Table.

Key events in the evolution of prenatal care delivery guidelines

Period	Key events in prenatal care delivery
Early 1800s	Prenatal care relatively unstructured and delivered by laypeople.
Mid-1800s	Recognition of association among blood pressure, proteinuria, and preeclampsia or eclampsia.
Late 1800s	Increasing organization of the medical profession.
1901	John Ballantyne (Edinburgh General Hospital) introduced “promaternity wards”; first home prenatal visits conducted by the Boston Lying-in Hospital.
1909	White House Conference on the Care of Dependent Children.
1912	The Children’s Bureau was formed.
1913	The Children’s Bureau released the first prenatal care booklet, recommending consultation with a physician early in pregnancy.
1914	John Whitridge Williams (Johns Hopkins Hospital) presented data suggesting that prenatal care can reduce infant mortality.
1915	The national birth-registration area was formed, providing national data on maternal and infant deaths.
1921	The Sheppard-Towner Bill was passed, providing federal funding for prenatal care.
1930	The Children’s Bureau released a second prenatal care booklet, with specific recommendations for physician visit schedule; the American Board of Obstetricians and Gynecologists first provides specialty certification.
1951	AAOG was formed.
1955	The ACNM was founded.
1957	The AAOG changed its name to the ACOG.
1959	The ACOG released the first “Manual of standards in obstetric-gynecologic practice,” which maintains the original prenatal visit schedule.
1970	The Kessner Index was introduced to assess the adequacy of prenatal care.
1985	Findings from the Institute of Medicine Committee to Study the Prevention of Low Birthweight were released, supporting the causal relationship between prenatal care and reduction of low birthweight infants.
1989	NIH Public Health Service Expert Panel on the Content of Prenatal Care that recommended a schedule of prenatal visits based on medical and social risk factors; Medicaid expansion occurred to improve prenatal care access.
1990s	Clinical trials demonstrated the safety of reduced visit schedules for low-risk patients; group prenatal care was first introduced.
2019	The first RCT of the prenatal care model integrating telemedicine was published.
2020	Outbreak of COVID-19, which resulted in a pandemic.

AAOG, American Academy of Obstetrics and Gynecology; ACNM, American College of Nurse Midwives; ACOG, American College of Obstetricians and Gynecologists; COVID-19, coronavirus disease 2019; NIH, National Institutes of Health; RCT, randomized clinical trial.

Peahl. Evolution of prenatal care guidelines. Am J Obstet Gynecol 2021.