As an expectant mother you will be offered a series of antenatal appointments during your pregnancy. These will be with a midwife, or sometimes with a doctor (an obstetrician). They will check that you and your baby are well, give you useful information about being pregnant and what to expect as well as answering any questions you may have.
Your antenatal appointments may take place at your home, in a Children’s Centre, in your GP’s surgery or in a hospital. They should always be in a setting where you feel able to discuss any issues or sensitive problems that may affect you, such as domestic violence, sexual abuse, mental illness or recreational drug use.
If you are expecting your first child, you are likely to have up to 10 antenatal appointments. If you have had a baby before, you should have around seven appointments. In certain circumstances, for example if you have or develop a medical condition, you may have more appointments.
Early in pregnancy your midwife or doctor will give you some information on the number of appointments you are likely to have, when they will happen and what they will involve. You should have your first antenatal check-up at 8-10 weeks of pregnancy and your booking appointment, where your handheld notes are completed, by 12 weeks of pregnancy.
Regular checks
Your urine and blood pressure will be checked at every antenatal appointment. Your urine is checked for a number of things, including protein, which can be a sign of infection and, in some cases, pre-eclampsia. A rise in blood pressure later in pregnancy can also be a sign of pre-eclampsia.
Blood tests
As part of your antenatal care, you will be offered a number of blood tests. Some are offered to all women and some are only offered if it is thought that you are at risk of a particular infection or inherited condition. You may be offered blood tests to check for:
- your blood group and rhesus factor,
- anaemia,
- immunity to rubella (German measles),
- syphilis
- hepatitis B
- hepatitis C, and
- HIV.
All of the tests offered are to help make your pregnancy safer or to check that your baby is healthy. Your midwife or doctor should give you information about the tests you are offered. Make sure that you understand why the blood tests are being offered so that you can make an informed choice about whether or not you want them.
Antenatal screening
Antenatal screening is a way of assessing whether your unborn baby could develop or has developed an abnormality or other condition during pregnancy.
You will be offered screening tests that can detect structural abnormalities like spina bifida, which is a defect in the development of the spine, or some chromosomal disorders like Down’s syndrome, which is caused by an abnormal number of chromosomes. Different maternity services may use different tests but screening usually involves a combination of ultrasound scans and blood tests.
If after screening tests the risk of problems is found to be high, you may be offered pre-natal diagnosis. These are tests to find out the likelihood that your baby will be born with the suspected condition.
Screening tests can:
- reassure you that your baby has no detected structural abnormalities,
- provide you with an opportunity to see your baby during the scan,
- give you time to prepare for the arrival of a baby with special needs,
- allow you to consider the termination of an affected baby.
Tests can also provide valuable information for your care during the pregnancy. However, no test can guarantee that your baby will be born without an abnormality. No test is 100% accurate and some abnormalities may remain undetected.