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Goal-Oriented Prenatal Care

by Jane Wangersky | December 30th, 2013 | Pregnancy

thoughtful pregnant womanHow often are you seeing your doctor during your pregnancy? The  answer may not be the same for you as for other expectant mothers, depending on whether you’re on a program of goal-oriented prenatal care. Goal-oriented prenatal care has been adopted by the U.S. Defense Department, so if you’re giving birth in a military hospital you can expect it.

From the mid-20th century till recently, pregnant women could plan on seeing their doctors on a very regular schedule: Every four weeks up to 28-32 weeks along, every two weeks up to 36 weeks, and weekly after that, for a total of about 14 visits. It was one of those practices few people questioned — until some began wondering if it was the best use of resources, including the doctor’s time and the mother’s. In low-risk pregnancies, especially, some of the doctor visits might not really serve any purpose. So the goal-oriented model of prenatal care was developed. It was first proposed by an expert panel of the U.S. Department of Health and Human Services in 1989.

Just as it says, this model means that every prenatal visit has a specific goal. For example, the first (6-8 week) visit’s goal is to get the mother’s family medical history, the 24-week goal is to prevent premature labor, and so on till the (possible) 41-week visit, which is all about whether the baby’s overdue. The visits take place at 6-8 weeks, 10-12 weeks, and after that during every four weeks of pregnancy up to 36, when it’s every two weeks.

This may sound good to you, and then again it may sound as if you’re not seeing the doctor often enough.

A few other facts to consider: Studies have found that the goal-oriented system doesn’t lead to low-risk pregnant women using other medical services (like the emergency room) more often, that in low- and middle-income countries it’s associated with an increase in perinatal mortality (death of the baby), and “Women in all settings were less satisfied with the reduced visits schedule and perceived the gap between visits as too long.”

You’re the only one who can decide what you feel most comfortable with, and it’s essential to be on the same page as your doctor. So if you need to make the decision on goal-oriented prenatal care, give it some careful thought.

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