Midwife appointments

Much of the care and support you receive during your pregnancy will be from a midwife. Most parents-to-be will be assigned to a community midwife and will see the same person for appointments throughout their pregnancy.  You may from time to time see a different midwife depending on shifts and holidays.

If your pregnancy is considered to be higher risk or complex in some way, you may also see an obstetrician but much of your care will still be provided by a midwife.

So, what can you expect when it comes to your midwife appointments?

One thing which is important to know is that you are entitled to paid time off work to attend antenatal appointments. Your appointments are an excellent opportunity to ask any questions you have about your pregnancy and share any concerns or worries.

Some people find it helpful to jot down anything they want to ask the midwife in a notebook or on their phone so they don’t forget the questions when they attend the appointment.

Your first appointment with your midwife won’t usually take place until you are between 8 weeks and 12 weeks pregnant. Once you have your positive pregnancy test, contact your GP practice to find out what the procedure is.

Some practices will give you the details to contact the midwife directly, while others may want you to see your GP first.

What can I expect from my first midwife appointment?

This first appointment with your midwife is usually known as your booking appointment. It is quite a long appointment as there’s lots of ground to cover so expect it to last around an hour and a half.

Your midwife will ask you lots of questions so that they can gain a good understanding of your circumstances and both you and your partner’s medical histories. This is important as it can identify any areas where you may need additional support, highlight any potential risks and will ensure you get the care you need for you and your baby.

As well as asking questions, your midwife will give you a lot of information about your pregnancy, what you can expect from your antenatal care and your estimated due date, which is worked out from the first day of your last period.   Don’t worry if you don’t know this exact date as a more official due date will be provided once you attend your first scan.  You will also be given advice and information concerning nutrition and exercise during pregnancy.  This is also an opportunity to discuss your options when it comes to screening for potential health issues and book you in for your first ultrasound scan.

Your midwife will also carry out a number of tests and checks, including collecting blood and urine samples, measuring your height and weight and checking your blood pressure and heart rate.

Depending on the area you are in, you may also be given paper maternity notes which you will need to bring with you to future appointments. Some areas no longer do this and have switched over completely to electronic notes.

When can I expect to see my midwife?

Throughout your pregnancy, your midwife will see you at regular intervals to check how you are and how your pregnancy is progressing. During all these appointments, your urine, pulse and blood pressure will be checked and your midwife will ask about how you are coping emotionally.

Your second midwife appointment will usually take place at 16 weeks, although this will not be as long and detailed as the first appointment. By this point, you should have had your dating scan, which will have given you a more accurate due date.  Your dating scan also offers the opportunity for screening for conditions such as Down syndrome, Edwards syndrome or Patau Syndrome.  You midwife should discuss what each of these mean.  It is important to understand that you do not have to have this screening if you do not wish to have it.

You will be given the results of your blood tests and arrangements will be made for your anomaly scan – a detailed ultrasound which is carried out between 18 and 20 weeks to check for any potential problems.

If this is your first pregnancy, your midwife will also see you at 25 weeks to carry out routine checks and see how you are.

You will the have an appointment at 28 weeks, which will include a blood test to check your iron levels as anaemia is a common issue during pregnancy. Your midwife will also start measuring your bump as this point and plotting it onto a growth chart.

Measuring your bump frequently allows your baby’s growth rate to be monitored to ensure everything is on track!  If these measurements don’t follow the chart as your pregnancy progresses, you may be sent for an additional ultrasound scan to check on baby’s development.  Try not to worry too much though if you are sent for a growth scan as in most cases the growth is found to be just fine.  If there is any concern about growth it is good to have this picked up as you and your baby can be monitored a little more closely throughout the rest of your pregnancy.

Those having their first baby will get another additional appointment at 31 weeks and then everyone is seen again by their midwife at 34 weeks.

When will my midwife discuss my birth plan?

The appointment at 36 weeks is usually used to discuss your birth and pain relief options so you can start writing your birth plan. Your midwife will talk to you about where you can choose to give birth and answer any questions you may have.

Historically “Birth Planning Appointments” were quite comprehensive.  However, in the majority of cases expectant parents are now sign posted to arrange their own antenatal education.  Let’s Talk Birth and Baby provide a whole host of classes that cover everything from labour and birth to caring for your newborn, including feeding, and the newborn screening programme. To find out more about our five star classes click here

You will then see your midwife again at 38 weeks where you will discuss what you should do when you start experiencing signs of labour and when you should contact the midwifery team or maternity unit. You will also be given information regarding what may be recommended if your pregnancy goes past its due date and what your options are when it comes to trying to get labour started.

What if I go past my due date?

You will continue to see your midwife regularly in the final stages of pregnancy. At 40 weeks, you will see your midwife if your baby hasn’t arrived.

There will be an opportunity to discuss the options when it comes to inducing birth and you might be offered a procedure known as a sweep. This is an internal examination of your vagina which will involve your midwife sweeping her finger around your cervix, separating the membranes of the amniotic sac.  You do not have to have this done if you don’t want to.

A membrane sweep encourages the release of hormones known as prostaglandins, which can encourage labour to start. It will be completely your decision whether you choose to have a sweep at this appointment or wait to see if labour starts naturally.

If baby doesn’t arrive of their own accord, you will have midwife appointments at both 41 and 42 weeks and you will be given information about going into hospital to have your labour induced. It is your choice whether to have an induction but if you choose to wait, it will be recommended that you have extra monitoring regularly to check on the health of you and your baby. This may include a cardiotocograph (CTG) to measure the baby’s heart rate.

What about midwife appointments after birth?

Once you have given birth to your baby, your midwife will usually visit you at home to see how you and your new addition are getting on. How much you see your midwife will depend on your individual circumstances but most new parents will have at least three appointments, which may be home visits or at a children’s centre or clinic.

Your midwife will usually visit on day 3, day 5 and day 10 and your baby will be weighed on each of these occasions. Your midwife will be able to provide advice on your own recovery, contraception, immunisations for your baby and caring for your newborn.

Your midwife will also carry out a heel prick test to check for a number of health issues and congenital conditions. This will involve taking a small amount of blood from your baby’s heel.  This should be done on day 5.

If all is going well and you do not need additional support, your midwife will discharge you on day 10 and you should receive a visit from your health visitor. There are many circumstances where you may continue to see a midwife for longer, for example if your baby takes a while to regain their birth weight or you are finding it difficult to cope emotionally.