Advice on the checks likely to be carried out during your later antenatal visits with information on screening tests, pregnancy care and ultrasounds.
After an initial booking appointment it is recommended that first time mums with a straightforward pregnancy have 10 more antenatal checks. These should be done at 16, 18-20, 25, 28, 31, 34, 36, 38, 40 and also at 41 weeks if your baby has not arrived.
It is recommended that women who have already had a baby, and who have an uncomplicated pregnancy, should have seven checks at about 16, 18-20, 28, 34, 36, 38 and 41 weeks. If you are unhappy about long gaps between visits talk with your midwife.
After the tests undertaken at your booking appointment you will have several more during your subsequent antenatal appointments:
- Measuring your baby - you will not be given internal examinations at your antenatal check-ups, but your midwife will feel, or 'palpate', your abdomen to make sure your uterus and baby are growing properly. Once you are near your due date, she will feel your bump to see what position your baby is in. Once you get to about 20 weeks, your midwife will also start measuring the size of your bump with a tape measure (from the pubic bone to the tip of your bump). This is not a particularly accurate way of measuring your baby's growth, but it will give your midwife a rough idea of how he or she is progressing. If she has any concerns about your baby's growth, she may refer you to hospital for an ultrasound scan.
- Blood tests - these involve taking a small sample of your blood, which is then tested for your blood group; whether your blood is rhesus negative or positive; whether you are anaemic, whether you are immune to rubella; for syphilis; for hepatitis B and sickle cell disease. Your midwife should explain to you exactly what is being tested for and why.
- Ultrasound - it is recommended that all women have a dating scan early on in pregnancy to establish their baby's gestational age and detect multiple pregnancies. This is usually around 12-13 weeks. You will also be offered another scan at 18-20 weeks to check that your baby is developing properly, and that your placenta is positioned in a way which will not cause problems with the birth.
- Screening tests - If you wish, you can have blood screening tests, in which the blood levels of certain chemicals are checked. Levels which are too high or too low could indicate that your baby has a condition such as spina bifida or Down's syndrome. These tests cannot tell you for certain whether or not your baby is affected, they can only give you an approximate risk.
- Diagnostic tests - If screening tests show that your baby has a higher risk of having spina bifida or Down's syndrome, you may choose to have a diagnostic test which can tell you for certain. These include amniocentesis and chorionic villus sampling in which a needle is inserted into your uterus to draw off either amniotic fluid or placental cells for examination. These procedures carry a small risk of miscarriage.