Routine antenatal care, screening and ultrasound
Your first pregnancy appointment (booking appointment)
At your first pregnancy appointment (your ‘booking appointment’) the midwife will ask you about your medical, pregnancy and social history and discuss with you the type of care you want during pregnancy and birth. This appointment is a good opportunity for you to ask any questions and normally takes about an hour. Your GP should listen to your heart and lungs as part of your fitness assessment.
Your midwife will provide health information on a number of topics to help you have a healthy pregnancy and prepare yourself for birth.
Routine blood screening tests
We will ask your permission at your booking appointment to take some blood samples for routine screening. This is so we can check your blood group and test for a variety of conditions including anaemia, sickle cell and thalassaemia disease, diabetes, hepatitis B, syphilis and HIV.
We also recommend taking a blood sample again at 28 weeks of pregnancy to ensure you are not anaemic and possibly to screen for gestational diabetes. Your midwife will provide more information.
Cervical screening
The Department of Health recommends that all women should have a cervical smear every three years. If your smear is due we recommend you have one at your 6–8 week postnatal check-up.
Ultrasound scans
You will be offered two scans, one early in pregnancy at approximately 11–14 weeks and another at 18–21 weeks (anomaly scan) to check the growth and development of your baby. You are welcome to bring someone with you when you come for your scan. Further scans are only arranged if there is a clinical need—your doctor or midwife will explain if this occurs.
Antenatal screening for Down’s Syndrome and other chromosomal anomalies
Screening for chromosomal anomalies such as Down’s syndrome is offered to all pregnant women of all ages. The screening tests provide information about the chance of your baby being affected. These tests use blood samples taken from you and measurements taken from ultrasound scans. The test you will be offered depends on how many weeks pregnant you are. This will either be a combined screening test or a quadruple test.
If you do receive a higher risk result from a screening test, your midwife or doctor will give you further information and support. You will be offered a diagnostic test which can confirm if your baby has Down's syndrome or not.
There are two diagnostic tests available—Chorionic Villus Sampling (CVS) and Amniocentesis. CVS is usually performed between 12 and 14 weeks. Amniocentesis is usually carried out from 16 weeks.
After your birth
Following your baby’s birth we recommend several screening tests for your baby such as a hearing check, newborn examination and bloodspot screening.
Further information is available from the ‘Screening tests for you and your baby’ leaflet. It is important that you read this leaflet and discuss these screening tests with your midwife, GP or obstetrician.
Further appointments (follow-up appointments)
After your booking appointment, you will be asked to make future antenatal appointments. If for any reason you cannot make an appointment or want to change the time, it is very important that you call the antenatal clinic or your midwifery team to rearrange your appointment and offer the original time to someone else.
Maternity notes
You will be given these at your booking appointment to keep with you during your pregnancy. Please always bring them with you when you go to see your midwife, GP or attend the hospital for any reason. Midwives and doctors will write about each visit you have and ensure your test results are available to you.
Your notes are a confidential record of your care and we are more than happy for you to write in them to comment on aspects of your pregnancy and treatment. After your baby is born, your notes will be retained by our Trust. A photocopy of your maternity records can be obtained for a small administrative fee.