Maternity care is the medical care you receive before, during, and after pregnancy. It spans from your first prenatal visit through labor and delivery to the postpartum period, sometimes called the “fourth trimester.” Under the Affordable Care Act, maternity and newborn care are classified as essential health benefits, meaning all qualified health plans must cover them.
The goal of maternity care is straightforward: keep you and your baby healthy through every stage of pregnancy. In 2024, 649 women died of maternal causes in the United States, a rate of 17.9 deaths per 100,000 live births. That number is significantly higher for Black women (44.8 per 100,000) compared to white women (14.2) or Hispanic women (12.1). Consistent, quality maternity care is one of the most effective tools for reducing those numbers.
Prenatal Care: Before the Baby Arrives
Prenatal care is the longest phase of maternity care, typically beginning in the first trimester and continuing until delivery. The standard visit schedule has barely changed since 1930: appointments every four weeks through the seventh month, every two weeks through the eighth month, then weekly until birth. Your provider will track blood pressure, weight, and the baby’s growth at each visit, adjusting the plan based on your gestational age and individual risk factors.
Several routine screening tests happen at specific points during pregnancy. Glucose screening, which checks for gestational diabetes, is typically done between 24 and 28 weeks. Group B strep screening happens later in pregnancy, and if the bacteria is present, you’ll receive antibiotics through an IV once labor begins to protect the baby from infection. Screening for birth defects, including blood tests and ultrasounds, is offered but not required. It’s a personal choice.
Mental health screening is also part of prenatal care. Current guidelines recommend screening for depression and anxiety at the initial prenatal visit, again later in pregnancy, and at postpartum visits. These screenings use standardized questionnaires that take just a few minutes and can flag conditions like depression, anxiety, PTSD, and bipolar disorder.
Labor and Delivery
Intrapartum care covers everything that happens from the onset of active labor through the birth of the baby and delivery of the placenta. During labor, your care team monitors your vital signs (pulse, blood pressure, temperature, breathing rate) and checks the baby’s heart rate regularly. Vaginal exams are offered roughly every four hours to track how far labor has progressed.
Pain management is a core part of delivery care, and you have a range of options. These include breathing and relaxation techniques, laboring in water, inhaled pain relief, opioid medications, and epidural or spinal anesthesia. Your provider will discuss these options with you, ideally well before labor day.
If labor slows or stalls, interventions may include breaking the amniotic sac artificially or using medication to strengthen contractions. After the baby is born, the third stage of labor involves delivering the placenta. Standard practice now includes delayed cord clamping (waiting at least one minute) and medication to help the uterus contract and reduce bleeding. Episiotomy, a small cut to widen the vaginal opening, is performed only when there’s a clinical reason, not routinely.
Postpartum Care: The Fourth Trimester
Postpartum care begins the moment your baby is born and extends through the first 12 weeks. Initial follow-up should happen within three weeks of delivery, either in person or by phone, with a full assessment completed by 12 weeks. Some situations call for earlier check-ins. If you had high blood pressure during pregnancy, you should have your blood pressure checked within seven days of delivery. If you were diagnosed with gestational diabetes, a glucose tolerance test is recommended between four and 12 weeks postpartum.
At your postpartum visits, your provider will assess both physical and emotional recovery. Physical concerns like urinary incontinence are common and can be evaluated with a simple exam. Breastfeeding support is another key component, with providers checking the baby’s latch, swallowing, and your comfort level. A routine pelvic exam isn’t automatically required unless you have specific concerns.
Every postpartum patient should be screened for depression and intimate partner violence. Postpartum depression affects a significant number of new parents, and validated screening tools can catch it early. If screening is positive, your provider should connect you with treatment and follow-up support rather than simply flagging the result.
Who Provides Maternity Care
Two primary types of providers handle maternity care in the United States: obstetrician-gynecologists (OB-GYNs) and certified nurse-midwives (CNMs). Their training paths differ substantially. OB-GYNs complete four years of medical school followed by four years of residency, qualifying them for both medical and surgical management of pregnancy. CNMs complete a graduate-level midwifery program (two to three years) after an undergraduate nursing degree and are nationally certified.
In practice, both can manage prenatal care, attend births, prescribe medications, order lab tests, and admit and discharge patients. The key difference is surgical capability. OB-GYNs perform cesarean sections and other gynecologic surgeries. CNMs focus on physiologic (non-surgical) birth and primary care for women from adolescence through menopause. Many hospitals and birth centers use collaborative models where midwives and OB-GYNs work together, with the OB-GYN available for complications or surgical needs.
Your choice between the two often comes down to personal preference and your pregnancy’s risk level. For uncomplicated pregnancies, midwifery care and OB-GYN care produce comparable outcomes. If you have a high-risk pregnancy, you’ll likely need an OB-GYN or a maternal-fetal medicine specialist involved in your care.
High-Risk Pregnancy Care
Certain conditions bump a pregnancy into the high-risk category, which means more frequent monitoring and potentially specialized interventions. Pre-existing health conditions like high blood pressure, diabetes, kidney disease, autoimmune disorders (lupus, multiple sclerosis), thyroid disease, obesity, and HIV all qualify. So do lifestyle factors like alcohol, tobacco, or drug use during pregnancy.
Age plays a role too. Pregnant teens and first-time mothers over 35 are considered higher risk. Women 40 and older face a maternal mortality rate of 62.3 per 100,000 live births, nearly four times the rate for women under 25 (13.7 per 100,000).
Conditions that develop during pregnancy can also elevate risk: carrying multiples (twins, triplets), gestational diabetes, preeclampsia, a history of preterm birth, and certain fetal anomalies. Management varies widely depending on the condition. It might mean something as simple as dietary changes and more frequent blood pressure checks, or something as involved as medication adjustments, progesterone supplementation to delay preterm labor, or in rare cases, fetal surgery. The common thread is closer surveillance, with providers monitoring both parent and baby more frequently than in a standard-risk pregnancy.