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Antenatal visits

You should book your first antenatal visit as soon as you know you’re pregnant (ideally between 10 to 12 weeks) and make sure you attend all your appointments. 2 Traditional antenatal care for a normal, uncomplicated pregnancy usually includes between 7 and 11 visits. 2

The first visit is a longer appointment as your doctor will need to take a full medical history and do a full physical examination. 2 At each visit, your blood pressure and weight will be recorded, a urine test will be done, and your baby’s heart rate will be evaluated. 2

The typical frequency of antenatal visits in a normal pregnancy are: 2

  • Every 4 weeks for the first 28 weeks
  • Every 2 to 3 weeks between 28 and 36 weeks
  • Weekly after 36 weeks
person holding up a image of ultrasound print out

Screening tests

As part of your antenatal care, you’ll be offered several routine screening tests. Some are offered to all women, while others are only offered if you might be at risk of an infection or condition. 2

The routine tests usually include: 2

  • Blood tests
    • Full blood count (FBC)
    • Blood type
    • Rhesus status
    • Rubella screen
    • Sexually transmitted infections testing which usually includes
      • Hepatitis B
      • Human immunodeficiency virus (HIV)
      • Syphilis
      • Gonorrhoea
      • Chlamydia
  • Urine testing to check for glucose or protein in the urine and to screen for a urinary tract infection. 2
  • Ultrasound scans: Ultrasound scans use sound waves to build a picture of the baby in the womb. 5 The scans are painless, have no known side effects on mothers or babies, and can be carried out at any stage of pregnancy. 5 Ultrasound scans are often the highlight of pregnancy, as it’s very exciting to “see” your baby in the womb, often moving their hands and legs. 5 You should have least 2 ultrasound scans during your pregnancy: 5
      • at 8 to 14 weeks
      • and between 18 and 21 weeks

    The first scan is sometimes called the dating scan. The healthcare professional performing the scan estimates when your baby is due (the estimated date of delivery) based on the baby’s measurements. 5 The second scan usually takes place between 18 and 21 weeks of pregnancy and checks for structural abnormalities (anomalies) in the baby. 5 Some women may be offered more than two scans, depending on their health and their pregnancy. 5

pregnant woman eating greens and salad

Nutritional care

It’s important to eat healthily during pregnancy, but there’s no need for you to go on a special diet. 6

  • You will probably find that you are hungrier than usual, but you don’t need to “eat for two” – even if you are expecting twins or triplets. 6
  • Eat plenty of fruit and vegetables because these provide vitamins and minerals, as well as fibre, which helps digestion and can help prevent constipation, which is a common problem in pregnancy. 6
  • Carbohydrates (starchy foods) should make up just over a third of the food you eat. Try to choose wholegrain or higher fibre options such as whole wheat bread and brown rice, instead of refined “white” starches such as white bread. 6
  • Eat some protein foods every day. Sources include beans, pulses, fish, eggs, poultry, nuts and meat. Choose lean meat and try not to add extra fat or oil when cooking. 6
  • Try to eat dairy foods such as milk, cheese and yoghurt regularly, because they contain calcium and other nutrients that you and your baby need. Choose low-fat varieties, wherever possible. 6

It’s best to get vitamins and minerals from the foods you eat, but when you’re pregnant you should take the pregnancy supplements recommended by your doctor to ensure that you and your baby are getting all the nutrients you need.1 [See Vitamin supplementation in pre-pregnancy section]

There are also certain foods you should avoid in pregnancy to prevent infections that can be harmful to both you and your baby (e.g. listeriosis, salmonella and toxoplasmosis). 7 These include: 7

  • Mould-ripened soft cheese such as brie and camembert
  • Soft blue-veined cheeses such as danish blue, gorgonzola and roquefort
  • Raw or partially cooked eggs
  • Raw or undercooked meat
  • Cold cured meats such as salami, prosciutto, chorizo and pepperoni
  • All types of pâté, including vegetable pâtés

You should also avoid liver or products containing liver, such as liver pâté, liver sausage or haggis, as they may contain a lot of vitamin A and too much vitamin A can harm your baby. 7

Limit your intake of tuna (2 tuna steaks or 4 medium cans of tuna per week) as it contains more mercury than other types of fish and it could affect your baby’s developing nervous system. 7 You should also avoid having more than two portions of oily fish (salmon, trout, mackerel, herring) per week as they can contain pollutants. 7

Try to limit the amount of caffeine to 200 mg per day, as high levels of caffeine can result in babies having a low birthweight and can also cause miscarriage. 7 One mug of instant coffee contains about 100 mg of caffeine. 7 

pregnant woman on gym ball doing exercise with dumbbells

Exercise

If you were exercising regularly prior to falling pregnant, you can continue with your exercise regime, unless otherwise advised by your doctor. If you didn’t really exercise before pregnancy, don’t suddenly start strenuous exercise. 8 It is a good idea to start with a moderate aerobic exercise programme should such as a 15-minute walk 3 times a week, building up to a 30-minute walk 4 times per week, unless told otherwise. 8 Exercise can make for a healthier pregnancy, can increase your pain tolerance and help you cope with labour and can help get you back into shape after the birth. 8,9 

 References: 1. Mayo Clinic. Prenatal vitamins: Why they matter, how to choose [Online] 2018 April13 [cited 2018 Aug 20]. Available from URL https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/prenatal-vitamins/art-20046945. 2. BMJ Best Practice:Routine antenatal care [Online] 2017 November 10 [cited 2018 Aug 20]. Available from URL: https://bestpractice.bmj.com/topics/en-us/493. 3. NHS: Vitamins, supplements and nutrition in pregnancy [Online] 2017 Jan 2017 [cited 20 Aug 2018] Available from URL: https://www.nhs.uk/conditions/pregnancy-and-baby/vitamins-minerals-supplements-pregnant/. 4. American College of Obstetricians and Gynecologists: Good Health Before Pregnancy: Preconception Care [Online] 2017 April [cited 2018 Aug 20] Available from URL:https://www.acog.org/Patients/FAQs/Good-Health-Before-Pregnancy-Preconception-Care. 5. NHS: Ultrasound scans in pregnancy [Online] 2017 Nov 30 [cited 20 Aug 2018] Available from URL: https://www.nhs.uk/conditions/pregnancy-and-baby/ultrasound-anomaly-baby-scans-pregnant/. 6. NHS: Foods to avoid in pregnancy [Online] 2017 Jan 23 [cited 20 Aug 2018] Available from URL: https://www.nhs.uk/conditions/pregnancy-and-baby/foods-to-avoid-pregnant/. 7. NHS: Have a healthy diet in pregnancy [Online] 2017 Jan 27 [cited 21 Aug 2018] Available from URL https://www.nhs.uk/conditions/pregnancy-and-baby/healthy-pregnancy-diet./ 8. NHS: Exercise in pregnancy [Online] 2017 Jan 14 [cited 21 Aug 2018] Available from URL https://www.nhs.uk/conditions/pregnancy-and-baby/pregnancy-exercise/. 9. Gaston A, Cramp A. Exercise during pregnancy: A review of patterns and determinants. J Sci Med Sport 2011;14:299-305.

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