Later antenatal check-ups
The amount of appointments you will receive with your midwife may vary slightly, depending on whether this is your first pregnancy, whether you have any complications and what type of midwife care you have opted for.
However, if you are a first time mother, there are recommendations as to how many antenatal checks you will receive. According to guidelines from the NHS’ National Institute of Clinical Excellence, (NICE), a woman who has never given birth before, should probably expect a schedule of ten antenatal appointments, and a woman who has already experienced the process with a previous pregnancy, will probably receive a schedule of seven antenatal appointments, unless they are experiencing complications and will have more checks.
Generally speaking, these appointments will occur at 12, 16, 20, 24, 28, 31, 34, 36, 38, 40 and 41 weeks, although there are bound to be exceptions to this programme: you may have your first antenatal appointment at something more like 9 weeks for example. You should receive a timetable for these at the beginning of your pregnancy and if you wanted to speak to your midwife outside of this time, you should normally have access to her. For more information on midwives, read our features on what can I tell my midwife and how often will I see my midwife? There is often a telephone service associated with the doctor's practice or hospital care you are under.
Early checks include:
8-12 weeks
Lots of women are offered a scan at their first antenatal visit or booking in visit. This scan measures the baby’s size to work out how many weeks pregnant you are. It may also show up if you are expecting twins or multiples.
11-14 weeks
You may be offered a nuchal fold translucency scan, for the early detection of Downs Syndrome. Not all women are offered this scan, although most women over 35 are.
18-20 weeks
All women are offered a scan at this stage in the pregnancy, and it is sometimes referred to as the foetal anomaly scan. The sonographer will be able to get a clear view of your baby’s organs and development, and can pick up on any abnormalities at this stage.
Most women won’t have any more scans after this, but some women are offered a 30 week scan which can help to detect placental problems, growth retardation and the volume of amniotic fluid.
Later antenatal checks:
25 weeks
Around weeks 24-28 most women will be offered a glucose tolerance test as part of their antenatal appointment. This test involves drinking a glucose mixture and then having your blood tested over a period of several hours afterwards. If Gestational Diabetes is suspected before this time, a glucose tolerance test may be given to you as early as 16 weeks, although it is the hormonal changes and therefore hormones made by the placenta to resist insulin, along with the growth demands of your baby in the second and third trimesters which can cause a woman's insulin levels to become unbalanced.
From 24 weeks onwards you will be offered an antenatal check every month until 34 weeks where depending on your pregnancy you may be offered an antenatal test every two weeks. Once you get to the end of your pregnancy you will be offered a check every week, just to check on how you and your baby are doing.
These visits are great opportunities for you to ask any questions you might have and to find out new information on your baby’s progress. It is a good idea to keep a small notepad that you can jot down questions in, so that you don’t forget what you want to ask at your check-up. Lots of questions can arise over a month long period.
What happens at each antenatal test?
Blood pressure
At each antenatal test your blood pressure will be taken, to test for conditions such as pre-eclampsia. Pregnant women's blood pressure should be slightly lower than before or after pregnancy, but if it is above 140/90 there may be a reason to worry. If your blood pressure is high, it can be controlled by blood pressure tablets and regular antenatal checks.
Urine
Most clinics will require you to give a urine sample at every antenatal visit. Your urine is tested for a number of things, but most importantly, for your sugar levels as an indication of gestational diabetes, protein levels for hypertension and ketones to see how your kidneys are coping with pregnancy.
Blood tests
Blood tests will be carried out a few times during your pregnancy, but typically they will happen at your first visit, around 15 weeks, 24-26 weeks (during your glucose test) and at 34 weeks. The blood test tests for conditions such as HIV, Syphillis, Hepatitis B, Sicle Cell anaemia and anaemia. The early blood test at around 15 weeks is designed to test for conditions such as Downs Syndrome and Spina Bifida.
Physical examination
Depending on your antenatal clinic you may or may not have a physical examination at the start of your pregnancy. More then likely you will be weighed and your height will be measured. In your booking-in visit you will be asked about your family history and your general health.
Internal examination
You will probably not need an internal examination unless it is deemed necessary.
Your baby's heartbeat
After about week 14 you should be able to hear your baby's heartbeat at every check-up. The midwife will listen to it with a doppler; is a long device which measures your baby's heartbeat through your abdomen. Sometimes if your baby is a wriggler, it can be hard to locate the heartbeat, but don't worry, even if it takes time they'll find it!
Palpation
Palpation basically describes when a midwife or doctor feels your abdomen to discover how your baby is lying in the womb, the size of your belly and also if the baby has engaged in the last stages of pregnancy.
Lots of women opt for shared care, which is when your midwife and your local GP share your antenatal care. This can be beneficial in the later stages of pregnancy when you are getting big, if your GP is close to home.
You should always tell your midwife or doctor about any concerns you may have, from swelling ankles, varicose veins to piles or feeling uncomfortable.
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Mothercare
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