How can you get free or low-cost prenatal care? What is your location at this point? What is prenatal care and why is it important? What tests will you have during pregnancy? How often do you need prenatal visits? Who can you go to for prenatal care? hat hospital or birthing center does the provider use? What do you know about it? Is it easy for you to get to? How often do you go for prenatal care checkups? How can you get ready for your first prenatal care checkup? How can you get free or low-cost prenatal care? If you don't have health insurance or can't afford prenatal care, find out about free or low-cost prenatal care services in your community: What is your location at this point? What is prenatal care and why is it important? Prenatal care is medical care you get during pregnancy. What tests will you have during pregnancy? These tests are to check that you and your baby are well. 1. Blood pressure checks 2. Urine tests 3. Blood tests 4. Abdominal palpation (feeling your womb) 5. Your baby’s movements 6. Group B Strep test Blood pressure checks Your midwife will check your blood pressure at each of your antenatal appointments. They use a cuff that is wrapped around your upper arm. Blood pressure checks should ideally be done on the same arm every time. Your first reading will give your antenatal team an idea of what your blood pressure normally is. They can then see whether your readings change during your pregnancy. Raised blood pressure can affect your baby’s growth and be a warning sign of pre-eclampsia. Urine tests You will be asked to give a sample of your urine (wee) at each antenatal appointment to check for protein, which can be a sign of pre-eclampsia. You may also be asked to give a urine sample If you show any symptoms of having a urinary tract infection at any time during your pregnancy. It is important to give a sample that is ‘midstream’ – this means it is taken halfway through weeing. This is the best way to tell if there is an infection in your bladder. Blood tests Your midwife will offer you blood tests at your booking appointment and later in your pregnancy. You may be offered more blood tests if there’s a chance you may have a health condition. Talk to your midwife if you are worried about having the tests or you don’t like needles. They may be able to reassure you and can support you to make an informed decision about having the tests. At your booking appointment, you will be offered a blood test to check: your blood group and rhesus status whether you have an infection, such as hepatitis B, HIV or syphilis whether you have iron-deficiency anaemia (not enough iron in the blood) whether you carry the gene for sickle cell anaemia or thalassaemia. You may be offered more blood tests at 28 weeks to check: your iron levels again whether you have developed gestational diabetes or if you are at risk whether you have developed anti-D antibodies, if you are rhesus-negative. The NHS website has more information about this. Measuring your baby’s growth From 24 weeks your midwife will start to measure your growing bump to check that your baby is growing well. This is done using a tape measure. They will measure your bump, in centimetres, from your pubic bone to the top of the uterus. This will be plotted on a graph in your notes. The measurement is usually the same as the number of weeks you are, give or take 1–2 cm. If the measurement is higher or lower than expected, your midwife may refer you for an ultrasound scan to check your baby’s size. Abdominal palpation (feeling your womb) At about 36 weeks, your midwife will feel your bump to check which position your baby is in. If your baby has their bottom or feet downwards, your midwife will refer you for an ultrasound scan to get a clearer idea of their position. This is because it may affect your labour and birth. Find out more about getting your baby into the best birth position. Your baby’s movements From the second half of your pregnancy your midwife will also ask you about your baby’s movements. Feeling your baby move is a sign that they are well. Be aware of your baby’s usual pattern of movements and if you notice that they have slowed down, changed or stopped, it may be a sign that your baby is not well. Contact your midwife or maternity unit immediately if you notice any changes to your baby’s movements. This could save your baby’s life. There are staff on the hospital maternity unit 24 hours a day, 7 days a week. Find out more about your baby’s movements. Group B Strep test Group B Strep (GBS) is a type of bacteria called streptococcal bacteria that lives in the body. Between 1 and 2 out of every 5 women (20-40%) has this bacteria and it doesn’t usually cause any health problems. The GBS bacteria do not produce any symptoms in women during pregnancy and your baby will usually be born healthy. However, there's a small risk it could spread to your baby during labour and make them ill. There’s also a very small risk you could have a miscarriage. Group B Strep is not routinely tested for but may be found during tests carried out for another reason, such as a urine test or vaginal swab. How often do you need prenatal visits? If it's your 1st pregnancy, your antenatal checks will be at: 8 to 12 weeks (booking appointment) 8 to 14 weeks (dating scan) 16 weeks 18 to 20 weeks (anomaly scan) 25 weeks 28 weeks 31 weeks 34 weeks 36 weeks 38 weeks 40 weeks 41 weeks (if you haven't already given birth) If you've had a baby before, your appointments will be at: 8 to 12 weeks (booking appointment) 8 to 14 weeks (dating scan) 16 weeks 18 to 20 weeks (anomaly scan) 28 weeks 34 weeks 36 weeks 38 weeks 41 weeks (if you haven't already given birth) antenatal-appointment-schedule_176765 Your antenatal checks: what happens at each appointment The purpose of your antenatal check-ups are, obviously, to find out how your baby is growing, flag up any concerns, give you info about the weeks ahead, and give you an opportunity to get answers to any questions or concerns you have. More like this Not every antenatal appointment is the same, though. You midwife will often run through some of the same checks each time but there'll also be new things, as your pregnancy progresses and, sometimes, the check will be really different and specific – like when it's time for an ultrasound scan. Here's what to expect: 8-12 weeks: Booking appointment or "booking in". Your midwife will ask about your lifestyle and medical history, carry out routine checks (blood pressure, height and weight, urine dip), calculate your due date and give you loads of info about your antenatal care. You'll probably also be asked to give some blood samples (or return later to give them) – which will be used for routine checks (your blood type, for example) and, if you give your consent, as part of a combined screening test for Down's syndrome. Find out more about your booking appointment 8-14 weeks: Dating scan or 12-week scan (even though it may not happen exactly at 12 weeks). This is your 1st NHS ultrasound! And the scan will check your baby’s heartbeat, see if your due date tallies with your baby's development – and show if you are expecting twins or more. You will also have, if you consent, the nuchal translucency scan that's the other part of the combined screening test. Oh, and you'll get to take some cute pics home! Find out more about your 1st pregnancy scan 16 weeks: 2nd midwife appointment. Your midwife will talk you through the results of any screening tests you have had (if you haven't done this already). You will have more urine and blood pressure checks, and your midwife will listen for your baby's heartbeat with a special monitor that amplifies the noise, so you can hear it too. You will be also given info about your 2nd ultrasound scan (the anomaly scan) which is coming up soon. 18-20 weeks: Anomaly scan or 20-week scan. This 2nd, more detailed, ultrasound scan is to check your baby has no physical abnormalities. The scan operator will look at your baby’s head, face, spine, limbs, heart and bladder. He or she may also be able to tell you the sex of your baby if you would like to know. 25 weeks: Routine appointment (if you're having your 1st baby). Your midwife will measure your bump with special tape measure, take your blood pressure, test your urine and listen to your baby's heartbeat. If, at your earlier appointments, you didn't consent having your blood screened for HIV, syphilis and hepatitis B, you may be asked again now. You may also be offered the whooping-cough vaccine (as best time to have this is after your anomaly scan and before 32 weeks). 28 weeks: Routine appointment. You will have your bump measured, blood pressure taken, urine checked and your baby's heartbeat monitored, as before. And, if you are rhesus negative, you will be offered your first anti-D injection. 31 weeks: Routine appointment (if you're having your 1st baby). All the usual bump measuring, heartbeat monitoring, urine and blood pressure checking, as before. 34 weeks: Routine appointment. As well as doing the usual checks, your midwife will want to discuss your birth plan with you (if she hasn't already), and give you information about pain relief and preparing for labour and birth. She will also talk to you about Caesarean sections, and the reasons why you may end up having one. If you are rhesus negative, you will be offered your second anti-D injection. 36 weeks: Routine appointment. You will be given info about breastfeeding and caring for a newborn, as well as looking after your own health after the birth and understanding the signs of post-natal depression. And, as well as the standard bump-measuring, heartbeat-monitoring and blood-pressure and urine checks, your baby's position will be checked – and if it's thought your baby is in the breech position (head up, rather than head down), you midwife may offer to try to 'turn' it by manipulating your bump. 38 weeks: Routine appointment. Your midwife will measure your bump, listen to your baby's heartbeat, and check your urine and blood pressure – and talk to you about your options if your baby goes overdue (if you're still haven't had it by 41 weeks). 40 weeks: Routine appointment (if you're having your 1st baby). As well as doing the usual bump, heartbeat, urine and blood pressure checks, your midwife will discuss your impending birth with you, and give you more info about your choices if you go over 41 weeks. 41 weeks: Last routine appointment (if your baby hasn't arrived already). Your midwife will – of course – check your bump size, your blood pressure and your urine, as well as listening to your baby's heartbeat. She'll then discuss your options for induction, and might offer you a membrane sweep, like she did to MFM Chat forum user Gen3: "I had my midwife app last Friday and they offered me a membrane sweep, which I took! This is supposed to kickstart labour by releasing the right hormones, and my midwife said, if it's successful, I would be in labour within 48 hours..." 42 weeks: 42-week check (if your baby still hasn't arrived). If you have chosen not be be induced, your midwife will be talking to you about increased monitoring of your baby.