Pregnancy brings many changes — to the body, to the routine and also to the emotions. Amid tests, appointments, questions and expectations, prenatal care plays a key role: looking after the health of the pregnant woman and the baby throughout the pregnancy.
But for the World Health Organization (WHO), good prenatal care goes beyond identifying diseases or preventing complications. Care should also help the woman have a positive experience during pregnancy, being welcomed, respected, informed and involved in decisions about her health.
In this article, we bring together some of the main points of the WHO recommendations to help pregnant women and their families better understand the role of prenatal care.
What is prenatal care?
Prenatal care is the follow-up provided by health professionals throughout pregnancy.
These visits make it possible to follow how the pregnancy is progressing, assess the health of the pregnant woman and the baby, offer guidance, identify possible problems early and plan the next steps of care.
According to the WHO, prenatal care is also an important opportunity to provide information, emotional support, health promotion, disease prevention, screening and diagnosis.
That's why appointments shouldn't be seen as just a series of tests.
They are also a space to talk, ask questions and understand what is happening at each stage of pregnancy.
How many prenatal appointments are recommended?
The WHO recommends that, in a routinely monitored pregnancy, there be at least eight contacts with health professionals over the course of the pregnancy.
These visits help monitor possible complications, treat problems when necessary and improve the pregnant woman's experience of prenatal care.
The number and frequency of appointments may differ depending on each person's needs.
Pregnancies with certain medical conditions, multiple pregnancies or other situations that require closer monitoring may need a different schedule, defined by the health team.
Prenatal care should start early
When you find out about or confirm a pregnancy, it's important to go to a health service to start prenatal care.
The WHO advises that the pregnant woman contact a health professional as early as possible after the pregnancy is confirmed.
Starting care early allows the team to learn the pregnant woman's history, assess her needs and organize care for the coming weeks and months.
What is monitored during prenatal care?
Prenatal care covers different aspects of the health of the pregnant woman and the baby.
The WHO recommendations cover areas such as:
food and nutrition;
assessment of maternal health;
assessment of fetal development;
preventive measures;
vaccination;
tests and screenings;
common pregnancy symptoms;
guidance on healthy habits;
preparation for childbirth;
quality and experience of care.
The procedures carried out at each appointment may vary according to gestational age, health history and the characteristics of the pregnancy.
Nutrition and physical activity are also part of care
During prenatal care, the pregnant woman should receive guidance on proper nutrition and healthy habits.
The WHO recommends counseling on healthy eating and staying physically active during pregnancy, respecting the pregnant woman's individual conditions.
This doesn't mean following restrictive diets or starting exercise on your own.
Pregnancy may require adjustments, and specific situations need to be assessed by the professional in charge of your care.
What about vitamins and supplements?
Supplements can be part of prenatal care, but their use should be guided by health professionals.
Among the WHO recommendations is daily iron and folic acid supplementation during pregnancy, within the doses and conditions set out in the guidelines.
This doesn't mean every pregnant woman should choose a supplement or a dose on her own.
Needs can vary, especially when there are existing conditions such as anemia, nutritional deficiencies or other clinical particularities.
That's why supplements and medicines should be part of the conversation with the team in charge of your prenatal care.
The importance of an ultrasound before 24 weeks
One of the WHO recommendations is to have an ultrasound before 24 weeks of pregnancy.
This recommendation was reviewed and reaffirmed by the organization in 2022.
The scan can help to:
estimate gestational age more accurately;
identify a multiple pregnancy;
assess some fetal abnormalities;
obtain information about the placenta and the pregnancy;
help plan follow-up care.
An early ultrasound also supports clinical decisions that depend on an accurate estimate of gestational age.
This doesn't mean only one ultrasound is needed during the whole pregnancy. Other tests may be requested depending on how the pregnancy progresses and on the health team's assessment.
Vaccination is also part of prenatal care
During appointments, the pregnant woman's vaccination history should be reviewed.
The WHO includes preventive measures, such as vaccination, among the important components of prenatal care.
The recommended vaccines may depend on the country, the vaccination schedule, the pregnant woman's history and the epidemiological situation.
That's why it's worth bringing your vaccination card or record to appointments and talking with the health team about which doses need to be updated.
Prenatal care is also a space to talk about emotional health
A healthy pregnancy isn't only about physical aspects.
Fears, insecurities, mood changes, worries about childbirth, family changes and expectations about the baby can also be part of this phase.
The WHO approach to a positive pregnancy experience puts the woman at the center of care, considering health, well-being, dignity and experience during care, not just disease prevention.
That's why questions and feelings also deserve space during appointments.
If something is causing you distress or worry, talk to a health professional.
The pregnant woman has the right to ask
It's common to leave an appointment and remember several questions afterward.
A simple strategy is to write down your questions between appointments.
Some questions could be:
Is my pregnancy progressing as expected?
Which tests will be needed in the coming weeks?
Which vaccines do I need?
Is there any specific guidance about food?
Can I keep doing physical activity?
Which medicines should I avoid?
Which symptoms are common at this stage?
In which situations should I seek care?
How can I prepare for childbirth?
Is there anything particular about my pregnancy that requires different follow-up?
There's no such thing as a “silly” question during prenatal care.
Understanding what's happening helps the pregnant woman and her family take part in decisions with more confidence.
What about the family? How can they take part?
Family support can make a big difference during pregnancy.
Partners, grandparents and other people close to her can help in many ways:
going to appointments when the pregnant woman wants;
helping to write down medical guidance;
taking part in preparing for the baby's arrival;
sharing tasks;
supporting healthy choices;
noticing important changes;
offering emotional support;
respecting the pregnant woman's decisions and autonomy.
The goal isn't to police the pregnancy, but to build a support network.
The WHO itself highlights prenatal care as an opportunity for communication and support not only for the woman, but also for families and communities.
It's important to know the signs that need to be checked
During pregnancy, some symptoms need to be assessed by health professionals.
The WHO advises that pregnant women know when and where to seek care if warning signs appear.
Examples mentioned by the organization include:
bleeding;
significant abdominal pain;
severe headache;
high fever;
significant swelling of the feet.
This list doesn't cover every possible situation.
If an intense or unexpected symptom appears, or one that worries you, it's safer to seek professional advice.
Good prenatal care also involves respect
Everyone has the right to be treated with respect and dignity during pregnancy.
This means being able to ask questions, receive understandable explanations and take part in decisions about your own care.
The pregnant woman should not feel like a mere spectator of her own pregnancy.
She is part of the decisions.
The goal is a positive pregnancy experience
This may be the most important point of the WHO recommendations.
Prenatal care doesn't exist only to look for problems.
It should also help the woman go through pregnancy with more information, support, safety and confidence.
The WHO describes prenatal care as part of an approach that aims not only for a healthy pregnancy and baby, but also for a positive transition to childbirth and to the experience of becoming a mother, father or family.
Every pregnancy is unique.
That's why general recommendations help to understand the path, but the care plan should always consider the individual needs of the pregnant woman and the baby.
During pregnancy:
start prenatal care as early as possible;
attend the recommended appointments;
bring your questions;
keep your records and test results organized;
talk about food, exercise, medicines, supplements and vaccination;
have the tests recommended by the team;
seek care if warning signs appear;
ask for explanations when you don't understand some guidance;
and remember that you have the right to respectful, participatory care.
Prenatal care is a partnership between the pregnant woman, her family and health professionals.
The more information, communication and appropriate follow-up there is, the better the conditions for going through this phase with safety and support.
Sources
World Health Organization (WHO). WHO recommendations on antenatal care for a positive pregnancy experience. 2016, with later updates.
World Health Organization (WHO). Maternal and fetal assessment update: imaging ultrasound before 24 weeks of pregnancy. 2022.
Important notice
This content is for educational purposes and does not replace appointments, tests, diagnosis or individual guidance from health professionals. Recommendations may vary according to medical history, the characteristics of the pregnancy and the protocols used where your care takes place.