Reduced frequency prenatal visits in midwifery practice: attitudes and use

Recent research supports the use of reduced frequency prenatal visit schedules (RFVS) for women of low obstetric risk. However, for the RFVS to be widely adopted for use in practice, health care providers must implement and support its use. The purpose of this study was to explore midwives' attitudes toward and use of reduced frequency prenatal care visit schedules for the care of low-risk women. A descriptive, correlational study was conducted at the 1999 Annual Meeting of the American College of Nurse-Midwives with completed surveys received from 234 midwives. Seventy-two percent (n = 170) responded that they were familiar with the reduced frequency visit schedule. Of those, 71% agreed that they could give effective prenatal care by using reduced frequency scheduling, although few (17%) reported using it in practice. Significant differences were found between the midwives who were familiar versus those who were unfamiliar with the visit schedule in their perceptions for five central themes: 1) quality of care of the RFVS, 2) women's empowerment or self-care with the RFVS, 3) ability to manage practice, 4) patient satisfaction, and 5) barriers to the use of RFVS. Providers' responses to the use of RFVS have been mixed. Successful integration of this schedule into prenatal care services may require more than knowledge of its safety for low-risk women. Careful selection of women for whom the schedule is appropriate and a commitment from midwives to tailor prenatal care to the individual women's needs is indicated. Further research is also needed to evaluate the barriers that prevent midwives from using a reduced frequency visit schedule for the prenatal care of low-risk clients.