Antenatal care

Expert reviewer, Dr Samantha Wild, General Practitioner, Bupa UK and Michelle Sheridan, Midwife, Bupa UK
Next review due May 2024

Antenatal care is the care you get from healthcare professionals to guide you through your pregnancy. It includes information on services and support to make informed choices right for you. You’ll have regular antenatal appointments with a midwife, ultrasound scans and screening tests.

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About antenatal care

If you’re fit and healthy and you’re expected to have a pregnancy without any major problems, a midwife will usually look after your antenatal care. Your GP may be involved in your care too. If your midwife or GP thinks you may have a more complicated pregnancy, they will refer you to see an obstetrician. An obstetrician is a doctor who specialises in pregnancy and childbirth.

Your antenatal appointments may be at a hospital maternity unit, your GP surgery, a local community centre, or at home. Your midwife or doctor will check the progress of your pregnancy and give you information to help you have a healthy pregnancy and birth. Other goals of antenatal care are to prepare you for taking care of your new baby.

Accessing antenatal care

When you find out you're pregnant, contact your GP or a midwife. Your GP surgery can put you in touch with your local midwife services, or you can contact them directly. They will book you in for your first appointment with a midwife – known as your ‘booking appointment’.

If you want to access private antenatal care, you can search for a private midwife on the Independent Midwives website. See Other helpful websites for details.

When you first make contact with a health professional, they should give you some initial information and advice about your pregnancy. This may include the following.

  • Folic acid supplements – if you’re not already taking folic acid, you should start taking 400 micrograms (400µg) a day as soon as possible.
  • Advice on stopping smoking and the risks of alcohol.
  • What foods to avoid when you’re pregnant, and how to reduce the risk of food-acquired infections.
  • Antenatal screening – what tests you’ll be offered during pregnancy.

Antenatal appointments

If you’re healthy, and it’s your first pregnancy, you’ll usually have up to 10 antenatal appointments. If you’ve already had a healthy pregnancy, you’ll usually only need around seven.

Booking appointment

Your first appointment with a midwife is called your booking appointment. You usually have a booking appointment with a midwife when you’re between eight and 12 weeks’ pregnant – ideally before you’re 10 weeks’ pregnant. The appointment can take around an hour. Your midwife will ask you questions about your medical and family history, your lifestyle, and about your mental wellbeing.

They will also go through lots of information with you at this appointment. This will include the following.

  • Vitamin supplements. You will normally need to take 10 micrograms (10µg) of vitamin D every day throughout your pregnancy to keep your bones strong. This is in addition to folic acid. Many pregnancy supplements combine vitamin D and folic acid into one pill.
  • How your baby develops during pregnancy. You should get written information on this that you can take away.
  • The possible options for where to have your baby.
  • The appointments you’ll have during your pregnancy, including screening tests and ultrasound scans.
  • Maternity benefits.
  • Lifestyle advice, including advice on nutrition, diet, food hygiene and exercising during pregnancy. This includes pelvic floor exercises.
  • Breastfeeding and where you can get support on this.
  • Antenatal classes – what’s available locally and when you should start them.

Your midwife will also want to do various measurements and tests. They’ll want to measure your height and weight to check your body mass index (BMI). They’ll also ask for a urine sample and take your blood pressure. This is to check for infections and pre-eclampsia (high blood pressure in pregnancy).

Your midwife will also offer you a blood test. Blood tests can check for anaemia, as well as blood disorders such as sickle cell anaemia and thalassaemia. They can also screen for sexually transmitted infections (STIs), including human immunodeficiency virus (HIV), hepatitis B and syphilis. A blood test will also show your blood group, and whether you’re rhesus-negative. See our FAQ for more information on what your rhesus D status means.

At the end of your booking appointment, your midwife may give you your maternity notes to look after. These contain all the information about your health and care, and you need to take them with you to every appointment. Some hospitals may be able to provide you with digital notes. Your midwife will advise you which system is used in your area.

Routine antenatal checks

After your booking appointment, you’ll have regular appointments with your midwife throughout your pregnancy. These become more frequent towards the end of your pregnancy.

At each appointment your midwife or doctor will check your blood pressure and test your urine for protein, to check for pre-eclampsia. They’ll also measure the size of your womb and your baby from 24 weeks, using a tape measure. They may talk to you about different aspects of your care at each appointment, for instance – whether you need any vaccinations.

Antenatal appointments in later pregnancy

Later on in your pregnancy, your midwife will give you information about labour, birth, breastfeeding and preparing to look after a newborn baby.

Once you’re about 36 weeks’ pregnant, your midwife will start checking the position of your baby in addition to other antenatal checks. If your baby is in the bottom downwards position (breech), your midwife or doctor might offer you a procedure called external cephalic version (ECV). This aims to turn your baby around from the outside of your abdomen (tummy).

At your 38- and 40-week appointments, you’ll be given information about the risks involved if your pregnancy lasts longer than 42 weeks. Your midwife will explain what options are available to you.

You’ll be offered a membrane sweep when you’re 40 or 41 weeks. This involves your midwife gently passing a finger through your cervix, and rotating it against the wall of your cervix. This separates the membranes of the amniotic sac surrounding your baby from your cervix, which can help to start labour naturally.

At your 41-week appointment, your midwife will offer to induce you. This means giving you drugs to start your labour artificially. You’ll have these in hospital.

Ultrasound scans

If everything is going well with your pregnancy and you’re fit and well, you’ll be offered two ultrasound scans. Ultrasound scans are safe for you and your baby. They show images of your growing baby, which you can see on a screen.

You’ll usually have your first scan, called a dating scan, when you’re between 10 and 14 weeks pregnant. It's used to check your baby’s heartbeat, work out when they’re due and check whether you’re having more than one baby. It can also form part of the combined screening test, if you choose to have this. See next section for further details.

You’ll have your second scan when you’re between 18 and 21 weeks pregnant. This scan will check that your baby is healthy and developing as it should be. The ultrasound images should show your baby’s main organs. This scan can show a number of health conditions, such as:

  • problems with your baby’s developing nervous system, such as spina bifida
  • heart and kidney conditions
  • problems with brain development

It’s important to understand that the scan isn’t perfect and it’s possible for some problems to be missed. This scan is also used to check the position of your placenta inside your womb (uterus). If your placenta is low in your womb, you’ll be asked to have another scan later in the pregnancy to check it. This is to make sure it won’t cause any problems, such as bleeding, later in your pregnancy.

Tests for Down’s syndrome and other inherited conditions

Screening tests

You’ll be offered a screening test to see how likely it is that your baby could have certain conditions caused by abnormal chromosomes. These include Down’s, Edward’s and Patau’s syndromes. It’s entirely up to you whether you have this or any other screening test. The tests show you your chance of having a baby with these syndromes, but don’t give a definite diagnosis. Talk to your midwife and make sure you have all the information you need to make the decision.

If you’re between 11 and 14 weeks pregnant, you can have what’s known as the ‘combined test’. There are two parts to this screening test.

  • Nuchal translucency screening. This is done as part of your first ultrasound scan. Your sonographer uses images from the scan to measure the fluid at the back of your baby’s neck.
  • A blood test which measures specific proteins in your blood.

If you’re later on in your pregnancy, screening is done by a blood test called the ‘quadruple test’. This can be done up to 20 weeks of pregnancy.

The results of these tests are used to calculate your chances of having a baby with Down’s or another type of chromosomal problem. Other factors are taken into account too, such as your age.

Diagnostic tests

If there’s a strong likelihood that your baby might have one of these conditions, you’ll be offered further tests to diagnose it.

You can choose to have one of two tests.

  • Chorionic villus sampling (CVS). In this test, your doctor takes a sample of cells from your placenta for testing. This is done during an ultrasound.
  • Amniocentesis. Your doctor takes a sample of the fluid that surrounds your baby (amniotic fluid) for testing. This is also done during an ultrasound.

Both of these tests can cause a miscarriage, so it’s important to understand the risks as well as the benefits of having them. For more information, talk to your midwife or doctor.

Non-invasive prenatal test (NIPT)

If you have a higher chance of having a baby with a chromosomal condition, you may be offered a newer type of screening test. This is called a non-invasive prenatal test, or NIPT for short. NIPT is a simple blood test that looks at DNA from your baby’s placenta that has ‘leaked’ into your circulation. NIPT is gradually being rolled out and may not be available everywhere yet. For the latest information about NIPT and its availability in your area, speak to your midwife.

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Related information

  • Discover other helpful health information websites.

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    • Antenatal care – uncomplicated pregnancy. NICE Clinical Knowledge Summaries., last revised February 2019
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    • Antenatal and postnatal mental health: clinical management and service guidance. National Institute for Health and Care Excellence (NICE)., last updated 11 February 2020
    • Women's digital care record. NHS Digital., last edited 18 August 2020
    • Inducing labour. National Institute for Health and Care Excellence (NICE)., November 2021
    • Torloni MR, Vedmedovska N, Merialdi M, et al. Safety of ultrasonography in pregnancy: WHO systematic review of the literature and meta‐analysis. Ultrasound Obstet Gynecol 2009; 33(5):599–608. doi: 10.1002/uog.6328
    • Screening in pregnancy: dating scan. Public Health England., updated 18 February 2021
    • Obstetric (pregnancy). The British Medical Ultrasound Society., accessed 7 May 2021
    • Screening in pregnancy: CVS and amniocentesis information for parents. Public Health England., updated 28 February 2020
    • Screening for Down’s syndrome, Edwards’ syndrome and Patau’s syndrome: NIPT. Public Health England., published 26 April 2021
    • New operational guidance for NIPT screening within the NHS. PHE screening blog., 26 April 2021
    • Non-Invasive Prenatal Testing (NIPT) for Down's syndrome (also known as cfDNA screening). Antenatal Results and Choices., accessed 7 May 2021
    • Antenatal classes – preparing you for the birth. Tommy's., last reviewed 29 June 2018
    • First trimester worries. Tommy's., last reviewed 28 June 2018
  • Reviewed by Pippa Coulter, Freelance Health Editor, May 2021
    Expert reviewer Dr Samantha Wild, General Practitioner, Bupa UK and Michelle Sheridan, Midwife, Bupa UK
    Next review due May 2024