june 2023

Antenatal Appointments - What to Expect When You See Your Midwife

This guide covers what happens during your antenatal midwife appointments and includes a midwife appointment schedule.

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a pregnant woman is speaking to her midwife at her antenatal appointment

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This guide covers what happens during your antenatal midwife appointments. It includes a midwife appointment schedule to help you understand what you can expect throughout your pregnancy whenever you have an antenatal appointment, from booking to the birth of your baby.

What are antenatal appointments?

Anything that happens before labour begins and the birth of your baby is referred to as antenatal. Every appointment you have with anyone to do with your pregnancy during this time – booking, blood tests, ultrasound scans, midwife, obstetrician – comes under that umbrella term of antenatal appointments.

You will have regular pregnancy appointments, and depending on whether your pregnancy is classed as low-risk or high-risk, you may have fewer or more appointments than other pregnant women.

  • Antenatal appointments are necessary because, at each contact, you will have some health tests completed to ensure you and your baby are safe and well, physically and emotionally.
  • Each appointment is tailored to your pregnancy. They will cover topics specific to your gestation and are designed to prepare you for labour, birth and beyond.
  • If your midwife feels it is necessary, they may refer you for more screening tests or to an obstetrician/specialist team for extra care.

How many midwife appointments do you have?

As a rule, first-time mums can expect about 10 routine antenatal contacts. In comparison, a mum who has already had a baby will usually be seen less, with 7 scheduled appointments.

The standard antenatal care as recommended by the NHS during pregnancy varies depending on whether:

  • This is your first baby
  • Your pregnancy is classed as low or high risk
  • You need to see your midwife more often due to personal preference

If you are considered to have a high-risk pregnancy, you will be offered additional appointments, usually for ultrasound scans and obstetrician-led antenatal clinics.

a pregnant woman is noting down her her midwife appointments in her diary

Will I see the same midwife throughout my antenatal appointments?

The Gold Standard within the NHS is for a small team of midwives to provide all of your antenatal, labour and postnatal care. This is called the Continuity of Carer approach, which has demonstrated improved outcomes and satisfaction.

However, this very much depends on where you live and will be affected by issues such as funding and staffing levels.

Don’t be disappointed if you don’t see the same midwife each time. All of the information about you and your pregnancy is documented either in your handheld notes or on an electronic record which subsequent caregivers can use to inform them of your care plan.

What happens at your first midwife appointment?

A woman is speaking to her midwife at her maternity appointment.

Your first appointment with a midwife is often called your booking appointment, when you will discuss and decide where you would like to birth your baby. You can choose to give birth in a hospital, a birth centre, or at home.

Remember, this is not a contract, plans might change, and you may change your mind.

This appointment takes place around 8-10 weeks of pregnancy, sometimes earlier if you are considered high-risk. The midwife will take a complete and detailed history – medical, lifestyle, obstetric, mental wellbeing, relationships etc.

The minimum you can expect to happen at your booking appointment includes the following:

  • A complete and detailed medical and lifestyle history will be taken and documented
  • A risk assessment to ensure you follow the right care pathway
  • A Venous Thrombo -Embolism (VTE) assessment and referrals, if indicated
  • A urine test to check for any signs of infection or protein
  • A blood pressure check
  • Blood tests offered and taken if consented
  • Ultrasound scans and genetic screening will be discussed, offered and booked
  • Height, weight, and BMI calculated
  • Advice about safe sleeping positions during pregnancy
  • Dietary advice – foods and drinks to avoid during pregnancy
  • Advice on vitamin supplements
  • Exercise and physical wellbeing advice
  • You will be provided with an FW8 form for free NHS prescriptions and dental treatment
  • Information about antenatal classes
  • Opportunity for you to gather information and ask any questions you may have

You will be given either a set of handheld paper notes or access to an app to view your notes, test results, appointments, and leaflets.

What questions should I ask at my first midwife appointment?

a woman is holding her pregnant bump.

Your midwife will conduct health and wellbeing checks at each appointment. And this is also a time for you to gather information which may help when making decisions about your pregnancy and birth. Making a note of any non-urgent questions as you think of them – either in a notebook, on the back of your paper notes or your phone – is valuable preparation for your appointment.

Any urgent concerns at this stage should go through your local Maternity Assessment Centre or Unit.

Your first appointment may feel overwhelming. With all of the information you receive, you may come out thinking, “I wish I had asked that!” So here’s a list of frequently asked questions you may want to consider:

  • When will I meet my Community Midwife?
  • How often will I be seen during my pregnancy?
  • Will I see the same Midwife throughout my pregnancy?
  • Will I have any scans? When? Can anyone else accompany me?
  • Where will I birth my baby?
  • What if I have any concerns about my pregnancy? Who do I contact?
  • Should I be taking pregnancy supplements?
  • Can I travel abroad during my pregnancy?
  • What foods should I avoid during pregnancy?
  • Can I continue exercising during pregnancy?
  • Antenatal classes? When should I book them?
  • Is it safe to continue taking prescription medications?
  • Is sex safe during pregnancy?
  • How will I know my baby is ok in pregnancy?

What happens at your 8-10 week appointment?

During this appointment, a midwife will take a comprehensive history of your mental health, previous pregnancies, lifestyle, family and medical wellbeing. You will also be offered screening tests, such as ultrasound scans, blood tests and a urine test.

You can expect the following:

  • To discuss the schedule of your antenatal appointments
  • To discuss and choose where you would like to give birth
  • Learn any symptoms that may be of concern during pregnancy
  • To discuss your partner and their family history
  • To undergo risk assessments for Pre-eclampsia, Gestational Diabetes and VTE (blood clots)
  • A discussion to ensure you are on the right care pathway
  • A calculation of your height, weight and BMI
  • A blood pressure test
  • A discussion about antenatal classes in your area

What happens at your 11-14 week appointment?

During the 11 - 14 week midwife appointment, you will have a dating ultrasound scan with a sonographer specialising in pregnancy to establish your EDD (Expected Due Date).

At 14 weeks, you may also be offered an appointment to have a blood test to check the baby's blood group and to check if your blood group is rhesus negative, to identify if you should be offered Anti-D prophylaxis.

What happens at your 16-week appointment?

At your 16-week appointment, you will undergo a health check, a scan and receive your blood test results. It may be possible for the midwife to hear the baby’s heartbeat at this gestation using a Doppler (handheld listening device).

What happens at your 20-week appointment?

You will be offered a Foetal Anomaly Ultrasound Scan (FAS) at the hospital. And, should you want to know, you may be able to find out the gender of your baby.

  • You will also be advised to book a Whooping Cough vaccination with your GP.
  • At this stage, you may start to feel the baby's movements, but don’t be concerned if this doesn’t happen until later.
  • You will receive a MatB1 certificate to hand to your employer or the Job Centre, which entitles you to either Statutory Maternity Pay (SMP) or Maternity Allowance (MA).

What happens at your 25-week appointment?

Only first-time mums-to-be will have this appointment in their schedule. You can expect the following during this midwife appointment:

  • A health check
  • To receive scan results
  • Labour and birth preparation advice
  • A discussion around antenatal classes
  • A discussion around foetal movements

Read our guide on the labour and birth care choices available to you.

What happens at your 28-week appointment?

The 28-week maternity appointment is a major appointment where you can expect the following:

  • A health check
  • Checking foetal movements
  • Repeat blood tests
  • An abdominal palpation examination
  • Plotting symphysis fundal height (SFH) on your Personalised Growth Chart (PGC)

At this stage, you will be offered an Anti-D prophylaxis if indicated.

You may also be offered an Oral Glucose Tolerance Test (OGTT) in an antenatal clinic if indicated to check for Gestational Diabetes.

By now, you should be feeling your baby move. If you have any concerns about the baby’s movements, you may be advised to have a CTG (Cardiotocograph) monitoring of their heartbeat to assess their wellbeing.

What happens at your 31-week appointment?

Usually, only first-time mums-to-be will have this midwife appointment. You can expect the following:

  • A health check
  • Checking foetal movements
  • SFH plotted on your Personal Growth Chart

Your baby will usually have developed a pattern of what movements are “normal” for them. Monitor these movements, and if you are ever concerned that the pattern of movements has changed, then you should call the Maternity Assessment Centre/Unit (MAC/MAU) for an assessment.

Changes to look out for include:

  • Movements have slowed down
  • You have not felt the baby move
  • Excessive continuous movements

What happens at your 34-week appointment?

At this appointment, you can expect the following:

  • A health check
  • Checking foetal movements
  • SPH plotted
  • Discussion about how to care for your newborn and feeding
  • Discussion about screening test results from the 28-week blood tests

Read our guides on breastfeeding and colostrum harvesting.

What happens at your 36-week appointment?

At this appointment, you can expect the following:

  • A health check
  • Checking foetal movements
  • SPH plotted
  • If you are considering an elective Caesarean, you will have this appointment with an obstetrician to discuss your options
  • Confirmation of the presentation of your baby (head-down, breech or transverse) and referrals to discuss options with an obstetrician if the baby is not head-down
  • If you are booked for a home birth, this appointment should be at home so the midwife can see how the space will work during labour and delivery

What happens at your 38-week appointment?

At this stage, you can expect the following:

  • A health check
  • Checking foetal movements
  • SPH plotted
  • To confirm birth preferences and place of birth

What happens at your 40-week appointment?

This appointment is usually just for first-time mums-to-be. You can expect the following:

  • A health check
  • Checking foetal movements
  • SPH plotted
  • A discussion about inducing labour
  • Offered a membrane sweep

What happens at your 41-week appointment?

At this stage, you can expect the following:

  • A health check
  • Checking foetal movements
  • SPH plotted
  • Booking an induction of labour
  • Offered a membrane sweep

Please note: Mums-to-be who have already had a baby usually will not have an appointment at 25, 31 and 40 weeks and will be offered a membrane sweep from 41 rather than 40 weeks gestation.

What you need to know about antenatal appointments

a pregnant woman is undergoing health checks at her midwife appointment

Midwife appointment schedules are fairly standard throughout the NHS, and your midwife should be able to explain this at your booking appointment. However, that schedule may be amended during pregnancy if your risk level increases or decreases.

Antenatal appointments ensure you are kept safe and healthy throughout your pregnancy and help prepare you for labour and transition to parenthood.

As part of routine care, your midwife should discuss antenatal classes in your local area and explain how and when to book them. It is entirely your choice as to which classes you enrol on; NHS or private, face-to-face or virtual, free or paid, and will be determined by your specific needs and wants and what is offered locally.

Get expert antenatal education with My Expert Midwife

My Expert Midwife has launched online antenatal classes covering 137 topics over 7.5 hours that you can take at your own pace. Our team of in-house registered midwives, consultant obstetrician and anaesthetist have written and presented all of the antenatal course material based on the most up-to-date evidence.

You can view it in your own time, at your own pace, as many times as you wish. With the classes, you will get access to our online forums and communities where you will get to chat with other pregnant families-to-be as well as with our Midwives.

For more expert advice from our midwives, visit our blog.