Find out more about the maternity care you can expect and what happens at routine antenatal appointments.

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How do I book my maternity care?

Finding out you’re pregnant can be both exciting and a little scary, especially if you’re unsure what to do next. As a first step, contact the NHS to register your pregnancy so you can begin your antenatal care, which will be provided by a particular hospital or NHS Trust. If you know of a local hospital or birth centre where you’d like to receive your maternity care and give birth, you can contact the midwives who work there directly. Otherwise, you can go through your GP or Children’s Centre.

Your antenatal appointments

As long as you’re healthy and your pregnancy is progressing as expected, you’ll have most or all your antenatal 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 a 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.

How many antenatal appointments will I have?

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.

It's a good idea to make a note of your baby’s pattern of movements so that you notice if this changes.

 

 

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 happens at the booking appointment?

One of the things that will happen during your booking appointment is that you'll have your blood pressure taken.

 

At the booking appointment, your midwife will want to get an overview of your health and medical history to plan your maternity care. You’ll be asked questions about: your physical and mental health, including any pre-existing medical conditions you have and medication you’re taking. your family’s medical history and any genetic conditions you’re aware of. the health and medical history of the baby’s father. both parents’ ethnic origin. your current lifestyle, including diet and exercise. your job and plans for working during pregnancy. how you’re feeling at this stage in the pregnancy – both physically and emotionally. any previous pregnancies and births, including miscarriages. the date of your last period. Your midwife will also do a few routine checks, some of which will be repeated at later antenatal appointments. They will: measure your blood pressure. take a blood test. test a urine sample. take weight and height measurements, to calculate your BMI. All the information gathered during your booking appointment will help medical staff to identify any factors that may increase the risk of complications during your 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 confirmed when you’re given a dating scan – this happens between weeks 10 and 14.

Choosing where to give birth

At the booking appointment, you’ll have a first discussion about where you’d like to give birth: at home, at a birth centre or in a hospital labour ward. Don’t worry if it sounds daunting to think about where to give birth so early on in your pregnancy. You can change your mind later if you decide you’d like to have your baby somewhere else that better suits your needs and preferences. If you don’t yet know where you want to have your baby, use our where to give birth tool to explore the different options.

Your 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.

 

Your midwife will write information about your health, family history and preferences for the birth in a booklet, known as your maternity notes. At the end of the appointment, you’ll be given the booklet – this also contains your own timeline of antenatal appointments, as well as details of who to call if you have any questions or concerns in between appointments. 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 and if you go away on holiday – in case you need emergency care. Some of the abbreviations used in maternity notes are listed at the end of this article.

When will I have my booking appointment and how long will it take?

Ideally, the booking appointment should take place by week 10 of your pregnancy, so there’s plenty of time to fit in your first ultrasound scan and any other recommended screening tests before the end of the first trimester. 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. It 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 your booking appointment is at a local hospital, you may have a dating scan at the same time. Otherwise, this will take place during the next few weeks. You should be able to book a time with your midwife during this appointment.

How to prepare for your booking appointment

Working out the date of your last period is just one of the ways you can prepare for your booking appointment.

 

As well as having 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. Write these down so you don’t forget. To help you prepare, you should also: Work out the date of your last period. Make notes of the medical information you may need, including anything you know about your family history and details of any medication you’re taking. If you’ve been asked to bring along a urine sample, do this shortly before your appointment. Wear a sleeveless or loose-fitting top, so the midwife can easily take your blood pressure. Bring a pen and paper to write down anything you want to remember or check after the appointment. You can ask your partner or a friend to attend the appointment with you. They can give you support, help to take notes and remember things for you. Be aware though that the midwife will be asking you some personal questions, and may request that the other person to leave the room at certain points. Anything discussed with your midwife is completely confidential.

Questions to ask the midwife at your booking 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 and how to cope with pregnancy symptoms, to finding mental health support services and giving up smoking. You might like to ask: What medication is safe to take during pregnancy? What vitamin supplements can I be take? Can I continue to exercise when I’m pregnant? Where can I find local antenatal classes? Who can I speak to about mental health concerns? If it’s not brought up during the appointment, you should also ask your midwife for: A maternity exemption certificate, which you can use to receive free NHS prescriptions and dental care during pregnancy and in your baby’s first year. Information about your birth options – you can also use our where to give birth tool to find the setting best suited to you.

What happens at the other antenatal appointments?

Your midwife or doctor will continue to do a number of routine checks to make sure you’re healthy and your baby is developing well throughout the rest of your pregnancy. 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 such as 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’s surrounding your baby.

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.

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 such as 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 appointments

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.

 

Write down a list of questions you want to ask in advance. Make notes of what your midwife says. Ask for explanations of anything you don’t understand. If your midwife can’t help with a specific problem, ask who you should contact instead. Check if your midwife knows of local services and support groups, for example for breastfeeding. Ask if there are leaflets or websites where you can find more information. 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.

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 such as 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 is 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