Benefits and Limitations of Prenatal Care
From Counting Visits to Measuring Content
- Dawn P. Misra, MHS, PhD;
- Bernard Guyer, MD
- From the Department of Maternal and Child Health, Johns Hopkins University School of Hygiene and Public Health, Baltimore, Md.
Since this article does not have an abstract, we have provided the first 150 words of the full text.
In this issue of THE JOURNAL, Kogan and colleagues1 identified trends in the patterns of prenatal care utilization in the United States from 1981 through 1995. Four measures of utilization were examined. First, the authors examined patterns based on the trimester that care began and the Institute of Medicine (IOM) Index of Adequacy of Care (Kessner Index).2 Clearly, the trimester that care began is an inadequate measure of prenatal care use because neither the total number of visits nor the number of visits relative to the length of gestation is incorporated. While the IOM Index does consider the number of visits, it has been criticized for failing to incorporate the full length of gestation in considering the adequacy of the number of visits. Second, because both these older indices had limitations, the authors also chose to examine patterns of prenatal care utilization using 2 newer measures: R-GINDEX3 …
