Title: Prenatal care in the United States - Wikipedia
Headings: Prenatal care in the United States
Prenatal care in the United States
Contents
Background
Schedule
Pre-conception counseling
Vaccination
Influenza vaccination
Rubella
Varicella
Tetanus and pertussis
Attitudes towards prenatal care
Positive influences
Negative influences
Disparities in accessibility
Low-socioeconomic areas
Minorities' access
Latina paradox
Contributing factors
Unintended pregnancy
Health insurance
Formal education
Consequences from lack of prenatal care
Delivery complications
Low birth weight
Congenital malformations
Infant mortality
Improving prenatal care
Preventing unintended pregnancy
Connection between physicians and patients
Increase insurance
Community outreach programs
See also
References

Content: During visits physicians determine the due date, family and medical history, conduct a physical exam and pelvic exam, and run various blood work. Physicians also conduct ultrasounds to monitor the baby's health periodically throughout the pregnancy. Ultrasounds are used to measure fetus growth, heartbeats, movement, and the identification of physically identifiable abnormalities. Regular check-ups allow physicians to assess changes to the mothers' blood pressure, weight, uterus size, protein supplies from urine samples, and various diseases such as diabetes through screen tests. Prenatal care serves as a tool to inform mothers on common concerns, and on methods to take care of themselves (amount of rest needed, the proper nutritional diet, etc.). Schedule
A prenatal care schedule is recommended to consist of: Monthly visits to a health care professional for weeks 1 through 28 - (up to month 7)
Visits twice a month from 28 to 36 weeks of pregnancy - (the 7th and 8th month)
Weekly after week 36 (delivery at week 38–40)- (After the 8th month)
More frequent visits are warranted for women older than 35 or in case of a high risk pregnancy, with the number and types of extra controls depending on individual risk factors. On the other hand, it has been suggested that 8 to 11 visits in total can be sufficient for women considered at low risk of adverse perinatal outcomes. Example of prenatal care schedule in the United States for low-risk pregnancies

Screening and monitoring
Education and intervention
Vaccination and other prophylaxis
Pre-conception check up
Height and weight to calculate BMI
Blood pressure
Medical history
Abdominal and pelvic examination
Rubella testing
Varicella testing
Domestic violence
Depression
Blood lipids (cholesterol and HDL)
Pap test
Preterm labor education and prevention
Substance use
Weight and nutrition and pregnancy
Domestic violence and pregnancy
List of medications, dietary supplements, herbal supplements
Accurate recording of menstrual dates
Counseling in case of potential vaginal birth after Caesarean
Tdap or tetanus booster if needed
rubella and/or varicella vaccination if needed
Hepatitis B vaccine
Folic acid supplementation
Visit 1, 3–6
weeks
Height and weight to calculate BMI
Blood pressure
Medical history
Abdominal and pelvic examination
Rubella testing
Varicella testing
Domestic violence
Depression
Complete blood count
ABO/rh blood typing
Syphilis test
Gonorrhea and chlamydia for women at high risk for STDs
Urine culture
HIV testing
Lead poisoning test if necessary
Hepatitis B
Hepatitis C if high risk
Preterm labor education and prevention
Exercise in pregnancy
Nutrition
Follow-up of modifiable risk factors in pregnancy
Nausea and vomiting in pregnancy
Warning signs
Course of care
Physiology of pregnancy
Counseling in case of potential vaginal birth after Caesarean
Discussion of diagnosis of fetal aneuploidy
Tdap or tetanus booster if needed
Nutritional supplements if needed
Influenza vaccination if necessary
Varicella vaccination if necessary
Tetanus and pertussis vaccination if necessary
Visit 2, 9–13 weeks
Weight
Blood pressure
Fetal heart monitoring
Diagnosis of fetal aneuploidy if warranted
Preterm labor education and prevention
Fetal growth
Review of labs from visit 1
Breastfeeding
Nausea and vomiting in pregnancy
Physiology of pregnancy
Follow-up of modifiable risk factors in pregnancy

Visit 3, 16 weeks
Weight
Blood pressure
Fetal heart monitoring
Fundal height
Depression
Diagnosis of fetal aneuploidy if warranted
Obstetric ultrasonography (optional)
Preterm labor education and prevention
Follow-up of modifiable risk factors
Physiology of pregnancy
Second-trimester growth
Quickening
Progesterone for prevention of preterm birth if necessary
Visit 4, 18–21 weeks
Weight
Blood pressure
Fetal heart monitoring
Fundal height
Preterm labor education and prevention
Follow-up of modifiable risk factors
Parent education program
Family issues
Length of stay
Gestational diabetes
Rho (D) immune globulin

Visit 5, 24–28 weeks
Weight
Blood pressure
Fetal heart monitoring
Fundal height
Preterm labor risk
Depression
Gestational diabetes screening
Domestic abuse
Rh antibody status if needed
Hepatitis B surface antigen if needed
Gonorrhea and chlamydia for women at high risk for STDs
Preterm labor education and prevention
Psychosocial risk factors in pregnancy
Follow-up modifiable risk factors
Work
Physiology of pregnancy
Preregistration
Fetal growth
Awareness of fetal movement
Rho (D) immune globulin if necessary
Visit 6, 29–32 weeks
Weight
Blood pressure
Fetal heart monitoring
Fundal height
Preterm labor education and prevention
Follow-up of modifiable risk factors
Travel
Contraception
Sexuality
Pediatric care
Episiotomy
Labor & delivery issues
pregnancy-induced hypertension
Counseling in case of potential vaginal birth after Caesarean

Visit 7, 36 weeks
Weight
Blood pressure
Fetal heart monitoring
Fundal height
Cervix exam
Confirming fetal position
Culture for group B streptococcus
Follow-up of modifiable risk factors
Postpartum care
Management of late pregnancy symptoms
Contraception
When to call provider
Discussion of postpartum depression

Visit 8-11, 38–41 weeks
Weight
Blood pressure
Fetal heart monitoring
Fundal height
Cervix exam
Follow-up of modifiable risk factors
Postpartum vaccinations
Infant CPR
Post-term management
Labor and delivery update

Pre-conception counseling
Main article: Pre-conception counseling in the United States
Pre-conception counseling in the United States is recommended to include: