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Baby & child.

12 July 2021

Your antenatal appointments

Find out when you’ll meet with your midwife during pregnancy, what happens at these routine appointments, and how to understand your maternity notes.
Martha Roberts
Sac antenatal appointments 483780

Will I see a midwife or a doctor for my antenatal appointments?

In general, as long as you’re healthy and your pregnancy is progressing as expected, you’ll have most or all your appointments with a midwife (or team of midwives).

However, depending on where you live, some of your antenatal appointments may be with your GP, and if you’re at higher risk of pregnancy complications you may see a consultant who specialises in pregnancy and birth.

The appointments can take place in different locations, including your GP surgery, children’s centre or your own home. If you have requests about where you want to be seen, you can ask your midwife or doctor for your local options.

What happens at antenatal appointments?

At every appointment, your midwife or doctor will do a number of routine checks to make sure that you’re healthy and your baby is developing well. Your midwife will:

  • Listen to your baby’s heartbeat to check that it’s beating at a steady rhythm and that blood is flowing from the placenta to your baby.
  • Check your blood pressure to make sure you aren’t at risk of developing pre-eclampsia. If your blood pressure is measuring high, you could be advised to go to triage to monitor your blood pressure for a longer period of time.
  • Do a urine test which can help your midwife spot signs of an infection or common pregnancy conditions like pre-eclampsia and gestational diabetes.

From your 28-week appointment onwards, your midwife or doctor will also:

  • Measure your bump (fundal height) to check that your baby is growing at the right rate. If you’re measuring larger or smaller than expected, you may be referred for a growth scan to check the size of your baby and the amount of amniotic fluid that surrounds him or her.
  • Have a feel of your bump (palpate) to see if your baby is head-down and how engaged your baby’s head is in your pelvis. If your baby is in the breech position (feet down) or lying sideways (transverse) at around 37 weeks, your midwife can talk to you about your options for trying to turn the baby around or giving birth to your breech baby vaginally or by c-section.

How many antenatal appointments will I have?

You'll get your own timeline of appointments for your antenatal care when you attend your booking appointment.

At your booking appointment, you’ll get your own timeline of appointments drawn up.

In general, as long as you’re healthy and your pregnancy is progressing as expected, you’ll see your midwife (or team of midwives) around 10 times if it’s your first baby, and seven times if you’ve given birth before.

Schedule of appointments and scans

Here's a week-by-week breakdown of antenatal appointments and scans:

  • 8-12 weeks: health check and information about pregnancy and birth
  • 10-14 weeks: dating scan
  • 16 weeks: routine check and review of screening tests
  • 18-21 weeks: anomaly scan
  • 25 weeks: routine check for first-time mums
  • 28 weeks: routine check and anti-D treatment if necessary
  • 31 weeks: second routine check for first-time mums
  • 36 weeks: routine check and information about after the birth and caring for a newborn
  • 38 weeks: routine check and information about going overdue
  • 40 weeks: third routine check for first-time mums
  • 41 weeks: routine check if baby hasn't been born yet

You can find out more details about what will happen at each routine appointment in our pregnancy week by week guide.

What else can my midwife help me with?

Midwives are experts in straightforward pregnancies and births, so they are a great first port of call for questions about random symptoms you’re experiencing or anything that’s worrying you.

For example, your midwife can:

  • Talk you through your options for giving birth by explaining the pros and cons of having a home birth, giving birth in a birth centre or on a labour ward.
  • Check that your baby is moving as expected and advise on how you should monitor their movements during your pregnancy.
  • Go through scans and screening tests that you will be offered and talk through the results after you’ve had them. They will also give you anti-D injections if you have RhD negative blood.
  • Advise you on diet and exercise during pregnancy to help you avoid injuries and make sure you get the nutrition that you and your baby need.
  • Give you advice on pregnancy symptoms and health problems like headaches, heartburn, pelvic pain and back pain.
  • Help you prepare for labour, by recommending antenatal classes, giving advice on writing your birth plan and telling you which signs of labour to look out for.
  • Talk to you about your plans for feeding your baby and answer any other questions about caring for a newborn.

Sometimes, the most difficult conversations are also the most important. During appointments with your midwife, you should feel able to bring up any problems that you’re having. This might include:

Mental health issues 

You may have heard of postnatal depression, but feelings of anxiety or depression are also common when you’re pregnant, especially if you have suffered from mental illness earlier in your life. Talking to your midwife about your feelings can get you the help you need.

Domestic abuse and sexual violence 

One in four women experience domestic violence during their lifetime and the threat is higher during pregnancy. So, if this is happening to you, first of all know that you’re far from alone. Your midwife can refer you to specialist services and suggest options to keep you safe.

Smoking, alcohol and drug use 

You’re probably aware that smoking, drinking alcohol or using drugs during pregnancy can have a negative effect on your baby, but that doesn’t necessarily make it any easier to stop. By talking to your midwife you can be referred to services that can help you give up, and plan for the safe birth of your baby.

Midwives are there to support you throughout pregnancy and to help you and your baby get the best start in life together. Your midwife will do their best to help you, or refer you to someone who is better placed to do so.

How to get the most out of your midwife appointment

There's lots you can do to get the most out of your midwife appointment, including writing down a list of questions you may have about your pregnancy and birth.
  1. Write down a list of questions you want to ask in advance.
  2. Make notes of what your midwife says.
  3. Ask for explanations of anything you don’t understand.
  4. If your midwife can’t help with a specific problem, ask who you should contact instead.
  5. Check if your midwife knows of local services and support groups, for example for breastfeeding.
  6. Ask if there are leaflets or websites where you can find more information.
  7. Bring your birth partner or another family member or friend with you if you would like someone there for support.

You can also download this checklist to keep at hand on your phone.

Remember, there are no stupid questions. Your midwife is likely to have heard it all before and would much rather you ask too many questions  than too few.

Can I get time off work for antenatal appointments?

When you’re pregnant, you have a legal right to paid time off work for every antenatal appointment that your midwife or doctor recommends. You should also be paid for the travel time.

Your partner has the right to take unpaid time off work to come with you to two appointments, although some employers may allow the time off with pay.

How can I get help between appointments?

At the front of your maternity notes, your midwife or doctor will write down contact information for your midwifery team as well as triage at your local hospital, so you always have a way of getting advice when you need it.

If you have any concerns, it’s always better to speak to someone and put your mind at rest rather than waiting weeks until your next appointment.

What are maternity notes?

Your maternity notes contain information about your health, family history, scans, antenatal appointments and preferences for the birth. They are also known as your handheld notes.

At your booking appointment you’ll be given your maternity notes, or handheld notes. This contains information about your health, family history, scans, antenatal appointments and preferences for the birth.

Every time you have an antenatal appointment or receive maternity care at a hospital, records of your and your baby’s health will be written down in your notes.

As well as bringing the notes with you to every antenatal appointment and visit to the maternity unit, you’re also encouraged to carry the booklet with you day-to-day as well as if you go away on holiday, in case you need emergency care at any time.

Understanding maternity notes abbreviations

When you have your antenatal appointments, your midwife or doctor will often write details about your health or observations about your baby as abbreviations in your maternity notes. These can seem a little cryptic if you haven’t seen them before. Here’s a quick run-through of some of the codes you may come across as you look through your notes.

Your pregnancy

When your baby’s due and whether you’ve been pregnant or given birth before can all impact your maternity care needs.

LMP - Last menstrual period - used to calculate your due date before your dating scan.

EDD - Expected due date.

How many weeks pregnant you are - For example, 16+4 (16 weeks and four days pregnant).

Gravida, or G - Whether you’ve been pregnant before. 

Primigravida - Pregnant for the first time. 

Multigravida - You’ve been pregnant before.

Parity, or P - How many times you’ve given birth before.

Nulliparous - Never given birth before.

Primipara or primip - Have given birth to one baby before.

Multipara or multip - Have had two or more babies before.

Your health

Your blood pressure and urine samples will be tested throughout your pregnancy, and other tests like blood checks will also be done occasionally to make sure the pregnancy’s progressing as expected.

NAD - No abnormality detected (your urine test was normal).

Tr (trace) - Small amount of protein or glucose was found in your urine.

+, ++, +++ - Greater amounts of protein or glucose have been found in your urine. This can be a symptom of pre-eclampsia or gestational diabetes.

BP - Blood pressure. If your blood pressure’s higher than usual it could be a sign of pre-eclampsia or pregnancy-induced hypertension.

Oed - Swelling (oedema) can also be a symptom of pre-eclampsia.

Hb - Haemoglobin - if your iron levels are too low you might need treatment for anaemia.

VE - Vaginal examination - sometimes done in pregnancy to check whether your cervix has started to efface and dilate.

Your baby’s heart rate and movements

A doppler or stethoscope will be used to record and measure your baby’s heart rate, and your midwife or doctor will ask you whether you’re feeling any movements.

FHH, or H - Foetal heart rate heard. This will be accompanied with beats per minutes (BPM).

FHNH, or NH - Foetal heart rate not heard. This isn’t unusual in the first and sometimes second trimester, but your midwife may like you to come for an extra check-up.

FMNF - Foetal movements not felt. Many women don’t start to feel movements until 20 to 24 weeks.

Whether your baby’s engaged in your pelvis

The midwife or doctor will also check how much of the baby’s head is in your pelvis (how engaged they are) when you’re in the later stages of your pregnancy.

5/5, NE, NEng, Not Eng or 'free' - Your baby’s head is above your pelvis.

4/5 - Your baby’s head is above your pelvis.

3/5 - The head is lower but still mostly above the brim.

2/5  -  Your baby’s engaged and mostly below the brim.

1/5 or 0/5 - Your baby’s head is deeply engaged and hardly palpable from above.

Your baby’s position in the womb

Your midwife will palpate (feel) your tummy to see which position your baby’s in throughout pregnancy and ahead of the birth.

Ceph, C or Vx - Cephalic (head down).

B or Br - Breech (head up with their bottom or feet in your pelvis).

R or Tr - Transverse (lying across your belly).

L or Long - Vertical.

O or Obl - Oblique or diagonally.

OA - Occiput Anterior (head down, facing your back).

OP - Occiput Posterior (head down, facing your front).

OL - Occiput Lateral (head down, facing your side).

Baby positions in the womb

Coronavirus and antenatal care

Routine antenatal care is essential for detecting common complications of pregnancy such as pre-eclampsia, gestational diabetes and urine infections that don’t present symptoms, and there's a potential risk of harm if you don't attend appointments - even in the context of coronavirus.

Gill Walton, CEO of the Royal College of Midwives (RCM), says, ‘If you are pregnant, with no coronavirus symptoms, you should continue to go to your antenatal appointments as usual, while following the social distancing guidance of keeping a two-metre distance from others and using private transport if possible. Even if you have symptoms, contact your midwife and they will work with you to ensure you continue to get the care and support you and your baby need.’

The RCM and the Royal College of Obstetricians and Gynaecologists (RCOG) say that a minimum of six face-to-face antenatal consultations should take place during the coronavirus pandemic.

Virtual consultations will be offered where appropriate, ensuring that women are seen in one-stop clinics that cover all medical and obstetric needs in the same visit, and making use of home monitoring of blood pressure where it’s safe to do so. This is to enable greater compliance with social distancing measures and to avoid unnecessary hospital admissions. 

However, risk assessment will be carried out to ensure that women who need it are prioritised for face-to-face care where available.

The RCOG says: 'The NICE recommended schedule of antenatal care should be offered in full wherever possible. Ideally and where safe, these appointments should be offered in-person, particularly to those from BAME communities, those with communication difficulties or those living with medical, social or psychological conditions that put them at higher risk of complications, or adverse outcomes, during pregnancy.'

Your birth partner should be allowed to be present at antenatal appointments, whether virtual or face-to-face, but check with your maternity team to see if this is the case.

If you are in self-isolation and have an antenatal appointment coming up, you should contact your midwife or antenatal clinic to inform them of your situation. It’s likely that your routine appointments will be delayed until your isolation period ends. If your maternity team advise you that your appointment can’t wait, the necessary arrangements will be made for you to be seen.

If you have suspected or confirmed COVID-19, you should also contact your maternity team and they’ll arrange the right place and time for you to attend your appointments: you should not attend a routine clinic.

If you have any concerns about the wellbeing or yourself or your unborn baby during your self-isolation period, contact your midwife or, out of hours, your maternity team for further advice on whether you need to attend hospital or not.

Page last updated 08/03/2021. Please check out Royal College of Obstetricians and Gynaecologists for any more recent updates.