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The first trimester provides a unique opportunity to predict and prevent complications, yet population\u2010based screening has failed to be translated into broad clinical practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>This study aimed to redesign antenatal care within an Australian public healthcare centre to align with evidence\u2010based maternity care, including population\u2010based first\u2010trimester screening with early initiation of preventative strategies in high\u2010risk pregnancies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A five\u2010phase action\u2010process model, sharing key elements with implementation science theory, was used to explore barriers to change in antenatal care, co\u2010design a novel service with consumers and establish a population\u2010based antenatal pathway commencing with a multidisciplinary first\u2010trimester screening, assessment and planning visit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The case for change and associated barriers were defined from the perspective of antenatal care stakeholders. Key needs of each group were established, and solutions were created using co\u2010design methodology, allowing the team to create a novel approach to antenatal care which directly addressed identified barriers. Implementation of the service was associated with a fall in the median gestation at first specialist maternity care provider visit from 20 to 13\u2009weeks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study confirms the feasibility of establishing a comprehensive first\u2010trimester screening program within a public Australian healthcare setting and highlights a co\u2010design process which places individualised assessment at the forefront of antenatal care. This framework may be applicable to most public maternity settings in Australia, with expansion aimed at providing equity of care, including in rural and remote settings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.13837","type":"journal-article","created":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T09:58:25Z","timestamp":1716458305000},"page":"588-595","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Redesigning antenatal care: Prospective use of an implementation framework to establish a population\u2010based multidisciplinary first\u2010trimester screening, assessment and prevention service"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4954-0449","authenticated-orcid":false,"given":"Ailsa","family":"Borbolla Foster","sequence":"first","affiliation":[{"name":"Department of Maternity and Gynaecology John Hunter Hospital  New Lambton Hts New South Wales Australia"},{"name":"School of Medicine and Public Health University of Newcastle  Callaghan New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Haxton","sequence":"additional","affiliation":[{"name":"Department of Maternity and Gynaecology John Hunter Hospital  New Lambton Hts New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Bennett","sequence":"additional","affiliation":[{"name":"Department of Maternity and Gynaecology John Hunter Hospital  New Lambton Hts New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon","family":"Hyett","sequence":"additional","affiliation":[{"name":"Ingham Institute, Faculty of Medicine Western Sydney University  Liverpool New South Wales Australia"},{"name":"Department of Obstetrics and Gynaecology Liverpool Hospital  Liverpool New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicity","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Maternity and Gynaecology John Hunter Hospital  New Lambton Hts New South Wales Australia"},{"name":"School of Medicine and Public Health University of Newcastle  Callaghan New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,23]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"New South Wales Mothers and Babies 2002\u20102021","author":"Centre for Epidemiology and Evidence","year":"2004"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/GCO.0000000000000420"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1471-0528.2003.02246.x"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2018.05.002"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1704559"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.6394"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19112"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19077"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.14605"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17560"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17109"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.23741"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12802"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogc.2022.03.002"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.117.10803"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.26106"},{"key":"e_1_2_7_18_1","volume-title":"Clinical Practice Guidelines: Pregnancy Care","author":"Department of Health","year":"2020"},{"key":"e_1_2_7_19_1","unstructured":"Australian Preterm Birth Alliance.Clinical guidelines for the safe reduction in preterm birth.2020. 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