With syphilis cases in U.S. newborns skyrocketing, a doctors group now recommends that all pregnant patients be screened three times for the sexually transmitted infection.

The American College of Obstetricians and Gynecologists issued new guidance on Thursday saying the screening should be done at the first prenatal visit, during the third trimester and at birth. Though the screening isn’t required, health professionals generally follow the group’s recommendations.

“The cases of congenital syphilis are definitely climbing, and they’ve been climbing over the last 10 years. And it’s completely preventable ... It’s unacceptable,” said Dr. Laura Riley, who chairs the Department of Obstetrics and Gynecology at Weill Cornell Medicine and helped with the guidance. “We need to be able to do better diagnostics and treatment.”

Previously, the group recommended one test in the third trimester — but only for women considered at risk of getting syphilis during pregnancy or those living in communities with high rates of the disease. But this risk-based approach is “how we get into trouble because we’re missing cases,” Riley said.