Redesigning Prenatal Care Initiative

ACOG and the Plan for Appropriate Tailored Healthcare in Pregnancy (PATH) Recommendations

Prenatal care is one of the most common preventive care services in the United States and aims to improve the health of 4 million pregnant patients and their children each year. In efforts to work towards a more optimal, evidence-based approach for prenatal care delivery for average risk patients, University of Michigan—along with ACOG—convened an independent panel of maternal care experts to review the evidence regarding current prenatal care delivery (e.g., the number, frequency, modality of antenatal visits) in this population. In addition to reviewing the evidence, the panel developed and published independent recommendations entitled “Plan for Appropriate Tailored Healthcare in Pregnancy (PATH).”

The PATH recommendations, along with other data points such as the forthcoming AHRQ Systematic Review, emerging literature, and findings from ACOG’s Listening Tour (a series of focus groups to gauge stakeholder input regarding implementation barriers, supports needed, and unintended consequences), will help inform the future development of ACOG guidance on this topic. While ACOG supports the PATH efforts, the PATH recommendations should not be construed as ACOG clinical guidance.

ACOG is aware that, with COVID-19, many adaptations for prenatal care delivery took place and ACOG provides a COVID-19 FAQ that addresses these adaptations. In particular, the FAQ notes, “it may still be necessary or preferred to provide prenatal and postpartum services by phone or electronically. If telehealth visits are anticipated, patients should be provided with any necessary equipment (e.g., blood pressure cuff) if available and as appropriate. Furthermore, although many institutions may no longer need to employ alternative care and staffing strategies in response to the COVID-19 pandemic, some institutions may decide to continue to implement a modified prenatal care schedule… Plans for modified care schedules are best made at the local level with consideration of patient populations and available resources." Additionally, ACOG fully supports the use of telehealth in obstetrics and gynecology and encourages physicians to become familiar and adept in this new technology. ACOG has developed several resources on telehealth including Committee Opinion 798, Implementing Telehealth in Practice and a systematic review by the ACOG’s Telehealth Work Group.

With questions, contact [email protected] with "RPCI" in the subject line.