reduced costs associated with six or seven versus thirteen visits were offset by the greater number of babies requiring special or intensive care, although maternal satisfaction and psychological outcomes were poorer in women attending fewer visits ( Henderson et al 2000). providing routine antenatal care through five compared with eight visits did not affect maternal and perinatal outcomes and therefore was more cost effective ( Villar et al 2001). Most of the existing research in developed countries is based on women assessed as at low risk of poor perinatal outcomes at first contact. The NICE guidelines found inconclusive evidence regarding the cost-effectiveness of a reduced number of antenatal visits. women who were over 35 years of age, had previous pregnancies, were less educated or had more than two children preferred fewer appointments, whereas women who were less than 25 years of age, single or had a prior adverse pregnancy history indicated a preference for more appointments than the standard schedule ( Hildingsson et al 2002).Īt the first contact with a woman during pregnancy, make arrangements for the first antenatal visit, which requires a long appointment and should occur within the first 10 weeks.Īpproved by NHMRC in December 2011 expires December 2016 8.2.2 Economic considerations. women who were satisfied with a reduced number of antenatal visits were more likely to have a caregiver who both listened and encouraged them to ask questions than women who were not satisfied with reduced schedules ( Clemet et al 1996). 
for some women, the gap between visits was perceived as too long when the number of visits was lower than that traditionally offered ( Dowswell et al 2015).The number of inductions of labour and caesarean sections were similar in women receiving reduced visits compared with standard care.Įvidence concerning women’s preferences about the number of antenatal visits suggests that: However, there was some evidence that in low- and middle-income countries perinatal mortality may be increased with reduced visits. 8.2 Number and timing of antenatal visitsĪ Cochrane review ( Dowswell et al 2015), which included studies in high-, middle- and low-income countries, found no strong evidence of differences in the number of preterm births or low birth weight babies between groups receiving a reduced number of antenatal visits (eight visits in high-income countries and fewer than five visits in low-income countries) compared with standard care. Indigenous women were less likely to attend either an antenatal visit in the first trimester (53% compared with 60% of non-Indigenous women) or to attend five or more visits (86% compared with 95% of non-Indigenous women) (age-standardised) AIHW 2016. 96% of women living in the highest SES areas compared with 93% in the lowest SES areas.
96% of women living in major cities compared with 90% in very remote areas. The proportion of women attending five or more antenatal visits varied slightly by remoteness and socioeconomic disadvantage (data exclude very preterm births and data from Victoria) AIHW 2016: Women living in the lowest socioeconomic status (SES) areas began antenatal care later in pregnancy just over half (55%) of women living in the lowest SES areas attended antenatal care in the first trimester compared with 68% in the highest SES areas in 2014 AIHW 2016. around one in eight women (12%) did not begin antenatal care until after 20 weeks’ gestation. 62% of women attended in the first trimester (less than 14 weeks). 43% of women attended at least one antenatal visit in the first 10 weeks of pregnancy. 57% had ten or more visits (excludes data from Victoria). 8.1 BackgroundĪlmost all women (99.9%) who gave birth in Australia in 2014 had at least one antenatal visit AIHW 2016: Systematic reviews and observational studies tend to show an association between number of antenatal visits and/or gestational age at first antenatal visit and pregnancy outcomes ( Dowswell et al 2015), although there are many differences in sociodemographic and risk profiles of women attending for antenatal care that may contribute to these findings ( Hueston et al 2003). While antenatal visits are well established as a means of improving perinatal outcomes, the number and timing of visits has been less studied NICE 2008. Incorporating assessments and tests into visits minimises inconvenience to the woman. 
Each antenatal visit should be structured around specific content that is based on the woman’s needs.
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