In 1930 the Children’s Bureau detailed a schedule of prenatal visits during pregnancy. And there the schedule sat while the world changed for nearly 100 years.
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.
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Alex Peahl is a health services researcher who studies how to better design and deliver prenatal care services to fit patients’ diverse needs and preferences. She is also a practicing obstetrician gynecologist who provides comprehensive women’s health care services, including in-person and virtual prenatal visits. She is an assistant professor in Obstetrics and Gynecology at the University of Michigan, and the chair of the American College of Obstetricians and Gynecologists Redesigning Prenatal Care Initiative.
Joel D. Howell studies how and why we have come to see medical technology as central for health care in the twentieth and twenty-first century United States. He is also a physician who uses that medical technology as he practices internal medicine in both the outpatient and the inpatient world. He is is Elizabeth Farrand Professor of the History of Medicine, with appointments in the History Department, Internal Medicine, and Health Management and Policy at the University of Michigan.
Episode Producers: Alex Peahl and Joel D. Howell
Voice Actors (in order of appearance): Taylor Sims, Audrey Tieman, Hayley Bowman, Andrew Johnston, and Josh McCurry
Host and Season Producer: Allie Goodman
Executive Producer: Gregory Parker
Editorial Board: Alexander Clayton, Henry Cowles, Christopher DeCou, Allie Goodman, Gregory Parker, Hannah Roussel
Image: John Ted Daganato, CC BY-SA 2.0
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Alex Peahl and Joel D. Howell
Alexander Clayton, Allie Goodman, Christopher DeCou, Gregory Parker, Hannah Roussel, and Henry M. Cowles
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