---
title: Prenatal Care Schedule
description: A comprehensive guide to the recommended schedule and clinical components of prenatal care.
keywords: [prenatal, antenatal, pregnancy, obstetrics, fetal monitoring]
category: clinical
---

## Introduction

Prenatal care is a critical component of managing a healthy pregnancy and ensuring the best possible outcomes for both the mother and the developing fetus. The prenatal care schedule, as recommended by major clinical guidelines, outlines the recommended frequency and content of visits throughout the course of a pregnancy.

## Initial Prenatal Visit

The initial prenatal visit should occur as early as possible, ideally within the first 8-10 weeks of pregnancy. This visit should include the following assessments and interventions:

- Comprehensive medical history, including obstetric, gynecologic, and medical/surgical history
- Physical examination, including vital signs, height, weight, and body mass index (BMI) calculation
- Screening for gestational diabetes using a 75g oral glucose tolerance test (OGTT)
- Screening for anemia with a complete blood count (CBC)
- Screening for sexually transmitted infections (STIs), including HIV, syphilis, hepatitis B, and chlamydia
- Rubella immunity assessment and vaccination if indicated
- Folic acid supplementation (400-800 mcg daily)
- Counseling on lifestyle modifications, including diet, exercise, and avoidance of alcohol, tobacco, and illicit drugs

## Routine Prenatal Visits

After the initial visit, routine prenatal visits should be scheduled every 4 weeks until 28 weeks gestation, then every 2 weeks until 36 weeks, and finally every week until delivery. These visits should include the following assessments and interventions:

- Measurement of maternal weight, blood pressure, and fetal heart rate
- Fundal height measurement to assess fetal growth
- Screening for gestational diabetes at 24-28 weeks using a 75g OGTT
- Screening for preeclampsia with blood pressure monitoring and laboratory testing (serum creatinine, liver enzymes, and platelet count)
- Screening for anemia with a CBC at 28 and 36 weeks
- Administration of Rh(D) immune globulin (RhIG) at 28 weeks for Rh-negative women
- Counseling on maternal nutrition, exercise, and preparation for labor and delivery

## Fetal Monitoring

Fetal monitoring is an essential component of prenatal care and should be performed at routine visits. This includes the following assessments:

- Fetal heart rate monitoring using a Doppler ultrasound
- Fetal movement counting, with the expectation of at least 10 movements per 12-hour period
- Screening for fetal anomalies using ultrasound examinations at 11-14 weeks (nuchal translucency) and 18-22 weeks (anatomical survey)
- Screening for fetal growth restriction using serial fundal height measurements and, if indicated, ultrasound examinations

## High-Risk Pregnancy Management

Certain maternal and fetal conditions may require more frequent or specialized prenatal care. These include:

- Gestational diabetes: More frequent glucose monitoring and potential need for insulin therapy
- Preeclampsia: More frequent blood pressure and laboratory monitoring, potential need for antihypertensive medications
- Fetal growth restriction: More frequent ultrasound examinations and fetal monitoring
- Multiple gestation: More frequent visits and specialized monitoring for fetal growth and development

In these cases, the prenatal care schedule may be modified, and the patient may be referred to a maternal-fetal medicine specialist for additional management.

## Postpartum Care

The postpartum period is also an important aspect of prenatal care. Recommended postpartum visits include:

- 4-6 weeks after delivery for a comprehensive postpartum evaluation, including assessment of maternal physical and mental health, contraception, and breastfeeding support
- Additional visits as needed for the management of postpartum complications, such as postpartum depression, hypertension, or breastfeeding difficulties

## Conclusion

The prenatal care schedule outlined in this document is designed to provide comprehensive, evidence-based care throughout the course of a pregnancy. By adhering to this schedule and implementing the recommended assessments and interventions, healthcare providers can optimize the health and well-being of both the mother and the developing fetus, and ensure the best possible outcomes for the pregnancy.