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Dr Sarah Temple
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A family doctor more than 20 years experience working with children in both General Practice and Mental Health Services. Trained to run Emotion Coaching Parenting Courses. She has a special interest in the link between child and parental wellbeing.
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Pregnancy / Antenatal Care

What antenatal appointments will I have?

Your antenatal appointments can be arranged in your home, at the doctor's surgery, children's health clinic or at the hospital antenatal unit. When you tell your doctor or midwife that you are pregnant, he or she will discuss your options with you. There are usually around ten appointments for your first child, and seven appointments if you've had a baby before. Antenatal appointments will be more frequent if you have a higher risk pregnancy. Even if you feel fine, don't miss any of your appointments since important routine tests and checks will be done.
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In Short

This article gives an overview of what generally happens at antenatal appointments. For example:

5-12 weeks - First appointment - Nutrition advice, overview of potential medical issues.

8-12 weeks - Booking in appointment - Dating scan, blood tests, general check up and advice.

10-14 weeks - Combined screening - Nuchal scan and blood test.

And so on.

What antenatal appointments will I have?
The appointments will generally be as follows:
  • 5-12 weeks – First appointment.
  • 8-12 weeks – Booking in appointment.
  • 10-14 weeks – Combined screening (nuchal scan and blood test).
  • 14-20 weeks – Quadruple test if you were too late for combined test.
  • 16 weeks – Follow-up of blood and urine results from booking in appointment and another urine test to look for protein in your urine.
  • 18-20 weeks – Anomaly scan.
  • 25 weeks – (first pregnancy only) Blood pressure, protein in your urine, bump size, which should be measuring around 25 cm (10 in) at 25 weeks. If the bump is bigger or smaller you may be referred for an extra scan to assess your baby’s growth and the amount of amniotic fluid.
  • 28 weeks – Blood test to assess maternal iron levels and look for antibodies in the blood to Rhesus factor. If you’re rhesus negative, you will be offered an anti-D injection to kill off any antibodies in your blood.
  • 31 weeks – (first pregnancy only) Blood pressure and urine protein test. Your bump measured again, fundal height from pubic bone to top of fundus should be around 31cm (12 in) now.
  • 32­-34 weeks – Repeat scan if 20-week scan showed problems with position of your placenta.
  • 34 weeks – Blood pressure, urine protein and bump checked. Fundal height should now be around 34 cm. If you’re rhesus negative, you may be given a second dose of anti-D to kill off any antibodies in your blood. You can discuss your birth plan with your midwife or obstetrician.
  • 36 weeks – Blood pressure, urine protein and bump checked. Fundal height should now be around 36 cm (14 in). The position of your baby will be checked if in breech position.
  • 38 weeks – Blood pressure, urine protein and bump checked. Fundal height should now be around 38 cm (15 in).
  • 40 weeks – (first pregnancy only) Blood pressure, urine protein and bump checked. Fundal height should now be around 40 cm (16 in).
  • 41 weeks – Blood pressure, urine protein checked. Fundal height be around 41cm (16 ½ in). You may be offered a membrane sweep to help start labour. This is gentler than a fully induced labour.
  • Over 42 weeks – You may need an ultrasound scan to assess the health of your baby. Your baby’s heartbeat will need frequent CCG to check he isn’t in distress and his heartbeats and movements are healthy.

health-problems-in-prenancy

What happens at the first appointment?

You will make this appointment with your GP or midwife as soon as you find out you’re pregnant. You will be given advice on nutrition and exercise during pregnancy, the importance of taking folic acid and vitamin D, as well as not smoking or drinking alcohol. You will be advised about the vaccinations, screening and diagnostic tests available to you.

You need to tell your doctor or midwife if you have any particular medical issues such as diabetes, high blood pressure, a family history of abnormalities or inherited diseases, previous premature births or other birthing difficulties, or a history of pre-eclampsia.

If you need help with English at your appointments, your doctor or midwife will help you get the information and support you need. Similarly, if you have a physical, hearing or sight impairment, let the team know as they can provide additional support if necessary.

What is the booking appointment?

The booking appointment usually happens when you are eight to 12 weeks pregnant and it can take up to 2 hours. You will be given information on baby development, nutrition, exercise, breastfeeding classes, maternity and paternity benefits, and planning your birth. Ask as many questions as you like. You can take your partner or a friend with you.

If you are feeling depressed or anxious, this is really normal, and it’s important to mention it. There are all sorts of things the midwives and doctors can do to support you.

At this appointment, your midwife will enter all your information in your maternity notes. You need to keep these notes with you at home and bring them to every appointment from now on. You also need to take them with you to any additional doctor/ hospital appointments.

If the booking appointment takes place at the hospital you will probably have your first dating scan at the same time. You will have blood tests to check your blood group, haemoglobin levels to assess for signs of anaemia, antibodies to rubella (German measles) and the presence of serious diseases such a syphilis, HIV, hepatitis B. In addition the baby’s father may be asked to have a blood test so that the team can check for inherited conditions such as sickle cell anaemia.

What routine appointments should I expect later in pregnancy?

From around 24 weeks into your pregnancy, your appointments may become more frequent. Your midwife or doctor will feel your tummy to check the baby’s position, he or she will listen to your baby’s heartbeat, measure your uterus to see that everything is growing well, take your blood pressure and check your urine. Findings will be recorded in your notes.

You mustn’t miss these appointments. High blood pressure or raised blood sugars can sometimes indicate conditions that are potentially serious for you and your baby. If you are having obstetrician led care you may need more blood tests taken at subsequent antenatal appointments to keep an eye on your iron levels.

You can help by keeping track of a number of times a day your baby moves or kicks. If the movements suddenly stop or reduce, you need to tell your doctor straightaway.

Remember you can ask questions about anything – your birth plan, your breastfeeding plan, what will happen during labour, screening tests, your energy levels and moods, domestic violence – anything that affects you and your baby. You may find you’ve forgotten some of your questions by the time you get to the clinic, so it’s a good idea to write them down so you have a list ready for your appointment.

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DISCLAIMER
This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Essential Parent has used all reasonable care in compiling the information from leading experts and institutions but makes no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details click here.