Objectives of perinatal care
- To promote the health and wellbeing of the pregnant woman, fetus, infant, and family up to 1 year after birth.
- The major components of perinatal care include: (1) early and continuing risk assessment, including preconception assessment; (2) continued health promotion; and (3) both medical and psychosocial assessment and intervention.
- Three levels of perinatal care are described (in Table 41.1).
Table 41.1 Levels of perinatal care
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| Level of care | Responsibility | Appropriate provider |
|---|---|---|
| Basic (level I) | Risk-oriented prenatal record, physical exam, laboratory data, and interpretation of findings. Determine gestational age. Provide ongoing risk assessment with referral to a specialist, if indicated. Provide psychosocial support, childbirth education, and overall care coordination | Obstetricians, family practitioners, certified nurse midwives, other advance-practice nurses |
| Specialty (level II) | Basic care plus fetal diagnostic testing (eg, basic ultrasound, amniocentesis, genetic counseling). Expertise in the management of medical and obstetric complications | Obstetricians |
| Subspecialty (level III) |