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What Happens at My Initial Booking Appointment?
Your initial booking appointment is one of the most important appointments we will have together.
It's the beginning of our relationship and gives us time to get to know one another properly. You can ask me anything you'd like about me, my experience, how I work and the care I provide. I'll always be open and honest with you.
It's also my opportunity to learn about you.
Your booking appointment is detailed because, to provide safe and personalised midwifery care, I need to understand the whole picture, not just how many weeks pregnant you are today.
Why Do I Ask So Many Questions?
I will ask you a lot of questions at your booking appointment but I don't want it to feel like an interrogation or a tick-box exercise.
We'll sit and talk through everything together at your own pace, and you can ask me questions throughout.
There is a reason I need so much information.
As one of your midwifery care providers, I need to understand your physical and mental health, your medical and family history, previous pregnancies and births, your current pregnancy, medications, allergies, lifestyle and home circumstances, as well as anything else that could be relevant to the care of you and your baby.
Some questions may initially seem completely unrelated to pregnancy, but there is usually a reason behind them. If you're ever unsure why I'm asking something, please ask me, I'm always happy to explain.
The more I understand about you, your health, your pregnancy and your individual circumstances, the better I can tailor my care to you.
Getting to Know You
We'll start with the basics, including your name, date of birth, address and NHS number.
We'll also talk about your partner or family circumstances where relevant and who will be supporting you during your pregnancy and after your baby arrives.
This is also your opportunity to get to know me.
Choosing a midwife is a very personal decision. You're trusting someone to care for you during an incredibly important period of your life, so please ask me questions too.
Your Medical and Mental Health History
We'll go through your medical history carefully, including any conditions you currently have or have experienced previously.
I'll ask about medications you're taking and any allergies you have, including allergies to medicines or latex.
Your mental health is an equally important part of your care. I'll sensitively ask about your current and previous mental health, including experiences such as depression, anxiety, eating disorders, self-harm or psychosis where relevant.
We may also discuss previous involvement with social care or other services where this is relevant to your maternity care.
These aren't questions asked to judge you. They're part of understanding what support you may need and ensuring that both your physical and emotional wellbeing are considered throughout your pregnancy.
Your Family History
Your family's health history can tell me important things about your own pregnancy.
I'll ask about relevant conditions within your immediate family and your partners family where appropriate.
This can include things such as diabetes, high blood pressure, blood clots, mental health conditions and relevant inherited or hereditary conditions.
I'll also ask about things such as multiple births in the family, childhood hearing loss, hip problems present from birth and relevant disabilities or medical conditions.
You may not know every answer, that's absolutely fine. We'll work with the information you have.
Your Previous Pregnancies and Births
If you've been pregnant before, we'll talk through your previous pregnancies and births.
I want to understand what happened clinically, but I also want to understand your experience of what happened.
We'll discuss previous pregnancy complications, births, caesareans, assisted births, pregnancy losses and any difficulties you experienced during pregnancy or after birth where relevant.
If a previous experience was difficult or traumatic, you don't have to tell me everything at once. We can approach those conversations sensitively and at your pace.
Understanding your previous pregnancies helps me identify anything we may need to consider during this pregnancy and allows us to start talking about the care and support that feels right for you.
Your Current Pregnancy
We'll then look closely at your pregnancy so far.
If you've already had scans, screening or blood tests, I'll review the results with you.
Depending on how far along you are, we may discuss your booking blood tests, screening for chromosomal conditions, including combined screening or NIPT and whether any additional tests or appointments may be recommended.
We'll also talk about how you conceived where relevant, including IVF or other fertility treatment.
As your pregnancy progresses, we'll discuss further blood tests and whether there are reasons you may be offered tests such as screening for gestational diabetes.
Looking at Your Individual Risk Factors
Part of good antenatal care is identifying anything that may mean you need additional monitoring, advice or medical input.
At your booking appointment I'll assess relevant risk factors for conditions including pre-eclampsia and venous thromboembolism (VTE), which includes DVT.
Your medical history, family history, previous pregnancies and individual circumstances all contribute to those assessments.
If I identify something that may require additional consideration, I'll explain it to you. Where appropriate, we can discuss further assessment, preventative treatment or referral to another maternity professional.
The aim isn't to frighten you with a list of things that could go wrong. It's to identify relevant risks early so that we can plan your care appropriately.
Your Lifestyle, Nutrition and Wellbeing
We'll talk about everyday things too.
That can include your diet, pregnancy vitamins and supplements, exercise and foods that are recommended to avoid during pregnancy.
I'll ask about smoking, alcohol and recreational drug use where relevant, including within your household, because understanding your baby's home environment forms part of providing appropriate care.
Again, these conversations aren't about judgement. They're about giving you the information and support you need.
Your Hospital and Place of Birth
We'll talk about where you're thinking about having your baby, whether that's at home or in hospital.
Even if you're planning a home birth with me, I recommend being booked with an NHS maternity service as well. This means the hospital has important information such as your booking blood results available should you need hospital care or transfer at any stage.
If you're planning a hospital birth, we'll discuss which hospital you're booked with or where you would like to give birth.
You can still have continuity of care with me while also being booked with an NHS maternity service.
If you need consultant-led input because of your individual circumstances, I will encourage you to attend those appointments, and we can discuss the recommendations you receive as part of your ongoing care.
Your Antenatal Check
Your booking appointment isn't only about talking.
Depending on your stage of pregnancy and individual circumstances, I'll also carry out the appropriate antenatal checks.
As your pregnancy progresses and I begin measuring your baby's growth using symphysis-fundal height measurements, I use GROW 2.0 to plot your baby's growth on an individualised chart.
You'll also be able to access your baby's growth information so you can see how your baby is progressing too.
Vaccinations, MATB1 and Other Practical Things
We'll talk about vaccinations offered during pregnancy so that you can make informed decisions about what is right for you.
As your pregnancy progresses, I can also explain when your MATB1 maternity certificate can be provided.
And if you're planning to travel during pregnancy and require documentation, we can discuss whether a fit-to-fly letter is appropriate for your circumstances.
These practical things are all part of looking after you throughout your pregnancy.
What If I Book Later in Pregnancy?
It doesn't matter when you book with me.
You may contact me at 6 weeks, 20 weeks, 30 weeks or 36 weeks pregnant. You may already have received antenatal care elsewhere or have had most of your screening and investigations completed.
I still need to get to know you and take a full history.
I need to understand your medical and mental health history, family history, previous pregnancies and births, your current pregnancy, screening and blood results, medications, allergies and anything else that may be relevant to you or your baby.
It also doesn't matter whether you're planning a home birth or hospital birth.
If I'm providing your midwifery care, I need the information necessary to care for you safely and individually. I don't want to make assumptions because you're further along in pregnancy or because another maternity service has already seen you.
Whether you come to me early or later in pregnancy, I want to understand the whole picture because that's how I can provide care that is genuinely guided by you.
Your Care Starts With Getting to Know You
Your booking appointment contains a lot of information, but it is also the beginning of something much simpler, getting to know each other.
I want you to feel comfortable asking questions, telling me what matters to you and talking openly about your hopes, worries and previous experiences.
You don't need to know exactly where you want to give birth or what you want your pregnancy and birth to look like. Those conversations can develop as we get to know one another.
My job is to bring my midwifery knowledge and experience.
Your job is simply to bring you.
Together, we can start building care around your individual needs, choices and circumstances.
I provide private midwifery care across London, Essex and Hertfordshire.
If you'd like to find out whether Guided By You Midwifery is right for you, get in touch to arrange a free 20-minute consultation.