Dr Azeem has shared a guide to NHS care for pregnant women. (Image: Humphrey Nemar/Getty)
Finding out you are pregnant is a life-changing moment. It is natural to feel a mixture of excitement, happiness and uncertainty. The NHS is there to support you throughout your pregnancy and in the weeks afterwards — here’s what to expect.
What to do after a positive test
Once you have a positive pregnancy test, you should contact your local NHS maternity service to arrange your first appointment. You can usually refer yourself online without needing to see your GP.
It is a good idea to let your practice know you are pregnant so medical records can be updated and any existing health conditions or medications reviewed if needed.
If you are not already taking folic acid, start as soon as possible, up to 12 weeks of pregnancy. Most women are also advised to take vitamin D throughout.
Your booking appointment
Your first appointment with a midwife, the booking appointment, usually takes place between eight and 10 weeks. This is an opportunity to discuss your health, medical history and any previous pregnancies.
Your midwife will ask about your lifestyle, family history and medicines. You will have blood tests, your blood pressure checked and usually be asked to provide a urine sample to identify health conditions that may need monitoring.
Most women receive care from community midwives. If you have a pre-existing condition such as diabetes or high blood pressure, or if complications develop, your care may involve an obstetrician and other specialists.
Routine antenatal care
Regular antenatal appointments allow your midwife or doctor to monitor your health and your baby’s development, while giving you the opportunity to ask questions and discuss concerns.
You will usually be offered two routine ultrasounds. The first, between 11 and 14 weeks, confirms your delivery date and can include optional screening for conditions such as Down syndrome. The second scan, usually between 18 and 21 weeks, checks your baby’s development. You may be offered additional blood tests or scans.
The NHS recommends vaccines against flu, whooping cough (pertussis) and respiratory syncytial virus (RSV) at appropriate stages. Maintaining a healthy lifestyle — eating a balanced diet, remaining active, and avoiding smoking and alcohol — is important.
Pregnancy also affects emotional health. Many women experience anxiety, low mood or stress, particularly if they have experienced pregnancy loss or complications in the past. Your midwife will ask about this. If you have a history of mental health conditions, let your maternity team know.
When to seek urgent medical advice
Contact your team immediately if you experience:
- reduced or absent movements from your baby
- vaginal bleeding or leaking fluid
- severe or persistent headache
- blurred vision or flashing lights
- sudden swelling of your face, hands or feet
- severe abdominal pain
- regular contractions before 37 weeks of pregnancy
Feeling reassured about your care
You may have seen news reports about failures in maternity care at some NHS hospitals. Investigations highlighted serious problems in a small number of services and have led to significant changes, including greater emphasis on listening to women and families, improving safety, and identifying concerns earlier.
Most pregnancies and births in the NHS are safe, but it is important that you feel heard throughout your care. If you are worried that something is not right, trust your instincts and contact your maternity team.
Never worry about raising concerns. They would much rather assess you and find everything is well than miss a serious problem.
Routine ultrasounds check on a baby’s development during pregnancy (Image: Getty)
Planning your baby’s birth
You will discuss birth preferences with your midwife. Options may include a consultant-led maternity unit, a midwife-led birth centre or occasionally a home birth.
Women with higher-risk pregnancies are generally advised to give birth in an obstetric unit where specialist medical care is immediately available.
You can also discuss pain relief, including gas and air, opioids and epidural anaesthesia. Your plan should reflect your preferences, while recognising that plans sometimes need to change if complications arise.
Care after your baby is born
While you are in hospital, or shortly after a home birth, midwives will check your recovery and your baby’s health. There will be a newborn physical examination and hearing screening, and you will be offered advice on feeding.
Once you return home, your community midwife will support you during the first 10 to 14 days. Care is then transferred to your health visitor, who will monitor your baby’s development and provide advice during the early years.
You should also attend your postnatal GP check, usually six to eight weeks after giving birth. This is an opportunity to discuss your physical recovery, emotional wellbeing, contraception and ongoing health concerns.
Pregnant women are entitled to free NHS prescriptions and dental treatment during pregnancy and for 12 months after giving birth, with a maternity exemption certificate.
Supporting you
Every pregnancy is different. NHS maternity services aim to provide personalised care. By attending your appointments, following healthy lifestyle advice and seeking help promptly if you have concerns, you can give yourself and your baby the best possible start.
