3/3/25, 10:50 PM Prenatal care - Wikipedia
Prenatal care Summarize
Prenatal care, also known as antenatal care, is a Chat With This Website
type of preventive healthcare. It is provided in the Prenatal care
form of medical checkups, consisting of
recommendations on managing a healthy lifestyle
and the provision of medical information such as
maternal physiological changes in pregnancy,
biological changes, and prenatal nutrition including
prenatal vitamins, which prevents potential health
problems throughout the course of the pregnancy
and promotes the mother and child's health
alike.[1][2] The availability of routine prenatal care,
including prenatal screening and diagnosis, has
played a part in reducing the frequency of maternal A doctor performs a prenatal exam.
death, miscarriages, birth defects, low birth weight,
neonatal infections and other preventable health problems.
Traditional prenatal care in high-income countries generally consists of:
monthly visits during the first two trimesters (from the 1st week to the 28th week)
fortnightly visits from the 28th week to the 36th week of pregnancy
weekly visits after 36th week to the delivery, from the 38th week to the 42nd week
Assessment of parental needs and family dynamics
The traditional form of antenatal care has developed from the early 1900s and there is very little
research to suggest that it is the best way of giving antenatal care.[3] Antenatal care can be costly
and uses many staff. The following paragraphs describe research on other forms of antenatal care,
which may reduce the burden on maternity services in all countries.
Visits numbers
The WHO recommends that pregnant women should all receive at least eight antenatal visits to
spot and treat problems and give immunizations. Although antenatal care is important to improve
the health of both mother and baby, many women do not receive eight visits.[4] There is little
evidence behind the number of antenatal visits, pregnant women receive and what care and
information is given at each visit.[3] It has been suggested that women who have low-risk
pregnancies should have fewer antenatal visits.[3] However, when this was tested, women with
fewer visits had babies who were much more likely to be admitted to neonatal intensive care and
stay there for longer (though this could down to chance results).[3] A 2015 Cochrane Review
findings buttresses this notion, with evidence that in settings with limited resources, where the
number of visits is already low, programmes of ANC with reduced visits are associated with an
increase in perinatal mortality.[3] Therefore, it is doubtful that the reduced visits model is ideal,
even in low income countries (LICs), where pregnant women are already attending fewer
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appointments.[2] Not only is visiting prenatal care early is highly recommended, but also a more
flexible pathway allowing more visits, from the time a pregnant woman books for prenatal care, as
it potentially enables more attention to those women who come late.[2] Also, women who had
fewer antenatal visits were not as satisfied with the care they received compared with women who
had the standard number of visits.[3] A new alternative for some of the routine prenatal care visits
is Telemedicine.[5]
There are many ways of changing health systems to help women access antenatal care, such as new
health policies, educating health workers and health service re-organisation. Community
interventions to help people change their behavior can also play a part. Examples of interventions
are media campaigns reaching many people, enabling communities to take control of their own
health, informative-education-communication interventions and financial incentives.[6] A review
looking at these interventions found that one intervention helps improve the number of women
receiving antenatal care.[6] However interventions used together may reduce baby deaths in
pregnancy and early life, lower numbers of low birth weight babies born and improve numbers of
women receiving antenatal care.[6]
The World Health Organization (WHO) reported that in 2015 around 830 women died every day
from problems in pregnancy and childbirth.[7] Only 5 lived in high-income countries. The rest lived
in low-income countries.[7]
A study examined the differences in early and low-weight birth deliveries between local and
immigrant women and saw the difference caused by prenatal care received. The study, between
1997 and 2008, looked at 21,708 women giving birth in a region of Spain. The results indicated
that very preterm birth (VPTB) and very low birth weight (VLBW) were much more common for
immigrants than locals (Castelló et al., 2012). The study showed the importance of prenatal care
and how universal prenatal care would help people of all origins get proper care before
pregnancy/birth (Castelló et al., 2012).
Group versus individual care
Group antenatal care has a couple of obvious benefits: it costs less than one-to-one visits and the
women have more hours of care as a group than on their own.[8] Only small studies have been
conducted looking at group care but they have found that mothers knew more about pregnancy,
birth and parenting in the group setting.[8] The mothers reported liking the group care and the
review found no difference between how the pregnancies developed between the group and
individual settings.[8]
Midwife-led care
Midwife-led care for low-risk women is where a midwife team (and GP if needed) leads the care a
woman receives and she does not usually see a specialist doctor in her pregnancy.[9] Women with
midwife-led pregnancies are more likely to give birth without being induced but have natural
labours. However they are less likely to have their waters broken, an instrumental delivery,
episiotomy or preterm birth.[10] Around the same number of women in each group had a caesarean
section.[10]
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Prenatal examinations
At the initial antenatal care visit and with the aid of a special booking checklist the pregnant
women become classified into either normal risk or high risk.
In many countries, women are given a summary of their case notes including important
background information about their pregnancy, such as their medical history, growth charts and
any scan reports.[11] If the mother goes to a different hospital for care or to give birth the summary
of her case notes can be used by the midwives and doctors until her hospital notes arrive.[11]
A review looking into women keeping their own case notes shows they have more risk of having a
caesarean section.[11] However the women reported feeling more in control having their notes and
would like to have them again in future pregnancies.[11] 25% of women reported their hospital
notes were lost in hospital though none of the women forgot to take their own notes to any
appointments.[11]
Prenatal diagnosis or prenatal screening (note that "Prenatal Diagnosis" and "Prenatal Screening"
refer to two different types of tests) is testing for diseases or conditions in a fetus or embryo before
it is born. Obstetricians and midwives have the ability to monitor mother's health and prenatal
development during pregnancy through series of regular check-ups.
Physical examinations generally consist of:
Collection of (mother's) medical history
Checking (mother's) blood pressure
(Mother's) height and weight
Pelvic exam
Doppler fetal heart rate monitoring
(Mother's) blood and urine tests
Discussion with caregiver
In some countries, such as the UK, the symphysial fundal height (SFH) is measured as part of
antenatal appointments from 25 weeks gestation.[12] (The SFH is measured from the woman's
pubic bone to the top of the uterus.[13]) A review into this practice found only one piece of research
so there is not enough evidence to say whether measuring the SFH helps to detect small or large
babies.[14] As measuring the SFH is not costly and is used in many places, the review recommends
carrying on this practice.[14]
Growth charts are a way of detecting small babies by the measuring the SFH.[15] There are two
types of growth chart:
1. Population based chart, which shows a standard growth and size for each baby
2. Customized growth chart, which is worked out by looking at the mother's height and weight,
and the weights of their previous babies.[15]
A review looking into which of these charts detected small babies found that there is no good
quality research to show which is best.[15] More research is needed before the customized growth
charts are recommended because they cost more money and take more time for the health care
workers to make.[15]
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Obstetric ultrasounds are most commonly performed during the second trimester at approximately
week 20. Ultrasounds are considered relatively safe and have been used for over 35 years for
monitoring pregnancy. Among other things, ultrasounds are used to:
Diagnose pregnancy (uncommon)
Check for multiple fetuses
Assess possible risks to the mother (e.g., miscarriage, blighted ovum, ectopic pregnancy, or a
molar pregnancy condition)
Check for fetal malformation (e.g., club foot, spina bifida, cleft palate, clenched fists)
Determine if an intrauterine growth retardation condition exists
Note the development of fetal body parts (e.g., heart, brain, liver, stomach, skull, other bones)
Check the amniotic fluid and umbilical cord for possible problems
Determine due date (based on measurements and relative developmental progress)
Generally an ultrasound is ordered whenever an abnormality is suspected or along a schedule
similar to the following:
7 weeks — confirm pregnancy, ensure that it's neither molar or ectopic, determine due date
13–14 weeks (some areas) — evaluate the possibility of Down syndrome
18–20 weeks — see the expanded list above
34 weeks (some areas) — evaluate size, verify placental position
A review looking at routine ultrasounds past 24 weeks found that there is no evidence to show any
benefits to the mother or the baby.[16]
Early scans mean that multiple pregnancies can be detected at an early stage of pregnancy[17] and
also gives more accurate due dates so that less women are induced who do not need to be.[17]
Levels of feedback from the ultrasound can differ. High feedback is when the parents can see the
screen and are given a detailed description of what they can see.[18] Low feedback is when the
findings are discussed at the end and the parents are given a picture of the ultrasound.[18] The
different ways of giving feedback affect how much the parents worry and the mother's health
behaviour although there is not enough evidence to make clear conclusions.[18] In a small study,
mothers receiving high feedback were more likely to stop smoking and drinking alcohol however
the quality of the study is low and more research is needed to say for certain which type of feedback
is better.[18]
Women experiencing a complicated pregnancy may have a test called a Doppler ultrasound to look
at the blood flow to their unborn baby.[19] This is performed to detect signs that the baby is not
getting a normal blood flow and therefore is 'at risk'. A review looked at performing Doppler
ultrasounds on all women even if they were at 'low risk' of having complications.[19] The review
found that routine Doppler ultrasounds may have reduced the number of preventable baby deaths
but the evidence was not strong enough to recommend that they should be made routine for all
pregnant women.[19]
Exercise intensity and delivery outcomes
Research suggests that physical activity levels during pregnancy can impact delivery outcomes.[20]
A study examining the effects of exercise intensity on delivery type and risk of preterm birth found
that varying levels of physical activity were linked to different pregnancy outcomes and associated
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risks.
Very low levels of physical activity are associated with an increased risk of both preterm and
instrumental deliveries.[21] Pregnant individuals with minimal activity may experience lower
overall fitness and muscle tone, which can impact the body's ability to manage the physical
demands of labor. Another study showed that individuals with higher handgrip strength are more
likely to have a vaginal delivery, as greater muscle strength and endurance can support the labor
process. In contrast, those who gained more weight during pregnancy or had larger arm and calf
circumferences were more likely to undergo cesarean delivery, particularly in cases of
nonprogressive labor.[22]
Low levels of physical activity during pregnancy have been linked to a slightly elevated risk of
cesarean delivery.[21] Regular moderate exercise may help enhance pelvic muscle tone and
cardiovascular fitness, potentially reducing the likelihood of cesarean intervention by supporting
the body's endurance during labor.
For individuals seeking to engage in levels of vigorous or high intensity physical activity, one study
did observe a slight increase in instrumental delivery, which involves the use of medical tools like
forceps or vacuum devices.[21] More intense physical activity may add extra demands on the body,
potentially affecting labor progression and increasing the need for instrumental assistance.
It is important for pregnant individuals to consult with their healthcare provider before beginning
or adjusting exercise routines, particularly if they are new to regular physical activity or have any
health conditions that may affect pregnancy.
United States
Proper prenatal care affects all women of various social backgrounds. While availability of such
services have considerable personal health and social benefits, socioeconomic problems prevent its
universal adoption in both developing and developed nations, such as the US. Although women
can benefit by utilizing prenatal care services, there exists various levels of health care accessibility
between different demographics throughout the United States.
See also
Brain health and pollution
Reproductive Health Supplies Coalition
References
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20. Hinman, Sally K.; Smith, Kristy B.; Quillen, David M.; Smith, M. Seth (November 2015).
"Exercise in Pregnancy: A Clinical Review" ([Link]
2376). Sports Health: A Multidisciplinary Approach. 7 (6): 527–531.
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7381 ([Link] PMC 4622376 ([Link]
v/pmc/articles/PMC4622376). PMID 26502446 ([Link]
21. Takami, Mio; Tsuchida, Akiko; Takamori, Ayako; Aoki, Shigeru; Ito, Mika; Kigawa, Mika;
Kawakami, Chihiro; Hirahara, Fumiki; Hamazaki, Kei; Inadera, Hidekuni; Ito, Shuichi; and the
Japan Environment & Children's Study (JECS) Group (2018-10-29). Rosenfeld, Cheryl S. (ed.).
"Effects of physical activity during pregnancy on preterm delivery and mode of delivery: The
Japan Environment and Children's Study, birth cohort study" ([Link]
c/articles/PMC6205641). PLOS ONE. 13 (10): e0206160. Bibcode:2018PLoSO..1306160T (htt
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22. ErtüRk çEli̇K, GüLsemi̇N; ErtüRk Aksakal, Sezi̇N; Engi̇N üStüN, Yaprak (2024-10-18). "The
impact of maternal muscle strength on cesarean delivery outcomes: a comparative study of
nulliparous women" ([Link] Turkish Journal of
Medical Sciences. 54 (5): 908–914. doi:10.55730/1300-0144.5867 ([Link]
F1300-0144.5867). ISSN 1300-0144 ([Link]
PMC 11518347 ([Link] PMID 39473746 (h
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Further reading
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Fiscella K (March 1995). "Does Prenatal Care Improve Birth Outcomes? A Critical Review" (htt
ps://[Link]/10.1016%2F0029-7844%2894%2900408-6). Obstetrics & Gynecology. 85 (3):
468–479. doi:10.1016/0029-7844(94)00408-6 ([Link]
2900408-6). PMID 7862395 ([Link] S2CID 2983070 (http
s://[Link]/CorpusID:2983070).
Sheiner E, Hallak M, Twizer I, Mazor M, Katz M, Shoham-Vardi I (September 2001). "Lack of
prenatal care in two different societies living in the same region and sharing the same medical
facilities". J Obstet Gynaecol. 21 (5): 453–8. doi:10.1080/01443610120071974 ([Link]
10.1080%2F01443610120071974). PMID 12521796 ([Link]
96). S2CID 218859219 ([Link]
Howard M, Sellors JW, Jang D, et al. (January 2003). "Regional distribution of antibodies to
herpes simplex virus type 1 (HSV-1) and HSV-2 in men and women in Ontario, Canada" (http
s://[Link]/pmc/articles/PMC149555). J. Clin. Microbiol. 41 (1): 84–9.
doi:10.1128/JCM.41.1.84-89.2003 ([Link]
PMC 149555 ([Link] PMID 12517830 (http
s://[Link]/12517830).
"Prenatal Care - FAQs" ([Link]
v//faq/[Link]). [Link]. April 2006. Archived from the original ([Link]
[Link]/faq/[Link]) on 24 October 2008.
External links
Pregnancy Education ([Link]
[Link]/)
CDC US birth and prenatal care statistics ([Link]
EngenderHealth-Prenatal Care and Planning ([Link]
p://[Link]/wh/mch/[Link])
Care and Planning ([Link]
Retrieved from "[Link]
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