Overview of appointments, tests and scans for women under midwife-led care:

At your booking appointment, your midwife will discuss the types of screening and testing available to you during pregnancy. It would be useful to have read about them prior to your appointment so that your midwife can answer any questions you may have about them.

Routine blood tests in pregnancy include:

At 28 weeks you will have the following blood tests:

Your blood test will confirm whether your blood is rhesus positive or rhesus negative. People with rhesus positive blood have a substance known as “D Antigen” on the surface of their red blood cells but people with rhesus negative blood do not. This can cause problems if a woman has rhesus negative blood and her baby has rhesus positive blood. If any of the baby’s blood gets into the mum’s blood stream, during birth, bleeding or an injury, the mum’s immune system can start to create antibodies against the rhesus antigen. The name for this is “sensitisation”. This is not a problem in first pregnancies, but in subsequent pregnancies there is a risk that these antibodies can attack the baby’s blood cells and cause a serious condition called haemolytic disease of the newborn. This can result in the baby suffering from jaundice and anaemia. It can also be a potential cause of miscarriage or stillbirth.

If we confirm that your blood group is rhesus negative we will offer you a further blood test. Genetic information (DNA) from the unborn baby can be found in the mother’s blood, which allows the blood group of the unborn baby to be checked without any risk. It’s usually possible to get a reliable result from this test after 12 weeks of pregnancy, which is long before the baby is at risk from the antibodies. If your baby is rhesus negative, they’re not at risk of rhesus disease and no extra monitoring or treatment will be necessary. If your baby is rhesus positive, we will offer anti-D injections.

Anti-D injections deal with any rhesus positive antigens so that the body doesn’t produce the antibodies, preventing mum from becoming sensitised. If your blood tests show that you need anti-d injections, your midwife will let you know, and you’ll receive the injection at 28 weeks. If you experience any vaginal bleeding, falls or bumps to the abdomen during pregnancy, it’s important to let your midwife now as you may need an additional injection.

Learn more about Anti-D injections

Some women will also need a Glucose Tolerance Test (GTT) to screen for gestational diabetes (diabetes during pregnancy). Your midwife will ask questions during your booking appointment to assess whether you are at risk of developing gestational diabetes and refer you for the test if necessary. The test is usually done between weeks 24 and 28 of your pregnancy.

If you’ve had gestational diabetes in a previous pregnancy, you’ll be given the test earlier. If it’s negative, the test will be repeated later in the pregnancy. Alternatively, you might be given a blood sugar monitor so that you can check your sugar levels yourself during your pregnancy.

The GTT takes about two hours. The first blood sample will be taken in the morning, when you have had nothing to eat or drink overnight or the morning of your test. This includes smoking, chewing gum or medication (unless you’ve been advised to continue to take it – speak to your midwife about this if unsure). You will then be given a special glucose drink, and another blood sample will be taken two hours later.

If you are diagnosed with gestational diabetes, you will be placed under the care of a consultant and a specialist diabetes team to support you and keep you well throughout your pregnancy.

If you and your baby are progressing well and there are no concerns, you will receive two scans during your pregnancy.

Remember to take some cash with you for any scan prints.