Season 3, Episode 2: Navigating Pregnancy: A Century of Prenatal Care

Reverb Effect

Why do we have the prenatal visit schedule that we have today? Where did it come from? What was the evidence for the recommended schedule of prenatal visits, and why hasn’t the schedule changed in nearly 100 years, despite medical advances? How can doctors amend that schedule to both increase equitable access to healthcare and keep parents and babies safe?

During the Progressive Era, high infant mortality rates captured public attention. Reformers concluded that medicalized prenatal care could positively impact infant and maternal outcomes: it could save lives. In 1930, the Children’s Bureau detailed a new schedule of prenatal visits—12-14 visits during pregnancy. The Children’s Bureau provided neither evidence for the schedule nor alternative plans for parents with social, environmental, or medical risk factors, but hoped a uniform schedule could prevent harm to parents and babies. And there the schedule sat while the world changed for nearly 100 years. Despite medical advances and attempts to alter the schedule to take risk factors—or a lack of risk factors— into account, nothing changed. Until everything did.