Antenatal care on trial

BMJ 1996; 312 doi: https://doi.org/10.1136/bmj.312.7030.524 (Published 02 March 1996) Cite this as: BMJ 1996;312:524
  1. Jim Neilson
  1. Professor of obstetrics and gynaecology University of Liverpool, Liverpool Women's Hospital, Liverpool L69 3BX

    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 …

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