Morris - value of prenatal care

When you look at the literature on prenatal care, we know that good quality prenatal care is associated with improved outcomes for mom and baby. If the care is started in the first trimester, it gives you the best chance to get all of the early dating, you know, identify any of mom’s health issues. It gives you a chance to offer them the maternal serum screening to assess risk of genetic concerns. And you can start working on planning for example for a pregnancy that’s high-risk. So first trimester visits has a big impact on the final outcomes.

We do have; most of our patients here in Winnipeg do access their prenatal care early enough to be of value. But we have; and Dr. Maureen Heaman’s done some wonderful work on accessing prenatal care. In our core area in Winnipeg, where the socioeconomic status is the lowest, actually have the poorest access to early prenatal visits and regular prenatal care. We’re running a study right now where we’ve actually assigned it extra resources to pulling those women into care early. So far it looks like it’s money well spent.

The minimum number of prenatal visits that the World Health Organization asks for is four so; and depending on where they are in the pregnancy; first trimester, second trimester and then again more visits in the third trimester. If you can achieve that the outcomes are good, as good as you can improve them by prenatal care. With no prenatal care the outcomes are not anywhere near as good. In our adolescent clinic, the average number of prenatal visits is actually 10 per pregnancy so we’re doing really well. The more visits you have with the teenagers, the more chances you have to pick up if they’re struggling with something or having problems. We strongly encourage early access because you can get all those things done and at least four visits total, most of our patients will have between 8-10 visits.