Congratulations, you’re pregnant! You’ve got your first midwife appointment coming up, here’s what you can expect to happen. It may vary slightly around the UK but the main essentials are the same. I can’t speak for other countries but it will be similar.
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Will there be an ultrasound at my first appointment?
First off, don’t expect a scan, that comes at around 12 weeks unless you’re really unsure of your last period date and how far along you are. If a scan is needed then your Midwife or GP can refer you for one. There is also no need for a vaginal exam or abdominal check unless you think you’re further on than 12 weeks, then we may do an abdominal (tummy) check to see if we can feel your growing uterus, which comes out of the pelvis after 12 weeks. You may ‘show’ before this, especially if it isn’t your first baby.
How much time should I allow for my first midwife appointment?
Your first appointment will take around one hour, there’s lots of paperwork and talking, and lots of information to take in. Quite often you’ll get your maternity notes and lots of leaflets, so take a bag big enough, especially if it’s still a secret and you’re heading back to work afterwards!
Will they take blood?
Yes, so be prepared. It’s one lot of blood, taken for screening purposes and to check your iron level and blood group. Here’s the blood tests you will be offered:
- Haemoglobin (iron level)
- Blood group and rhesus factor
- Hepatitis B
- Rubella immunity
You can opt out of any if you want to, but they are all routine tests that can be dealt with and can affect your baby if not treated.
Are there any other tests offered at this appointment?
Your midwife will check your blood pressure and pulse to get a baseline reading and then check it at each subsequent appointment. She will also check your urine for any signs of infection and diabetes, and send a urine sample off to be tested in the lab for signs of infection. Later on in the pregnancy it can be checked for signs of pre-eclampsia. Your weight and height will be checked to work out your BMI. There will only be one more weight, usually at week 30 of pregnancy.
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Your midwife will go through you and your family’s medical history. It is useful to know your baby’s father’s medical and family history too. It’s to check for anything that could be hereditary, then they can organise any extra checks if needed.
Past obstetric history
Do you suffer from endometriosis? Is this your first pregnancy? If you’ve had a termination in the past it can be listed confidentially if you prefer. If you’ve had children already we’ll talk about your births, the weight of your babies and any ongoing issues both with yourself and your children.
It’s at this booking in appointment that we will refer you for your scans, both your 12 week and 20 week one. If you need to be referred to a consultant that will happen too. There may also be referrals to the dietitian if your BMI is over 35, smoking cessation if you would like help quitting smoking and any specialist referrals. Your Midwife will also get you on the system and give you emergency contact numbers, which are also usually the numbers you phone when you’re in labour.
Screening for genetic conditions like down’s syndrome
Your Midwife will talk to you about whether you would like screening for common chromosomal abnormalities, namely Edward’s, Down’s and Patau’s syndrome. At your 12 week scan (which is the best time for dating the pregnancy) you can also have a blood test and scan measurement to give you a risk factor of those conditions. This test is optional. S/he will discuss it in more detail with you at the time. Some trusts are now offering the harmony blood test (also known as the NIPT) whereas in other areas it is available privately. This is a non invasive maternal blood test which gives you a 99% accurate result. You have to think about whether you would terminate or not if you knew, or whether you’d just want to know. If you get a high risk factor for down’s, you’d then need to decide if you want an amniocentesis or CVS which would tell you a definite answer but carries a 1% risk of miscarriage. It can be pretty daunting so be prepared for this discussion and have a chat with your partner or family before going.
Breastfeeding/ Bottle Feeding
They may bring up any thoughts you have on Breastfeeding. This is not to put pressure on you but to give you the right information.
You should have an opportunity to ask questions, be given another appointment or details on how to book. You may not need one until after your 12 week scan.
Questions you may want to ask:
- What is the trust’s c-section rate?
- Will you be my named Midwife during the pregnancy?
- What percentage of women need to transfer to the hospital (if planning a home birth or birth centre birth)? What is the typical reason?
- Does the trust offer gentle c-sections?
- Does the trust offer walking epidurals?
- What is the epidural rate?
- What is the induction rate?
- Do you offer antenatal classes?
- When is induction offered for post dates?
- Is water birth available?
- How many birth pools does the hospital have?
- Are home births available?
- How long is the average hospital stay after birth?
You don’t need to ask all of these and they will mostly be answered during your pregnancy, but feel free to use them as a guide.
You can in theory request a different hospital if you prefer one over the other but you will have to travel to it which could be stressful.
I hope this has helped you know what to expect from your first Midwife appointment, have I left anything out? What happened at your first appointment?