Your pregnancy health care

When you first learn that you are pregnant, it is important to let your GP or local hospital know as soon as possible. This will allow all of your pregnancy care, or “antenatal care” to be organised. You will receive a “booking appointment” for when you are approximately 8-12 weeks pregnant. This will be the first occasion you meet your midwife.

Midwives have undergone specialist training in looking after mums-to-be and the delivery of babies. Throughout your pregnancy, midwives will provide regular checks that both you and your baby are well. These may occur at home, at your GP surgery, in a children’s centre or in hospital. In order to ensure safe pregnancy care and delivery of healthy babies, your midwife will ask you many questions regarding your own health, your partner and family’s health and any other issues that may relate to your pregnancy. Midwives work closely with other health professionals including doctors to provide the best level of care to mums.

The Booking Appointment

The first appointment, or “booking appointment”, with the midwife will be a longer appointment, usually lasting 1-2 hours. The midwife will ask you many questions regarding your own health and any previous pregnancy issues. This will be the opportunity to let your midwife know if:

• you have any existing medical conditions that you may have received treatment for, or are still taking medication for e.g. high blood pressure
• you have had any previous pregnancies and any complications in pregnancy, e.g. significant bleeding, pre-eclampsia, large (>4kg) or small (<2.5kg) babies, etc.
• any of your family members are affected by conditions such as diabetes or genetic conditions such as haemophilia or cystic fibrosis
• your partner has any medical conditions that may be relevant to the baby
• you have had any fertility treatment to get pregnant

You will also be asked about potentially sensitive issues including domestic abuse, drug and alcohol use, social and housing situations, mental health issues and female genital mutilation. As health care professionals it is our job to give women the opportunity to talk confidentially. This allows those at risk to receive the extra support needed during their pregnancy journey. All of the information provided in the booking appointment is strictly confidential.

The aim of gathering so much information is to get an idea of you and your pregnancy. This will help to decide how many appointments you are likely to need, whether you will need additional scans to assess your baby’s growth and whether you will need the involvement of your obstetrician (doctors who look after mums to be) or your paediatrician (doctors who look after babies). This also helps to plan your labour and where it will be most appropriate to deliver your baby.

You will be offered information about:

• nutrition, diet and exercise
• antenatal screening tests available e.g. infectious diseases, risk of Down’s syndrome etc., and the benefits and limits of these tests so you can make an informed decision whether to have them or not
• antenatal classes
• maternity benefits
• options for where to deliver your baby

Antenatal care

During your pregnancy you will be offered a series of appointments with midwives. These are a lot shorter than the booking appointment, usually only 10-15 minutes. There will be around eight to ten appointments if this is your first baby or five to seven if you are already a mum. You may also meet an obstetric doctor if you already have a medical condition or any complications arise in your pregnancy.

You will also have two scans: the “dating scan” – between 8-14 weeks, to estimate when the baby is due – and an “anomaly scan” – at 18-20 weeks, to check for any physical abnormalities in the baby and to assess the location of the placenta (which supplies blood from you to the baby via the umbilical cord). You may require further scans, e.g. if you have twins or any medical conditions e.g. diabetes.

At every appointment your midwife or doctor will assess:

• your blood pressure and urine (this is to look for a pregnancy condition called pre-eclampsia and urine infections)
• the growth of your baby by measuring your bump
• your physical and mental well-being during pregnancy
• your baby’s heart beat if you request

At around 34-36 weeks you will be given further information about labour and birth itself, including caesarean section. At this stage you should start to develop a birth plan with the help of your midwife. This should include location of delivery, ways of coping with labour pain and vitamin K for babies (given to prevent bleeding in newborns). You will also be given information about what to do if your baby is overdue.

The antenatal appointments are also the ideal opportunity for you to ask any questions relating to your pregnancy or to discuss any worries you have. It is often useful to write these down so every question can be addressed. You may want to bring your partner to the appointments in case they have any concerns or questions.

Main Points

• It is important to inform your GP or hospital of your pregnancy at the earliest opportunity.
• You will first meet your midwife during your 8-12 week pregnancy “booking appointment”.
• The booking appointment will last around 1-2 hours.
• Your midwife is there to be your regular point of contact.
• During the booking appointment you will be asked about your pregnancy and health history as well as for details of any relevant family medical history.
• You will be asked about potentially sensitive issues including domestic abuse, drug and alcohol use, social and housing situations, mental health issues and female genital mutilation.
• All of the information provided in the booking appointment is strictly confidential.
• You will be offered information about antenatal screening, antenatal classes, maternity benefits and your delivery options.
• You will have around 8-10 antenatal appointments during your pregnancy (5-7 if you are already a mother).
• Antenatal appointments are an opportunity to get both your health and that of your baby checked out. Feel free to ask any questions you may have.
• You will have a dating scan at 8-14 weeks and an “anomaly scan” at 18-20 weeks.
• You will receive specific information about labour and birth at around 34-36 weeks, including what to do if your baby does not arrive by your EDD (estimated date of delivery)