There are differences around the UK which may affect exactly how you are cared for in your pregnancy. For example, if you are in a large town or city you may be assigned to a team of midwives who share your casenotes, but in a smaller town or village it might be your GP or one midwife who oversees all your tests and check-ups and even attends the birth. However, there are certain people who are likely to encounter at some stage over the next nine months, so who are they and what do they do?
Your GP
When you think you might be pregnant or have done a home pregnancy test, your first port of call to set up your chain of antenatal care is your GP (General Practitioner), or family doctor.
At your first visit your GP will want to do a test to confirm your pregnancy by taking a urine sample. You’ll be asked for the date of the first day of your last menstrual period and be given an estimated due date. Your doctor may wish to discuss your gynaecological history, will probably give you some guidelines on health and nutrition in pregnancy and will set the ball rolling to sort you out with your first midwife appointment.
Expert Tip
At any stage in your pregnancy you can ask your midwife about issues such as hiring a TENS machine, maternity unit options, enquire about facilities like a birthing pool at the hospital or even ask about home birth.
Anne Richley, midwife
Along with your midwife, your GP will continue to be your main medical support throughout pregnancy. If you have any questions or health concerns relating to your pregnancy then your doctor or midwife should usually be your first point of contact. Your GP will refer you to hospital for scans and may refer you to hospital or a particular obstetrician if there are any problems that need investigating.
Your GP is not usually involved in labour and birth itself, but once you are back home following birth the general healthcare of both you and your baby reverts back to your doctor, although your midwife will continue to be involved for the first few days.
The midwife/midwifery team
Midwives are specially trained in health care for pregnant women and new babies and are usually the mainstay of your antenatal care. Exactly how the provision of midwives works under the NHS varies from area to area: your midwife may be attached to your GP’s surgery or to a local hospital or may be attached to a local health centre.
You may be cared for by a single midwife, whom you come to know quite well, or by a team of midwives who share the task of supporting you through pregnancy, birth and into the first six weeks of motherhood. Once home after giving birth you will usually have a daily visit from a midwife for the first ten or so days.
Under the midwives' code of conduct they are qualified to conduct antenatal check-ups and scans and deliver babies using procedures such as episiotomies when necessary: midwives do not investigate complications in pregnancy nor handle complications in birth such as forceps deliveries and c-sections. A midwife will always be present to assist during the birth of your child, and the presence of a doctor will only be necessary in the event of complications, although doctors are usually present at most hospital births. As most midwives work in shifts and you, obviously, can't control when your child arrives, you can't usually choose which midwife will help at the birth.
Obstetrician
This is a doctor who specialises in pregnancy and birth; an obstetrician is often also a gynaecologist. You are likely to see an obstetrician if you are booked in for a hospital delivery, or you have complications during pregnancy that need investigating and/or treating. With some pregnancy conditions you may be seen by another doctor specialising in that condition (such as gestational diabetes). When you book a hospital birth, the ultimate responsibility for your care is given to a consultant obstetrician. However, if you have a normal, healthy pregnancy and birth there might well be no occasion at all for you to see your consultant obstetrician as care will be largely delegated to midwives and less senior doctors who work under the supervision of the consultant.
Sonographers
During your pregnancy you will usually have two major ultrasound scans to check on your baby's development at around 12 and 20 weeks. In a normal, healthy pregnancy you probably won’t need any more scans, but if you experience any bleeding during pregnancy, or there are other signs of complications then you may have more. Your scans won’t necessarily be given by the same person and the sonographers may also be qualified midwives or obstetricians.
Anaesthetists
If you have an epidural or other form of anaesthetic for delivery then you will come in contact with an anaesthetist, a specialist doctor responsible for administering anaesthetics for pain-relief and surgery.
Paediatricians
Paediatricians are specialist doctors in the area of baby and child care. Your baby will be checked by a paediatrician within a few hours of the birth if you have had a normal, healthy pregnancy and delivery. If there have been any pregnancy complications a paediatrician may help advise on the best options for birth and will be on hand to check your baby as soon as he or she is born. If there are any health complications with your new born baby then s/he will be placed under the care of a paediatrician until fully well.
Nurses
In hospitals nurses will work alongside midwives and doctors to give you medical help and support through birth and throughout your stay in hospital. Labour and delivery nurses will have special training to enable them to play a supportive role, as well as administering medicines, monitoring mother and baby and providing initial postnatal care.
Interested in private options for your antenatal care? We explain what doulas, independent midwives and maternity nurses are all about.
