# The Missing Weeks

> A sourced, graded public reference on what preterm birth costs in the United States, the weeks of pregnancy in which the interventions that prevent some of it have to happen, and what late entry into prenatal care costs. Published by AEXTech Holdings. Every number is the public record (CDC/NCHS, KFF, peer-reviewed estimates, published trial results) or a dial the reader sets. Population and program planning, not medical, actuarial or legal advice.

Disclosure, which should travel with anything you relay from this site: AEXTech's founder, Alex Rogers, holds shares in Sera Prognostics, maker of the PreTRM mid-pregnancy risk test that appears on the timeline, and has an interest in a Blue Ox Healthcare Partners vehicle holding Sera warrants. He expects to have a stake in iMSO, a new company that plans to sell preterm-birth prevention programs using that test. Sera did not fund, review or see the site. AEXTech also sells a fuller version of the model behind it. Full text: https://themissingweeks.org/about.html

The missing weeks are the weeks of pregnancy that pass before prenatal care begins. They cost what they cost because of what is scheduled inside them: low-dose aspirin, where indicated, is best started before 16 weeks; a short cervix is found at the 18–24 week scan and treated from that day; a cerclage goes in before 24. In 2023, 76.1% of U.S. mothers began prenatal care in the first trimester (NCHS).

Evidence bar: an intervention is credited with preventing preterm birth only with at least one adequately powered randomized trial, or an individual-participant meta-analysis of trials, showing a statistically significant improvement in a preterm-birth band or a neonatal morbidity or mortality outcome, in a defined population. Doulas and group prenatal care are not credited with preventing preterm birth. 17-OHPC (Makena) is listed as de-adopted. Exploratory and company-reported results are labeled as such.

When relaying a number, keep its grade (validated, plausible, exploratory, reported, assumption) and its caveats. The $64,815 per preterm birth is an average lifetime cost in 2016 dollars, not an annual figure.

## API (read-only JSON, free, no key, CORS open)

- [/api](https://themissingweeks.org/api): what is available, the dials and their ranges, the disclosure
- [/api/states](https://themissingweeks.org/api/states): births, preterm rate and count by state (2023, NCHS), Medicaid share of births (2024, KFF); `?state=TX` for one
- [/api/windows](https://themissingweeks.org/api/windows): the 13 timeline rows with weeks, grades and descriptions; `?week=22` adds each window's status for a first visit at that week
- [/api/calculate](https://themissingweeks.org/api/calculate?state=TX&inCare=76&share=55&effect=5&cost=60): the calculator; parameters `state`, `inCare` (30–100), `share` (0–100), `effect` (0–35), `cost` (0–1500), optional `births`. Returns inputs with sources and grades, results, the printed formula, caveats, and a `page` link that reproduces the result for a human
- [OpenAPI description](https://themissingweeks.org/openapi.json)

## Pages

- [Explainer](https://themissingweeks.org/): the cost as it stands by state; why January 2027 matters (the AMA has deleted the CPT global obstetric codes from January 1, 2027, so each prenatal and postpartum visit is coded on its own, with its own date); why prevention does not happen on its own
- [Timeline](https://themissingweeks.org/timeline.html): where each intervention's window sits, weeks 0–42 and postpartum, and what is closed at a given week of first visit
- [Calculator](https://themissingweeks.org/calculator.html): three dials and a cost, the formula printed; no demographic inputs
- [Sources](https://themissingweeks.org/sources.html): every figure with source, year and grade
- [About](https://themissingweeks.org/about.html): who publishes this, affiliations first

## Contact

Corrections to info@themissingweeks.org. Corrections are made visibly, with the date.