Content of First Prenatal Visits
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Content of First Prenatal Visits J. Dyer1 · G. Latendresse1 · E. Cole1 · J. Coleman1 · E. Rothwell1,2
© Springer Science+Business Media, LLC, part of Springer Nature 2018
Abstract Objective The purpose of this study was to examine the content of the first prenatal visit within an academic medical center clinic and to compare the topics discussed to 2014 American College of Obstetrics and Gynecologists guidelines for the initial prenatal visit. Methods Clinical interactions were audio recorded and transcribed (n = 30). A content analysis was used to identify topics discussed during the initial prenatal visit. Topics discussed were then compared to the 2014 ACOG guidelines for adherence. Coded data was queried though the qualitative software and reviewed for accuracy and content. Results First prenatal visits included a physician, nurse practitioner, nurse midwife, medical assistant, medical students, or a combination of these providers. In general, topics that were covered in most visits and closely adhered to ACOG guidelines included vitamin supplementation, laboratory testing, flu vaccinations, and cervical cancer screening. Topics discussed less often included many components of the physical examination, education about pregnancy, and screening for an identification of psychosocial risk. Least number of topics covered included prenatal screening. Conclusions for Practice While the ACOG guidelines may include many components that are traditional in addition to those based on evidence, the guidelines were not closely followed in this study. Identifying new ways to disseminate information during the time constrained initial prenatal visit are needed to ensure improved patient outcomes. Keywords Prenatal care · Pregnancy guidelines · Pregnancy · Qualitative
Significance Statement The significance of this study highlights a potential problem to provide patients with all of the education recommended during the first prenatal visit including complex decisions such as prenatal genetic screening. Innovative, technology based educational tools that can deliver patient education outside the clinic are needed.
Introduction A significant and long-standing problem in healthcare is the timing, volume, and variety of care and education that could be covered during busy prenatal visits. Guidelines for * E. Rothwell [email protected] 1
College of Nursing, University of Utah, 10 South 2000 East, Salt Lake City, UT 84112, USA
Division of Medical Ethics and Humanities, University of Utah, 10 South 2000 East, Salt Lake City, UT 84112, USA
2
the content of the first prenatal visit have been developed and endorsed by a variety of professional and public health organizations for over a century. The most recent guidelines for prenatal care, including first prenatal visits, are the 2014 American College of Obstetricians and Gynecologists (ACOG). Early and complete first prenatal visits are promoted as opportunities for screening, identifying, and addressing risk factors to improve pregnancy outcomes, provide import
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