By Midwife Astrid Wilson

Congratulations on your pregnancy!

Whether it’s your first baby or you’re a parent already, this is a general guide as to what to expect over the next few months.

The main aim of antenatal care is for optimum condition of the mother and baby. We do this by regularly monitoring your health and the health and development of your baby.

After you’ve had your pregnancy confirmed, you will be referred to the community midwife who is based at your surgery. We will see you for a ‘booking’ appointment at about 8-10 weeks of pregnancy which may take up to an hour. We will go through your medical and family history and details of any previous pregnancies. We will then map out a plan of care for this pregnancy. Provided that you fit certain low risk criteria, your antenatal care will be performed at the surgery by the midwife. If we feel that there are certain conditions which put you into a medium or a high risk category, you will be referred to one of the hospital consultants. The majority of your care will be with your midwife.

At this initial visit your midwife will discuss with you where you would like to have the baby. Most babies are born in hospital though a small percentage are born at home. We are happy to chat to you about your options.

Your midwife will also like to do some blood tests to check your general health. This will include finding out your blood group, your rubella (German Measles) status, your blood iron levels and certain infections that may affect you. We will also offer you an HIV check. Tests to determine if your baby is affected by Down’s syndrome or a neural tube defect like spina bifida are not available until 15 weeks. 

A scan will be arranged for when you are 12-14 weeks pregnant. This will confirm your due date as well as telling us how many babies you’re expecting! A further scan is offered at most hospitals at 20 weeks which will look at how the baby is developing as well as the position of the placenta.

*More information on Ultrasound scans*

A private (Nuchal Translucency) scan is available at some centres at 11-13 weeks which will give you a risk factor for Down’s syndrome. Please ask your midwife for further details if you are interested.

*More information on Nuchal Scan*

At your booking visit we will also discuss your diet in pregnancy. It’s important to remember to have a well balanced diet with a variety of foods to get the right balance. Some foods are best avoided in pregnancy: pate, mould-ripened soft cheeses, undercooked eggs, peanuts or foods made with peanut oil, liver and liver products, unpasteurised milk and fish such as marlin, swordfish and shark.

*More information  MIDIRS Informed Choice leaflet - Diet in Pregnancy*

You will also need to fill in a form to request free prescriptions which will last until the baby is a year old. Dental care is also free provided you have an NHS dentist. You will need to fill in the appropriate forms when you arrive for a check-up.

All of the information gathered at the booking visit is put into a set of notes which you keep with you for the duration of the pregnancy. This helps you to become totally involved in your care and progress. You will need to bring them with you each time you have an antenatal appointment or a scan and when you go into labour. Once you have given birth, your notes will stay with the rest of your records at the hospital.

At the end of your booking visit, your midwife will give you contact numbers for her and her colleagues together with a follow up appointment at the surgery. At each antenatal visit you will need to bring along a specimen of urine. As well as testing the urine, your consultation involves taking your blood pressure, palpating the uterus if over 14 weeks and listening in to the baby’s heartbeat. This appointment is also the time when we assess your general wellbeing and answer any queries you may have. It is also the time when we try and build up a rapport with you. This is important as the midwife is at the centre of your care before, during and after the birth of your baby.

According to your risk factor, you will be seen approximately every 4-6 weeks in the early part of pregnancy. This will increase from about 28 weeks to fortnightly and then weekly for the last month. This plan will vary from patient to patient but it is also important to remember that you have been given contact numbers to use and if you have any concerns, there is always one of us on duty.   

As your pregnancy progresses we will give you information about local antenatal classes and include a tour of the hospital. Many areas also offer antenatal yoga and swimming for pregnant women.

Pregnancy for many people can be a vulnerable and worrying time particularly for the first baby. As midwives we recognise a lot of these fears and are there for advice and guidance. Please use us and enjoy this special time!

Astrid Wilson, Community Midwife