Chapter 1 Index

A. General Information about the well child examination

The Prenatal Visit
AAP Statement - January 1996*

Introduction: The prenatal visit is recommended for all first parents, and all parents considering switching to your practice.  This type of visit should also be considered for new patients coming to the practice.  Statistical information is lacking about the effectiveness of these visits, but the general impression of pediatricians and parents is that it helps solidify doctor-family ties.

Four Reasons for Doing a Prenatal Visit:

1. Establishing the physician-parent relationship: the personal interaction that occurs during this visit can solidify a relationship that could go on over 20 years.  It gives the parents and the pediatrician an opportunity to see if the right chemistry is there.
2. Gathering basic information.  This visit is an important time to get information on family   history, genetic history, medical history, as well as social history.  Also information about date of delivery, feeding plans, circumcision is also discussed. Some suggest finding all areas of stress, exposures such as drug, alcohol, and smoking in the family.
3. The visit also gives the doctor a chance to explain how the office and practice work, how the hospital works, frequency, and length of office visits. Some specific subjects pediatrician could discuss: jaundice, weight gain, etc.  A tour of the office is often helpful.
4. Parenting skills can be built during this visit. Education about breastfeeding, car seats.

Types of Prenatal Visits: Which type chosen might vary with reimbursement.

• a longer more complete visit can be planned with both parents present.  This visit can take 30-45 minutes; primary caregiver, siblings should come if appropriate.

• a brief visit taking 5-10 minutes.  This visit particularly useful for those doctors shopping

• group prenatal visit: Just as some physicians utilize group well child visits, many pediatricians opt for this visit that can go on for a longer period of time.

• telephone call prenatal visit: booklets or information can be mailed to the expectant parent

Recommendations:

1. Every practice needs to have a policy on prenatal visits.  Must decide about charges, length of appointment time, whether your group will grant an appointment with each physician (some parents want an interview with each doctor in the group).
2. Brochures advertising the availability of these visits should be sent to obstetricians.  This is a good way to advertise and encourage the growth of new physicians in the group. Often people would call and not know the name of any one pediatrician - those were always referred to the newest physicians in the group. 
3. Negotiations with third party payers and insurance companies should be done so that they understand the cost-benefit ratio of prenatal visits.

* AAP Statement on The Pediatric Prenatal Visit.  Pediatrics 1996;98:1195-96.

Prenatal Form Checklist

Date: _______________

Name of Physician: ______________________________________

Name of Mother: _______________________________________

Name of Father: _____________________________________

Name of Primary Caregiver - if different: _____________________________

Name of Hospital Where Mother to Deliver:___________________________

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Department of Pediatrics  |  Medical College of Georgia
Please email comments, suggestions or questions to:
John T.  Benjamin M.D.,  jbenj@mcg.edu

February 27, 2004