Antenatal care: appointments, screenings, schedule and more

Table of content

What is antenatal care?

What are the benefits of antenatal care?

How to register for antenatal care?

Is antenatal care compulsory?

What does antenatal care include?

How many antenatal appointments during pregnancy?

What happens at the first antenatal appointment?

What happens at a standard antenatal appointment?

Blood and screening tests offered as part of antenatal care

Antenatal care timeline: when should the different appointments take place?

Am I entitled to paid time off for antenatal appointments?

A final word on antenatal care in the UK
 

What is antenatal care?

Antenatal care, sometimes also called prenatal care or pregnancy care, encompasses all the medical care, tests and screenings that are offered to women during pregnancy. It mainly involves the different antenatal appointments which are scheduled throughout pregnancy, but it also includes additional care provided by health professionals to cater to the mother’s social, mental and emotional needs.

Prenatal care is typically provided by a small team of healthcare professionals that specialise in different fields. The team typically includes one or several midwives, a doctor, an obstetrician (i.e. a doctor specialised in pregnancy and birth) and a sonographer who is in charge of carrying out the ultrasound scans. Depending on the area, there might also be health visitors available to provide additional support during pregnancy and after birth.

How to register for antenatal care?

Registering for antenatal care happens automatically at the first contact with a GP or midwife. This means that the first appointment marks the beginning of the mother’s pregnancy journey. It’s at the booking appointment where all the planning for subsequent check-ups and appointments happens.

Mums-to-be who are not registered with a local GP can find their nearest maternity services under this link. It’s also possible to take the self-referral route for accessing NHS antenatal care. NHS hospitals that are open to self-referral can be found here.

Is antenatal care compulsory?

Antenatal care is not compulsory in the UK. It is offered to all pregnant women to help them have a safe pregnancy, but there is no obligation for future mothers to take the offer. Every woman has the right to opt out of antenatal care if she has any concerns or if it goes against her beliefs.

The same goes for the different screening tests and examinations that are routinely carried out during pregnancy. It is always up to the mother to decide if she wants to have them or not. For instance, mums-to-be can opt out of the standard screening for Down’s, Edwards’ and Patau’s syndrome. They can also decide to opt out of the standard ultrasound scans during pregnancy.

What does antenatal care include?

As mentioned earlier, antenatal care encompasses all the medical care that is provided to women during pregnancy. This notably includes:

• regular health check-ups
• provision of information on pregnancy diet, supplements, physical activity and more
• ultrasound scans
• screening tests for different genetic conditions and hereditary diseases in the baby
• diverse blood tests and screening tests to check for different conditions in the mother
• urine tests
• regular blood pressure checks
• additional screenings and diagnostic tests in cases of increased risk or suspicious findings during a previous test
• antenatal classes

How many antenatal appointments during pregnancy?

The number of antenatal care appointments depends on several factors. Women who haven’t given yet are typically offered ten appointments. For women who have already had one or several children, the prenatal care team typically schedules seven appointments.

Women with a high-risk pregnancy which requires close monitoring are offered additional appointments. Either for additional check-ups or for extra tests and screenings to make sure that the baby’s development progresses normally.

In the early stages of pregnancy, antenatal appointments are spread further apart. The further the pregnancy progresses, the more frequent the appointments become. This is typically the case starting from week 24.

Antenatal appointments can take place in different places. Depending on the area and other circumstances, the appointments might be at a GP surgery, at a hospital or clinic, at the local Children’s Centre or in the mother’s own home.

What happens at a standard antenatal appointment?

The booking appointment is the first in a series of appointments and check-ups that take place throughout pregnancy. Some appointments come with additional screening tests (e.g. an ultrasound scan) while others are just standard appointments that are used for checking the mother’s state of health and the baby’s development.

Checks that are routinely carried out during antenatal appointments include:

• urine check for protein (to detect early signs of preeclampsia)
• uterus measurement to monitor the baby’s growth
• blood pressure checks
• checks for baby movements
• monitoring of pregnancy weight gain

Blood and screening tests offered as part of antenatal care

Antenatal care encompasses a range of different blood and screening tests. They include:

• screening for sickle cell and thalassaemia
• blood test for determining blood group and rhesus status of mother and baby
• screening for Down’s, Edwards’ and Patau’s syndrome
• screening for syphilis, HIV and hepatitis B infections
• blood tests for anaemia (i.e. iron deficiency in pregnancy)
• screening test for certain inherited conditions
• pregnancy blood sugar test for detecting gestational diabetes
• screening for eleven different physical conditions (20-week scan)

If antenatal screening tests find something, further tests are needed to get a clear diagnosis. Diagnostic tests that are carried out during pregnancy to get clarity on whether or not the baby might be born with a condition include amniocentesis and chorionic villus sampling.

Antenatal care timeline: when should the different appointments take place?

During the booking appointment, the GP or midwife will usually propose a schedule of antenatal appointments in accordance with the mother’s individual situation (i.e. first or second or third pregnancy, high-risk or low-risk pregnancy etc.). Here is an example of what a typical antenatal care schedule could look like for a first-time mother:

• 8 to 12 weeks (or earlier): booking appointment with GP or midwife (see above for details)
• 11 to 14 weeks: first ultrasound scan (dating scan)
• 16 weeks: standard antenatal appointment with blood pressure check and urine test
• 18 to 21 weeks: second ultrasound scan (anomaly scan)
• 25 weeks: standard appointment with blood pressure check, urine test and checks of baby’s movements and growth
• 28 weeks: standard appointment with blood pressure check, urine test, checks of baby’s movements and growth and start of birth preparations (and anti-D treatment for mothers who are rhesus negative)
• 31 weeks: standard appointment with blood pressure check, urine test, checks of baby’s movements and growth
• 34 weeks: standard appointment with blood pressure check, urine test, checks of baby’s movements and growth and start of birth preparations (and anti-D treatment for mothers who are rhesus negative)
• 36 weeks: standard appointment with blood pressure check, urine test, checks of baby’s movements, growth and position and information on breastfeeding, baby care, health checks for babies and more
• 38 weeks: standard appointment with blood pressure check, urine test, checks of baby’s movements, growth and position
• 40 weeks: standard appointment with blood pressure check, urine test, checks of baby’s movements, growth and position and discussion of options in case the baby is overdue
• 41 weeks: antenatal appointment with blood pressure check, urine test, checks of baby’s movements, growth and position and discussion of options for induced labour

Please note: The provided antenatal care timeline is for informational purposes only. It is an example of what an antenatal care schedule might look like. It should in no case be seen as a substitute for professional medical advice. Antenatal appointment schedules vary depending on several aspects, including the mother’s state of health and medical history and when she has started her antenatal care journey.

Am I entitled to paid time off for antenatal appointments?

When working a normal 9-to-5 job, scheduling a medical appointment outside working hours can be difficult. Luckily, the appointments can be scheduled at any time. That’s because women in the UK are entitled to paid time off for their antenatal appointments.

The important thing to remember is that the appointment must be part of standard antenatal care or be deemed necessary by a health professional, e.g. a doctor or midwife. 

Good to know: The right to paid time off for antenatal appointments also applies to female part-time employees. What’s more, the right is applicable starting from the first day of employment.

A final word on antenatal care in the UK

In the UK, all pregnant women are offered free antenatal care to help them have a safe pregnancy and give birth to a healthy baby. Pregnancy care includes a range of healthcare services that are provided in the form of several antenatal appointments.

While some appointments are just basic health check-ups during which the mother’s blood pressure, weight gain and urine are checked (along with the baby’s development), others involve additional screening tests and ultrasound scans. The number of appointments ranges between seven and ten although there might be additional appointments if the pregnancy is considered high risk.

Antenatal appointments are usually led by a midwife or an obstetrician. Unless they involve an ultrasound scan in which cases they are typically done by a sonographer. In addition to monitoring the mother’s health and the baby’s development, health professionals can use the appointments to check the mother’s mental health and make sure that she receives all the support she needs.

References

• Your antenatal appointments - NHS (www.nhs.uk)
• Your antenatal care - NHS (www.nhs.uk)
• NG201 Schedule of antenatal appointments (nice.org.uk)
• Time off for appointments - Maternity leave and pay - Acas
• Antenatal support: meet the team - NHS (www.nhs.uk)
• NHS Antenatal Care: Self Referral (patient.info)
• Screening tests in pregnancy - NHS (www.nhs.uk)