The care and advice that you receive from healthcare professionals whilst you are pregnant is referred to as ‘Antenatal care’.
If this is your first baby or you have experienced problems in a previous pregnancy, you are usually offered up to ten antenatal appointments. A woman who has had a previous birth will usually receive up to seven appointments throughout her pregnancy.However, some areas and some midwives may offer more or fewer appointments depending on location or personal need. Antenatal appointments may take place in your doctor’s surgery, in hospital, at home or in a local children’s or health centre. There are no set guidelines for where an antenatal appointment can happen but it does need to be somewhere with privacy and where you feel able to talk about personal matters with your midwife.
As with any medical appointment, it is important that you try your best to attend your antenatal appointments and that you inform your midwife if you are unable to attend. If you are working, you have the right to attend all antenatal appointments without losing any pay if they take place during your working hours.
During each antenatal appointment, your midwife will check on both you and your baby. You will be explained the care that you are receiving and you will be offered advice and information about your pregnancy, labour and about newborn care. You will also be able to ask your midwife about anything concerning you.
Everything that happens or is said during an antenatal appointment is confidential although if you want to discuss something very private you should tell your midwife in case you bring the dad-to-be, children or your birthing partner to a subsequent appointment and you do not want the conversation brought up in front of them.
Here is an approximate guide of when you may see your midwife and what might happen at each appointment. It is important to realise that this is only a guide and your individual antenatal care may vary depending on your needs. If you have any questions, you should speak to your midwife.
First Contact with doctor
You will need to tell your doctor that you are pregnant. You may be asked to carry out another Pregnancy Test or possibly sent for blood test in order to confirm your pregnancy. You will receive a folder of information including information on healthy eating, Folic Acid and vitamin supplements, how your lifestyle such as alcohol and drugs may need to change and also information about your antenatal care.
You will need to tell the doctor, if you have any health or medical complications such as family history of an inherited disease, spina bifida or cystic fibrosis. You will also need to tell your doctor if you have had a previous pregnancy or birth with complications as you may need extra antenatal care.
Your Booking Appointment: 8-12 weeks
You will receive your hand-held antenatal notes and your midwife will ask you many questions which are known as ‘taking a history’. Questions will include:
- Your medical history
- Any medicines you are taking
- Your family’s health
- The Dad-to-be’s health
- His medical and family history
- Whether you smoke
- Your alcohol consumption
- Your sexual health
- Your relationship with the dad-to-be
- Your ethnic origin
- Previous pregnancies
- Your religion
Some of these questions may sound very personal but they are very important to your health care, for example some ethnic groups are more prone to certain medical conditions than others.
You should receive information on:
- How your baby is growing and developing
- Your nutrition and diet
- Exercise during pregnancy
- Pelvic floor exercises
- Screening tests
- Antenatal classes
- Maternity benefits
- Your birth plan
- Where you want to give birth
- How to contact your midwife or the labour ward
Your midwife will also
- Measure your height and weight and calculate your BMI (Body mass index)
- Measure your blood pressure and test your urine
- Offer you screening test and ultrasound scans
- Plan the care you are to receive
- Identify any potential risks associated with your work (carrying heavy goods, chemical use)
- You will be sent for blood tests
Dating Scan – 12 weeks (may vary between 10-14 weeks)
This is an ultrasound scan carried out at your local hospital. This scan can estimate your baby’s due date and is also used to check your baby is growing and developing normally and it can also screen for abnormalities. Most hospitals allow you to take a photo of your scan to keep for a small donation of a few pounds to the hospital.
16 week appointment
During this appointment, your midwife will check your urine and blood pressure. They will also discuss with you the results from your dating scan and the blood tests which had been taken. Your midwife may feel your tummy and may listen for baby’s heart beat.
Anomaly Scan – 18-20 weeks
You will attend the hospital for another ultrasound scan to check your baby’s development. You should also be able to purchase a photo and you may be able to ask what sex your baby is.
24 week appointment
Your midwife will discuss with you the results from the anomaly scan. She will measure your blood pressure and test your urine sample. Your midwife will feel your tummy and check the size of your uterus. She may also listen to your baby’s heart-beat.
Your midwife may advise what you should pack in your hospital bag if you are planning a hospital or birthing centre delivery.
Your midwife may also encourage you to attend antenatal classes.
28 week appointment
Your blood pressure will be taken and your urine sample tested. The size of your uterus will also be measured and baby’s heartbeat will be listened to. Your midwife will be able to answer any concerns that you have and may start to discuss how you are planning to feed your baby. You may be offered further screening tests such as a blood test.
31 week appointment
Your midwife will test your blood pressure and urine sample. She will measure the size of your uterus with a tape measure and listen to your baby’s heartbeat. If you have had your blood tests since your last appointment, she will discuss the results and as always record the details in your hand-held antenatal notes.
34 week appointment
Your midwife will give you information on labour including how to recognise labour, the stages of labour, types of pain relief and writing your birth plan. Your midwife will also check your blood pressure, your urine sample and the size of your uterus. She will also listen to your baby’s heartbeat and possibly feel to see what position your baby is in.
36 week appointment
During this appointment, you should receive information on your baby after the birth.You will be told about the vitamin K and the screening tests that your baby will need, how you should care for your baby and information on feeding your baby. Your midwife will also talk to you about your health after the birth and also about the signs of postnatal depression or ‘baby blues’.
Your midwife will also check your blood pressure, your urine sample, the size of your uterus, the baby’s heartbeat and also what position the baby is in.
38 week appointment
As well as the regular checks of blood pressure, urine, size of uterus, heartbeat and position of baby, she will discuss with you the options available to you if you should be overdue and need your labour to be induced.
41 week appointment
Your midwife will perform all the regular checks and will also perform a membrane sweep to try and start your labour. Your midwife will discuss with you some techniques for trying to kick-start labour yourself and give you more information about induction of labour.
by Jenny, mum to William and James