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Antenatal Care

 

Antenatal Care

Antenatal care is the care you get during pregnancy from midwives, doctors and if required specialist doctors. It is important to attend these appointments as they keep an eye on your health, well being and that of your growing baby.

What are antenatal classes?

Antenatal classes help you to prepare physically and emotionally for the birth of your baby. At the classes you can ask questions and explore the different ways in which you can give birth.

If you are a working mother you are entitled to paid time off to attend antenatal classes. Antenatal care is the key to healthy mothers and babies and it’s very important you attend your appointments.

When do I start having antenatal care?

After confirmation of your pregnancy your doctor will make arrangements for your antenatal care. Most women have their first and longest antenatal check- up between weeks 8 and 12 of pregnancy. The earlier you start attending antenatal check-ups the better. You should then attend antenatal check-ups once a month until 28 weeks, then twice a month until you are 36 weeks pregnant. During the last 4 weeks of your pregnancy you should go every week. Where you receive antenatal care may depend on your personal situation, they are usually carried out at your doctors surgery but can also be at your local hospital, health centre, young persons centre or even from home.

The first visit

Your first visit will be the longest, it is often referred to as your ‘booking appointment’. This appointment can be an hour long, you will be given plenty of information and will be given your maternity notes, these must then be brought along to all future appointments.  You will be asked many questions and the answers to these questions will help the doctor or midwife, discover anything that could affect your pregnancy or your baby.

You may be asked questions on the following:

  • The date of your last period so they can estimate when your baby is due.
  • You and your partner’s medical and family history. This will include any racial origins. This is in case you carry the gene for any inherited blood disorders which may affect your baby.
  • If there is a history of twins in either your family or your partner’s.
  • If you have had any previous pregnancies, this will include miscarriages or abortions.
  • If you have any known allergies.
  • Whether you are taking any medications for illnesses.
  • What serious illnesses or operations you have had in the past.
  • Your mental health history but also how you are feeling about the pregnancy. Don’t be afraid to tell the truth, they are there to support you during pregnancy.
  • You may also be asked about your backgrounds – what your jobs are and about your living accommodation. This is in case there is anything in your circumstances that may affect your pregnancy.

General examination

You will have regular checks on your heart and lungs to make sure your general health is good. Your blood pressure will be closely monitored throughout your pregnancy. Towards the end of pregnancy most women tend to suffer from swollen ankles. This usually happens towards the end of the day, especially if you have been on your feet for most of the day. If you notice a lot of swelling in your hands and feet you should consult your midwife or doctor, as it could be the sign of pre-eclampsia. Pre-eclampsia is a condition that quite often develops in late pregnancy and is characterised by a rise in blood pressure and swelling of hands, feet or face. Mild pre-eclampsia is not dangerous, but needs to be treated as it can progress to more serious conditions. Severe pre-eclampsia can produce symptoms such as, severe headaches and abdominal pain. In rare cases women with pre-eclampsia can develop full blown eclampsia. Eclampsia describes one or more convulsions, or seizures, occurring during or immediately after pregnancy. If you have any worries you should consult your doctor who will monitor your condition very carefully.

Your abdomen will be felt on each visit, to check the rate at which your baby is growing and the position.

Internal examination

It is unlikely that this will be carried out on your first visit and you usually may only need one during labour. However, on occasions your doctor may carry out an internal examination, enabling them to feel the size of your uterus, this will help to estimate your stage of pregnancy. During this procedure you will be asked to lie on your back with your legs bent and your knees apart. The doctor will place two fingers of one of his/her hands into your vagina and press your abdomen gently with the other hand. This examination will not hurt and if you relax it will not even be uncomfortable. Most doctors prefer to use an ultrasound either at the first or later visit. They must always ask your permission before carrying out an internal investigation.

Height check

Your height is a rough guide to the size of your pelvis. If you have a small pelvis you can sometimes have a difficult delivery. If you are over 5ft you are unlikely to have any problems.

Weight check

You will be weighed on your first visit and then your weight gain should be checked regularly. Some clinics/hospitals will weigh you at every visit and others may not. If you are weighed at every visit, you should take this into consideration and try to wear similar weight clothes on each visit. The majority of weight gain will be after week 20 and this will be about 22 -28 pounds.

Blood tests

Blood samples will be required in your first visit. This blood test will check for:

Urine tests

You will be asked to give a urine sample on every visit, the urine will be checked for the following:

  • Sugar – this could be a sign of pregnancy diabetes.
  • Protein – this may indicate that there is an infection that needs treating.

Diet

You will be given advice on healthy eating, what foods to avoid and will be given recommendations on what vitamins you should take.

If you are over 37 you may be offered some special tests. If you fall into this category your doctor will discuss these with you.

Later visits

After the booking appointment future ones are much shorter usually only about 10-15 minutes providing there are no complications.

You will be offered 2 scans during your pregnancy these are usually at week 12 and week 20.

You will be able to hear your baby’s heartbeat after week 14 with a device called a Sonicaid, which enables the beat to be amplified so that it can be heard.

After week 16 you will usually have an ultrasound scan, this may however be carried out at any stage. This process is completely safe and painless. An ultrasound scan uses sound waves to build up a picture of the baby in the uterus (womb). You and your partner can watch the picture displayed on a small screen and sometimes you will be given a copy of the picture to keep. This will usually be the first time you will actually see your baby moving around and it will make the baby seem real for possibly the first time.

Around week 16 of pregnancy you may have a blood test for A.F.P. (Alpha-fetoprotein). A.F.P. is a substance found in the blood and high levels could indicate that you baby has a neural tube defect such as spina bifida. If the result is positive further tests such as an amniocentesis will be carried out. An amniocentesis is used to detect spina bifida and Downs syndrome. This test involves a small (1 in 100) risk of miscarriage and so is not a routine test. You are more likely to be offered this test if you are over 37 years of age.

Many women sometimes feel bored and frustrated with the lengthy procedures at the clinic, try taking your partner or a friend along with you to keep you company. It is very important you attend antenatal appointments as they will ensure you and your baby receive all the care and attention needed to maintain a healthy, happy pregnancy.