20th July 2021
Finding out you’re pregnant is both exciting and scary, and it can be tricky to know what to do next. As a first step, you should contact the NHS to register your pregnancy and begin your antenatal care.
The first appointment you have with a midwife, when you’re around 8 to 12 weeks pregnant, gets you booked in for maternity care provided by a particular hospital or NHS Trust.
If you know of a local hospital or birth centre where you might like to have your maternity care and give birth, you can contact the midwives there directly. Otherwise, you can go through your GP or Children’s Centre.
Next, you’ll be given a time for your booking appointment – your first meeting with a midwife – which usually takes place when you’re around 8 to 12 weeks pregnant.
At the booking appointment, your midwife will want to get an overview of your health and medical history to plan your maternity care.
They’ll ask you questions about:
All the information gathered during your booking appointment will help medical staff to identify any factors which may put you at increased risk of complications during pregnancy or birth.
This means they can provide you with the right maternity care and support throughout your pregnancy.
Your midwife will also calculate your estimated due date, based on the date of your last period. This will be further confirmed by a dating scan between weeks 10 to 14.
Don’t worry if it sounds daunting to think about so early on in your pregnancy. You can still change your mind later on if you decide that you would like to have your baby somewhere else that better suits your needs and preferences.
Your midwife will make notes about your health, family history and preferences for the birth in a booklet, known as your maternity notes.
The appointment probably won’t be much earlier than eight weeks, as the risk of miscarriage is higher before this point. If you haven’t booked in with the NHS until 12 weeks or later, you should have your booking appointment as soon as possible.
The booking appointment may take up to an hour, as there’s a lot to cover during this first visit. In some places, this will be split into two shorter sessions – you’ll be told what to expect when you register your pregnancy and the appointment is scheduled.
If you have your booking appointment at a local hospital, you may have a at the same time. Otherwise, this will take place during the next few weeks and you should be able to book a time with your midwife during this appointment.
As well as going in with an idea of what your midwife will want to discuss at this first meeting, it’s good to spend some time before the appointment thinking about any questions you’d like to ask.
To help you prepare:
You might like your partner or a friend with you for support, and they can also help to take notes or remember things for you.
However, the midwife will be asking you some personal questions, so they may ask anyone else to leave the room at certain points during the appointment.
Your booking appointment is the perfect time to raise questions or voice any worries you’ve been having in the early weeks of pregnancy.
Your midwife can offer advice on everything, from what foods to avoid or how to cope with pregnancy symptoms, to finding mental health support services or giving up smoking.
You might like to ask:
If it’s not brought up during the appointment, you should also ask your midwife for:
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 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 Royal College of Midwives (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.