How often should routine antenatal care for low-risk women be provided and by whom?

Antenatal care programmes, as currently practiced, originate from models developed in Europe in the early decades of the past century. It has been suggested that models with a reduced number of visits or managed by providers other than obstetricians for low-risk women can be as effective and safe as standard models of antenatal care.

Key messages

• A model of antenatal care with a reduced number of visits compared with a standard model probably leads to little or no difference in maternal or perinatal outcomes
• A reduced number of visits model compared with the standard model may slightly decrease the costs per pregnancy to women and providers but may slightly increase the costs of perinatal care for newborns
• Midwife/general practitioner managed antenatal care compared with obstetrician/gynaecologist led shared care may not lead to any difference in any of the perinatal outcomes assessed, except for pregnancy induced hypertension and pre-eclampsia which probably occurs less frequently with midwife/general practitioner managed antenatal care
• Antenatal care managed by providers other than obstetrician/gynaecologists may not lead to any difference in patients’ perceptions of care
• Costs were not measured or not reported in the studies comparing antenatal care managed by different professionals
• Most of the results were similar in high and low- and middle-income countries, and most likely apply to under-resourced settings