Antenatal check-ups: what happens at each appointment

We explain which weeks of your pregnancy you'll have an antenatal appointments, and what tests, scans and questions to expect at each of them

antenatal-appointment-schedule_176763

Welcome to the world of antenatal appointments! It’s hugely exciting – and sometimes a little bit nervy – to track the progress of your unborn child from he or she gradually grows tiny speck to ready-to-roll-in-the-outside-world baby. 

Advertisement

But it can also be a little confusing trying to figure out when your appointments are likely to be, as they don’t always come in equally spaced intervals – and, towards the end of your pregnancy, they are actually spaced out differently, depending on whether it’s your 1st baby or not.

So, to make things a bit easier, here’s your at-a-glance overview of your antenatal-appointment schedule – along with some helpful info on what happens at each appointment, including any tests you’ll have, and a handy list of need-to-know antenatal-appointment facts and tips. 

If it’s your 1st pregnancy, your antenatal checks will be at:

  • 8 to 12 weeks (booking appointment)
  • 8 to 14 weeks (dating scan)
  • 16 weeks
  • 18 to 20 weeks (anomaly scan)
  • 25 weeks
  • 28 weeks
  • 31 weeks
  • 34 weeks
  • 36 weeks
  • 38 weeks
  • 40 weeks
  • 41 weeks (if you haven’t already given birth)

If you’ve had a baby before, your appointments will be at:

  • 8 to 12 weeks (booking appointment)
  • 8 to 14 weeks (dating scan)
  • 16 weeks
  • 18 to 20 weeks (anomaly scan)
  • 28 weeks
  • 34 weeks
  • 36 weeks
  • 38 weeks
  • 41 weeks (if you haven’t already given birth)
antenatal-appointment-schedule_176765

Your antenatal checks: what happens at each appointment

The purpose of your antenatal check-ups are, obviously, to find out how your baby is growing, flag up any concerns, give you info about the weeks ahead, and give you an opportunity to get answers to any questions or concerns you have. 

Not every antenatal appointment is the same, though. You midwife will often run through some of the same checks each time but there’ll also be new things, as your pregnancy progresses and, sometimes, the check will be really different and specific – like when it’s time for an ultrasound scan. 

Here’s what to expect:

8-12 weeks: Booking appointment or “booking in”. Your midwife will ask about your lifestyle and medical history, carry out routine checks (blood pressure, height and weight, urine dip), calculate your due date and give you loads of info about your antenatal care. You’ll probably also be asked to give some blood samples (or return later to give them) – which will be used for routine checks (your blood type, for example) and, if you give your consent, as part of a combined screening test for Down’s syndrome.
Find out more about your booking appointment

8-14 weeks: Dating scan or 12-week scan (even though it may not happen exactly at 12 weeks). This is your 1st NHS ultrasound! And the scan will check your baby’s heartbeat, see if your due date tallies with your baby’s development – and show if you are expecting twins or more. You will also have, if you consent, the nuchal translucency scan that’s the other part of the combined screening test. Oh, and you’ll get to take some cute pics home!
Find out more about your 1st pregnancy scan

16 weeks: 2nd midwife appointment. Your midwife will talk you through the results of any screening tests you have had (if you haven’t done this already). You will have more urine and blood pressure checks, and your midwife will listen for your baby’s heartbeat with a special monitor that amplifies the noise, so you can hear it too. You will be also given info about your 2nd ultrasound scan (the anomaly scan) which is coming up soon. 

18-20 weeks: Anomaly scan or 20-week scan. This 2nd, more detailed, ultrasound scan is to check your baby has no physical abnormalities. The scan operator will look at your baby’s head, face, spine, limbs, heart and bladder. He or she may also be able to tell you the sex of your baby if you would like to know. 

25 weeks: Routine appointment (if you’re having your 1st baby). Your midwife will measure your bump with special tape measure, take your blood pressure, test your urine and listen to your baby’s heartbeat. If, at your earlier appointments, you didn’t consent having your blood screened for HIV, syphilis and hepatitis B, you may be asked again now. You may also be offered the whooping-cough vaccine (as best time to have this is after your anomaly scan and before 32 weeks). 

28 weeks: Routine appointment. You will have your bump measured, blood pressure taken, urine checked and your baby’s heartbeat monitored, as before. And, if you are rhesus negative, you will be offered your first anti-D injection.

31 weeks: Routine appointment (if you’re having your 1st baby). All the usual bump measuring, heartbeat monitoring, urine and blood pressure checking, as before. 

34 weeks: Routine appointment. As well as doing the usual checks, your midwife will want to discuss your birth plan with you (if she hasn’t already), and give you information about pain relief and preparing for labour and birth. She will also talk to you about Caesarean sections, and the reasons why you may end up having one. If you are rhesus negative, you will be offered your second anti-D injection.

36 weeks: Routine appointment. You will be given info about breastfeeding and caring for a newborn, as well as looking after your own health after the birth and understanding the signs of post-natal depression. And, as well as the standard bump-measuring, heartbeat-monitoring and blood-pressure and urine checks, your baby’s position will be checked – and if it’s thought your baby is in the breech position (head up, rather than head down), you midwife may offer to try to ‘turn’ it by manipulating your bump.

38 weeks: Routine appointment. Your midwife will measure your bump, listen to your baby’s heartbeat, and check your urine and blood pressure – and talk to you about your options if your baby goes overdue (if you’re still haven’t had it by 41 weeks).  

40 weeks: Routine appointment (if you’re having your 1st baby). As well as doing the usual bump, heartbeat, urine and blood pressure checks, your midwife will discuss your impending birth with you, and give you more info about your choices if you go over 41 weeks.

41 weeks: Last routine appointment (if your baby hasn’t arrived already). Your midwife will – of course – check your bump size, your blood pressure and your urine, as well as listening to your baby’s heartbeat. She’ll then discuss your options for induction, and might offer you a membrane sweep, like she did to MFM Chat forum user Gen3: “I had my midwife app last Friday and they offered me a membrane sweep, which I took! This is supposed to kickstart labour by releasing the right hormones, and my midwife said, if it’s successful, I would be in labour within 48 hours…”

42 weeks: 42-week check (if your baby still hasn’t arrived). If you have chosen not be be induced, your midwife will be talking to you about increased monitoring of your baby.

How big will your bump get? Check out our week-by-week bump photo galleries

antenatal-appointment-schedule_176766

What routine tests will I have at my antenatal appointments? 

You’ll normally have a urine test and a blood-pressure check at every antenatal appointment. From 16 weeks, your midwife will listen for your baby’s heartbeat and, from 25 weeks, your bump will be measured with a special tape. At various times, you will be offered other blood tests, screening tests and scans – which you don’t have to have if you don’t want to.

Here’s your guide to what each test is checking for:

Urine tests

Your wee is checked, using a dipstick, for protein or albumin, either of which could suggest you have an infection. Protein in your urine can also be a sign of pre-eclampsia

Blood-pressure checks

A rise in blood pressure could be a sign of gestational hypertension (pregnancy-induced high blood pressure), which affects 16% of pregnant women. If that’s you, you may need to be monitored more closely as it means your heart needs to work harder to pump blood around your body. In some cases, hypertension can be a sign of pre-eclampsia. It’s quite common for your blood pressure to be lower in the middle of your pregnancy than it is at other stages. This is nothing to be worried about, but it can cause lightheadedness if you get up too quickly. 

What is the normal range for blood pressure? Everyone is different and blood pressure measurements can vary a lot but, as a general guide:

  • Between 110/70 and 120/80 is a healthy.
  • Between 140/90 and 149/99 indicates mild hypertension.
  • Between 150/100 and 159/109 indicates moderate hypertension.
  • 160/110 or higher indicates severe hypertension.

Blood tests

You will be offered various blood tests at different stages of your pregnancy to check your blood type, rhesus status, or whether you have or may be developing anaemia or diabetes. You’ll also be asked if your blood can be tested for HIV, syphilis and hepatitis B (you can say no) and, perhaps on a separate occasion, if you want your blood screened, as part of the combined screening test for genetic conditions such as Down’s syndrome (again, you can say no). 

Listening to your baby’s heart rate

Your midwife will check your baby’s heart rate to check that it is within a healthy range. Anything between 110 and 160 beats per minute is considered normal – it sounds very fas when you hear it!

Bump measurements

Give or take 3cm, your bump measurement, taken from about 25 weeks, using a special tape measure, should be around the same as the number of weeks pregnant you are. Easy to remember!

Ultrasound scans

You will be offered 2 routine (but not compulsory) ultrasound scans: one at about 12 weeks (the dating scan) and 1 at about 20 weeks (the anomaly scan). Both check that your baby’s growth tallies with your due date, and screen for abnormalities – and provide you with black-and-white scan-image pics to take away. 

Doppler scan

Your midwife may recommend a Doppler scan if your baby seems small for your dates or if you have specific problems with your pregnancy.  A doppler measures blood flow in various parts of your baby’s body and checks your baby is getting all the oxygen it needs.

row of bigger and bigger eggs

Stuff you may want to know before your 1st appointment

How soon will I have my 1st antenatal appointment? It’s very unlikely to be before 8 weeks (unless there are special circumstances) and itdepends a bit on how things work in your local area – andwhen you tell your GP you’re pregnant: it’s your GP who plugs you into the antenatal system that generates your 1st appointment.

How long do the appointments take? About 15 to 20 minutes – except for the 1st one, which can take about an hour.

Can my partner come with me? It’s entirely up to you. You can bring whoever you want – your partner, mum, sister or friend – to any or all of your appointments. 

Can I take time off work for antenatal appointments? Yes, you have the legal right to paid time off for antenatal care, including any antenatal and parenting classes that your doctor or midwife has recommended you to attend. Your partner is also legally entitled to take unpaid leave to accompany you to 2 of your antenatal appointments.

What should I wear? Whatever you feel comfortable in, along as it can be lifted up easily over your belly. Bear in mind, too, that when you have a scan, the sonographer will need to apply lubricating gel to your bump, so that may not be the best day for your favourite pure silk top…

What questions can I ask? Anything you like! “Talking to your midwife about your concerns or things you don’t understand is important,” says Mervi Jokinen of the Royal College of Midwives. Apparently, the most-asked questions are about bump size and baby movements. But don’t worry if it’s not a strictly medical question: many women have questions about sex during pregnancy, for example, says Mervi. So don’t be shy: your midwife’s definitely heard it all before!

Will the midwife at my appointments be the person who delivers my baby? That will largely depend on when and where you give birth and the shift patterns of the maternity unit staff. While the NHS says it tries to create a situation where women get to know the people who will care for them during labour and birth, the reality is that you may see several different midwives during your pregnancy – and maybe a different one altogether at the birth. However, if you are planning a home birth with the support of a small team of community midwives, you will may well be delivered by a midwife you already know.

Can I call my midwife outside of my antenatal appointments? Of course! You should always ring your midwife (or your midwifery team) if you have any worries about your pregnancy. Don’t feel you have to wait for your next appointment to raise them. And, if you experience any bleeding or pain or (later in your pregnancy) an abnormal pattern of baby movement, you should immediately contact your midwife to get things checked out.

Read more:

Advertisement

Comments ()

Please read our Chat guidelines.