Your antenatal care

When you first learn that you're pregnant, get in touch with a midwife or GP as soon as possible. Ideally this should be by 10 weeks of your pregnancy. Telling your GP and/or midwife promptly will help to make sure you receive maternity healthcare that takes into account all your health needs and preferences.

You can read all the information on this page, or click on the links below to go straight to the relevant section:

What is antenatal care?

Starting your antenatal care

How many appointments you'll have

Your first visit and booking appointment

Later visits

Checking your baby's development and wellbeing

Your maternity notes

What is antenatal care?

Antenatal care is the care you receive from healthcare professionals during your pregnancy. You'll be offered a series of appointments with a midwife, or sometimes with a doctor who specialises in pregnancy and birth (an obstetrician).

They will check that you and your baby are well, give you useful information to help you have a healthy pregnancy (including healthy eating and exercise advice) and answer any questions you may have.

You will also be offered antenatal classes, including breastfeeding workshops. You need to book antenatal classes in advance, so ask your midwife about when you should book classes in your area.

Starting antenatal care

You can book an appointment with your GP or directly with your midwife as soon as you know that you're pregnant. Your GP surgery or a Children’s Centre can put you in touch with your nearest midwifery service. 

It's best to see them as early as possible to obtain the information you need to have a healthy pregnancy, and because some tests, such as screening for sickle cell and thalassaemia should be done before you're 10 weeks' pregnant.

If you have special health needs, your midwife, GP or obstetrician may take shared responsibility for your maternity care. This means they will all see you during your pregnancy.

Let your midwife know if you have a disability that means you have special requirements for your antenatal appointments or for labour. If you don't speak English, let your midwife know and arrangements will be made.

Antenatal appointments

If you're expecting your first child, you'll have up to 10 antenatal appointments. If you've had a baby before, you'll have around seven antenatal appointments. Under certain circumstances, for example if you develop a medical condition, you may have more.

Early in your pregnancy, your midwife or doctor will give you written information about how many appointments you're likely to have and when they'll happen. You should have a chance to discuss the schedule with them. If you can't keep an antenatal appointment, let the clinic or midwife know and make another appointment.

Your appointments can take place at your home, in a Children's Centre, in your GP surgery or in hospital. You will usually go to the hospital for your scans. Your antenatal appointments should take place in a setting where you feel able to discuss sensitive issues that may affect you, such as domestic violence, sexual abuse, mental illness or drugs.

To give you the best pregnancy care, your midwife will ask you many questions about your health, your family's health and your preferences. Your midwife will do some checks and tests, some of which will be done throughout your pregnancy. The results of these tests may affect your choices later in pregnancy, so it’s important not to miss them.

Your midwife will also ask about any other social care support you may have or need, such as support from social workers or family liaison officers.

Your first visit

Your first visit with your midwife or GP is the appointment when you tell them that you're pregnant. At this first visit, you will be given information about: 

They will give you information on keeping healthy, and ask whether you have had any previous health or pregnancy issues, such as complications in pregnancy. It's important to tell your midwife or doctor if:

  • you've had any complications or infections in a previous pregnancy or delivery, such as pre-eclampsia or premature birth 
  • you're being treated for a chronic disease, such as diabetes or high blood pressure 
  • you or anyone in your family have previously had a baby with an abnormality, such as spina bifida 
  • there's a family history of an inherited disease, such as sickle cell or cystic fibrosis
  • you know that you are a genetic carrier for an inherited condition such as sickle cell or thalassaemia. You should also tell the midwife if you know the baby's biological father is a genetic carrier for one of these conditions
  • you have had fertility treatment and either a donor egg or donor sperm

An important part of antenatal care is getting information that will help you to make informed choices about your pregnancy. Your midwife or doctor will give you information in writing or some other form that you can easily use and understand.

They can provide you with information in an appropriate format if you: 

  • have a physical, learning or sensory disability
  • do not speak English

The booking appointment

Your next appointment should happen when you are 8-12 weeks pregnant. This is called the booking appointment. It will last for up to two hours, and could take place either at a hospital or in the community, for example in a clinic at a health centre, in a GP surgery or at home.

You'll see a midwife and sometimes a doctor. You may also be offered an ultrasound scan. You will be given information about:

The midwife or doctor will ask questions to build up a picture of you and your pregnancy. This is to make sure you're given the support you need, and so that any risks are spotted early.

You will probably want to ask a lot of questions. It often helps to write down what you want to say in advance, as it’s easy to forget once you're there. It’s important to find out what you want to know and to talk about your own feelings and preferences.

Several antenatal screening tests are performed on a sample of your blood which is usually taken at your booking appointment. 

Questions you might be asked

The midwife or doctor might ask about:

  • the date of the first day of your last period 
  • your health
  • any previous illnesses and operations
  • any previous pregnancies and miscarriages 
  • ethnic origins of you and your partner, to find out whether your baby is at risk of certain inherited conditions, or other relevant factors, such as whether your family has a history of twins
  • your job or your partner's job, and what kind of accommodation you live in to see whether your circumstances might affect your pregnancy
  • how you're feeling and whether you've been feeling depressed

Your booking appointment is an opportunity to tell your midwife or doctor if you're in a vulnerable situation or if you need extra support. This could be due to domestic abuse or violence, sexual abuse or female genital mutilation.

Later antenatal visits

From around 24 weeks, your antenatal appointments will usually become more frequent. However, if your pregnancy is uncomplicated and you are in good health, you may not be seen as often as someone who needs to be more closely monitored.

Later visits are usually quite short. Your midwife or doctor will: 

  • check your urine and blood pressure
  • feel your abdomen (tummy) to check the baby's position
  • measure your uterus (womb) to check your baby's growth
  • listen to your baby's heartbeat if you want them to

You can also ask questions or talk about anything that's worrying you. Talking about your feelings is as important as all the antenatal tests and examinations. You should be given information about:

  • your birth plan 
  • preparing for labour and birth
  • how to tell if you're in active labour
  • induction of labour if your baby is overdue (after your expected date of delivery) 
  • the "baby blues" and postnatal depression
  • feeding your baby
  • vitamin K (which is given to prevent bleeding caused by vitamin K deficiency in your baby)
  • screening tests for newborn babies
  • looking after yourself and your new baby

The NICE antenatal care guidelines (from the National Institute for Health and Care Excellence) give useful information on the timing of visits during pregnancy and a description of what will happen each time.

Checking your baby's development and wellbeing

At each antenatal appointment from 24 weeks of pregnancy, your midwife or doctor will check your baby's growth. To do this, they'll measure the distance from the top of your womb to your pubic bone. The measurement will be recorded in your notes.

In the last weeks of pregnancy, you may also be asked to keep track of your baby's movements. If your baby's movements become less frequent, slow down or stop, contact your midwife or doctor immediately. You'll be offered an ultrasound scan if they have any concerns about how your baby is growing and developing.

Your maternity notes

At your booking appointment, your midwife will enter your details in a record book and will add to them at each visit. These are your maternity notes, sometimes called handheld notes. You’ll be asked to keep your maternity notes at home and to bring them along to all your antenatal appointments.

Take your notes with you wherever you go in case you need medical attention while you're away from home. Always ask your maternity team to explain anything in your notes that you don't understand.

Waiting times in clinics can vary, and having to wait a long time for an appointment can be particularly difficult if you have young children with you. Planning ahead can make your visits easier, so here are some suggestions: 

  • Write a list of any questions you want to ask and take it with you.
  • Make sure you get answers to your questions or the opportunity to discuss any worries.
  • If your partner is free, they may be able to go with you. This can make them feel more involved in the pregnancy.
  • In some clinics you can buy refreshments. If not, take a snack with you if you're likely to get hungry.

Find out about your schedule of antenatal appointments and what to expect at each one.

Who's who in the antenatal team

While you're pregnant, you will normally see a small number of healthcare professionals regularly, led by your midwife or doctor. They want to make you feel as comfortable as possible while you're pregnant and when you have your baby.

Many pregnant women would like to get to know the people who care for them during pregnancy and the birth of their baby. The NHS is trying to make this happen, but in the meantime you may see several different professionals.  

The professionals you see should introduce themselves and explain what they do. If they forget, ask them. Make a note of who you have seen and what they have said in case there is a point you need to discuss later on.

Below is a list of the people you are most likely to meet. Some may have students with them who are being trained, and you'll be asked if you mind the students being present.

Midwife

A midwife is an expert in normal pregnancy and birth. Midwives are specially trained to care for mothers and babies throughout normal pregnancy, labour and after the birth. They provide care for most women at home or in hospital.

Increasingly, midwives work both in hospitals and in the community (GP surgeries and home visits) so that the same midwife can provide antenatal care and be present at the birth. You will know the name of the midwife responsible for your care.

A midwife will look after you during labour if everything is straightforward, and they'll probably deliver your baby. If any complications develop during your pregnancy or delivery, you'll also see a doctor. You will probably also meet student midwives and student doctors. After the birth, you and your baby will be cared for by midwives or maternity support workers. 

Obstetrician

An obstetrician is a doctor who specialises in the care of women during pregnancy, labour and after birth. In some hospitals, you'll automatically see an obstetrician. In others, your midwife or GP will refer you for an appointment if they have a particular concern, such as previous complications in pregnancy or chronic illness. You can ask to see an obstetrician if you have any concerns that you want to discuss.

Anaesthetist

An anaesthetist is a doctor who specialises in providing pain relief and anaesthesia. If you decide to have an epidural for pain relief during labour, it will be given by an anaesthetist, who's responsible for making sure you stay pain-free throughout your labour.

If you require a caesarean section or instrumental delivery, for example with forceps or ventouse (a vacuum device that helps deliver the baby's head), an anaesthetist provides the appropriate anaesthesia. In many hospitals, your midwife can arrange for you to talk to an anaesthetist about pain relief if you have medical or obstetric problems.

Paediatrician

A paediatrician is a doctor specialising in the care of babies and children. A paediatrician may check your baby after the birth to make sure everything is OK, and they will be present when your baby is born if you've had a difficult labour. If your baby has any problems, you'll be able to discuss these with the paediatrician. If your baby is born at home or your stay in hospital is short, you may not see a paediatrician at all. Your midwife or GP can check on you and your baby.

Sonographer

A sonographer is specially trained to carry out ultrasound scans. A sonographer will perform your dating scan (around 12 weeks), nuchal translucency scan (around 11-13 weeks, usually done at the same time as the dating scan) or anomaly scan (around 20 weeks). Some women are also scanned at other times in their pregnancy.

Obstetric physiotherapist

An obstetric physiotherapist is specially trained to help you cope with physical changes during pregnancy, childbirth and afterwards. Some attend antenatal classes and teach antenatal exercises, relaxation and breathing, active birth positions and other ways to keep yourself fit and healthy during pregnancy and labour. After the birth, they advise on postnatal exercises to tone up your muscles.

Health visitor

Health visitors are specially trained nurses who support and educate families from pregnancy through to a child's fifth birthday. You may meet your health visitor before the birth of your baby and in the first few weeks after the birth. You may continue to see your health visitor or a member of the team at home or at your child health clinic, Children's Centre, health centre or GP surgery. Find a Children's Centre near you.

Dietitian

If you have any concerns about special diets or eating healthily, a dietitian can give you the advice you need, for example if you develop gestational diabetes. 

Supervisor of midwives

A supervisor of midwives (SoM) can help and support you if you are having any problems with your care, or if you feel that your wishes and requests are not being considered. A SoM is an experienced midwife who has had extra training and education to support other midwives in providing the best quality maternity care. Every midwife has a named SoM.

The phone number for your supervisor of midwives should be in your handheld notes, or you can call your hospital's labour ward or local birth centre. You can also ask your local supervising authority midwifery officer, whose contact details are on the Nursing and Midwifery Council website. Discussing issues with the SoM won't affect your care or influence how you're further supported in your pregnancy, birth and aftercare.

Your antenatal appointments

You'll have a number of antenatal appointments during your pregnancy, and you'll see a midwife or sometimes an obstetrician (doctor specialising in pregnancy).

They will check the health of you and your baby, give you useful information – for example, about a healthy pregnancy diet or antenatal screening – and answer any questions.

Pregnant employees have the right to paid time off for antenatal care.

This page lists the appointments you'll be offered, and when you should have them. If you're pregnant with your first baby, you'll have more appointments than women who already have children.

First contact with midwife or doctor

Eight to 12 weeks: booking appointment

Eight to 14 weeks: dating scan

16 weeks

18-20 weeks: anomaly scan

25 weeks

28 weeks

31 weeks

34 weeks

36 weeks

38 weeks

40 weeks

41 weeks

First contact with midwife or doctor

Contact your GP or midwife as soon as possible after you find out that you're pregnant. They should give you information about:

  • folic acid supplements
  • nutrition, diet and food hygiene
  • lifestyle factors – such as smoking, drinking and recreational drug use
  • antenatal screening tests – including screening for sickle cell disease and thalassaemia, infectious diseases, the anomaly scan and screening for Down's syndrome, and the risks, benefits and limits of these tests. Screening for sickle cell disease and thalassaemia should be offered before 10 weeks. This is so you and your partner can find out about all your options and make an informed decision if your baby is at risk of inheriting these disorders 

It's important to tell your midwife or doctor if: 

  • there were any complications or infections in a previous pregnancy or delivery, such as pre-eclampsia or premature birth
  • you're being treated for a chronic disease, such as diabetes or high blood pressure
  • you or anyone in your family has previously had a baby with an abnormality – for example, spina bifida
  • there is a family history of an inherited disease – for example, sickle cell or cystic fibrosis
  • you know that you are a genetic carrier for an inherited condition such as sickle cell or thalassaemia. You should also tell the midwife if you know the baby's biological father is a genetic carrier for these conditions 
  • you have had fertility treatment and either a donor egg or donor sperm

Eight to 12 weeks: booking appointment

It's best to see your midwife or doctor as early as possible to obtain the information you need to have a healthy pregnancy. Some tests, such as screening for sickle cell and thalassaemia, should be done before you're 10 weeks pregnant.

Your midwife or doctor should give you information about: 

  • how the baby develops during pregnancy
  • nutrition and diet
  • exercise and pelvic floor exercises
  • antenatal screening tests
  • your antenatal care
  • breastfeeding, including workshops
  • antenatal education
  • maternity benefits
  • your options for where to have your baby

Your midwife or doctor should:

  • give you your handheld notes and plan of care
  • see if you may need additional care or support
  • plan the care you will get throughout your pregnancy
  • identify any potential risks associated with any work you may do
  • measure your height and weight, and calculate your body mass index (BMI)
  • measure your blood pressure and test your urine for protein
  • find out whether you are at increased risk of gestational diabetes or pre-eclampsia
  • offer you screening tests and make sure you understand what is involved before you decide to have any of them
  • offer you an ultrasound scan at 8-14 weeks to estimate when your baby is due
  • offer you an ultrasound scan at 18-20 weeks to check the physical development of your baby and screen for possible abnormalities
  • ask about your mood to identify possible depression
  • ask about any past or present severe mental illness or psychiatric treatment

This appointment is an opportunity to tell your midwife or doctor if you're in a vulnerable situation or if you need extra support.

This could be because of domestic abuse or violence, sexual abuse, or female genital mutilation (FGM).

FGM can cause problems during labour and childbirth, which can be life threatening for mother and baby. It's important you tell your midwife or doctor if this has happened to you.

Eight to 14 weeks: dating scan

This is the ultrasound scan to estimate when your baby is due, check the physical development of your baby, and screen for possible abnormalities including Down's syndrome.

16 weeks pregnant

Your midwife or doctor will give you information about the ultrasound anomaly scan you will be offered at 18-20 weeks. They will also help with any concerns or questions you have.

Your midwife or doctor should: 

  • review, discuss and record the results of any screening tests
  • measure your blood pressure and test your urine for protein
  • consider an iron supplement if you're anaemic  

18-20 weeks

You will be offered an ultrasound scan to check the physical development of your baby. This is also known as the anomaly scan. The main purpose of this scan is to check that there are no physical abnormalities.

Screening for HIV, syphilis and hepatitis B will be offered again by a specialist midwife to women who opted not to have it earlier in pregnancy. These tests are recommended as they greatly reduce the risk of passing infection from mother to baby.

From 20 weeks, you will be offered the whooping cough vaccine. The best time to have this vaccine is after your scan, up to 32 weeks. But if for any reason you miss the vaccine, you can still have it up until you go into labour.

25 weeks pregnant

You will have an appointment at 25 weeks if this is your first baby.

Your midwife or doctor should:

  • use a tape measure to measure the size of your uterus
  • measure your blood pressure and test your urine for protein

28 weeks

Your midwife or doctor should: 

  • use a tape measure to measure the size of your uterus
  • measure your blood pressure and test your urine for protein
  • offer more screening tests
  • offer your first anti-D treatment if you are rhesus negative
  • consider an iron supplement if you're anaemic 

31 weeks

You will have an appointment at 31 weeks if this is your first baby.

Your midwife or doctor should:

  • review, discuss and record the results of any screening tests from the last appointment
  • use a tape measure to measure the size of your uterus
  • measure your blood pressure and test your urine for protein

34 weeks

Your midwife or doctor should give you information about preparing for labour and birth, including how to recognise active labour, ways of coping with pain in labour, and your birth plan.

Your midwife or doctor should: 

  • review, discuss and record the results of any screening tests from the last appointment
  • use a tape measure to measure the size of your uterus
  • measure your blood pressure and test your urine for protein
  • offer your second anti-D treatment if you are rhesus negative

Your midwife or doctor should give you information about caesarean section, as around one in four women will have a caesarean.

This discussion may take place at the 34 week appointment, or at another time during your pregnancy.

They will discuss with you the reasons why a caesarean might be offered, what the procedure involves, risks and benefits, and implications for future pregnancies and births.

36 weeks

Your midwife or doctor should give you information about:

  • breastfeeding
  • caring for your newborn baby
  • vitamin K and screening tests for your newborn baby
  • your own health after your baby is born
  • the "baby blues" and postnatal depression

Your midwife or doctor will also:

  • use a tape measure to measure the size of your uterus
  • check the position of your baby
  • measure your blood pressure and test your urine for protein
  • offer external cephalic version (ECV) if your baby is in the breech position

38 weeks

Your midwife or doctor will discuss the options and choices about what happens if your pregnancy lasts longer than 41 weeks.

Your midwife or doctor should: 

  • use a tape measure to measure the size of your uterus
  • measure your blood pressure and test your urine for protein

40 weeks

You will have an appointment at 40 weeks if this is your first baby.

Your midwife or doctor should give you more information about what happens if your pregnancy lasts longer than 41 weeks.

Your midwife or doctor should:

  • use a tape measure to measure the size of your uterus
  • measure your blood pressure and test your urine for protein

41 weeks

Your midwife or doctor should:

  • use a tape measure to measure the size of your uterus
  • measure your blood pressure and test your urine for protein
  • offer a membrane sweep
  • discuss the options and choices for induction of labour 

42 weeks

If you have not had your baby by 42 weeks and have chosen not to have an induction, you should be offered increased monitoring of the baby.

Time off for antenatal appointments

Find out more about rights to time off for antenatal appointments at the GOV.UK page on working when pregnant: your rights.

Baby positions in the womb

During pregnancy, babies often twist and turn. By the time labour begins, however, most babies settle into a position that allows them to be born headfirst through the birth canal. That doesn't always happen, though.

Here are some of the possible baby positions at the end of pregnancy and how they can affect the birth:

  • normal position (head down)
  • feet first (breech position)
  • lying sideways (transverse position)

Feet first (breech baby)

If your baby is lying feet first with their bottom downwards, they are in the breech position. This makes your care more complicated. Your obstetrician and midwife will discuss with you the best and safest form of care. You will be advised to have your baby in hospital. 

Turning a breech baby

You'll usually be offered the option of an external cephalic version (ECV). This is when an obstetrician tries to turn the baby into a head-down (cephalic) position by applying pressure on your abdomen. It's a safe procedure although it can be a little uncomfortable. Around 50% of breech babies can be turned using ECV, and of those, most stay head-down, allowing you to have a normal birth.

Giving birth to a breech baby

If an ECV doesn't work, you'll need to discuss options with your midwife and obstetrician. Although breech babies can be born vaginally, you will probably be offered a caesarean section. This is the safest way of giving birth to a breech baby.

If you plan a caesarean and then go into labour before the operation, your obstetrician will assess whether to proceed with the caesarean delivery. If the baby is close to being born, it may be safer for you to have a vaginal breech birth.

The Royal College of Obstetricians and Gynaecologists (RCOG) has more information on:

The RCOG states that you may be advised against a vaginal breech delivery if: 

  • your baby's feet are below its bottom (known as a footling breech)
  • your baby is large (more than 3.8kg or 8.4lb)
  • your baby is small (less than 2kg or 4.4lb)
  • your baby is in a certain position, for example, if their neck is tilted back
  • you've had a caesarean delivery before
  • you have a narrow pelvis (there's less room for the baby to pass safely through the birth canal)
  • you have a low-lying placenta
  • you have pre-eclampsia

Lying sideways (transverse baby)

If your baby is lying sideways across the womb instead of vertically it's said to be in the transverse position.

Although many babies lie sideways early in pregnancy, most have turned themselves into the normal (head down) position by the final trimester.

Giving birth to a transverse baby

Depending on how many weeks you are when a transverse position is diagnosed, you may be admitted to hospital. This is because of the very small risk of the umbilical cord prolapsing if your waters break. This is a medical emergency where the umbilical cord comes out of the womb before the baby and the baby must be delivered very quickly.

Sometimes, it's possible to manually turn the baby to a head down position and you may be offered this.

It's almost impossible for a transverse baby to be born naturally. So, if your baby is still in the transverse position when you approach your due date or by the time labour begins, you'll be advised to have a caesarean section.