Antenatal Appointments & Care

Your midwifery care starts when you are about eight weeks pregnant. Please let your local midwifery team know of your pregnancy as early as possible by requesting your antenatal first booking appointment. Your midwife can then plan your pattern of care with you, based on national guidelines and your personal needs.

Please remember to:

  • come to your appointments on time, and cancel them if you cannot attend

  • bring your “yellow book” (maternity notes)

  • bring a urine sample.

You may need a Maternity Certificate (Mat B1) to claim Statutory Maternity Pay (SMP) or other benefits. A midwife will issue this at your scheduled antenatal appointment when you are over 21 weeks of pregnancy. For more on information on Mat B1 visit www.gov.uk/employers-maternity-pay-leave

Your GP

If you have a medical problem that is unrelated to pregnancy you will need to see your GP. Midwives are unable to prescribe medications.

Preparation for birth and feeding also known as Antenatal Classes

Your community midwifery team will offer you sessions locally, where you can meet other new parents and gather information.

Booking appointment (ideally at 8-10 weeks and by 12 weeks pregnant)

  • Maternity / pregnancy health assessment and care planning
  • Blood tests offered (blood group & Rhesus D status, anaemia, Sickle Cell & Thalassaemia (haemoglobinopathies)HBO’s, red cell antibodies, Hepatitis B, HIV, and Ssyphilis
  • Discuss screening for Down’s, Edwards & Pataus Syndrome
  • Offer early dating ultrasound scan USS for gestational age assessment and screening for structural anomalies
  • BMI calculation
  • Blood pressure & urine analysis, including screening for asymptomatic bacteriuria
  • Mental health & wellbeing discussed
  • Information given on breastfeeding, antenatal classes, benefits, exercise, nutrition & diet, pre- eclampsia and fetal movements.

First Trimester Combined Screening (FTCS)

This FTCS test is offered to all pregnant women to assess the chance of their baby being born with:

  • Down’s syndrome (Trisomy 21)
  • Edwards’ syndrome (Trisomy 18)
  • Patau’s syndrome (Trisomy 13).

Women can choose:

  • Not to have screening
  • To have screening for Down’s, Edwards’ and Patau’s syndrome
  • To have screening for Down’s syndrome only
  • To have screening for Edwards’ & Patau’s syndrome only.

This screening test can only be undertaken between 11 weeks and two days (11+2) and 14 weeks and one day (14+1) of gestation. This screening test includes a blood test and an ultrasound scan. At the scan your pregnancy will be dated by measuring the length of baby and also measuring the fluid on the back of your baby’s neck. Occasionally, the FTCS test may not be able to be performed. If this is the case the healthcare professional undertaking the scan will inform you of the reason(s) for this and you will be offered a Quadruple test in the second trimester for Down’s syndrome screening with your community midwife.

For more information on Down's syndrome visit www.positiveaboutdownsyndrome.co.uk

The Quadruple test does not screen for Edwards & Patau’s syndrome. Screening for Edwards’ & Patau’s syndrome in the second trimester is the 18-20+6 week anomaly scan.

Dating Scan – this ultrasound scan is undertaken after 10 weeks of pregnancy to accurately date the pregnancy and is offered when women choose not to have Down’s, Edwards’ and Patau’s syndrome screening (FTCS).

You will need to bring money if you wish to purchase scan photographs. These are £4* per photo (*subject to change). Payment can be made by cash or card.

For more information on FTCS download Microsoft Office document iconAntenatal Information Sheet.doc

14 weeks - 16 weeks pregnant

  • Review, discuss and record results of screening tests
  • Blood pressure & urinalysis
  • Investigate haemoglobin levels below 11g/ml and consider iron supplementation
  • For rhesus D-negative women, a free fetal DNA blood test offered, if results are negative anti-D prophylaxis is not required, if positive anti-D prophylaxis is offered.
  • Offer second trimester down’s screening blood test only, if required. Optimum time is between 15-16 weeks but can be taken up to 20+0

18 weeks - 20+6 weeks pregnant anomaly scan

The Anomaly Scan usually takes place between 18 and 20+6 weeks of pregnancy to check baby’s development. In most cases the scan will show that your baby appears to be developing as expected but if any problems are found/suspected you will be referred to Fetal Medicine.

A second attempt to perform this scan, if needed, is offered before your 23rd week of pregnancy.

You may be able to find out your baby's gender at this scan but this is not the purpose of this screening test.

You will need to bring money if you wish to purchase scan photographs. These are £4* per photo (*subject to change). Payment can be made by cash or card.

25 weeks pregnant

  • Symphysis Fundal Height (SFH) measured in centimetres and discussion about fetal movement
  • Screening test results reviewed, discussed and recorded
  • Blood pressure & urinalysis.

28 weeks pregnant

  • Second screening for anaemia and atypical red cell antibodies offered
  • Anti-D prophylaxis to women who are rhesus D-negative offered
  • Symphysis Fundal Height (SFH) measured in centimetres

31 weeks pregnant

  • Blood pressure & urine analysis
  • Symphysis Fundal Height (SFH) measured in centimetres and discussion about fetal movement
  • Review, discuss and record results of all blood testsundertaken at 28 weeks gestation

34 weeks pregnant

  • For multiparous women (second and subsequent babies): review, discuss and record results of all blood tests undertaken at 28 weeks gestation.
  • Breastfeeding information provided www.unicef.org.uk/babyfriendly
  • Information provided on preparation for labour & birth, recognising active labour and coping with pain
  • Blood pressure & urinalysis
  • Symphysis Fundal Height (SFH) measured in centimetres and discussion about fetal movement.

36 weeks pregnant

  • Presentation of baby checked. If breech position, you may be referred to hospital for a scan
  • Symphysis Fundal Height (SFH) measured in centimetres
  • Maternal weight and BMI checked
  • Information given on care of new baby, vitamin K prophylaxis, newborn blood spot and newborn screening tests
  • Blood pressure & urinalysis.

38 weeks pregnant

  • Symphysis Fundal Height (SFH) measured in centimetres and discussion about fetal movement
  • Information given (verbal and written) on options for management of care in late pregnancy and prolonged pregnancy
  • Blood pressure & urinalysis
  • Information on Induction of Labour.

40 weeks pregnant

  • Symphysis Fundal Height (SFH) measured in centimetres and discussion about fetal movement
  • Further discussion on management of prolonged pregnancy
  • Membrane sweep offered (stretch and sweep)
  • Blood pressure & urinalysis.

41 weeks pregnant

  • Symphysis Fundal Height (SFH) measured in centimetres and discussion about fetal movement
  • Membrane sweep offered
  • Induction of labour (IOL) reviewed.

For more information

For more information visit www.nhs.uk/conditions/pregnancy-and-baby