Innovations in prenatal care: Insights from ACOG 2024

In a recent interview, Alex Peahl, MD, MS, FACOG, Kimberly Malloy, MA, MD, FACOG, and Malini Nijagal, MD, FACOG, discussed their presentation about improving prenatal care at the 2024 ACOG Annual Clinical & Scientific Meeting.

For decades prior to the COVID-19 pandemic, little change was observed for prenatal care practices. The standard for prenatal care remained a 12-to-14 in-person visit schedule focused on identifying illness rather than promoting wellness.

This schedule led to some patients receiving too much care while others did not receive enough, and many received the wrong type of care. Following the COVID-19 pandemic, innovations such as telemedicine and use of targeted visit schedules changed how care is delivered.

According to Peahl, it is necessary to determine how to incorporate these practices into prenatal care. The session provided a foundation about why prenatal care needs to change and the tools necessary to innovate care.

Three models of prenatal care delivery were discussed during the presentation. The first was The Michigan Plan for Appropriate, Tailored Healthcare (MiPATH) in pregnancy. This model was developed during the COVID-19 pandemic to incorporate patient choice, educational needs, and social factors into care.

The second model discussed was a modified MiPATH prenatal care schedule. This model was utilized to support a growing need for prenatal care in clinics with a shortage of available clinical appointments.

Social needs that a clinic may not be equipped to managed has remained a concern at locations such as San Francisco General Hospital. These concerns can be managed through a cross-center collaborative where organizations come together to provide a “monthly, one-stop shop” where patients can access a diverse range of care services.

Peahl hoped doctors would walk away from the session understanding the importance of prenatal care. “We have 9 months to help people successfully navigate birth and the postpartum period, to help ensure that their health is optimized,” Peahl said, noting that the inpatient and outpatient settings are both important to support patient care.