In Tennessee, 74% of pregnancy-related deaths in 2023 were preventable. Early prenatal care is one of the most powerful tools to change that, but data from the Healthy Tennessee Report shows that around 30% of pregnant BlueCross members did not receive prenatal care during their first trimester.

To learn more, WellTuned spoke with Dr. John Calvin Channell, a medical director at BlueCross BlueShield of Tennessee.

“Prenatal care is more than routine pregnancy visits,” Dr. Channell says. “It is a preventive-care system. It is designed to help identify risk early and monitor maternal and fetal well-being. It can also reduce preventable complications.”

Why Tennessee moms need prenatal care

Dr. Channell: Tennessee continues to face measurable maternal and infant health challenges. In 2024, Tennessee’s preterm birth rate was 10.9%, higher than the national average of 10.4%. In 2025, March of Dimes gave Tennessee a “D” grade on preterm birth and ranked the state 34th of 52 based on 2024 data.

What prenatal care may help prevent

Dr. Channell: Prenatal care may improve the detection and management of chronic conditions and pregnancy complications. Tennessee’s 2025 Maternal Mortality Report identified the leading causes of pregnancy-related deaths:

• Mental health and substance use disorders: 27%
• Cardiovascular conditions: 24%
• Infection, including COVID-19: 18% of deaths
• Hemorrhage: 8%
• Embolism: 5%

Early prenatal care may help identify and manage these conditions before they become life-threatening.

When to start and what to expect

Dr. Channell: Prenatal care should ideally start before pregnancy, by addressing risk factors that would affect pregnancy, or care should start prior to 10 weeks of gestation. Visit frequency may vary based on individual risk and needs as determined by your doctor. Prenatal care is not a one-size-fits-all schedule.

Care may include screenings, medical care, anticipatory guidance on things like preparing the house for baby, car seats, choosing a pediatrician, and support throughout pregnancy. It also addresses social needs. These include transportation, food, housing, intimate partner violence and insurance coverage.

Know the urgent warning signs that you might need care or help

Dr. Channell: Seek immediate medical care, call 911 or go to the ER if you experience any of these conditions while pregnant:

• Severe headache, dizziness or fainting
• Vision changes
• Chest pain or trouble breathing
• Fever of 100.4°F or higher
• Severe abdominal pain
• Heavy vaginal bleeding or fluid leaking
• Severe swelling of the face, hands or a leg
• Thoughts of harming yourself or your baby

Prenatal care checklist

Dr. Channell: Use this checklist to stay on track:

As soon as you think you’re pregnant:

• Schedule your first prenatal appointment as early as possible
• Start taking prenatal vitamins containing folic acid after consulting with your doctor
• Stop smoking, vaping, alcohol use and taking non-prescribed drugs
• Share current medications, past pregnancies, medical conditions and family medical history with your doctor

At your first prenatal visit:

• Discuss your medical history, mental health history and any previous pregnancies
• Complete recommended laboratory testing and screening
• Ask about nutrition, exercise, genetic screening and vaccinations
• Discuss any challenges affecting your pregnancy like transportation, housing or mental health concerns

During pregnancy:

• Attend all scheduled prenatal appointments
• Monitor and report to your doctor significant swelling, persistent headaches, vision changes, decreased fetal movement, vaginal bleeding or leaking fluid
• Discuss your emotional well-being at every visit

After delivery:

• Keep all postpartum appointments
• Discuss birth control, breastfeeding, depression or anxiety symptoms, and chronic health conditions

WellTuned: what new moms need to know about postpartum care

“Ask questions — there are no silly questions during pregnancy,” Dr. Channell says. “The goal is to keep both mother and baby healthy from the very beginning.”

More from Dr. Channell on WellTuned

Get more information about specific health terms, topics and conditions to better manage your health on bcbst.com. BlueCross BlueShield of Tennessee members can access wellness-related discounts on fitness products, gym memberships, healthy eating and more through Blue365®. BCBST members can also find tools and resources to help improve health and well-being by logging into BlueAccess and going to the Managing Your Health tab.