Topic: Models of Prenatal Care

Population: Pregnant Women Prenatal care is critical for maternal and child health and wellbeing. There are several models of prenatal care in use throughout the United States.

Questions:

1. What model of prenatal care is best for low risk women?
2. Does the ideal prenatal care model differ based on a women s personal characteristics such as age, weight, race/ethnicity?
3. What prenatal visit schedule (timing and interval of visits) is appropriate for low risk women?
4. What interventions/care models increase appropriate utilization of prenatal care resources?
5. What practice structures are most effective at delivering prenatal care for low risk women?
6. What collaborative care models are effective for delivering prenatal care for low risk women?
7. Does type of prenatal care provider impact outcomes for low risk women?
8. What is the impact of telemedicine prenatal care on outcomes for low risk women?
9. What postpartum visit schedule (timing and interval of visits) is appropriate for low risk women?

There are approximately 4,000,000 births in the United States annually. Women who receive early and regular prenatal care are more likely to have healthier infants. Prenatal care includes a process of ongoing risk identification and assessment in order to develop appropriate care plans. This plan of care should take into consideration the medical, nutritional, psychosocial, cultural, and educational needs of the patient and her family, and it should be periodically reevaluated and revised in accordance with the progress of the pregnancy.

The first visit for prenatal care typically occurs in the first trimester. The frequency of follow-up visits is determined by the individual needs of the woman and an assessment of her risks. The frequency and regularity of scheduled prenatal visits should be sufficient to enable health care providers to accomplish the following activities: assess the well-being of the woman and her fetus; provide ongoing, timely, and relevant prenatal education; complete recommended health screening studies and review results; detect medical and psychosocial complications and institute indicated interventions; and reassure the woman.

Clinicians will be more equipped to determine an appropriate prenatal model and schedule for low risk pregnant women. Recommendations based on the systematic review will be used by clinicians to optimize treatment and prevention strategies and improve outcomes for patients.

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Professional Society

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American College of Obstetricians and Gynecologists

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