Pregnancy App Article: "Antenatal appointments and scans"

Week 8
Antenatal appointments and scans
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Brace yourself: you'll be attending a fair few appointments over the next nine months. 

Although there may be some variations depending on where you live, the content and timing of your appointments will be roughly the same, and they'll take place with your GP, a hospital-based midwife, a midwife attached to your GP's surgery or with a community midwife. 

First visit: As soon as you find out you're pregnant, you should make an appointment with your GP. This will be a chance to confirm the pregnancy and ask any questions you might have about diet and lifestyle.

You should be told at this appointment about the screening tests and maternity services available in your area, as well as about any specialist midwifery services that will be available to you if you have disabilities or additional health needs.

Booking appointment (between eight and 10 weeks): This is the point at which you'll be officially booked in for maternity care, given a preliminary due date and have screening scans arranged. You'll be asked to give blood and urine samples, your blood pressure will be taken, and you may be weighed.

Dating scan (eight-14 weeks): At the dating scan a sonographer will use an ultrasound machine to work out the exact age of your foetus, and to measure and screen for any evident health problems or signs of genetic abnormalities. It's totally painless - she or he will just rub some jelly on your stomach and pass the sonogram (which looks a bit like a plastic microphone) over it. For most parents, this appointment is a highlight: it's your first chance to get a look at your baby.

Nuchal translucency scan (11-14 weeks): This generally happens as part of your dating scan, but can sometimes be offered separately. It tests for chromosomal abnormalities such as Down's syndrome by measuring the depth of fluid under the skin at the back of the foetus's neck. It can't tell you for sure whether or not your baby will have Down's syndrome, but it can estimate the risk. If your result is one in 1,000, for example, this means that for every 1,000 babies with your level of risk, one will have Down's syndrome. A risk of anything under one in 150 is considered high.

16 weeks: This appointment should include a review of the test results from your scans and blood tests, along with information about any further screening tests you may need, and any treatments you may require as a result of problems your blood tests have flagged up.

Anomaly scan (18-20 weeks): Used to check the health of the placenta, and to confirm that your baby is growing normally. It's also <drumroll> the scan at which it's possible to tell the sex of your baby, so it's important to decide in advance whether you'd like to find out or not, and let your sonographer know. 
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Antenatal care is important, if only for reassurance.
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Antenatal care can be hit and miss. I have a choice of two hospitals and the care at each couldn’t be more different. If you are unhappy, it might be worth exploring alternatives.
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I'm quickly coming around to the fact that there seems to be LOTS of worrisome waiting during pregnancy. I never knew it could be so stressful.
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I didn’t have anything other than basic scans and blood tests done when I was pregnant. My daughter was born with Down’s syndrome. I’m so pleased I didn’t know before and have never regretted not being scanned or tested. But each person has to do what they feel is right.
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The problem with all antenatal tests is that we then have to make choices. It’s great if we get the result we want - although nothing's guaranteed - and not so great when we don't.
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20 weeks onwards: From this point in, your appointments will be more regular. At each appointment, you'll have the usual urine and blood pressure tests, your bump will be measured and the midwife will have a feel of your bump to check your baby's development and position. You may also be able to listen to your baby's heartbeat.

Appointments give you a chance to ask questions about your baby, the birth, or any health niggles you're experiencing. You can always call your midwife or doctor if you have any worries between appointments, or if you feel you need to see them.

At some stage, you'll be encouraged to write a birth plan, which can help you work out the way you would like your birth to go - whether you anticipate using pain relief or would prefer not to; how you feel about interventions, and where you would ideally like to give birth.

You should be given information about the pain relief that will be available to you, the mechanisms of labour, what will happen if your baby is late and the possibility of postnatal depression. 

You may be offered the option of attending breastfeeding workshops, and your midwife will discuss feeding options and baby screening tests, and give you information about vitamin K injections or drops.

If your pregnancy is going well and you do not need extra monitoring, you will have appointments at:

25 weeks: first-time mothers only.
28 weeks: when any rhesus negative women will be offered an Anti-D injection.
31 weeks: first-time mothers only.
34 weeks: when a second Anti-D injection should be offered to those who need it.
36 weeks: general check-up.
38 weeks: general check-up.
40 weeks: first-time mothers only.

41 weeks: If your baby hasn't arrived by now, this appointment will check on your baby's health. You may be offered a sweep to kickstart labour, and you may be advised that induction of labour might be appropriate, although it's up to you to decide whether or not to go ahead.
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