Antenatal appointments are scheduled during the 40 weeks gestation period to make sure you and your baby’s health is maintained to the highest standard. Antenatal care can be ‘Hospital-led. This means all your visits take place within the hospital setting and you are seen by a doctor or a midwife at each visit. Antenatal care can also be ‘Midwife-led. This means that after your initial booking visit in the hospital if you are deemed to be low risk all your visits can be with the midwife (either in the hospital or else in the community). Antenatal care can be ‘Consultant –led’, which is when all your visits are within the hospital and you are seen by the Consultant at each visit (usually the case when attending privately). Or antenatal care can be ‘Combined-care’, whereby your visits are shared out equally between your GP Practice (you may see the midwife at this visit) and the hospital.
Antenatal appointments should happen at the following stages of pregnancy:
- Initial visit to the GP at 4-8 wks
- Booking Appointment in the hospital (ideally before 10 wks)
- Routine visit at 16 wks
- Anomaly Scan at 18-20 wks
- Routine Visit at 24 wks for women on their first pregnancy
- Routine Visit at 28 wks
- Routine Visit at 32 wks- Rhesus Negative Women need a repeat blood sample at this stage
- Routine Visits at 34 wks, 36 wks,38 wks & 40 wks
- If you have not delivered by this time you will come back again at 41 wks & 42 wks
At all times throughout your visits the doctor/midwife will assess the growth of your baby by measuring the distance of the top off your womb from your pubic bone. They will also measure your blood pressure and test a sample of your urine for protein and bacteria. They will also check what position your baby is lying in from 24 wks.
You should also be given every opportunity to ask questions at these visits and the doctor/midwife should provide you with up-to-date evidence based information which is supported with written information; thus ensuring women centered care is provided.
The information and education you should be provided with includes:
- Work- identifying any risks to you /baby in your work place and deciding whether it is safe for you to continue working. Discussing your maternity rights and benefits.
- Nutritional supplements - recommend taking folic acid supplementation before conception and during the first 12 wks (400 mcg per day). Vit D supplementation during pregnancy and breastfeeding is 10 mcg per day for women at risk of low Vit D stores due to inadequate sunlight exposure ( environmental/cultural reasons) or women who have a diet low in Vit D. (Vit D can be found in oily fish, eggs, meat and some fortified milks and cereals). Iron supplements should not be taken routinely.
- Reducing the risk of listeriosis and salmonella (correct storing of food in the fridge, thoroughly cooked meat and poultry, avoid undercooked/raw egg products, unpasturised cheeses, wash all fruit and veg) and how to avoid Toxoplasmosis infection( wearing gloves when gardening, handling pet faeces, washing hands )
- Complementary therapies - few have been proven as being safe and effective during pregnancy
- Exercise - No risk with sustaining or starting moderate exercise. But sports that may cause abdominal trauma, falls or excessive joint stress & scuba diving should be avoided.
- Sexual intercourse- thought to be safe during pregnancy.
- Alcohol - when planning a pregnancy to avoid alcohol in the first 3 months. If women choose to drink alcohol to have no more than 1-2 units during the week and to avoid binge drinking and getting drunk.
- Smoking - discuss smoking status and give information about the risks of smoking during pregnancy (low birth weight baby, risk of cot death)
- Air travel - long haul travel is associated with an increased risk of clots – but the possibility of additional risk in pregnancy is unclear. Advise women to wear compression stockings as with the general population.
- Car travel - wear the seat belt under the bump and not over it.
Overall there is a lot of information that you should expect to be informed of during your antenatal visits. That is why it is important to attend all your antenatal visits as scheduled.
Gráinne Grundy RGN RM - Mama & Me
Gráinne holds monthly antenatal classes in Kildare www.MamaAndMe.ie
