Journal Issue: Low Birth Weight Volume 5 Number 1 Spring 1995
Prenatal care has long been endorsed as a means to identify mothers at risk of delivering a preterm or growth-retarded infant and to provide an array of available medical, nutritional, and educational interventions intended to reduce the risks of low birth weight and other adverse pregnancy conditions and outcomes. In both Europe and the United States, an increasing interest in the beneficial role of prenatal care was evident from the beginning of this century and has continued to date.1,2 In the late 1800s, the content of prenatal care and the timing and frequency of visits were initially developed to detect a rare but potentially life-threatening illness—eclampsia—which results in high blood pressure, convulsions, and potentially death.3 Regular screening of the mother's urine and blood pressure was routinely incorporated into prenatal care to detect the occurrence of this disease.2,4
In 1901, organized outpatient prenatal care in the United States was reported and consisted of home visits performed by social reformers and nurses.2,3 The purpose of these visits was to provide instruction in self-care and emotional support for low-income women.2,3 Eighty-four years later, the enrollment of all pregnant women in a system of prenatal care was promoted as a national policy to reduce the risk of low birth weight.5 In spite of this national recognition of the importance of prenatal care, considerable ambiguity still exists regarding its content and efficacy.6
Today, the content of prenatal care varies but typically is initiated in the first trimester of pregnancy and has an increasing schedule of visits as the pregnancy progresses. If a woman's pregnancy goes to term, she may typically have anywhere from 10 to 14 prenatal visits. The content of this care usually includes screening for a variety of medical conditions, physical exams, and ancillary educational or counseling services. Providers who serve very-low-income populations often assist women to enroll in Medicaid and refer them to public and private food supplementation programs and other social services.