After nearly a century of a “one-size-fits-none” approach to prenatal care, the American College of Obstetricians and Gynecologists (ACOG) just dropped recommended some radical changes to its own operating model for pregnant women and people.
On April 17, 2025, ACOG released groundbreaking clinical guidance that recommends ditching the antiquated 12-to-14 visit schedule and instead tailoring prenatal care to you—yes, you, mama with the insane work schedule, patchy WiFi in rural America, and maybe a toddler already doing Olympic-level couch flips.
Let’s break down why this change matters—and how it could be the first real step toward bringing U.S. prenatal care into the 21st century.
So, what’s changing?
Under the old model, whether you were a low-risk pregnancy or a high-risk one, the typical approach involved regular checkups on a fixed schedule: every four weeks until the seventh month, every two weeks until the eighth month, and then weekly thereafter. While this schedule was standard for many low-risk pregnancies, higher-risk pregnancies often required more frequent visits and specialized care.
It didn’t matter if you were juggling a job, other kids, or lacked transportation—this was the schedule.
But ACOG’s new guidance, based on years of research and a major post-COVID rethink, is flipping that model. Now, for patients with low to average risk, prenatal care can be customized based on individual needs, risk factors, and even social determinants of health like race, employment status, or access to transportation.
Dr. Christopher Zahn, ACOG’s Chief of Clinical Practice and Health Equity and Quality, said it plainly: “Research has shown that the standard 12 to 14 visits do not ensure that patients receive the recommended prenatal care…In order to improve access and outcomes, we have to adjust the system and meet patients where they are.”
Related: New CDC data shows that more pregnant women are unable to access prenatal care
Translation: Less rigidity, more reality
Tailored prenatal care means that instead of automatically scheduling a dozen-plus appointments, ob-gyns and patients will work together to decide what makes sense. As a mother myself who suffered from Hypermesis Gravidarum, it’s comforting to know that I may have gotten more aggressive support—support that I wish I didn’t have to fight for—even in early pregnancy when women go a month or more in between appointments.
ACOG’s recommended changes are to include include:
- Fewer in-person visits (because not everyone needs that many)
- More tailored visits for whatever conditions you do need support with, even in early pregnancy.
- Telemedicine check-ins (shoutout to rural moms and those without PTO),
- Longer, more intentional appointments when they do happen,
- Support for real-world barriers like transportation or lack of childcare.
This isn’t about less care. As Dr. Alex Peahl from the University of Michigan put it: “Tailored care means delivering the right care, by the right professional, through the right modality.”
Why it really matters: health equity
If you’ve ever read our coverage on maternal health, you know that the U.S. has a horrifying track record, especially for Black, Indigenous, and other mothers of color. These communities face disproportionately high maternal mortality and morbidity rates—and outdated systems only make it worse.
ACOG’s guidance explicitly calls out the need to screen for social drivers of health and adjust care accordingly. That means recognizing when a mom is more likely to miss an appointment because of job demands or when racial bias in healthcare has made her distrustful of the system.
The new model includes the PATH framework—Plan for Appropriate Tailored Healthcare in Pregnancy—which lays out how and when to monitor everything from blood pressure to baby bump growth in a way that actually works in the real world.
Related: Maternal deaths are dropping—but Black moms are still at the highest risk
What this means for you:
- Talk to your ob-gyn about tailoring your prenatal schedule based on your lifestyle and health needs.
- Ask whether telehealth check-ins are an option.
- If transportation or childcare is an issue, flag it early—ACOG’s new guidance says it matters.
- Keep a record of symptoms between visits so nothing gets overlooked during fewer in-person checkups.
Will this actually change anything?
Change this big won’t happen overnight. Many healthcare providers still don’t have the staffing, tech, or funding to offer robust telehealth or community resource support. And as always, systemic progress will depend on insurance companies, hospital systems, and lawmakers catching up to the needs of families.
But this is a start.
It’s a recognition that pregnant people are not all the same, and that modern prenatal care should reflect that.
This isn’t just medical policy. It’s modern feminist infrastructure.
And moms? You deserve nothing less.