Routine Antenatal Appointments
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Rest assured that during your pregnancy, you will have regular appointments with the medical team caring for you. NHS protocols lay down a calendar of appointments that every pregnant woman must be offered, prescribing the tests and checks that must be done at each one. There is also a clear and detailed list of issues that midwives and other health professionals are obliged to discuss with you to ensure that you are fully informed as to how best to care for yourself and your baby during the pregnancy.
Who will care for you?
You may choose to confirm your pregnancy with your GP. After this, and providing your pregnancy is without complication, you will primarily meet with your midwife. If issues do arise, then you are most likely to be referred to an Obstetric Consultant who is hospital based, at which point your care may (or may not) become what is known as 'Consultant led'. There is a general principle within the NHS that pregnant women should be cared for by a small group of professionals who provide continuity of care.
The vast majority of women are already at least four weeks into the first trimester before discovering for certain that they are pregnant. Your first appointment with the midwife, commonly called your booking appointment, will happen between your eighth and twelfth week. This will be a lengthy and detailed look at a range of issues, from nutrition to antenatal education, maternity benefits to screening tests, and much more besides. If not already known to your GP, then the midwife will also discuss family medical history, and previous pregnancy complications, if relevant. Also at around twelve weeks you will have your dating scan, usually at your local hospital, where an ultrasound scan will determine the due date of your baby, and check your baby's physical development. Increasingly, nuchal fold tests (that determine the likelihood of your baby having Down's syndrome and a number of other genetic disorders) are being performed at the point of your dating scan, as the test is at its most reliable between weeks 11 and 13.
At the sixteen week point, you will meet with your midwife again for a general check on your progress and to give you information about the anomaly scan, which is performed at around 18-20 weeks. This scan will tell you the sex of your baby (if you want to know!) and also look at your baby's development in a more detailed way than has previously been possible.
Your baby's arrival is edging ever closer, and, particularly if this is your first baby, you will start to see you midwife with greater frequency; the NHS protocol prescribes meetings at 25, 28, 31, 34, 36, 38 and 40 weeks. A small number of regular tests, such as your urine and your blood pressure will be carried out at each meeting. You will also have a chance to talk about a range of wider issues, including caring for your baby and postnatal depression.
Over 41 weeks
Your midwife will meet again with you at this point if your baby is overdue, to confirm the arrangements for induction of labour, and to offer a sweep of your membranes. Most NHS Trusts do not allow women to go past the 42 week point without attempting to induce labour through the use of drugs.
Tests, tests and more tests...
Saying 'yes' or 'no' to the range of tests you are offered is a personal choice. However, all of them are carried out to afford you and your baby the power of knowledge, and to keep you both well throughout the pregnancy. So what is routinely tested or checked during pregnancy, and why?
- Your weight and height. Your BMI is calculated to ensure that your weight gain is progressing normally.
- Urine. This is tested for protein which is linked to gestational diabetes and pre-eclampsia.
- Blood pressure. Hypertension can become a problem in later pregnancy.
- Blood group and other tests. It is important to establish whether you are Rhesus negative, as this can cause Rhesus disease. Other blood tests check for a variety of inherited diseases, and the presence of anaemia.
- Tests for infections, such as STDs and your susceptibility to rubella are important, as they pose significant threats to you and your baby if left untreated.