For many years, practitioners have scheduled prenatal visits on a monthly basis until about 7112 or 8 months (30 or 32 weeks), followed by visits at 2 or 3 week intervals until the last month (36 weeks), when they become weekly. Some practitioners vary this schedule by seeing women every 3 weeks between 6 and 7 months, which adds one additional visit (i.e., visits at 24, 27, 30, and then 32 weeks, instead of 24, 28, and 32 weeks). Women following one of these schedules have between 12 and 15 prenatal visits. The Expert Panel on the Content of Prenatal Care questioned the value of such frequent care and recommended fewer visits for women with healthy pregnancies.For multiparous women – women who have already had a baby. The recommendations allowed the second visit to be a telephone contact. In our experience, few if any providers have actually adopted dill pregnancy visit schedule. We provide it here to demonstrate that the timing of visits in pregnancy can be flexible. We must emphasize thaI a reduced number of visits in pregnancy is safe only when certain conditions are met:
• The pregnancy must be normal and free from risk; otherwise, visits must be more frequent. They must become more frequent if the pregnancy changes from normal to
abnormal. Risks include, for example, preexisting diseases, such as high blood pressure, diabetes, sickle-cell anemia, blood clotting disorders, and severe asthma, pregnancy-induced diseases such as gestational diabetes or pregnancy-induced hypertension a previous poor pregnancy outcome, such as a premature or low birth weight baby, a poorly growing fetus; problems with the placentaor the development of signs of preterm labor.
• Extensive health education must be provided at each visit. focusing especially on danger signs to report before the next visit
• Childbirth education classes must be offered-either a series of five or six classes or two refresher classes for women who attended a series in a previous pregnancy. If a woman does not choose to attend classes, then more frequent prenatal visits should be considered.
• Support services such as smoking cessation programs and psychological counseling must be available as integral pam of prenatal care whenever needed.ikoniикони