During your pregnancy, you will be offered a number of medical tests and appointments that aim to ensure the health and wellbeing of both you and your baby. Making informed choices about these tests is essential for a healthy pregnancy journey. This article provides an overview of the key checks and appointments for a typical low-risk pregnancy and additional information for high-risk pregnancies.
Confirming pregnancy
One of the first antenatal checks involves confirming the pregnancy, often through a urine or blood test to detect the presence of the hormone human chorionic gonadotropin (hCG). Once confirmed, healthcare professionals establish an estimated due date based on the last menstrual period and confirm it through a dating scan.
Booking appointment
By 10 weeks, you will have a booking appointment with your midwife. This is a comprehensive consultation to discuss your medical history, lifestyle, and family background. It serves as the basis for developing a personalised care plan throughout your pregnancy. During this appointment, your midwife will measure your weight, height, and blood pressure and may recommend various blood tests.
What is the difference between the confirmation and booking appointment? The confirmation is purely to verify the presence of pregnancy, while the booking appointment is a comprehensive assessment and planning session that marks the start of structured antenatal care.
Nutritional assessment and guidance
During the first trimester, healthcare professionals may offer nutritional guidance and recommendations to support the health and wellbeing of both the mother and the developing foetus. This may include discussions about dietary intake, supplementation with vitamins containing folic acid, vitamin D and other essential nutrients, and strategies for managing common pregnancy-related symptoms such as nausea and fatigue. If you need any referrals for extra monitoring or input from consultants, these will be made at this initial assessment by your midwife.
Blood tests
Routine blood tests include determining your blood type and Rh factor to identify compatibility issues, checking iron levels, and screening for infectious diseases such as hepatitis B, syphilis, and HIV.
Ultrasound and dating scan
An ultrasound scan, typically done between weeks 8 and 14, confirms the gestational age, number of babies, and checks for basic developmental markers. If needed, a transvaginal ultrasound may be performed in early pregnancy to obtain clearer images.
Screening for genetic disorders
You may be offered screening tests to assess the risk of genetic disorders such as Down’s syndrome, Edwards’ syndrome, and Patau’s syndrome. These involve a combination of blood tests and ultrasound measurements. If screening suggests an elevated risk, diagnostic tests may be recommended.
A urine analysis may be conducted to identify the presence of Group B Streptococcus (GBS). If GBS is detected, you will be offered antibiotics to treat the infection and protect your baby during labour.
Antenatal screening
Around week 16, you may be offered the Multiple Marker Screening (MMS) or Quadruple Test. These tests assess the risk of chromosomal abnormalities like Down’s syndrome. However, they are only offered for free in certain NHS Trusts.
Anomaly (Anatomy) scan
Between weeks 18 and 21, you will have an anomaly scan to examine your baby’s growth, development, and anatomy in detail. The position of your placenta will also be assessed. If any concerns arise, your midwife may suggest additional scans or referrals.
Midwife appointments
Regular appointments, typically scheduled every 4-6 weeks, include routine checks on blood pressure, urine analysis, and foetal growth and wellbeing. These are valuable opportunities to discuss any questions, changes in symptoms, or concerns with your midwife.
Glucose Tolerance Test (GTT)
If you have risk factors for gestational diabetes (e.g., a high BMI, family history, or certain ethnic backgrounds), a GTT will be offered between weeks 24-28. This test checks how your body manages blood glucose and helps in diagnosing gestational diabetes.
Additional scans and appointments
As you approach your due date, appointments will become more frequent, especially if you have any health concerns or if additional monitoring is needed, such as in cases of gestational diabetes or suspected foetal growth issues.
Sweep and induction
If you go beyond your due date, your midwife may offer a cervical sweep to encourage labour. If this does not initiate labour, induction may be recommended to reduce risks associated with a prolonged pregnancy.
Postnatal check-ups
After birth, your midwife will visit you at home to monitor your physical and emotional recovery and the health of your newborn. A 6-8 week postnatal check with your GP is recommended to discuss ongoing health and recovery.
Mental health support
Throughout your pregnancy, it’s essential to prioritise your mental health. Pregnancy can bring a range of emotions, from joy and excitement to anxiety and uncertainty. If you have any concerns or find the emotional changes challenging, don’t hesitate to speak to your midwife or healthcare team. They can provide mental health support and resources tailored to your needs.
Parental education classes
Parental education classes are a great way to prepare for childbirth and early parenthood. These classes cover practical information on labour, breastfeeding, and newborn care, while also providing opportunities to connect with other expectant parents.
The video below looks at managing this fear so you can have medical checks and treatment.
