Congratulations! There it is - the positive pregnancy test that has brought excitement and perhaps a bit of surprise into your life. You’re pregnant, high five Mama! But what now?
From doing happy dances around the house to devouring a tub of ice-cream, I hope you've celebrated the news in your unique way. But now, as the reality of the journey ahead sinks in, it's time to focus on what lies ahead. Amidst the wealth of information available, it's natural for some aspects to appear a tad confusing. In this guide, we'll walk you through what to anticipate in terms of maternity care in the UK, providing you with valuable insights to approach this phase positively and with a sense of control.
Maternity Care in the UK
Within the NHS, maternity care for women with uncomplicated pregnancies is primarily led by midwives, with some areas also involving General Practitioners (GPs). For pregnancies deemed low risk, statistics show that better outcomes are achieved when the care during pregnancy and birth is solely managed by midwives. However, should you enter pregnancy with a more intricate medical history or encounter any health concerns along the way, both midwives and obstetricians may share the responsibility of your care.
The Initial Steps
As soon as you confirm your pregnancy, reaching out to your GP or community midwives to schedule your first appointment is advisable. Alternatively, you have the option to self-refer online to a hospital or trust of your preference, without being limited to the nearest facility. You can also choose to book the services of a Independent Midwife.
Navigating Your Antenatal Journey
Whether this is your first pregnancy or not, the number of antenatal appointments offered will vary. Typically, first-time mothers can expect around 10 appointments, while those who've previously given birth will have approximately 7. These numbers may increase based on individual circumstances.
Your First Midwife appointment
The first antenatal appointment, which usually occurs between 8 and 12 weeks of pregnancy, is not only an exciting milestone but also an opportunity to discuss some key information with your midwife. During this session, you should be given some insights into foetal development, nutrition, exercise, pelvic floor exercises, antenatal screening tests, and antenatal education. You'll also gain knowledge about your maternity benefits and the diverse options available for birthing places - be it at home, in a midwife-led unit, or an obstetric unit. While time constraints might limit the depth of discussion, this is an opportune moment to start asking questions and to mention any existing fears or worries that you may have.
During this initial session, your midwife will evaluate whether you require any additional care or support. A thorough assessment of your physical well-being will take place, including your activity-related risks, Body Mass Index (BMI) calculation, blood pressure measurement, and protein presence detection in your urine. Additionally, your risk of gestational diabetes or pre-eclampsia will be assessed. Your midwife will also delve into your mental health through a series of thoughtful questions.
Make sure that you're actively part of any decision making from this point onwards. At the end of your appointment, you'll receive written information detailing the number of anticipated antenatal appointments and their scheduling. This provides you with the opportunity to engage with the proposed plan and address any queries you might have.
As you embark on this incredible journey, remember that every step is a chance to learn and take control. With the guidance of your care providers and your determination to stay informed, you're empowered to navigate your maternity care journey with confidence and positivity.
Here is an overview of what you should expect:
What to expect after that first appointment:
During each subsequent antenatal appointment, either a midwife or a consultant will diligently monitor the health of both you and your baby (or babies). These assessments include routine checks such as blood pressure measurement and urine sample analysis. Beyond these fundamentals, you should also receive valuable information to support and guide you through your pregnancy. Although the NHS only offers very short appointments (one of the main benefits of a Private Midwife is that they can take more time during each visit to answer your questions and offer a deeper level of support), you should still be able to ask questions and be signposted to additional resources if needed. Your appointments must serve as platforms to explore and discuss your care options throughout your pregnancy, labour, and postpartum. It's crucial that you're equipped with comprehensive insights into the benefits, risks, and alternatives associated with each choice.
Informed consent is a cornerstone of a positive pregnancy and birth journey, ensuring you are central to decisions concerning your health and well-being.
Feel free to ask any questions that arise during these appointments - your active involvement in your antenatal care is essential. This journey is about your pregnancy, your body, and your baby. Your voice matters, and taking charge of your care enhances the experience.
The Settings
Your antenatal appointments can occur in a variety of settings depending on your NHS trust - or if you have hired a private midwife. This includes your home, a Children's Centre, a GP surgery, or a hospital. Although this isn't always the case, the environment should foster open communication, especially regarding sensitive topics such as mental health issues or histories of sexual abuse. Remember, discussing your emotions and feelings is equally vital alongside the clinical aspects of care.
Progressing Through Pregnancy
From approximately 24 weeks onward, your antenatal appointments may become more frequent, though this varies based on your individual circumstances and your care choices. Despite the frequency, later appointments are generally brief, characterised by continued urine and blood pressure checks, as well as physical examinations of your abdomen. Assessing your baby's position, measuring womb growth, and listening to your baby's heartbeat are standard practices.
Ultrasound Scans
Expect to be offered two pregnancy ultrasound scans in England - one between 8 to 14 weeks, known as the 'dating scan,' and another at 18 to 20 weeks, the '20-week scan.' These scans provide essential insights into your baby's development and offer screenings for potential conditions.
Certain circumstances may warrant additional scans, including unexplained bleeding after the first trimester, complications from prior pregnancies, diabetes, high blood pressure, breech positioning in late pregnancy, or concerns about foetal size. Remember that it is your choice to attend ultrasound scans and additional scans should always be clinically justified.
Preparing for Birth and Beyond
As your journey advances, you should be equipped with essential information to craft your 'birth plan', understanding birth physiology, and preparing for a birth experience in line with your wishes and preference. You should also be given further information about possible interventions such as induction of labour, and your options of birth places. You care providers should also provide information about postnatal emotional well-being, baby feeding, and more.
Recognising the time constraints within appointments means that we can fill the gaps when it comes to antenatal education by investing in a birth preparation course - which I believe should be progressive and woman-centred. With comprehensive preparation, you'll be able to confidently approach childbirth, well-aware of your options and fully equipped to advocate for your preferences.
Asserting Your Rights
Should you encounter any barriers during your care journey, remember that your questions and concerns should be met with open arms by your care providers. If this isn't the case, consider reaching out to your local Maternity Voices Partnership (MVP) or seeking guidance from independent midwives for unbiased perspectives.
Inclusive Partner Participation
Encouraging partners to join you at antenatal appointments fosters support and engagement. This shared experience not only strengthens your bond but also deepens their involvement in this transformative period.
Reach Out for Support
If anxiety or apprehension takes hold, remember that help is readily available. Reaching out to organisations like Bluebell in the UK can provide invaluable support during this time.
Feel free to connect directly with me for any queries or concerns you may have. This journey is yours, and I'm here to support you every step of the way!
For a comprehensive understanding of the antenatal appointments provided through the NHS system, consult the dedicated page here.
For more information about my Antenatal and Hypnobirthing Courses, click here.