Antenatal Care and Case Booking

Antenatal Care (ANC)
Antenatal care refers to the systematic and periodic supervision of a pregnant woman throughout pregnancy to ensure the optimal health and well-being of both the mother and the developing fetus.

It involves

o Clinical evaluation,
o Preventive care and
o Counseling, and health education

Objective of ANC and Booking the Case
The primary objective of antenatal care is to ensure that every pregnancy results in a healthy mother and a healthy newborn.

Why Antenatal Care and Case Booking Are Essential?
The aims of ANC are to:

Identify high-risk pregnancies through regular screening and risk assessment.
Earliest possible; detect and manage complications of pregnancy
Prevent complications of pregnancy
Complications during pregnancy or childbirth are often unpredictable: The healthcare system should always be ready to manage them promptly.

o The woman and her family should be counseled in advance: They must understand the possibility of an obstetric emergency.
o Facilities and services for managing emergencies should be identified early: This ensures timely access when an emergency occurs.

Educate the mother about pregnancy and labor and allay anxiety
Promote exclusive breastfeeding (EBF) and Newborn care
Counsel on:

Nutrition,
Rest,
Hygiene, and
Birth preparedness.

Offer family planning counseling and discuss suitable postpartum contraceptive options.
Provide appropriate guidance to couples seeking medical termination of pregnancy (MTP) in accordance with the Medical Termination of Pregnancy Act, 2021 (India).

Case Booking
Booking refers to:

Registration of a pregnant woman for antenatal care
Scheduling the follow-up visits throughout pregnancy.
Preparing the mother and family for childbirth and possible complications
It ensures systematic documentation and continuity of care.

Recommended Number of Visits:
The ideal schedule includes 13 visits distributed across trimesters as follows:

First trimester: One visit (preferably before 12 weeks of gestation).
Second trimester: Every 4 weeks (making a total of 3 visits)
Third trimester:

o From 28 to 36 weeks – every 2 weeks (total, 4 visits);
o From 36 weeks till term – every week (approximately 4-5 visits)

Minimum Four-Visit Schedule (as per MoHFW and WHO recommendations)
When frequent visits are not feasible—especially for women from lower socioeconomic backgrounds or those residing in remote areas:

A minimum of four antenatal visits is recommended (As per the Government of India (GoI) guidelines under the Reproductive, Maternal, Newborn, Child, and Adolescent Health (RMNCH+A) strategy):

First Visit (Registration Visit): As soon as pregnancy is suspected, ideally within 12 weeks of gestation. Registration of pregnancy and comprehensive baseline evaluation are done.
Second Visit: During the second trimester (between 14–26 weeks).
Third Visit: Between 28 and 34 weeks of gestation.
Fourth Visit: Between 36 weeks and term.

Definition of a Booked Pregnancy
A woman is considered to have a booked pregnancy if she meets the following criteria:

She has had a minimum of three antenatal visits after registration, with at least two visits in the third trimester.
She has received iron and folic acid (IFA) and calcium supplementation as per national guidelines.
She has been immunized with two doses of tetanus-toxoid as Td vaccine.

Note: These three visits represent the minimum standard of care; additional visits may be scheduled based on individual risk factors or complications.

References

Dutta DC. Textbook of Obstetrics. 9th ed. New Delhi: Jaypee Brothers Medical Publishers; 2023.
Padubidri VG, Daftary SN. Shaw’s Textbook of Gynaecology. 18th ed. New Delhi: Elsevier; 2022.
Park K. Park’s Textbook of Preventive and Social Medicine. 28th ed. Jabalpur: Bhanot Publishers; 2025.
Babu SA. Clinical Obstetrics and Gynecology. 2nd ed. New Delhi: Wolters Kluwer India Pvt Ltd; 2025.
5-Page ANC History Taking Format: 5-Page ANC History Taking Format: Essential Guide for Perfect Assessments
Why ANC History Taking Matters?

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Trimester-wise History Taking in Antenatal Care: FIRST Trimester
Trimester-wise History Taking in Antenatal Care: SECOND Trimester
Trimester-wise History Taking in Antenatal Care: THIRD Trimester
Trimester-wise History Taking in Antenatal Care: A Comprehensive Guide (all 3 trimesters))
Components of Birth Preparedness and Complication Readiness (BPCR)
BPCR in brief: ‘Birth Preparedness and Complication Readiness’ (BP/CR)
Specific Health Protection during Antenatal Visits