Antenatal Care

Your first appointment should happen before you are 10 weeks pregnant and it will last around an hour and a half. If you are more than 10 weeks pregnant and have not seen a GP or Midwife, contact one as soon as possible.

This is the first appointment where you will have the opportunity to meet your midwife. At the initial appointment the midwife will explain the pattern of care for the pregnancy using the pregnancy planner for timing of midwifery appointments.

They will ask questions about your medical, social and obstetric history to determine the right care pathway for you and your pregnancy. Your height, weight, blood pressure and carbon monoxide level (CO) will be measured. Your urine will be tested, and a sample sent to the lab.

The midwife will offer blood tests to determine your blood group and Rhesus D status. These blood tests can also screen for anaemia, haemoglobinopathies, red-cell antibodies, hepatitis B virus, HIV, and syphilis in line with National Screening Guidance.

• Birth place decisions: information on where to have your baby
• Screening testing for you and your baby

Your dating scan is usually held between 11 – 14 weeks into your pregnancy and for most women this is the first scan they have to give them a more accurate due date. You will also be offered combined screening if you would like to test for Down’s, Edward’s and Patau’s syndrome.

• Early pregnancy scan leaflet
• Screening testing for you and your baby
• Down’s, Edward’s and Patau’s syndrome screening

During this 30-minute appointment, your midwife will check your blood pressure, test your urine, perform CO measurement for all smokers or for those who have a previous CO level less than or equal to 4ppm. Your blood and screening results will be reviewed and recorded in your notes.

Your midwife will discuss the onset of baby’s movements. If you are under the consultant, then the midwife will check your appointment has been booked. If you have had a previous caesarean section, your birth options will be discussed, and a leaflet provided. You will also have the opportunity to discuss any issues and ask questions.

• Blood groups and red cell antibodies in pregnancy
• Your baby’s movements during pregnancy leaflet
• Birth options after a previous caesarean section

This appointment should happen between 18 – 21 weeks. An ultrasound scan will be performed to detect structural anomalies.

• Fetal anomaly screening
• Anomaly scan information

This appointment will last approximately 30 minutes. Your midwife will check your blood pressure, test your urine, perform CO measurement for all smokers or for those who have a previous CO level less than or equal to 4ppm.

Your baby’s movements will be discussed, and you will have the opportunity to discuss any issues and ask questions. If you need one, you will be given a MatB1 form for maternity leave.

If you have risk factors, you will be offered a glucose tolerance test to check for diabetes in pregnancy.

• Gestational diabetes mellitus
• Gestational diabetes at MKUH

During your 30-minute appointment, your midwife will check your blood pressure, test your urine, perform CO measurement for all smokers or for those who have a previous CO level less than or equal to 4ppm.

If you are having serial scans, then your midwife will check this has been booked. If not, the midwife will measure your abdomen and document this on your customised GROW chart. Pelvic floor exercises will be discussed, and leaflets provided.

Your midwife will offer a blood test to recheck your iron levels and blood group. If you are rhesus D-negative your midwife will give you anti-D tablets. Your baby’s movements will be discussed, and you will have the opportunity to discuss any issues and ask questions. You will be offered the opportunity to attend antenatal classes.

• Blood groups and red cell antibodies in pregnancy
• Protecting women and babies with anti-D Immunoglobulin

During your 30-minute appointment, your midwife will check your blood pressure, test your urine, perform CO measurement for all smokers or for those who have a previous CO level less than or equal to 4ppm.

If you are having serial scans, then your midwife will check this has been booked. If not, the midwife will measure your abdomen and document this on your customised GROW chart. Your blood and screening results from your last appointment will be reviewed with you and recorded in your notes.

Your baby’s movements will be discussed, and you will have the opportunity to discuss any issues and ask questions. You will be given an information pack regarding birth preferences.

• Monitoring your baby’s heartbeat in labour
• Epidural – your choice
• Assisted vaginal birth – ventouse or forceps
• Use of water in labour and birth
• Vitamin K for newborn babies
• Postnatal community care
• Perineal care
• Newborn feeding
• Screening testing for you and your baby

This appointment will last about an hour. Your midwife will check your blood pressure, test your urine, perform CO measurement for all smokers or for those who have a previous CO level less than or equal to 4ppm.

If you are not having serial scans, your midwife will measure your abdomen and document this on your customised GROW chart. If your iron levels were low at 28 weeks, your midwife will offer a blood test to recheck them, and you will be offered nasal screening for MRSA.

Your birth preferences will be discussed with your midwife and recorded in your notes. Your baby’s movements will be discussed, and you will have the opportunity to discuss any issues and ask questions.

This appointment will last about 30 minutes. Your midwife will check your blood pressure, test your urine, perform CO measurement.

If you are not having serial scans, your midwife will measure your abdomen and document this on your customised GROW chart.

The midwife will also check the position of your baby to make sure they are head down. If you had your iron level rechecked at your last appointment, this will be reviewed with you and recorded in your notes. Your baby’s movements will be discussed, and you will have the opportunity to discuss any issues and ask questions.

• Baby is breech – what are your choices

This appointment will last about 30 minutes. Your midwife will check your blood pressure, test your urine, perform CO measurement for all smokers or for those who have a previous CO level less than or equal to 4ppm. If you are not having serial scans, your midwife will measure your abdomen and document this on your customised GROW chart.

The midwife will also check the position of your baby to make sure they are head down. Your baby’s movements will be discussed, and you will have the opportunity to discuss any issues and ask questions.

This appointment will last about 30 minutes. Your midwife will check your blood pressure, test your urine, perform CO measurement for all smokers or for those who have a previous CO level less than or equal to 4ppm. If you are not having serial scans, your midwife will measure your abdomen and document this on your customised GROW chart.

The midwife will also check the position of your baby. Your midwife will discuss and offer a membrane sweep and induction of labour with you. Your baby’s movements will be discussed, and you will have the opportunity to discuss any issues and ask questions.

• Outpatient induction of labour
• Induction of labour

This appointment will last about 30 minutes. Your midwife will check your blood pressure, test your urine, perform CO measurement for all smokers or for those who have a previous CO level less than or equal to 4ppm. If you are not having serial scans, your midwife will measure your abdomen and document this on your customised GROW chart.

The midwife will also check the position of your baby. Your midwife will discuss and offer a membrane sweep and induction of labour with you, booking your induction if appropriate. Your baby’s movements will be discussed, and you will have the opportunity to discuss any issues and ask questions.

• Outpatient induction of labour
• Induction of labour