Overview of appointments, tests and scans for women under midwife-led care:
|8-10 weeks||Booking appointment|
|11-14 weeks||Scans and blood tests|
|16 weeks||Follow up with midwife to check scans and blood tests and arrange Anti-D and glucose tolerance test if needed|
|18-20 weeks||Detailed scan (anomaly)|
|25 weeks||Routine antenatal check*|
|28 weeks||Blood test – Maternity Certificate (MAT B1) given|
|31 weeks||Routine antenatal check*|
|34 weeks||Routine antenatal check|
|36 weeks||Routine antenatal check – birth plan should be completed now|
|38 weeks||Routine antenatal check|
|40 weeks||Routine antenatal check*|
|41 weeks||Routine antenatal and induction of labour arranged|
*First time mums or enhanced care only
Please note: visits may be made by a midwife or a maternity support worker.
To make sure that you receive the best possible care, children will no longer be able to attend antenatal scans.
If you are concerned about this, please speak to your midwife.
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.
Cervical screening is one of the best ways to protect yourself from cervical cancer. Cervical screening checks the health of your cervix. It’s not a test for cancer, it’s a test to help prevent cancer. If you missed your last cervical screening, you do not need to wait for a letter to book an appointment.
If you are due for a cervical screening test while pregnant, this should be rescheduled for 12 weeks after the birth. Being a new mum can be a very busy time but It is very important that you do find the time to reschedule your appointment, so please contact your GP.
Routine blood tests in pregnancy include:
At 28 weeks you will have the following blood tests:
Full blood count
Group and save (this checks your blood type, and checks for any antibodies that your body may have produced in response to the pregnancy)
If you are a rhesus negative blood group, you will be offered an Anti-D injection
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.
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.
Glucose tolerance test (GTT)
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. 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 fiabetes, 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.
12-14 weeks: Dating scan
This scan will check your baby’s development so far and give you an estimated due date.
You may also choose to have combined screening, which combines details from your scan and a blood test to assess the chances of your baby having Down Syndrome (also known as Trisomy 21 or T21), Edwards Syndrome (Trisomy 18 or T18) or Pataus syndrome (Trisomy 13 or T13). This is explained in detail in the screening tests for you and your baby document.
18-20 weeks: Anomaly scan
The purpose of this scan is to make sure your baby is developing well and to look for physical abnormalities. The scan only looks for certain problems in your baby and cannot find everything that might be wrong. The sonographer looks in detail at your baby’s bones, heart, brain, spinal cord, face, kidneys and abdomen.
If your baby is in an awkward position, you may be asked to go away and come back the same day or to attend for another appointment entirely. This will usually be because the sonographer has not been able to clearly visualise a part of your baby. It does not mean they have found a problem. If a problem has been identified, you will be given support and an appropriate care plan will be developed.
It may be possible to tell whether you’re having a girl or boy, but this is not guaranteed.
You will usually be able to purchase some pictures from your ultrasound. The cost of these is usually supplied with your appointment letter.