What's next
We don't have a plan for you to adopt. Preventing preterm birth takes advocates, lawmakers, health plans and clinicians, and each of them owns a different piece of it. Nobody needs to wait for the others to agree on a method. What keeps the pieces pointed the same direction is one shared, public number that anyone can check.
The share of pregnancies in prenatal care by the end of the first trimester. It's the first dial on the calculator, and it's the one we propose everyone watch.
Our argumentEvery clinical step on the timeline comes after the first visit. Whatever you do about preterm birth, it works only for the pregnancies that are already in care.
A plan can compute the shared number for its own members from its claims, every month, rather than waiting two years for the national record. From January 2027 every prenatal visit is billed on its own, with its own date, so that becomes easier. This is our argument; see the explainer.
Four groups own a piece of this. Each piece is stated as a challenge rather than a method. How you meet it is up to you.
Get active, and stay on the number.
Pick the barrier you know best in your state: coverage that starts late, a clinic too far away, appointment wait times, outreach that never arrives. Work on it your way. Then tie it to the shared number, so that the people you're pressing can see whether it's moving.
Ask your state Medicaid agency whether it reports prenatal timeliness for mothers 21 and older. If it doesn't, that's a concrete and modest first ask.
Yours to bring: your state's numbers from the calculator, with the sources attached, ready to hand to a staffer.
Fund it, and require the report.
Fund the approach your state believes in. We aren't asking you to choose any particular one, including prevention programs built on the test we have a financial interest in (see About). Whatever you fund, require that it report against the shared number. Report Medicaid prenatal timeliness for every age, not only the required one, and publish it by health plan.
Our argumentA state sees more of both sides of this ledger than any one plan: it pays for much of the NICU stay through Medicaid, and it carries much of what comes after.
Yours to bring: the money and the reporting rule. Nobody else at the table can bring either.
Find the pregnancies sooner, and measure the gap.
You may learn that a member is pregnant before her first prenatal visit: from a pregnancy test claim, a pharmacy fill, or an eligibility change. The weeks between knowing and the first visit are the missing weeks you can see. Measure them, shorten them in whatever way fits your members, and report the shared number for your book of business.
Yours to bring: the earliest signal in the system that a pregnancy exists, and, from 2027, a dated claim for every visit after it.
Start with what's already in published guidance.
Most of the steps on the timeline are already in published guidance, and several cost a few dollars. Find the windows your practice misses most often, and close them in whatever way fits your practice. Not every step on the timeline is in guidance yet: the mid-pregnancy risk screen, the test we have a financial interest in, rests on its own trial, and this page doesn't ask you to start it. The first visit is the door to every window, so how soon a newly pregnant patient can be seen is part of this too.
Yours to bring: the visit itself, and a record of when each step happened. What applies to each pregnancy is your call. This site is a population reference and not clinical guidance.
You're owed care that starts in time. None of the work on this page is yours.
The missing weeks are the system's to catch, not yours. If you want to know what's scheduled and when, the timeline shows the windows, and you can ask about any of them at your first visit, for example whether low-dose aspirin is right for you, or what the anatomy scan will check. If you couldn't get an appointment as early as you wanted, that delay is what the shared number counts, and it is exactly what the people above are being asked to fix.
Not medical advice. Your clinician decides what applies to your pregnancy.
We'll keep the numbers on this site public, sourced and graded, and grade every approach against the same evidence bar, whoever sells it. When a figure changes we'll correct it on the page, with the date. We don't endorse methods, and we won't rank the people working on this.
If you're working on any piece of this and the shared number is the wrong one for what you do, tell us why at info@themissingweeks.org. A benchmark that nobody can argue with is a benchmark that nobody is checking.