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WHO recommendations on antenatal care for a positive pregnancy experience

This document provides the World Health Organization’s guidelines on the antenatal care (ANC) that all pregnant women and adolescent girls should receive. The recommendations aim to improve quality of care and therefore reduce stillbirths and pregnancy-related complications and to enable women to have a positive pregnancy experience.

Quality of care during pregnancy and childbirth can prevent many maternal and newborn deaths and stillbirths. Yet only 64% of women receive at least 4 antenatal visits. In many countries the percentage is much lower (see a bar chart of ANC in Africa here).

What’s new in these recommendations?

  • There is a new model of ANC which recommends all women have at least 8 contacts with their health provider. Previously the recommendation was for at least 4 visits. This is an evidence based change. New evidence shows that increasing the frequency of contact between the woman and the health system is associated with a reduced likelihood of perinatal deaths (stillbirths and deaths of newborn babies in the first 7 days). This is due to the increase in opportunities to find and deal with potential problems. Having at least 8 contacts can reduce perinatal deaths by up to 8 per 1000 births compared to 4 visits. The term ‘contact’ instead of ‘visit’ is to emphasise the provision of care and support. The recommendations provide detail on the schedule of contacts women should have, i.e. what should happen when.
  • There is flexibility in the new model. It should be adapted to country needs, for example with task-shifting or offering ANC contacts in the community as well as at facilities.
  • The guidance moves beyond only improving clinical outcomes to emphasising the importance of a person centred approach to care
  • Women’s views were incorporated into this set of recommendations. This included the call to provide a positive pregnancy experience. This is defined as “maintaining physical and sociocultural normality, maintaining a healthy pregnancy experience for mother and baby (including preventing or treating risk, illness and death), having an effective transition to positive labour and birth, and achieving positive motherhood (including maintaining maternal self-esteem, competence and autonomy).” (page 2)

The 39 recommendations cover:

  1. Nutritional interventions
  2. Maternal and fetal assessment
  3. Preventative measures
  4. Interventions for common physiological symptoms
  5. Interventions to improve the utilisation and quality of antenatal care

To download the guideline for free, click here.

World Health Organization. (2017). WHO recommendations on antenatal care for a positive pregnancy experience. Geneva: WHO.
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