What sort of care do you want?

You can attend your GP's surgery throughout your pregnancy, and see either your GP or midwife. If you have any special problems you may want to see or you may need to see a hospital specialist.

What routine tests will you need?

Once your pregnancy has been confirmed, you will be offered routine tests. These tests include blood tests; to check on anaemia, your blood group, past infections (like Rubella and Syphilis) and blood disorders (like sickle cell or thalassaemia). We do not test routinely for Aids or HIV infection. You will also be offered a urine test to make sure you do not have a kidney infection.

What happens at the antenatal clinic?

Your first appointment will be to attend the antenatal booking clinic to see the midwife. All the information about you and your pregnancy will be collected to 'book' your care, and you will have the routine blood and urine tests. Your next appointment will be for the routine antenatal clinic. Each time you attend you will be seen by the nurse or midwife for your routine tests (weight, urine and blood), then by one of the doctors or midwife to check on how you are. Throughout your pregnancy you will be seen regularly by your doctor or midwife. These routine checks are flexible according to your need. If you cannot attend the antenatal clinic, you may see the doctor during normal surgery hours.
Unfortunately a small number of abnormal pregnancies occur each year and there are a number of special tests available in order to detect these.

What are the special tests?

Ultrasound Scan

All women are offered an ultrasound scan. This is normally performed at 16-18 weeks and will help to check your dates; confirm that you have only one baby and check the position of the afterbirth. The scan can also detect the vast majority of abnormal babies.

Alpha Feto Protein and Human Chorionic Gonadotrophin

This blood test is offered to all pregnant women at 16-18 weeks of their pregnancy. If the level of this protein is high then it may be that the baby has an abnormality, like Spina Bifida or Down's syndrome. A further test would then be advised. Sometimes a further scan may be all that is required, or possibly an amniocentesis. The risk of a baby having Down's syndrome can also be calculated from a knowledge of the mothers age, measurement of the maternal AFP and HCG. If the risk is high enough then an amniocentesis may be advised.

Amniocentesis

This test will involve taking a small amount of fluid from around the baby at around 16-18 weeks. The result is not usually available until 2-3 weeks after the test. Occasionally this test is offered to mothers with a family history of hereditary diseases. All these cases are very few and the overwhelming majority of our mothers have normal healthy babies.

Where will you have your baby?

You will be encouraged to have your baby in hospital. By arrangement with the midwife you can have a short stay (Domino Delivery). This means that your baby will be delivered in hospital, and if you and your baby are well, you will be discharged home a few hours after delivery. Fathers are invited to be present during labour and delivery. Most mothers stay in hospital for 1-5 days. If you are keen to have your baby at home you will need to discuss this with the midwife and doctor.

What happens afterwards?

Your Community Midwife

The community midwife will see you regularly for care and advice during your pregnancy, either at clinic or at home. She will continue to visit you after the birth of your baby for the first 14 days, when your care will be transferred to your Health Visitor. The midwife is available for advice 24 hours a day. She can be contacted by means of radio pager which she carries with her when out on routine calls. You will also be given an emergency number.

Your Health Visitor

You will meet your health visitor during your pregnancy. After your discharge by the midwife, your health visitor will visit as agreed with you. Health visitors are nurses with special training in all aspects of health related to the whole family. She is able to advice on all aspects of child care and development.

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