An audit of antenatal care: the value of the first antenatal visit.

A critical analysis of the events recorded at the first antenatal visits in a city where all pregnant women are seen by specialist obstetricians for booking for antenatal care and confinement showed that many women attended too late for optimal care. The selection of women for their risk of complications was not very effective, partly because of failure to take account of information that was available, but mainly because many obstetric complications cannot be predicted, except by classifying large proportions of pregnant women as high risk. Even with the greatest care, inappropriate bookings are made at the first visit, and reappraisal of booking for continuing care and confinement is necessary during pregnancy.