How do I access antenatal care?
Once you know you’re pregnant, calling your GP or midwife is the first step. They’ll book you in for your first appointment with a midwife – known as your ‘booking appointment’.
If you want to see a private midwife, you can look for one on the Independent Midwives website.
If you’re expected to have a pregnancy without any major problems, a midwife will usually look after your antenatal care. A GP can provide medical support if required.
If your pregnancy is high risk, your care is provided by an obstetrician. An obstetrician is a doctor who specialises in pregnancy and childbirth. Some people choose to have full obstetrician care even without their pregnancy being high risk.
Your antenatal appointments may be at a hospital maternity unit, your GP surgery, a local community centre, or at home. If you’re having full obstetrician care, all of your appointments will be at the maternity unit.
Before your first appointment, you should be given some initial information and advice. 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.
- Your diet and reducing risk of food-acquired infections.
- Antenatal screening – what tests you’ll be offered during pregnancy.
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.
What happens in antenatal appointments?
First appointment (booking appointment)
The booking appointment can take around an hour. Your midwife will ask you questions about your medical and family history, your lifestyle, and about your mental health and wellbeing.
They will also go through some information with you at this appointment. This will include the following.
- Taking supplements. You’ll need to take 10 micrograms (10µg) of vitamin D per day throughout your pregnancy. Vitamin D helps keep your bones strong. This is in addition to folic acid. Many pregnancy supplements combine vitamin D and folic acid into one pill. You should get written information on this that you can take away.
- How your baby develops during pregnancy.
- 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, including:
- measuring your height and weight to check your body mass index (BMI)
- taking a urine sample and your blood pressure. This is to check for infections and pre-eclampsia (high blood pressure in pregnancy)
- blood tests to check for blood disorders, sexually transmitted infections (STIs), and your blood group. Blood tests also check if you’re rhesus negative
You should be able to get your maternity notes to look after. This can be in a paper book or there may be an option to keep digital notes. These contain all the information about your health and care, and your pregnancy to date.
You need to take your notes to every appointment and everywhere with you. This is because they hold important information about your pregnancy. If you have to see a GP or go to hospital, the notes will give them the all the details of your pregnancy.
Routine antenatal checks
After your booking appointment, you’ll have regular midwife appointments. 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 25 weeks, using a tape measure. You will be offered vaccinations during pregnancy for whooping cough, Covid and flu.
Antenatal appointments in later pregnancy
At your 36-week appointment, your midwife will check your baby’s position. If your baby is in the bottom downwards position (breech), you might be offered 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 get information about the risks of your pregnancy lasting longer than 42 weeks. Your midwife will explain what options are available to you. One option is a membrane sweep.
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, you'll have the option to induce your labour artificially with drugs. You'll need to have this done in hospital so you and your baby can be monitored.
What is an antenatal scan?
Ultrasound scans are safe for you and your baby. In general you’ll be offered two ultrasound scans during your pregnancy. The first scan between 11 and 14 weeks is a dating scan. The dating scan checks:
- your baby’s heartbeat
- how far along you are in your pregnancy
- if you’re having more than one baby
You also have the option for screening at the dating scan. This checks your baby’s chance of having Down's syndrome, Edwards’ syndrome, and Patau’s syndrome, if you wish to know.
Your second scan will be between 18 and 21 weeks. This is a foetal anomaly scan. This scan helps your doctor to locate your placenta and checks for conditions that might affect your baby. If anything is found, your doctor will discuss this further with you. It is your choice if you want to be screened.
You might need more ultrasound scans if there’s any problems with how your baby is developing.
What is antenatal screening?
Antenatal screening checks if your baby is at risk of having a certain health condition. You can have screening when you go for your ultrasound scan. See the above section for more detail. The scans don’t confirm that your baby will have a condition. But you can get a diagnosis.
You can choose to have one of two tests below for a diagnosis.
- 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 tests carry risk of causing miscarriage. For more information about benefits and risks, talk to your midwife or doctor.
If you have a higher chance of having a baby with a chromosomal condition, you may be offered a test called non-invasive prenatal test (NIPT for short). NIPT is a simple blood test that looks at DNA from your baby’s placenta that has ‘leaked’ into your blood. This can give a more accurate result.
The importance of antenatal care is to help you have a healthy pregnancy. Your antenatal appointments can also help to pick up any problems early on.