What should my antenatal care consist of? I need MN help to plan my own care.

[allhailtheaubergine]

I am outside UK and paying for my own antenatal care.

I have the option of buying a private hospital's all inclusive care pack, but I think they tend to include things I don't want and leave out things I do. In order to work out what is best I need to start out knowing what I want and when I need it. I would really appreciate knowledgeable MNers help with this.

I am now 9 weeks pg. 3rd pregnancy.

I am travelling between 11wks and 15 wks. During this time it would be possible to organise medical care if necessary, but not ideal.

So far I have...

Dating scan at 11 weeks
Blood tests - Blood group / Haemoglobin / VDRL / HIV
Urine regularly (how regularly?) - Glucose / Ketones
CTG regularly?
Hep B towards the end

Anything else I need? The above is a first draft and I realise I will have forgotten things.

Another question: I have been told that the crucial window for tests is while I am travelling. Which tests are these?

The only tests that have a critical window are nuchal fold scans are far as I know. The blood tests for genetic screening are done from fifteen weeks (my appt was 14+6 and I was too early), but I had neither a nuchal scan or the genetic screening tests in the end so may not be the best person to ask.

I've had my urine checked every four to six weeks at my MW appts but this is my first pregnancy and I'm under the impression that in my health board at least you get fewer appts in subsequent pregnancies unless you're high risk.

Here standard is...

Booking bloods (hiv, hep, iron, immunities, fbc, etc)
Nuchal/dating scan between 11 and 13 weeks.
20wk scan
Midwife appointment (urine check, heartbeat, fundal height, bp, general chat) at 16, 24, 28, 32, 36, 38 and 40 weeks.

That's about all in a normal, low risk pregnancy.

Oh forgot, repeat bloods (iron, fbc) done at 28 weeks.

Thank you both. That's helpful.

I know I didn't have the nuchal scan last time and am happy to miss it out again this time, I think.

I also know I did test or scan for something else though - something about incompatibility with life? Sorry to be vague, it's been a while. I wonder if that's the 20 week scan?

The 20wk scan is an anomoly scan checking very closely for lots of different things.

I see. Thank you Show.

So, if I get a dating scan at the last minute before I go, then I don't need anything else until I get back? Assuming all is well. And I'm 32 and have had 2 healthy pregnancies - I mean, I know you can never know but I have no reason to think this won't be a normal pregnancy.

The main hospital here offers a choice between an Early Package from 12 weeks (12 consultations / 3 scans / etc) or a Mid Package from 24 weeks (9 consultations / 2 scans / etc).

Would the Mid Package be offering the anomaly scan at 24 weeks?

General question there, not meaning to back Showy into a corner and interrogate her

There is also the combined screening test from11-14 weeks which uses a combination of blood tests (hcg/pappa) and scan results to give you a calculated risk ratio for things like trisomy 21 (downs) 18 and 13 (Edwards is incompatible with life). I would really recommend that you have an indepth consultation with a obstetrician based in your country. Tests offerred, when they are offerred and the frequency is likely to vary greatly. My combined screening risk showed a low pappa which means that I have been on aspirin and so far I've had loads of scans including a anomaly scan at 16 & 20 weeks. Basically what I'm saying is that you never know what's going to happen and it's best to get as much medical support and advice as possible.

Ahh, so there's bloods that need to be done in the 11wk - 15wk window too?

Have a good at the nice website as it has guidelines on it.