Tailoring options for prenatal care deliveryįor some patients, a more frequent prenatal visit schedule and more intense monitoring is still appropriate, guidelines state. “These guidelines will help maternity care providers to match individuals’ needs to services delivered,” Peahl said. These visits would be supplemented with home monitoring devices and telemedicine. Alternative approaches to prenatal care during the COVID-19 pandemic helped us develop recommendations focused on ‘right sizing’ prenatal care for each individual.”įor those with uncomplicated pregnancies, this could mean choosing fewer, more widely spaced prenatal visits (down from 12-14 to eight to 10), which is more in line with peer countries with better maternity outcomes than the United States., Peahl said. “We came together to revisit several aspects of prenatal care delivery, including tailored care based on medical conditions and social and structural determinants of health. “Maternal and fetal experts from across the country recognized that prenatal care guidelines were long overdue for reconsideration,” Peahl said. Nineteen clinicians and researchers who represented expertise across maternity care, pediatrics, telemedicine, and health equity joined a national panel to consider the new recommendations. The new guidelines, which stem from a collaboration between ACOG and the University of Michigan through MiPATH, recommend individualizing care, incorporating telemedicine, and considering both medical conditions and social and structural determinants that may impact outcomes in routine care delivery.
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Although many prenatal services, such as vaccinations and imaging, are evidence-based, Peahl said, the field lacked robust data on how to provide these services. “The COVID era has taught us that for many of our pregnant patients, we can offer a more flexible approach that maintains high-quality care for moms and their babies.”Ī uniform 12–14 in-person visit recommendation for all pregnancies has remained unchanged since 1930.
“Prenatal care delivery hasn’t changed since World War II, and it doesn’t always line up with what many patients both want and need during their pregnancy journey,” said senior author Alex Peahl, M.D., MS.c., an obstetrician-gynecologist at University of Michigan Health Von Voigtlander Women’s Hospital and head of the Michigan Plan for Appropriate, Tailored Healthcare in Pregnancy, also known as MiPATH, that guided the new recommendations. Michigan Medicine’s redesign of prenatal care delivery during the pandemic, which included a flexible approach involving fewer in-person visits for uncomplicated pregnancies and use of telemedicine, may serve as a national model moving forward, according to n ewly released guidelines in Obstetrics & Gynecology, a journal published by the American College of Obstetricians and Gynecologists.
Education, Training & Faculty Developmentįor nearly a century, being pregnant usually meant seeing a doctor at least a dozen times before the baby was born.īut after COVID hit and office visits were limited due to exposure risks in 2020, that practice shifted out of necessity – and now, some of those changes may be here to stay.National Clinician Scholars Program at IHPI.
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