Antenatal appointments

Stethoscope on pregnant bellyYou've taken the test, you're definitely pregnant and you're now ready to enter the world of antenatal appointments.

There are quite a lot of them and although there will be variations depending on the area you live in, the content and timing will be roughly the same. You may have your appointments with your GP, a hospital-based midwife, a midwife attached to your GP's surgery or with a community midwife. This will depend on what's on offer locally.

First visit: This should happen shortly after you find out you are pregnant and will be a chance to confirm the pregnancy and discuss diet and lifestyle.

You may be told about screening tests and the maternity services that are available in your area, and about any specialist midwifery services if you have disabilities or additional health needs.

If you are interested in having a home birth you may be able to get a referral to midwives who specialise in home births if this is an option in your area. You can also refer yourself to a midwifery service.

Booking appointment (between 8 weeks10 weeks): This is where you book in for maternity care with either your GP or a midwife (or shared care between the two). It could be at the hospital, your local midwifery unit, at your GPs or even in your home.

You will be asked lots of questions about your general health and lifestyle, any previous births, miscarriages, abortions and whether you have a family history of genetic disorders.

You will also be asked about the date of your last period so a preliminary due date can be worked out, although this might change after your first scan. All this information will be put into your maternity notes.

Blood will be taken to test for:

  • Your rhesus status and blood type
  • Anaemia
  • Rubella immunity
  • HIV and STIs

And a urine test to see if you have protein in your urine and to check for:

  • Infection
  • High blood pressure
  • Diabetes
  • Kidney problems

You will also have your blood pressure taken and you may be weighed.

You may discuss your birthing options and whether you have an idea where and how you want to give birth. You will be told of the services available in your area and whether there are any antenatal classes that you can attend.

You may also be asked how you plan to feed your baby. You should also be given advice on maternity benefits, and exercise and healthy eating during pregnancy.

During this appointment your screening scans should be arranged. You're under no obligation to have these but many women want to know how their baby is doing in there. And you may be offered further blood tests for sickle cell anaemia, Tays-Sachs disease or thalassemia, depending on whether or not you are in a high-risk group.

Between 8 weeks14 weeks: Dating scan, an ultrasound to work out the exact age of your foetus and to measure and screen for any evident health problems or signs of genetic abnormalities.

11 weeks14 weeks: Nuchal translucency scan, which tests for chromosomal abnormalities such as Down's syndrome, if this is on offer in your area.

16 weeks: This appointment should include a review of the test results from your scans and blood tests, along with information about any further screening tests that you may need as a result of the first ones and any treatments you may need to follow up the blood tests. Again, you will have your blood pressure and urine tested (this happens at every appointment).

18 weeks20 weeks: The anomaly scan, which will show any foetal anomalies and will be used to check the health of the placenta and that your baby is growing normally.

20 weeks onwards: From this point in, your appointments will be more regular. At each appointment you will have the usual urine and blood pressure tests, your bump will be measured and the baby palpated (this basically involves the midwife having an expert feel of your bump to check your baby's development and check on the position). You may also be able to listen to your baby's heartbeat.

During your appointments you will have a chance to ask any questions you have about the birth, or any health niggles. You can always call your midwife or doctor if you have any worries between appointments or if you feel you need to see them.

At some stage you will be encouraged to write a birth plan, which can help you work out the way you would like your birth to go - whether you think you would like painkillers or do it au naturel, how you feel about interventions, whether you would like a water birth and where you would ideally like to give birth.

You should be given information about pain relief, the mechanisms of labour, what will happen if your baby is late and the possibility of postnatal depression.

You may be able to go to breastfeeding workshops and your midwife will discuss feeding options, baby screening tests and give you information about vitamin K injections or drops.

If your pregnancy is going well and you do not need extra monitoring you will have appointments at:

  • 25 weeks: first-time mothers only
  • 28 weeks: when any rhesus negative women should be offered an Anti-D injection
  • 31 weeks: first-time mothers only
  • 34 weeks: when a second Anti-D injection should be offered to those who need it
  • 36 weeks
  • 38 weeks
  • 40 weeks: first-time mothers only
  • 41 weeks: if you haven't had your baby by now, this one is check on your baby's health. You may be offered a sweep to kickstart labour and you may be advised that induction of labour might be appropriate. You may or may not agree.

 

Image: Shutterstock

Last updated: 16-Dec-2013 at 3:16 PM