What is antenatal care?

Antenatal care is the care you receive from healthcare professionals during your pregnancy. You'll be offered a series of appointments with a midwife, or sometimes with a doctor who specialises in pregnancy and birth (an obstetrician). They will check that you and your baby are well, give you useful information to help you have a healthy pregnancy (including healthy eating and exercise advice) and answer any questions you may have. You will also be offered antenatal classes, including breastfeeding workshops. You need to book antenatal classes in advance, so ask your midwife about when you should book classes in your area.

Starting your antenatal care

You can book an appointment with your GP or directly with your midwife as soon as you know that you're pregnant. Your GP surgery or a Childrens Centre can put you in touch with your nearest midwifery service. It's best to see them as early as possible. If you have special health needs, your midwife, GP or other doctors may take shared responsibility for your maternity care. This means they will all see you during your pregnancy. Let your midwife know if you have a disability that means you have special requirements for your antenatal appointments or for labour. If you don't speak English, let your midwife know and arrangements will be made for an interpreter.

How many appointments you will have

If you're expecting your first child, you'll have up to 10 appointments. If you've had a baby before, you'll have around seven appointments. Under certain circumstances, for example if you develop a medical condition, you may have more. Early in your pregnancy, your midwife or doctor will give you written information about how many appointments you're likely to have and when they'll happen. You should have a chance to discuss the schedule with them. If you can't keep an antenatal appointment, let the clinic or midwife know and make another appointment Your appointments can take place at your home, in a Children's Centre, in your GP surgery or in hospital. You may be asked to go to hospital for your scans. Your antenatal appointments should take place in a setting where you feel able to discuss sensitive problems that may affect you, such as domestic violence, sexual abuse, mental illness or drug use. To give you the best pregnancy care, your midwife will ask you many questions about your health, your family's health and your preferences. Your midwife will do some checks and tests, some of which will be done throughout your pregnancy. The results of these tests may affect your choices later in pregnancy, so its important not to miss them. Your midwife will also ask about any other social care support you may have or need, such as support from social workers or family liaison officers.

Your first visit and booking appointment

Your first visit with your midwife or GP is the appointment when you tell them that you're pregnant. At this first visit, you will be given information about:

folic acid and vitamin D supplements nutrition, diet and food hygiene lifestyle factors that may affect your health or the health of your baby, such as smoking, recreational drug use and drinking alcohol antenatal screening tests for abnormality

They will give you information on keeping healthy, and ask whether you have had any previous health or pregnancy issues, such as complications in pregnancy. It's important to tell your midwife or doctor if:

There were any complications or infections in a previous pregnancy or delivery, such as pre-eclampsia or premature birth. You're being treated for a chronic disease, such as diabetes or high blood pressure. You or anyone in your family have previously had a baby with an abnormality, such as spina bifida. There's a family history of an inherited disease, such as sickle cell or cystic fibrosis.

An important part of antenatal care is getting information that will help you to make informed choices about your pregnancy. Your midwife or doctor will give you information in writing or some other form that you can easily use and understand. They can provide you with information in an appropriate format if you:

have a physical, learning or sensory disability do not speak English

Your next appointment should happen when you are eight to 12 weeks pregnant. This is called the booking appointment. This will last for up to two hours, and could take place either at a hospital or in the community, for example in a clinic at a health centre, in a GP surgery or at home. You'll see a midwife and sometimes a doctor. You may also be offered an ultrasound scan. You will be given information about:

how the baby develops during pregnancy (see the pregnancy development slideshow) nutrition and diet general exercise and pelvic floor exercises antenatal screening tests your antenatal care and antenatal classes breastfeeding workshops maternity and paternity benefits planning your labour and where to have your baby

The midwife or doctor will ask questions to build up a picture of you and your pregnancy. This is to make sure you're given the support you need, and so that any risks are spotted

early. You will probably want to ask a lot of questions. It often helps to write down what you want to say in advance, as its easy to forget once you're there. Its important to find out what you want to know and to talk about your own feelings and preferences.

Questions you might be asked

The midwife or doctor might ask about:

the date of the first day of your last period, to help work out when the baby is due (you can also use the due date calculator) your health any previous illnesses and operations any previous pregnancies and miscarriages your and your partner's ethnic origins, to find out whether your baby is at risk of certain inherited conditions, or other relevant factors, such as whether your family has a history of twins your job or your partner's job, and what kind of accommodation you live in to see whether your circumstances might affect your pregnancy how you're feeling and whether you've been feeling depressed

Your booking appointment is an opportunity to tell your midwife or doctor if you're in a vulnerable situation or if you need extra support. This could be due to domestic abuse or violence, sexual abuse or female genital mutilation. Female genital mutilation, sometimes called cutting, is practised in some cultures and involves the removal of some or all of the external genitalia, such as the labia and clitoris. It is illegal in the UK.

Later visits
From around 20-24 weeks, your antenatal appointments will usually become more frequent. However, if your pregnancy is uncomplicated and you are in good health, you may not be seen as often as someone who has concerns. Later visits are usually quite short. Your midwife or doctor will:

check your urine, blood pressure and sometimes your weight feel your abdomen to check the baby's position measure your abdomen to check your baby's growth listen to your baby's heartbeat if you want them to

You can also ask questions or talk about anything that's worrying you. Talking about your feelings is as important as all the antenatal tests and examinations. You should be given information about:

your birth plan preparing for labour and birth how to tell if you're in active labour induction of labour if your baby is late the "baby blues" and postnatal depression feeding your baby

vitamin K prophylaxis (to prevent bleeding caused by vitamin K deficiency in your baby) screening tests for newborn babies looking after yourself and your new baby

The NICE antenatal care guidelines (from the National Institute for Health and Clinical Excellence) give useful information on the timing of visits during pregnancy and a description of what will happen each time.

Checking your baby's development and wellbeing

At each antenatal appointment from 24 weeks of pregnancy, your midwife or doctor will check your baby's growth. To do this, they'll measure the distance from the top of your womb to your pubic bone. The measurement will be recorded in your notes. In the last weeks of pregnancy, you may also be asked to keep track of your baby's movements. If your baby's movements become less frequent, slow down or stop, contact your midwife or doctor immediately. You'll be offered an ultrasound scan if they have any concerns about how your baby is growing and developing.

Your maternity notes

At your booking appointment, your midwife will enter your details in a record book and will add to them at each visit. These are your maternity notes, sometimes called hand-held notes. Youll be asked to keep your maternity notes at home and to bring them along to all your antenatal appointments. Take your notes with you wherever you go in case you need medical attention while you're away from home. Always ask your maternity team to explain anything in your notes that you don't understand. Waiting times in clinics can vary, and having to wait a long time for an appointment can be particularly difficult if you have young children with you. Planning ahead can make your visits easier, so here are some suggestions:

Write a list of any questions you want to ask and take it with you. Make sure you get answers to your questions or the opportunity to discuss any worries. If your partner is free, they may be able to go with you: this can make them feel more involved in the pregnancy. In some clinics, you can buy refreshments. If not, take a snack with you if you're likely to get hungry.

In some cases, the babys father may be asked to have a blood test to check for inherited conditions, such as sickle cell or thalassaemia.