Clinical Practice Guidelines Antenatal care - Module I

Summary

Page last updated: 02 April 2013

Antenatal care is a routine part of pregnancy for most of the 280,000 women who give birth in Australia each year. Women receive antenatal care in community and hospital-based settings and see a range of health professionals. Effective models of antenatal care have a focus on the individual woman’s needs and preferences, collaboration and continuity of care. Taking a woman-centred approach also ensures that a woman’s social, emotional, physical, psychological, spiritual and cultural needs and expectations are considered and respected. Throughout the pregnancy, women need to be given information in an appropriate form to support them in making choices about their care.

Within the diversity of women that make up the Australian population, some face greater disadvantage in terms of access to health services and may experience poorer outcomes. The broader context of a woman’s life should be taken into account in planning antenatal care. For example, cultural competence at the individual and organisational level is essential to effective communication and cultural security for Aboriginal and Torres Strait Islander women and those from culturally and linguistically diverse backgrounds. Specific approaches may also improve the experience of antenatal care for adolescent women and women living in rural and remote areas.

Depending on when a woman first seeks pregnancy care, the initial antenatal visit may be her only contact with health services in the first trimester. This visit provides the opportunity to discuss with the woman her expectations for the pregnancy. It is also a valuable opportunity to give verbal and other forms of information, support and advice about pregnancy and the transition to parenthood, and to explain to the woman the aims of the care offered during pregnancy. This includes:

  • discussing pregnancy care options;
  • where there is a need, having an ultrasound examination in the first trimester to assess the gestational age of the baby, so that any tests a woman chooses to have are undertaken at the most appropriate time, the date of birth can be estimated and multiple pregnancies are identified;
  • assessing for any conditions that may affect the health of the women or the unborn baby (such as existing kidney disease or infection);
  • assessing the health of the woman, in particular factors that indicate additional care may be required (such as high blood pressure, high or low body mass index);
  • offering screening to assess the risk of chromosomal abnormalities in the baby;
  • discussing mental health and psychosocial issues that may affect the woman and her baby during pregnancy and beyond;
  • providing advice on symptoms that are common during pregnancy (eg nausea and vomiting and constipation);
  • discussing other issues that may affect the health and wellbeing of the woman during pregnancy (eg smoking, alcohol, prescription and over-the-counter medicines, nutritional supplements, domestic violence and oral health); and
  • providing opportunities for women to raise any concerns they wish to discuss.

A planned schedule of antenatal visits should also be agreed at the first antenatal visit based on the individual woman’s needs. For a woman’s first pregnancy without complications, a schedule of ten visits should be adequate. For women having subsequent uncomplicated pregnancies, a schedule of seven visits should be adequate. Assessment of a woman’s risk and need for additional care continues throughout pregnancy.

The Guidelines provide a reliable and standard reference for health professionals providing antenatal care. They take a woman-centred approach, which includes considering the woman’s context, ensuring cultural safety and involving family following the woman’s preferences. Specific discussion of antenatal care for Aboriginal and Torres Strait Islander women is included. The Guidelines aim to promote consistency of care, provide a summary of the currently available evidence on aspects of antenatal care and improve the experience and outcomes of antenatal care for all families.