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Baskets of Care: Obstetric Care
Component Grid Worksheet
Scope: This basket of care is for Prenatal services provided to women with a confirmed, singleton intrauterine pregnancy. The
timeframe is from the confirmation of pregnancy until the onset of obstetrical labor. Services are provided by licensed healthcare
professionals. Excluded are those with high-risk pregnancies such as HIV, insulin dependent diabetes, and multiple gestations.
Components
Number of Prenatal
Visits (move this to
end)
Screening
Maneuvers
Risk Assessment
Hgt./Wgt./BMI
Blood Pressure
GC/Chlamydia
History/Physical exam
Rubella
Varicella
Herpes
Syphilis
HIV
CBC
ABO/Rh/Ab
Urinalysis/culture
Hepatitis B S Ag
Frequency
Rationale (Evidence) and Comments
Typical range
10-14 wks
Prenatal only. Visits may be clinic-based, e-visit, centering, etc.
Number of visits are discussed between patient and provider . 24
hour access
Initial
Initial Ht/Wt/BMI
Weight at every visit
Every visit
0-2
Initial
Initial
Gestational age appropriate
Repeat as app
Repeat as app
Initial
As indicated
Initial
Age and Risk specific
Assessment/test of needed
Assessment
Test
Test
Rh and Ab repeated if negative
Components
Blood Lead Screening
Fetal heart tones
2nd trimester Serum
Fetal Aneuploidy Scr
OB Ultrasound
Cervical Assessment
Preterm Labor Risk
Gestational Diabetes Scr
Fundal Height
Confirm Fetal Position
Group B Strep culture
Counseling Education
Intervention
Preterm labor
Substance Use (tobacco,
alcohol, drugs
Nutrition and weight,
exercise
Nausea and Vomiting
List of medications,
vitamins, herbal suppl
Domestic violence
Depression
Other Prenatal education
and Lifestyle counseling
Frequency
Rationale (Evidence) and Comments
Based on Assessment
Each visit
All patients offered
0-2 (Level I)
As needed
Not evidence-based for improved outcomes
Assessment
1-2
After 20 wks
After 36 wks
once
As needed
Every visit
As needed
Update each
trimester
Initial and each
trimester
Initial/each trimester
Repeat as needed
Discuss fetal aneuploidy
screening testing
once
Awareness of fetal
movement
Labor and Delivery
concerns
Post-Partum concerns
Components
As needed
Warning signs
VBAC
Immunizations and
Chemoprophylaxis
Tetanus booster
Hepatitis B vaccine
Folic acid supplement
Influenza
Progesterone
Nutritional supplements
RhoGAM
Frequency
Rationale (Evidence) and Comments
For previous C-sections
If needed
If at risk
If indicated
If and when indicated