de Uvery risky are seen in a pr. egnancy visit, the woman is referred to a su. itable facility or health p. rofessionals who are skilled in managin g her needs. The visit, then, becomes an indirect way of reducing maternal complic ations. Continuity of care is an important element in p1·ovision of services. Nurses are an important link in ensuring that current and subsequent pregnancy visits are done in a manner that conform to standard. Nurses are highly skilled in making c Hnical judgment s that form as a basis for pl:rnnin!;!, and interventions. They can help the woman make a commitment to a good pregnancy outcome. Hodnett (2000) performed a meta-analysis of two studies involving 1815 women. Cn the studies, the women were cared for by (nurse) mi<lwives who performed continui ty of care and anoll1er set by a combination of physicians and (nurse) michvives. Women who had continuity of care from a team of (nur. se)midwives were less Ukely to have prenatal hospital admission, and more likely Lo participate in preuatal e<luca Lloo programs. They wet'e. Liso less likely to have drugs for pain relief during labour und their newbo1·ns were less likely to requfre resuscitation. No differences were detected in Apgar scores, low birthweigbt and stillbirths or neonatal deaths. They were mo1:e likely to be pleased with their antenatal, intrapartum and postnatal care (5). The results of this study highligh t and beneficial effects of continuity of ca1·e which ls in part is dependent on the health care provider. STANDARDS OF PRENATAL CARE Prenatal care is the monitoring and management of the patienl dudng pregnancy to prevent complications of pregnancy and promote a healthy outcome for both mother and infant ( (Bulecheck et al 2008, p. 580) (6) In the NHDS of 2003, 9 out of 10 mothers received can? from nurses and 01-idwives (50%) and physicians (38%) and traditional birth attendants (7%) while 6% did not receive any prenata l care. A woman without pregnancy complications need.,:; to have one prenatal visit every 4 weeks up to the 28 weeks, and every 2 weeks from 37-36 weeks and every week thereon until birth. (Murray & Mac Kinney, 2006; Lowdermilk & Perry, 2004) (6,7) The frequency is increased in the 3"1 trimester because of the possibility of complications thntmay arise. This warrants more frequent monitoring. The more risks a pregnant woman has, the more visits are needed. Information from the 2003 NHDS show that one (1) out of ten (;10) had the 1"' prenatal check up at 6-7 months of pregnancy. Three out of ten had their prenatal check up on the 4th to 5th month. There is a segment of Filipino wom,en who are at the highest health risk during pregnancy (2): (1) preg;nant women less thau 18 years old, (2) women who received only up to elementary education; (3) women in 20% of the poorest households; (4) women in areas of armed conflict; (5) women victims of domestic violence; and (6) pregnant women with concurrent chronic illness (iron deficiency anemia, tuberculosis, cardiovascu lar diseases, diabetes mellitus, etc) The goal of the governmen t is for a U pregnant women to have at least four (4) antenatal visits in a pregnancy. The 2007 WHO standard recommends at least 4 prenatal visits. This is largely based on a study done by Villar et al (2001) who reviewed ten trials involving ove1· 60,000 women. Seven trials evaluated the number of antenatal clinic visits, and tliree trials evaluated the type of care provider. A reduction in the number of antenatal visits was nol associ:1ted with an increase in any of the negative maternal and perinatal outcomes reviewed. However, trials from develope d countries suggest that women can be less satisfied with the reduced number of visits and feel that their e:icpectations with care,ire not fulfilled. Antenatal care provided by a midwife/general 290 