Introduction

The practice of prenatal health care (regular visits to a health professional throughout pregnancy) is well accepted as essential to the well-being of mother and fetus. This chapter examines in some detail this issue of prenatal care and its effect on maternal medical conditions. First, maternal juvenile diabetes mellitus is presented as an example of the superb benefits that prenatal care can bring to both mother and fetus. This paradigm is then considered with regard to a number of other conditions, including hypertensive disease, assessment of fetal growth, cardiovascular disease, maternal smoking, autoimmune diseases, hematologic disorders, disorders of coagulation, renal disease, neurologic disease, and liver disease. The chapter concludes by acknowledging the need to rigorously evaluate the effectiveness of new therapies and their outcomes in prenatal care.

Historical perspective on prenatal care

Organized prenatal care began in the United Kingdom early in the present century and the structure of visits defined by the British Ministry of Health in 1929 is still practiced (Banta et al., 1984). Prenatal care is comparatively recent in the United States. The first edition of the American classic, Williams' Obstetrics, published in 1903, had no section on prenatal care, and only a few pages on the diagnosis of pregnancy (Williams, 1903).