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The first visit

Most women have their first, and longest, antenatal check-up around the 8th to 12th week of pregnancy. The earlier you go the better. You should allow plenty of time as you will probably see a midwife and a doctor, and may be offered an ultrasound scan.

 

Questions

You can expect a lot of questions on your health, on any illnesses and operations you have had, and on any previous pregnancies or miscarriages. You will be asked for any information you have on your own family and your partner’s family (whether there are twins on your side or any inherited illness, for example). You will also be asked about your ethnic origin. This is because certain inherited conditions that need attention in early pregnancy are more common in some ethnic groups.

 

There may also be questions about your work or your partner’s work and what kind of accommodation you live in, to see if there is anything about your circumstances that might affect your pregnancy.

All this information will help to build up a picture of you and your pregnancy so that any special risks can be spotted and support provided.

 

The midwife or doctor will want to know the date of the first day of your last period, to work out when the baby is due. You will probably want to ask a lot of questions yourself. This is a good opportunity and it often helps if you can write down what you want to say in advance, as it’s easy to forget once you are there. It’s important to find out what you want to know and to express your own feelings and preferences.

 

Let your midwife or doctor know if:  

  • there were any complications in a previous pregnancy or delivery, such as pre-eclampsia or premature delivery;

  • you are being treated for a chronic disease such as  diabetes or high blood pressure;

  • you, or anyone in your family, have previously had a baby with an abnormality,for example spina bifida, or there is a family history of an inherited disease such as thalassaemia or cystic fibrosis.  

Remember that, if you’re working, you have the right to paid time off for your antenatal care (see section on Right and Benefits).

 

Weight

You’ll be weighed. From now on, your weight gain will probably be checked regularly, although this is not done everywhere. Most women put on between 10–12.5 kg (22–28 lbs) in pregnancy, most of it after the 20th week. Read pages 8-12 on what to eat in pregnancy, and take regular exercise. Much of the extra weight is due to the baby growing, but your body will also be storing fat ready to make breast milk after the birth.

 

Height

Your height will be recorded on the first visit because it is a rough guide to the size of your pelvis. Some small women have small pelvises and although they often have small babies they may need to discuss their baby’s delivery with their doctor or midwife.

 

General physical examination

The doctor will check your heart and lungs and make sure your general health is good.

 

Urine

You will be asked to give a sample of urine each time you visit. This will be checked for a number of things including:

  • sugar – pregnant women may have sugar in their urine from time to time but, if it is found repeatedly, you will be checked for diabetes (some women develop a type of diabetes in pregnancy known as ‘gestational diabetes’ which can be controlled during pregnancy usually by a change of diet and, possibly, insulin; the condition usually disappears once the baby is born);
  • protein, or ‘albumin’, in your urine may show that there is an infection that needs to be treated; it may also be a sign of pregnancy-induced hypertension (see High blood pressure and pre-eclampsia.)

 

Blood pressure

Your blood pressure will be taken at every antenatal visit. A rise in blood pressure later in pregnancy could be a sign of pre-eclampsia.

If you’re going to have your baby in a GP or midwife unit or at home, then you will probably go to your own GP and community midwife for most of your antenatal care. You may need to visit the hospital for an initial assessment and perhaps for an ultrasound scan or for special tests. Sometimes your midwife may visit you at home.

 

If you’re going to have your baby in hospital, your GP or midwife will send or give you a letter for the hospital. Antenatal care varies around the country.

 

In some areas, the first (booking) appointment is at the hospital then all or most subsequent appointments are with the GP or community midwife unless the pregnancy is complicated, when all appointments are at the hospital. In other areas, all care is given by the GP and/or midwife unless there is a reason for referral to the hospital antenatal clinic.

 

Blood tests

You will be offered a blood test which will check:

  • your blood group;
  • whether your blood is rhesus negative or positive – a few mothers are rhesus negative (usually this is not a worry for the first pregnancy. Some rhesus negative mothers will need an injection after the birth of their first baby to protect their next baby from anaemia.; in some units, rhesus negative mothers are given injections called ‘anti-D’ at 28 and 34 weeks as well as after the birth of their baby – this is quite safe and is done to make sure that the blood of future babies is not affected by rhesus disease.
  • whether you are anaemic – if you are, you will probably be given iron and folic acid tablets to take (anaemia makes you tired and less able to cope with losing blood at delivery);
  • your immunity to rubella (German measles) – if you get rubella in early pregnancy, it can seriously damage your unborn baby and if you are not immune to rubella and come into contact with it, blood tests will show whether you have been infected; if so, you’ll be offered the option of ending your pregnancy after discussing the possible problems your baby might have;
  • for syphilis – it is vital to detect and treat any woman who has this sexually transmitted infection as early as possible;
  • for hepatitis B – this is a virus which causes liver disease and may infect the baby if you are a carrier of the virus or are infected during pregnancy (the baby can be immunised at birth to prevent infection, so most units will routinely offer a test to check if you are carrying the virus).

 

 Information provided by Health Promotion England.