Faculty, Staff and Student Publications
Publication Date
7-1-2022
Journal
Journal of Women's Health
Abstract
Prenatal care is an important preventive service designed to improve the health of pregnant patients and their infants. Prenatal care delivery recommendations have remained unchanged since 1930, when the 12-14 in-person visit schedule was first established to detect preeclampsia. In 2020, the American College of Obstetricians and Gynecologists, in collaboration with the University of Michigan, convened a panel of maternity care experts to determine new prenatal care delivery recommendations. The panel recognized the need to include emerging evidence and experience, including significant changes in prenatal care delivery during the COVID-19 pandemic, pre-existing knowledge of the importance of individualized care plans, the promise of telemedicine, and the significant influence of social and structural determinants of health (SSDoH) on pregnancy outcomes. Recommendations were derived using the RAND-UCLA appropriateness method, a rigorous e-Delphi method, and are designed to extend beyond the acute public health crisis. The resulting Michigan Plan for Appropriate Tailored Healthcare in pregnancy (MiPATH) includes recommendations for key aspects of prenatal care delivery: (1) the recommended number of prenatal visits, (2) the frequency of prenatal visits, (3) the role of monitoring routine pregnancy parameters (blood pressure, fetal heart tones, weight, and fundal height), (4) integration of telemedicine into routine care, and (5) inclusion of (SSDoH). Resulting recommendations demonstrate a new approach to prenatal care delivery that incorporates medical, SSDoH, and patient preferences, to develop individualized prenatal care delivery plans. The purpose of this document is to outline the new MiPATH recommendations and to provide practical guidance on implementing them in routine practice.
Keywords
COVID-19, Delivery of Health Care, Female, Humans, Maternal Health Services, Michigan, Pandemics, Pregnancy, Pregnancy Outcome, Prenatal Care, antenatal care, pregnancy, prenatal care, remote monitoring, social and structural determinants of health, telemedicine
DOI
10.1089/jwh.2021.0589
PMID
35549536
PMCID
PMC11362983
PubMedCentral® Posted Date
8-30-2024
PubMedCentral® Full Text Version
Author MSS
Published Open-Access
yes
Included in
COVID-19 Commons, Medical Sciences Commons, Obstetrics and Gynecology Commons, Telemedicine Commons, Women's Health Commons