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Key takeaways

• Antenatal care keeps you and your baby well during pregnancy.
• Regular appointments monitor your health and your baby's growth.
• It helps to spot and manage potential problems early.
• You receive important health and lifestyle advice.

What is antenatal care and why it's essential

Antenatal care is the healthcare and support you receive from your maternity team while you are pregnant. This care involves monitoring your health, your baby’s health, and preparation for becoming a parent. They hope to help you and your baby to be as healthy as possible.

Your midwife or doctor will check your health and your baby's health. They will also give you useful information for a healthy pregnancy. This includes advice about healthy eating and exercise.

Healthcare professionals will offer support where necessary for physical, mental and social well being. They will discuss your options for care during pregnancy, labour, and birth. You can ask any questions you may have.

Contacting your GP or maternity service as soon as you know you are pregnant is important. Attending all your appointments provides support and advice. It also includes regular checks to see if you and your baby are well.

What to expect at your antenatal appointments

Your antenatal appointments will include various checks and screenings. Some tests, like screening for sickle cell and thalassaemia, should ideally be done before you are 10 weeks pregnant.

Your midwife or doctor will give you your handheld / electronic notes and plan of care. They will also identify any potential risks related to your work. Your care plan may change as your pregnancy develops depending on your circumstance.

Initial checks and screenings

Your booking appointment should ideally be before 10 weeks. It often takes around 1 hour. At this appointment, your midwife will:

• Ask information about your menstrual cycle and when you estimate your last period to have been.
• Measure your height and weight – this helps work out a measure of your weight in relation to your height (your body mass index, or BMI).
• Measure your blood pressure – this will be checked at every midwife appointment.
• Test your urine – this will also be checked at every midwife appointment.
• Ask you questions on your medical history, family history and the baby’s father. They will understand if you do not know the answer to all of the questions.
• Discuss your culture and lifestyle
• Find out if you are at increased risk of high blood sugar during pregnancy (gestational diabetes) or a condition that causes high blood pressure (pre-eclampsia).
• Ask about your mood and how you are feeling about being pregnant– this helps assess your mental health.
• Ask about any past or present severe mental illness or psychiatric treatment.

Every pregnant person is asked the same questions at the beginning of any pregnancy.

You will be offered screening tests. Your midwife will make sure you understand what is involved before you decide to have any of them.

Blood tests

Several blood tests are offered early in pregnancy:

• Infectious diseases – screening for HIV, hepatitis B, and syphilis.
• Inherited conditions – screening for sickle cell and thalassaemia. These are offered to specific populations, and you can also request them.
• Blood group and rhesus status – this identifies your blood type.
• Checking for low iron levels – A blood test to check for a condition caused by low iron levels (anaemia). ‘Iron’ in your blood may also be described as haemoglobin and ferritin levels. This test is routinely offered again around 28 weeks.
• Carbon monoxide test – this may be done at your booking appointment and again at 36 weeks. Sometimes more often if you are a smoker.

These tests give you and the health professionals information on your health, to help plan your pregnancy care. Further tests are sometimes offered depending on your well-being and medical history.

A test to check for high blood sugar (an oral glucose tolerance test, or OGTT) is offered at your first appointment if you had it in a previous pregnancy. This involves having a sugary drink followed by blood tests. It is also offered between 24 and 28 weeks if risk factors are present.

Ultrasound scans

You will be offered two routine pregnancy ultrasound scans:

• Dating scan – offered at 11 to 14 weeks. This estimates your baby's due date, checks their physical development, and can also screen for conditions such as Down syndrome.
• Development (anomaly) scan – offered at 18 to 21 weeks. This checks your baby's physical development and looks for 11 rare conditions.

If you choose screening for genetic conditions, blood tests are taken around the time of your dating scan. These screen for Down syndrome, Edwards syndrome, and Patau's syndrome.

Later pregnancy appointments

From around 24 weeks, your antenatal appointments usually become more frequent. Later visits are often short and last 20 to 30 minutes. Your midwife or doctor will:

• Check your urine - looking for signs of infection, gestational diabetes and and pre-eclampsia
• Measure your blood pressure.
• Feel your tummy (abdomen) to check the baby's position.
• Measure your womb (uterus) to check your baby's growth.
• Listen to your baby's heartbeat, if you want them to.
• Checking in on your mental health
• Offering advice and support with home life and social circumstances

You should keep track of your baby's movements. If you have not felt any movement by 24 weeks, contact your midwife.

If baby's movements may become less frequent, slow down, or stop after 24 weeks, it is important to contact your midwife or doctor immediately. Maternity services are available 24 hours per day in all maternity hospitals.

Key benefits for your health

Regular antenatal care helps to monitor your health throughout pregnancy. Your midwife or doctor will check for any concerns, in the hope that early support can be provided.

Managing health conditions

Going to all your antenatal appointments is the best way to protect your health. Your pregnancy team can help with any problems you might face. They can also take steps to prevent or manage them.

Some pregnancy conditions are unavoidable. However, help can be available to treat and manage many pregnancy conditions. Attending your antenatal appointments is an important opportunity to pick up earlier signs and symptoms.

Some individuals may have pre-existing health conditions which may or may not impact on a pregnancy. It is important to disclose any known previous or current medical condition at your first midwife appointment.

Guidance and information

Your midwife or doctor should give you information about:

• How your baby develops during pregnancy.
• Nutrition and diet – it is important to eat a healthy, balanced diet. There are also some things that you must avoid.
• Exercise and pelvic floor exercises – you should do some physical activity every day.
• Antenatal screening tests.
• Your antenatal care plan.
• Infant nutrition and breastfeeding.
• Antenatal education.
• Maternity benefits.
• Your options for where to have your baby.

If your BMI is 30 or over, you are at higher risk of gestational diabetes and other pregnancy and birth complications. Dieting is not recommended whilst you are pregnant, but a healthy diet and regular exercise is. You may also be offered a referral to a dietitian or other health professional for specialised advice.

Promoting a healthy start for your baby

Antenatal care is important for your baby's health and development. Part of your midwife's job is to provide you with information so you can make choices to meet the needs of you and your baby.

Monitoring growth and development

Regular antenatal appointments monitor how your baby is growing after 24 weeks. Growth is checked by measuring your bump from the top of your womb to your pubic bone (this measurement is called the fundal height). These measurements are done by your midwife and recorded on a chart in your pregnancy notes.

You might also be offered an ultrasound scan as part of your pregnancy care plan. Additional growth scans may be indicated for some medical conditions or if you have an increased pregnancy risk factors.

In the later months of pregnancy, your midwife will continue to check how your baby is growing using the fundal height measurements. These checks are more frequent as the pregnancy continues.

If your midwife has any concerns, they will arrange for an ultrasound scan to check your baby's health and growth. You may also be offered an appointment with a specialist midwife or doctor.

Early detection and intervention

Antenatal care helps to pick up any issues or concerns early. This gives the maternity team a chance to identify any risks you and your baby may have.

Regularly meeting with your midwife, healthcare worker or medical team, provides opportunity to check the health of your and your baby. It is a safe space to ask questions and to get information to help you make informed decisions throughout your pregnancy.

Screening tests and scans can provide you and your healthcare professionals with information, to help plan your care safely. They can also help you receive treatment quickly if it is needed. This assists you to get the right care at the right time.

If any issues or health conditions are found, this will be discussed with you. You will be supported to make choices that feel right for you and your baby.