Antenatal Care

NHS

Antenatal care is the care you get from health professionals during your pregnancy. It's sometimes called pregnancy care or maternity care. You'll be offered appointments with a midwife, or sometimes a doctor who specialises in pregnancy and birth (an obstetrician).

You should start your antenatal care as soon as possible once you know you're pregnant. You can do this by contacting a midwife or GP.

What is antenatal care?

This is the care you receive while you're pregnant to make sure you and your baby are as well as possible. The midwife or doctor providing your antenatal care will:

  • check the health of you and your baby
  • give you useful information to help you have a healthy pregnancy, including advice about healthy eating and exercise
  • discuss your options and choices for your care during pregnancy, labour and birth
  • answer any questions you may have

If you’re pregnant in England you will be offered:

  • 2 pregnancy ultrasound scans at 8 to 14 weeks and 18 to 21 weeks
  • antenatal screening tests to find out the chance of your baby having certain conditions, such as Down's syndrome
  • blood tests to check for syphilis, HIV and hepatitis B
  • screening for sickle cell and thalassaemia

You may also be offered antenatal classes, including breastfeeding workshops. Ask your midwife about classes in your area.

Starting antenatal care

You can book an appointment with your GP or directly with your midwife as soon as you find out you're pregnant. Your GP surgery or a children's centre can put you in touch with your nearest midwifery service.

You can find your nearest children's centre through your local council. It's best to see a midwife or GP as early as possible to get the information you need about having a healthy pregnancy.

Some tests, such as screening for sickle cell and thalassaemia, should be done before you're 10 weeks pregnant. If you have special health needs, your midwife, GP or obstetrician may take shared responsibility for your maternity care. This means they'll all be involved in your care during pregnancy.

Let your midwife know if you have a disability that means you have special requirements for your antenatal appointments or for labour.

How many antenatal appointments will I have?

If you're expecting your first child, you'll have up to 10 antenatal appointments. If you have had a baby before, you'll have around 7 appointments, but sometimes you may have more – for example, if you develop a medical condition.

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. If you cannot keep an appointment, let the clinic or midwife know and rearrange it.

Where will I have my antenatal appointments?

Your appointments can take place at:

  • your home
  • a Children's Centre
  • a GP surgery
  • a hospital

You'll usually go to the hospital for your pregnancy scans. Antenatal appointments should take place in a setting where you feel able to discuss sensitive issues, such as domestic abuse, sexual abuse, mental health problems or drugs.

To make sure you get the best pregnancy care, your midwife will ask you many questions about your and your family's health, and your preferences.

Your midwife will carry out some checks and tests, some of which will be done throughout your pregnancy, such as urine tests and blood pressure checks.

The results may affect your choices later in pregnancy, so it's 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.

Questions you might be asked

The midwife or doctor might ask about:

  • the date of the first day of your last period
  • your health
  • any previous illnesses and operations you have had
  • any previous pregnancies and miscarriages
  • the ethnic origins of you and your partner to find out whether your baby may be at risk of certain inherited conditions
  • whether your family has a history of twins
  • your job, 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 have been depressed

Your antenatal appointments are an opportunity to tell your midwife or doctor if you're in a vulnerable situation or if you need extra support. This could be because of domestic abuse or violence, sexual abuse or female genital mutilation.

Antenatal appointments after 24 weeks

From around 24 weeks of your pregnancy, your antenatal appointments will usually become more frequent. But if your pregnancy is uncomplicated and you're in good health, you may not be seen as often as someone who needs to be more closely monitored. Later visits are usually quite short.

Your midwife or doctor will: 

  • check your urine and blood pressure
  • feel your tummy (abdomen) to check the baby's position
  • measure your womb (uterus) 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:

  • making your birth plan
  • preparing for labour and birth
  • how to tell if you're in active labour
  • induction of labour if your baby is overdue (after your expected date of delivery)
  • the "baby blues" and postnatal depression
  • feeding your baby
  • vitamin K (given to prevent vitamin K deficiency bleeding in your baby)
  • screening tests for newborn babies
  • looking after yourself and your new baby

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.

Your baby's movements

Keep track of your baby's movements. At any stage of pregnancy, if your baby's movements become less frequent, slow down or stop (called reduced foetal movement), contact your midwife or doctor immediately – do not wait until the next day.

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 put your details in a record book and add to them at each appointment. These are your maternity notes, sometimes called handheld notes.

You'll take your maternity notes home and be asked to bring them 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.

You can ask your maternity team to explain anything in your notes that you do not understand.

Planning ahead for your appointments

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. 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 chance to discuss any worries
  • if your partner is free, they may be able to go with you – this can help them feel more involved in the pregnancy
  • you can buy refreshments in some clinics – take a snack with you if you cannot buy one at the clinic

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

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