,568 and native_american births from 215 to 91 in 2008. race_unknown (unknown ethnicity, and in 2008-2016 also births recorded with no race) peaks at 5.1% of Georgia's births in 2009 (0.6% in 2025), so the race groups run that much low. Counties break harder and for longer: in 84 county-years of 2000-2012 (none since; 17 counties) more than 25% of births have no recorded race or ethnicity, up to 78%, most often in Catoosa, Dade and Walker (the Tennessee border) and in Tift and nearby counties from 2007, so OASIS's race groups for those county-years run far low (Tift: 414 of its births in 2011 had no recorded race or ethnicity, and OASIS counts its black births as 16 in 2011 and 199 in 2015). Hispanic births spiked in Sumter, Walton and Macon in 2008-2009 (Sumter: 92, 336, 290 and 56 in 2007-2010). Compare a county's race groups over time from 2013 only (its race_unknown share has been at most 17% since). Those county-years, and the others with more than 20% of births of unknown race, have their race groups NULL here (our mask), Tift's 2011 black births among them. Where the mother's race or ethnicity is unknown for more than 20% of a place-year's births (race_unknown / all num_births, the births topic's rule on the same births), every race group's percent, count and num_births for that place and year are NULL (our mask, OASIS's own 20% threshold for missing items): each group's figures would rest only on the births whose race was recorded. The all, mother's age, payer and race_unknown rows are kept, so the unknown share stays visible. That covers 97 county-years (2000-2012, 19 counties; never Georgia), 2,037 race-group rows. Race groups are the mother's race and ethnicity in the platform convention: hispanic is Hispanic of any race; white, black, asian, native_american (American Indian or Alaska Native), pacific_islander (Native Hawaiian or Other Pacific Islander) and multiracial are non-Hispanic. race_unknown is our calculation, the total minus those seven (unknown ethnicity, or non-Hispanic of unknown race), so the race groups' counts add up to all where every one is published (our masks NULL some, below); it has no percent: OASIS publishes one only for its unknown-ethnicity cell, which equals race_unknown except in 2008-2016 (when race_unknown also holds non-Hispanic births of unknown race), so none is served, keeping one definition. mother_age is the mother's age at the birth in OASIS's groups (10_14, 15_17, 18_19, then five-year groups to 40_44, and 45_55); the groups' counts add up to all where every one is published (our 20%-missing mask NULLs some, below). Payer rows start in 2008, as in births_by_payer: before the revised birth certificate (mid-2007, per OASIS) the payer was recorded only as medicaid or unknown (2000-2004) or not at all (2005-2006), and 2007 is the transition. medicare rows exist only in 2013 and 2014 and peachcare rows only in 2013, 2014 and 2016, the years either has births (the revised certificate has no box for either, our reading); in other years no birth could carry them, so those rows are not served. With nothing published 2008-2014, race groups and payers compare from 2015. Percents of 100% (41 rows) all rest on few births with recorded care (at most 69): small groups, and groups where OASIS has the care status of only a few births (the border counties in 2024-2025); preserved as published. 2025, the newest year, was added to OASIS on 2026-04-30; OASIS marks no year provisional. Counties add up to Georgia, and the race groups (with race_unknown), mother's ages and payers to all, in both counts, wherever every count is published. Our masks NULL some (the 20%-missing mask 1,530 counts, 154 of them county totals, the 0-of-0 rows' 73, and 227 race_unknown counts; the race mask 742 race-group counts and 2,037 num_births in 97 county-years), so a sum across counties or groups falls short where they apply; never rebuild a masked count by subtraction. Not served: OASIS's SES-vulnerability rows (their percents are valid, each dividing by the SES group's own births, but the platform has no SES group yet) and the mother's education. tract_geoid is always NULL.