As for most healthcare, telemedicine for routine visits became ubiquitous during the COVID-19 pandemic. Telemedicine is a relatively new approach to routine antenatal care. Since 1989, several US-based and international CPGs have recommended fewer antenatal visits (6 to 9), 2, 6, 12, 13 but most of U.S. In addition, it is recommended to discuss risk counseling, psychosocial issues including mental health screening, and expectations about the course of pregnancy during the course of antenatal care. 11 These include first trimester laboratory tests (complete blood count, blood type and screen, urinalysis, and testing for HIV, hepatitis B, syphilis, chlamydia, and rubella immunity), first and second trimester ultrasounds (for dating and viability and to evaluate anatomy, respectively), a diabetes screen between 24 and 28 weeks, and, in the third trimester, a repeat complete blood count, Tdap vaccination, testing for group B strep, and an assessment for fetal presentation. ![]() 10 The American College of Obstetricians and Gynecologists (ACOG) has instituted a set of recommended services for pregnant individuals to receive during the course of their antenatal care. 1 Notably, the overall number and cadence of visits has remained unchanged since the schedule was first published by the Children’s Bureau in 1930: monthly visits until 28 weeks, every 2 weeks until 36 weeks, and weekly until delivery. In the U.S., current recommendations include 12 to 14 office-based visits for low-risk pregnant patients, in addition to laboratory testing and ultrasounds. 7-9 However, the evidence on specific aspects of delivering antenatal care related to frequency and cadence of visits, and to telemedicine for women with uncomplicated pregnancies is less clear. Studies have established the benefit to maternal and neonate outcomes of several evidence-based practices (screenings, counseling, and interventions) delivered during antenatal care visits. 3-5 Clinical practice guidelines (CPG) for antenatal care delivery (including visit frequency, timing, and use of telemedicine) are based largely on expert opinion. 2 However, the way routine antenatal care has been delivered has remained largely unchanged since the 1930s. ![]() 1, 2 The World Health Organization’s definition of antenatal care includes the patient-centered goal of a "positive pregnancy experience". Antenatal care aims to improve the health and wellbeing of pregnant patients and their babies through 1) medical screening and treatment 2) anticipatory guidance and 3) psychosocial support. Antenatal care is one of the most common preventive health services in the United States, accessed by 4 million women annually.
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