Historically, the traditional antenatal care service model was developed in the early 1900s. This model assumes frequent visits and classifying pregnant women into low and high risk through predicting the complications ahead of time.

Although the approach is announced to be the best way to promote ANC, it was unable to identify accurately women who are "at risk" of developing any of the life-threatening conditions. Rather, it categorises some pregnancy as "low risk" when it is liable that the women may subsequently develop danger symptoms that need urgent professional attention.

Hence, it is currently replaced by focused antenatal care (FANC) which is a goal-oriented antenatal care approach, recommended by researchers in 2001 and adopted by WHO in 2002. In line with this, Ethiopia has also accepted FANC's approach as its ANC policy.

The advantage of FANC over the traditional ANC approach is that the former is an ANC strategy which uses evaluation, intervention and promotion to implement ANC without classifying pregnant women as high and low-risk case, and also:

• Takes into consideration that every pregnancy ends with the delivery of a healthy baby without also impairing the health of the mother.
• Assures those pregnant women and their families are advised on how to prepare for birth and subsequent potential complications.
• Helps pregnant women to receive special care and attention from the family, community and the health care system
• Promotes the benefit of skilled attendance during pregnancy and at birth including encouragement for postpartum care for themselves and their newborns
• Supports counselling women on the advantages of family planning and provision of the options of contraceptives
• Helps to assure the continuum of the link with higher levels of care as needed
• Helps to identify and treat maternal conditions appropriately, cost-effectively and as an individualized case.

In general, FANC contributes a lot to the effort of decreasing the high Maternal Mortality Rates (MMR) in Sub-Saharan Countries including Ethiopia. That is, FANC is currently gaining much popularity because of its effectiveness regarding reducing maternal and perinatal mortality (deaths) and morbidity (disease, disorder or disability).

• MMR is the total number of women dying from complications due to pregnancy or childbirth in every 100,000 live births while,
• The perinatal mortality rate is calculated as the number of stillbirths (babies born dead after the 28th week of gestation) and neonatal deaths (newborns who die in the first seven days of life) occurring in every 1000 live births. It is an internationally recognised measure of the quality of antenatal care.

The top three unpredictable killing disorders of pregnant mothers appearing very late in gestation include:

• Hypertensive disorders of pregnancy (hypertension means high blood pressure), specifically eclampsia, which commonly occurs very late in pregnancy, or during labour or after delivery (you will learn this later in this module).
• Haemorrhage (heavy bleeding) which occurs most commonly in the third trimester (it is described in late pregnancy bleeding session), or the more often fatal postpartum haemorrhage, which occurs after delivery (described in detail in the labor and delivery care module)
• Pregnancy-related infection (postpartum infection of the uterus), which usually develops after birth.