What We Cover at Your Antenatal Appointments: From Booking to Birth

When you first find out you’re pregnant, the number of appointments, tests, decisions, advice and bits of information coming your way can feel overwhelming.

You might also wonder what we’re actually going to talk about at all those appointments.

The answer is quite a lot!

Your antenatal care isn’t simply a series of clinical checks. As your pregnancy progresses, different conversations become relevant at different times. There are things I want you to know early on, things that can wait until later, and things we’ll probably talk about more than once.

Having continuity of care means we have the time to work through all of that together.

Your care will always be individual to you, so this isn’t a rigid timetable. Sometimes we’ll bring a conversation forward, sometimes we’ll revisit something several times, and if there’s something important to you, we don’t have to wait until a particular week to discuss it.

But this gives you an idea of how our appointments together might unfold from booking through to birth.

Your booking appointment: getting to know you

Our first full booking appointment is usually one of our longest because there is a lot for us to talk about.

This is where I begin to understand the whole picture of you and your pregnancy.

We’ll go through your medical history, mental health and emotional wellbeing, social history, family history and any previous pregnancies or births. I’ll also record your height and weight and calculate your BMI.

Knowing your BMI is an important part of your initial assessment. Whether your BMI is lower, within the expected range or higher can influence aspects of your pregnancy care, including whether any additional assessment, advice or referral may be recommended.

We’ll discuss screening and blood tests, scans, vaccinations, vitamins and supplements, including the appropriate dose of folic acid for your individual circumstances, and anything else that’s relevant to you at this stage of pregnancy.

It’s thorough, but it’s also the beginning of our relationship.

You don’t need to remember everything we discuss, and you certainly don’t need to have worked out what you want for the rest of your pregnancy or birth.

We’ve got time for that.

Your early antenatal appointments: settling into your pregnancy

Those earlier appointments give us time to continue getting to know each other while keeping an eye on how you and your baby are doing.

We’ll carry out the appropriate antenatal checks, go through results as they come back and talk about anything that’s cropped up since I last saw you.

This is often when questions start appearing too.

You might have read something that worried you. Someone may have mentioned induction. Perhaps you’re starting to wonder where you’d like to give birth. Or you might have a list on your phone entitled Things to ask Emma.

Bring it on.

You don’t have to work pregnancy out on your own between appointments.

Around 24 weeks: information is power

As pregnancy progresses, there are some things I really want you to know about.

For me, information is power.

Giving you clear information about what to look out for is part of keeping you and your baby safe. It isn’t about frightening you or giving you a long list of things that might go wrong. It’s about making sure you recognise when something isn’t quite right and know when to contact me or maternity services.

Around this stage, we’ll talk about conditions such as pre-eclampsia and intrahepatic cholestasis of pregnancy (ICP), including the signs and symptoms I want you to be aware of.

We’ll also talk about your baby’s movements and the importance of getting to know what’s normal for your baby.

I want you to feel confident that if something changes or doesn’t feel right, you know what to do and who to contact.

Around 28 weeks: keeping an eye on your baby’s growth

From around 28 weeks, where appropriate, I’ll start measuring your symphysis-fundal height (SFH). I’ll then repeat these measurements at regular intervals as your pregnancy progresses.

I plot the measurements on your GROW 2.0 growth chart, which allows us to build up a picture of your baby’s growth over time rather than looking at one measurement in isolation.

If you have ultrasound growth scans, those measurements can also be recorded so that we can look at the information together and keep an eye on your baby’s growth throughout the rest of your pregnancy.

Depending on your individual care, there may also be blood tests, results or other routine antenatal care to discuss at this stage.

And, as always, we’ll talk about how you’re actually feeling too.

Around 30 weeks: getting practically prepared

By around 30 weeks, birth doesn’t feel quite so far away anymore.

This is a good time to start thinking about what you might want in your hospital or birth bag.

To be clear, I don’t actually pack your bag for you!

But I can give you plenty of advice about what’s useful to have with you, what you may want for your baby and some of the things I recommend having at home ready for those first days after birth.

I also really encourage your partner to pack the bag with you. If you’re in labour and ask for something, it’s much easier if they know exactly where it is rather than having to empty the entire contents of the bag onto the floor looking for it!

And even if you’re planning a home birth, I still recommend having a hospital bag packed and ready. Most home births won’t require it, but if circumstances change and we need to transfer into hospital, having everything prepared means it’s one less thing for you or your partner to think about at the time.

There is practical preparation for having a baby that goes beyond writing a birth plan, and we have time to talk about that too.

Around 32 weeks: Mabel makes an appearance

At around 32 weeks, we can start doing some more practical antenatal education.

And this is where you may meet Mabel.

Mabel is my demonstration baby, and she’s very useful when we’re talking about some of the everyday realities of looking after a newborn.

We can go through things such as holding and handling your baby, changing a nappy, winding and safe sleeping. We’ll talk about reducing the risk of SIDS and I’ll direct you towards trusted information from The Lullaby Trust so that you know where to find reliable advice too.

If you’ve never changed a nappy or held a tiny newborn before, you’re absolutely not expected to magically know how to do it because you’re pregnant.

This is exactly what antenatal education is for.

Your partner is very welcome to get involved too. In fact, it can be particularly useful for partners who may not have spent much time around newborn babies before.

And if you’ve already had three babies and could change a nappy with your eyes closed, we’ll spend our time on what’s useful to you instead.

Around 34 weeks: let’s talk about your birth

By now we’ve probably already had lots of conversations about birth, but around 34 weeks we’ll spend some dedicated time putting your birth preferences together.

We’ll talk about what’s important to you, the choices available to you and any questions or concerns you have.

For me, a birth plan isn’t about trying to predict exactly how your labour and birth will unfold.

It’s a way of exploring your options, understanding your choices and making sure the people caring for you know what matters to you.

And because we’ve already spent months together, I’m not meeting you for the first time and asking, “So, what do you want for your birth?”

We’ve been building that picture together throughout your pregnancy.

Around 36 weeks: getting ready

We’re getting close now.

We’ll revisit your birth preferences and make sure you’re still happy with everything we’ve discussed.

We’ll check that you’ve thought about the practical things too, including that hospital or birth bag we discussed a few weeks ago!

Around this stage we can also talk about antenatal colostrum harvesting, where appropriate, perineal massage and the importance of looking after your pelvic floor.

We’ll talk about preparing for labour, what to expect and when you should contact me.

And if something has changed since we wrote your birth plan, that’s okay too.

Plans can change. We talk again.

From 37 weeks onwards: when do I call you?

As you approach the end of pregnancy, some of our conversations will deliberately become repetitive.

When should you call me?

What might the beginning of labour feel like?

What if your waters break?

What if you’re worried about your baby’s movements?

When should you contact maternity services or go into hospital?

What shouldn’t wait until your next appointment?

We’ve probably discussed some of these things already, but important information is worth repeating.

I don’t expect you to remember something I mentioned once several months ago.

We’ll keep talking.

And in between all of that...

This is only a snapshot of what we might cover.

There are still all the usual clinical assessments and observations appropriate to your stage of pregnancy, and your individual circumstances might mean there are other things we need to discuss or monitor.

But your appointments aren’t a checklist that I work through while you sit quietly on the other side of the room.

If you’ve had a difficult week, we’ll talk about it.

If something happened at another appointment and you want to understand it, bring it to me.

If your partner has questions, they can ask them.

If you’ve changed your mind about something, tell me.

And if everything is going beautifully and we end up having a cup of tea and talking about something completely unrelated for ten minutes, that’s allowed too.

That’s one of the things I love about continuity of care.

Over the months, we don’t just tick off a series of antenatal appointments.

We prepare for birth and becoming a family together.