Excerpt from The WHO Reproductive Health Library Published by Update Software Ltd.

Patterns of routine antenatal care for low-risk pregnancy

Two components of antenatal care are compared: the frequency of antenatal care visits and the type of health care provider for antenatal care. A moderate reduction in the number of antenatal visits was not associated with an increase in adverse perinatal or maternal outcome. Compared with obstetrician-led antenatal care, women reported greater satisfaction with care managed by a midwife or general practitioner.

RHL Commentary by Matthews Mathai

EVIDENCE SUMMARY

This review focused on two components of antenatal care: the frequency of antenatal care visits, and the type of care-provider for antenatal care. When a schedule of reduced number of antenatal care visits was compared with the conventional schedule of antenatal visits, a moderate reduction in the number of antenatal visits was not associated with an increase in adverse perinatal or maternal outcome. In some trials with a schedule of reduced number of antenatal visits, the emphasis at each of these visits was on goal-oriented activities rather than ritualistic routines. The largest trials involved antenatal care clinics in developing countries where there were significant reductions in number of antenatal visits as well as provider and client costs in the goal-oriented antenatal care group. However, women can be less satisfied with the reduced number of visits.

In comparison to obstetrician-led shared antenatal care, women’s satisfaction was greater in the midwife/general practitioner managed care which provided greater continuity of care and care providers. The latter category was clinically equally effective and less costly in terms of salary costs of care providers.

The review has been carried out satisfactorily. Relevant trials on the subject have been included and appropriately analysed.

The full RHL commentary also includes sections on:

Relevance
- Magnitude of the problem
- Feasibility of the intervention
- Applicability of the results of the Cochrane Review
- Implementation of the intervention
- Research

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This document should be cited as: Matthews Mathai. Patterns of routine antenatal care for low risk-pregnancy: RHL commentary (last revised: 14 June 2002). The WHO Reproductive Health Library, No 9, Update Software Ltd, Oxford, 2006. www.rhlibrary.com