Antenatal care

The main aim of antenatal care is to monitor your health during pregnancy, as well as the health and development of your baby.

12:53 03 June 2009

The main aim of antenatal care is to monitor your health during pregnancy, as well as the health and development of your baby. It can help predict possible problems with your pregnancy or birth, so they can be either avoided or treated. This article also appears on www.bbc.co.uk/parenting/having_a_baby

Your pre-baby care

In the UK, the way antenatal appointments are scheduled is fairly standard, but some areas offer fewer appointments to mums who are not expected to encounter any problems. You can use the appointments to ask any questions you may have, and to share any concerns.

If you need to have advice or investigations between appointments, call the antenatal clinic and either speak to a midwife or a doctor, or arrange an earlier appointment.

Where do you have it?

Hospitals where babies are born have antenatal clinics, but not every mum who books to give birth there will have all her antenatal care at that clinic.

Other places where you might have your care are:

• with your family doctor
• with community midwives at a health centre
• at your own home, where the midwife or doctor visits you
• at another hospital, where there may be special facilities not on offer at the hospital you are booked
• some women may be offered 'share care', where the appointments are split between your doctor and the hospital where you plan to give birth.

Unless you have a problem with your pregnancy, you will probably have most of your antenatal care away from the hospital. You might go to the hospital antenatal clinic if your doctor or midwife suggests an appointment with an obstetrician, and you may be asked to go to the hospital for your later appointments.

What happens?

Your first antenatal appointment will probably be your booking-in appointment. It's usually at about 8 to 12 weeks. In some areas, this is routinely done at home by a community midwife; in others, you'll be asked to visit the hospital antenatal clinic. If you plan to have your baby at home, you will almost certainly have the booking appointment at home, or else at a local health centre. It's normally a midwife who will do your booking.

You'll be asked a number of questions " about your health, your family history and about any previous pregnancies. The aim is to get a good basic idea of your health and your pregnancy so far.

You might find the midwife takes the opportunity to discuss issues like diet, smoking and work; she may ask about your thoughts on breast- or bottlefeeding, and share information with you about them. You don't have to make up your mind about your choices on this or on any other matter, but it's a good chance to ask questions, and to clear up anything you're worried about.

You may be asked to offer a sample of blood at this appointment, and you may also well be weighed. Depending on your local hospital policy, you may be weighted to get an idea of weight gain during pregnancy. It can be a useful guide to weight gain and fluid retention.

Routine checks at other appointments are likely to include:

• taking your blood pressure
• weighing you
• palpation
• listening to your baby's heart " this can be done with a stethoscope, a Pinard (looks like an ear trumpet) or with a small device called a Doppler which uses ultrasound to detect and measure the heart rate
• asking you about your baby's movements
• checking your urine
• checking any swelling in your legs, arms, face
• asking how you feel

How often?

Not counting appointments for scans (link to scans and tests copy) or other hospital-based tests, you can probably expect to have an appointment every four weeks after 12 weeks, and then every two weeks from about 32 weeks, and for the last three or four weeks to have weekly appointments. This is variable, though " ask your midwife what the likely schedule for you is.

Info Box

If you have anything that's worrying you, or that you need to discuss, do it sitting up! It's far easier to have a proper exchange when you are face to face with the midwife or doctor, than lying down looking upwards.

The waiting game

Visiting hospital antenatal clinics often means waiting a long time... think of the whole thing as lasting about two hours, and only a small time of it will be spent with a midwife or doctor. Community-based clinics in health centres aren't usually quite so busy. If you have to take an older child, you'll need to take a drink and a snack, and something to play with or read " you'll need those things for yourself, too.

Your notes

Depending on your hospital's policy you may be given your notes to keep with you " sometimes from the beginning of your care and sometimes later in your pregnancy. The hospital may have their own copy as well. The midwife and doctor should write their findings in your notes, and if you see something you can't read, or don't fully understand, then ask them about it. Sometimes abbreviations are hard to make out, and your health professionals should make sure you are as well informed about your pregnancy as they are.