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Antenatal Care

After self-referral to your local midwives base, your midwife will plan to see you face to face before 10 weeks of pregnancy so that they can support you to keep as healthy and well as possible. At your first appointment we take a detailed social and medical history and will ask you about any previous pregnancies. We will fill in and give you your pregnancy notes and we ask you to bring these with you to each appointment.

We will provide you with written information about your birth place choices and you will be able to discuss concerns and ask questions at all appointments. There is a place at the back of your maternity notes for you to jot down questions you may want to ask.

Some women will need to see an obstetrician if there are any complications in the pregnancy. Your midwife will refer you to the doctor. Some or all of your antenatal care may then be with the obstetrician.

If you and your baby are healthy and well you will only see a midwife. We do our best to make sure that you see the same midwife at each appointment so that you can build a trusting relationship with her.

At each appointment your midwife will listen to you to find out how you are feeling. We ask you to bring a specimen of urine for testing and we will monitor your blood pressure and the growth of your baby by examining your abdomen.

Routine antenatal care during your first pregnancy

Before 10 weeks

Booking appointment with community midwife (to include screening blood tests)

12-14 weeks

Dating Scan (optional for screening for Down’s syndrome, Edwards’ syndrome and Patau’s syndrome see Antenatal Screening Wales information on the Public Health Wales website)

16 weeks

Routine antenatal assessment with midwife

20 weeks Anomaly scan (see Antenatal Screening Wales information on the Public Health Wales website)
26 weeks Routine antenatal assessment with midwife, MAT B1 form given
28 weeks Routine antenatal assessment with midwife & routine blood tests
31 weeks Routine antenatal assessment with midwife
34 weeks Routine antenatal assessment with midwife
36 weeks

Routine antenatal assessment and birth plan discussion with midwife

38 weeks Routine antenatal assessment with midwife
40 weeks Routine antenatal assessment with midwife
41 weeks Routine antenatal assessment with midwife, membrane sweep offered

All antenatal assessments follow NICE guidance for Antenatal Care.  The schedule of antenatal appointments may differ depending on your needs.

Tests

Regular checks
Your urine and blood pressure will be checked at every antenatal appointment. Your urine is checked for a number of things, including protein, which can be a sign of infection and, in some cases, pre-eclampsia. A rise in blood pressure later in pregnancy can also be a sign of pre-eclampsia.

Blood tests
As part of your antenatal care, you will be offered a number of blood tests. Some are offered to all women and some are only offered if it is thought that you are at risk of a particular infection or inherited condition. You may be offered blood tests to check for:

  • Your blood group and rhesus factor
  • Anaemia
  • Syphilis
  • Hepatitis B and C 
  • HIV
  • Thyroid function
  • Diabetes test

All of the tests offered are to help make your pregnancy safer or to check that your baby is healthy. Your midwife or doctor should give you information about the tests you are offered. Make sure that you understand why the blood tests are being offered so that you can make an informed choice about whether or not you want them.

Antenatal Screening

Antenatal screening is a way of assessing whether your unborn baby could develop or has developed an abnormality or other condition during pregnancy.

You will be offered screening tests that can detect structural abnormalities like spina bifida, which is a defect in the development of the spine, or some chromosomal disorders like Down’s syndrome, which is caused by an abnormal number of chromosomes. Screening usually involves a combination of ultrasound scans and blood tests.

If after screening tests the risk of problems is found to be high, you may be offered pre-natal diagnosis. These are tests to find out the likelihood that your baby will be born with the suspected condition. Tests can also provide valuable information for your care during the pregnancy. However, no test can guarantee that your baby will be born without an abnormality. No test is 100% accurate and some abnormalities may remain undetected.

Antenatal screening in Wales in provided under a national framework. More information on the tests and screenings you could receive is available on the Public Health Wales website.

Details of antenatal classes and other community services can be found here.

Useful links:
Safer pregnancy poster