Pregnant women don't like minimalist packages

There has been a growing worry among health professionals that much of antenatal care has become an unthinking ritual with few tangible returns and much inconvenience for pregnant women.1 The scheduling of clinic visits was inherited from the 1920s, when the risks from pregnancy were quite different. Many believe that, today, we have too many antenatal visits to see too many different professionals in too many settings.

Several bodies have advocated possible improvements, including smaller “packages” of antenatal care (in which each visit has an explicit clinical purpose) and different mixes of contribution by general practitioners, midwives, and obstetricians. Obstetricians disagree as to whether they should, or should not, be involved in the antenatal care of healthy women with normal pregnancies.2 3

There is, however, little quantitative evidence of high scientific quality to inform these debates. Randomised trials …