Fewer Women Are Getting Prenatal Care (and Missing an Important Chance to Prevent Congenital Syphilis)
A new report shows that fewer women are getting prenatal care. That means too many patients are missing the chance to prevent congenital syphilis.
Syphilis rates in pregnant women are higher than they’ve been since the early 1990s according to a new report from the National Center for Health Statistics (NCHS). The report finds that the syphilis rate among pregnant women went up 222% percent between 2016 and 2022 and another 28% between 2022 and 2024. Syphilis is treatable even in pregnancy if a woman knows she has it. This alarming increase shows too many pregnant women are not being screened.
Syphilis is a sexually transmitted infection caused by the Treponema pallidum. It can be passed during vaginal, anal, or oral sex. It can also be passed from a mother to an infant during pregnancy or delivery. This is referred to as congenital syphilis. Congenital syphilis can cause miscarriage, stillbirth, and even infant death. Babies born with syphilis can face lifelong medical issues.
Syphilis often has no symptoms in its early stages. For many people, the only way they know they have is to get tested. Syphilis can be detected by a simple blood test.
Women who have access to prenatal care are usually tested for syphilis at their first pregnancy check-up. In fact, most states mandate syphilis screening at that first prenatal appointment. Some states also require testing during the third trimester and at the time of delivery. Health care providers may recommend this even in states where it is not required.
Because of rapidly climbing congenital syphilis rates, the American College of Obstetricians and Gynecologists (ACOG) released new guidelines suggesting more frequent syphilis testing during pregnancy. ACOG is now recommending that all pregnant people be screened three times: at the first prenatal visit, during the third trimester, and at birth.
Unfortunately, too many people in this country do not have access to prenatal care. Financial issues like lack of insurance or high deductibles can prevent some women from getting care. Others may have trouble with transportation or taking time from work. Many rural areas don’t have local pregnancy care providers and hospitals in those areas are closing their maternity wards. One study found that in the United States, 35% of women of reproductive age (usually defined as 15-44) live in an area without a maternal health provider. These issues are most likely to impact low-income women, women of color, and women in rural areas.
In its new report, the NCHS notes that the maternal syphilis rate is higher among black and Hispanic women than among white women. In 2024, there were 887 cases of maternal syphilis per 100,000 births to Black women, 411 cases of per 100,000 births to Hispanic women, and 188.2 cases per 100.000 white women. The highest rates of maternal syphilis, however, were among Native American and Alaskan Natives with 2,145 cases per 100,000 women.
Congenital syphilis is preventable if people have access to the testing and care they need. The Centers for Disease Control and Prevention (CDC) points out that 40% of people who had a baby with syphilis in 2022 did not get proper prenatal care. Some pregnant patients were not screened for syphilis while others were not treated after testing positive. The CDC believes that 9 in 10 cases of congenital syphilis might have been prevented with timely testing and treatment.
We’re missing opportunities to prevent congenital syphilis and save lives. Public health efforts must focus on expanding this care to all women.
Prenatal care is essential in preventing congenital syphilis. Below are resources for pregnant patients.
A new report shows that fewer women are getting prenatal care. That means too many patients are missing the chance to prevent congenital syphilis.
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ASHA believes that all people have the right to the information and services that will help them to have optimum sexual health. We envision a time when stigma is no longer associated with sexual health and our nation is united in its belief that sexuality is a normal, healthy, and positive aspect of human life.
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