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I am pregnant – what happens now?

So you have just found out that you are pregnant! So, what happens now?

Once you know that you are pregnant, it is important you are able to get information and care in order to have a healthy pregnancy. Pregnancy (antenatal) care is mainly provided by a team of midwives and doctors both in your local community and a hospital setting. Antenatal care is free under the NHS in England.

1. Referral to maternity services

To get access to antenatal care, you will be referred to a hospital to start your antenatal journey. You should either directly contact the hospital you would like to receive your care at and do your own referral online, or you can contact your GP who will make the referral on your behalf. You are able to choose which hospital will provide your care during your pregnancy.

Although you will be allocated a hospital during your pregnancy, a lot of antenatal care is provided in the community and can also be provided in your GP surgery, at the hospital, a children’s centre and even your home. Where your appointments happen depend on the pregnancy services provided in your local area, as well as any specific needs you may have.

2. Your first midwife appointment – the booking appointment

Once you have been referred, you will receive an appointment for your first midwife appointment called the booking appointment, that takes place usually before you are ten weeks pregnant. This appointment lasts around an hour, and covers many topics such as: the baby’s father, your living arrangement, your employment, other pregnancies or children, your physical and mental health, and domestic abuse as well as female genital mutilation. These are covered to make sure you get the right care for your pregnancy, as well as any extra support you may need.

At the booking appointment your height, weight and blood pressure will be measured, and a sample of your urine and blood will be tested. These checks can check for any infections such as urinary tract infections (UTI), syphilis, hepatitis B, human immunodeficiency virus (HIV) as well as any blood disorders such as sickle cell. You may not realise you have these conditions, so it is important to test for them in order to prevent harm to you or the baby.

Your midwife may also provide you with information about a healthy diet during pregnancy as well as specific foods to avoid, pelvic floor exercises, breastfeeding, antenatal classes, maternity benefits such as free prescriptions and dental care, your labour choices, and tests and scans you will be offered in pregnancy.

All of your notes will be given to you, and you should carry your maternity notes with you at all times until you give birth.

3. Dating scan (8-14 weeks)

A dating scan is the first visual look at the baby during your pregnancy. The dating scan is performed by a specially trained staff (called a sonographer) who uses an ultrasound machine, which uses high-frequency sound waves to create real-time images of the baby. A handheld probe is moved across your abdomen with some gel to gain a black and white image of the baby. In combination with a blood test, these images can be used to measure the size of the baby in order to estimate the due date, check how the baby is developing physically, as well as screening for conditions such as Down syndrome.

4. Routine antenatal appointments

During the pregnancy, you will be offered multiple routine antenatal appointments. These appointments are usually with your midwife, however for some women with risk factors these appointments are with a pregnancy doctor (obstetrician). For a first-time pregnancy, you will be offered appointments at 16, 25, 28, 31, 34, 36, 38, and 40 weeks. If this is not your first pregnancy, you will have fewer antenatal appointments if you have a low-risk pregnancy and no complications. At each appointment, your blood pressure will be measured, and your urine is tested. Your pregnancy bump (uterus) will be measured using a tape measure to roughly check how the baby is growing, and any results from previous appointments will also be discussed. Later in the pregnancy you will have the opportunity to discuss your labour options and be given more information about what will happen after the birth.

5. 20-week scan (18-21 weeks)

Around halfway during the pregnancy, you will be offered another ultrasound scan to check for the physical development of the baby. The scan looks for eleven rare conditions by looking in detail at the heart, brain, spinal cord, bones, kidneys, abdomen, and face of the baby.

All antenatal care is optional. Tests and checks are offered in order to provide the best care for you during the pregnancy, however you do not have to consent to some or all of the care provided. If you change your mind later during the pregnancy, you may be able to have these performed later. Some tests and checks can be done privately outside of the NHS; however, all necessary care will be provided by the NHS if it is deemed necessary.

References 

    1. Your NHS pregnancy journey – NHS (www.nhs.uk)
    2. Your antenatal appointments – NHS (www.nhs.uk)
    3. 20-week scan – NHS (www.nhs.uk)

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