Antenatal care and visits
When you first learn that you’re pregnant, get in touch with a midwife or doctor as soon as possible so that you can start your antenatal (pregnancy) care. This will also help to make sure you receive maternity healthcare that takes into account all your health needs and preferences.
Antenatal care is the care you receive from healthcare professionals during your pregnancy. This care can be provided by a team that can include a doctor, a midwife, and usually with a doctor who specialises in pregnancy and birth (an obstetrician). The person providing the care can depend on where you live e.g in some rural areas all care including delivery is provided by the doctor.
Your doctor or midwife will check that you and your baby are well, give you useful information to help you have a healthy pregnancy (including healthy eating and exerciseadvice) and answer any questions you may have. You may also be offered antenatal classes, including breastfeeding education classes.
Starting your antenatal care
You can book an appointment with your doctor as soon as you know that you’re pregnant. At this visit, you and your doctor can discuss what type of care you would like to have, and when and where you should have your next visit. You can choose to give birth at a public hospital, which means you will probably have antenatal appointments with a midwife or doctor at the hospital or in the community. You can choose to share the care with your doctor.
If you are planning to give birth at a birth centre, your appointments will probably be with a midwife at the birth centre. If you are planning to give birth at a private hospital, you will probably see an obstetrician in his or her private rooms.
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.
It’s best to see a member os the team as early as possible. If you have special health needs, you may need more antenatal visits. Let your doctor or midwife know if you have a disability that means you have special requirements for your antenatal appointments or for labour.
It’s recommended that you book into the hospital as soon as your pregnancy is confirmed usually by a doctor. Most women who choose to have their babies in a public hospital or birth centre have their first antenatal visit between week 10 and 16 but it is important to see the doctor as soon as pregnancy is confirmed. The earlier a pregnancy is assessed is best for mother and baby. This is especially true if it’s your first pregnancy or you have other health conditions.
What happens at your first antenatal visit?
Your first antenatal visit (or booking visit) should happen when you are at least 10 to 16 weeks pregnant. This may last for up to 2 hours, and could take place either at a hospital or in the community, for example in a clinic at a health centre, in a doctor’s surgery or at home.
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.
It’s important to tell your midwife or doctor if:
- You’ve had 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 are on medications for any other condition or are taking regular over the counter therapies from a pharmacy or other practitioner.
- 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.
Your booking visit 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 or sexual abuse.
You’ll be offered some tests (to check for anything that may cause problems during pregnancy or after the birth). These tests will be discussed with you and you can choose whether you have them or not. If you haven’t already had a general health check- up, your midwife or doctor might recommend:
- a check to make sure your heart, lungs and blood pressure are okay
- a urine test, to make sure your kidneys are healthy and check for signs of infection
- a blood test, to check for conditions like anaemia, infections such as hepatitis, to see what blood group you are especially if it’s Rh positive or Rh negative
- a Pap smear test
- a breast check
- an ultrasound, to confirm dates of pregnancy and general wellbeing of the fetus.
From around 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 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 abdomen (tummy) to check the baby’s position
- measure your uterus (womb) 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.
It is now recommended that all pregnant women receive a pertussis (whooping cough) vaccination during their third trimester (ideally at 28 weeks). A combination of antibodies being passed through the mother’s bloodstream and the reduced risk of the mother contracting the disease makes this an ideal time to administer the vaccine. Most states now offer the pertussis vaccination for free. Speak to your doctor or antenatal care provider to schedule an appointment.
Questions you might be asked
Throughout your antenatal care the midwife or doctor might ask about:
- the date of the first day of your last period
- your health
- any previous illnesses and operations
- any previous pregnancies and miscarriages
- ethnic origins of you and your partner, 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.
You might also be asked whether you smoke or use other drugs. This is not to judge you but because the more information your doctor or midwife has, the better they can support you and care for your health and your baby’s health.
It’s up to you whether you answer any of these questions you’re asked – anything you say will be kept in confidence. The information will only be given with your permission to any health worker who needs to know as part of working with you.
Your due date
If you have a regular menstrual cycle and you know the date your last period started this can be used to work out when your baby is due. Your due date is calculated by adding 40 weeks (280 days) to the first day of your last menstrual cycle. An ultrasound scan will give you a more accurate date for the birth of your baby.
Many women and their partners like to attend antenatal classes to learn more about pregnancy and birth, and about parenting a new baby. They can also give you the chance to ask questions and discuss your feelings about pregnancy and parenthood. Antenatal education is also a good way to meet other parents-to-be.
You may be asked to pay a fee. Ask your midwife or doctor about antenatal education available in your area and try to book your antenatal classes early as they tend to be very popular.