Breaking Down the Antenatal Checkup: Everything You Need to Know

Antenatal checkups are essential for monitoring your health and your baby’s development during pregnancy. These appointments ensure that potential complications are identified early and provide support and guidance tailored to your individual needs. Whether your pregnancy is low risk or high risk, antenatal care plays a vital role in achieving a healthy outcome for you and your baby.

This guide explores what happens during antenatal checkups, highlighting differences for women with low-risk pregnancies versus high-risk pregnancies. With this information, you can approach your appointments with confidence and clarity.

What Are Antenatal Checkups?

Antenatal checkups are routine medical visits designed to ensure the well-being of both mother and baby. These appointments focus on prenatal care, including monitoring the baby’s growth, screening for health conditions, and offering advice on lifestyle, diet, and mental health.

Key Goals of Antenatal Care:

To monitor the baby’s development.

To identify and manage any health concerns early.

To provide emotional support and education.

The NHS Approach:

The NHS Pregnancy Guide emphasises that antenatal checkups are tailored to individual circumstances, with extra care provided for women with high-risk pregnancies.

When Do Antenatal Checkups Begin?

Antenatal care typically starts with a booking appointment between 8 and 10 weeks of pregnancy. This is followed by regular checkups throughout pregnancy, with the frequency increasing closer to your due date.

Low-Risk Pregnancy Schedule:

Every 4 weeks until 28 weeks.

Every 2 weeks from 28 to 36 weeks.

Weekly from 36 weeks until delivery.

High-Risk Pregnancy Schedule:

Women with high-risk pregnancies may need more frequent appointments, additional tests, or specialist care. Your midwife or doctor will outline a personalised schedule based on your needs.

What Happens During an Antenatal Checkup?

1. General Overview for All Pregnancies

Regardless of risk level, each antenatal appointment focuses on:

Monitoring maternal health (e.g., blood pressure and weight).

Assessing the baby’s growth and development (e.g., fundal height or ultrasound scans).

Providing guidance on lifestyle choices, such as taking antenatal vitamins.

2. Differences for Low-Risk and High-Risk Pregnancies

Low-Risk Pregnancies: Routine Care

Low-risk pregnancies are generally straightforward, with fewer interventions required. Key elements include:

Blood Pressure Monitoring: Ensures there are no signs of preeclampsia.

Urine Tests: Checks for protein (a sign of preeclampsia) or glucose (gestational diabetes).

Blood Tests: Carried out in early pregnancy to determine blood type, iron levels, and immunity to infections like rubella.

Fundal Height Measurements: Starting around 20 weeks, your midwife will measure your bump to assess the baby’s growth.

Foetal Heartbeat Monitoring: From around 16 weeks, your baby’s heartbeat may be checked using a Doppler device.

Why It’s Important: Regular monitoring ensures that your pregnancy stays on track and provides reassurance that your baby is developing as expected (Royal College of Obstetricians and Gynaecologists, RCOG).

High-Risk Pregnancies: Enhanced Care

High-risk pregnancies require additional monitoring and specialised care to address potential complications. This might include:

Frequent Scans: Growth scans are often performed every 2–4 weeks to ensure the baby is developing properly.

Specialist Consultations: Involves obstetricians, endocrinologists, or cardiologists if conditions like diabetes or heart disease are present.

Advanced Testing: May include tests for foetal well-being, such as Doppler studies to assess blood flow to the placenta.

Why It’s Important: High-risk pregnancies are more likely to involve complications, but enhanced care significantly improves outcomes (NICE Guidelines for Antenatal Care, 2021).

Special Tests and Scans

1. Ultrasound Scans

Both low-risk and high-risk pregnancies benefit from routine scans, but additional ultrasounds may be required for high-risk pregnancies.

Dating Scan (10–14 Weeks): Confirms the due date and checks for multiples.

Anomaly Scan (18–20 Weeks): Examines the baby’s organs and checks for structural abnormalities.

Growth Scans: In high-risk pregnancies, growth scans monitor the baby’s size and amniotic fluid levels.

Evidence: The NHS Antenatal Care Guide highlights that timely scans reduce the risk of undetected complications.

2. Blood Tests

Blood tests are an integral part of antenatal care for all pregnancies. However, high-risk pregnancies may require additional testing.

Low-Risk Pregnancy Tests:

Blood type and Rh factor.

Screening for anaemia and infections like HIV or syphilis.

Glucose tolerance testing if at risk for gestational diabetes.

High-Risk Pregnancy Tests:

Additional glucose testing for women with a history of diabetes.

Tests for clotting disorders if there’s a history of blood clots.

Lifestyle Guidance During Antenatal Care

Diet and Antenatal Vitamins

Low-Risk Pregnancies: General advice includes eating a balanced diet and taking antenatal vitamins, such as folic acid and vitamin D.

High-Risk Pregnancies: Your healthcare provider may recommend specific dietary adjustments, such as increasing protein intake for preeclampsia risk.

Exercise and Antenatal Yoga

Staying active is beneficial for most pregnancies. Activities like antenatal yoga or walking are safe and effective for improving flexibility and reducing stress.

Evidence: A study in Complementary Therapies in Clinical Practice (2019) found that antenatal yoga reduced stress levels by 40%.

High-Risk Considerations: Some women with high-risk pregnancies may need to modify or limit exercise. Always consult your doctor before starting a fitness routine.

Emotional Support and Antenatal Education

Antenatal Classes

Antenatal classes provide valuable insights into labour, delivery, and early parenting. They also create opportunities to connect with other parents.

Low-Risk Pregnancies: Classes cover labour techniques and postpartum recovery.

High-Risk Pregnancies: Additional sessions may focus on managing complications or planning for a caesarean delivery.

Actionable Tip: Search for “antenatal classes near me” or ask your midwife for recommendations.

Managing Stress

Pregnancy can be stressful, particularly for high-risk pregnancies. Techniques like mindfulness, antenatal massage, or relaxation therapies can help.

Evidence: Research in the International Journal of Therapeutic Massage & Bodywork (2021) highlighted the benefits of prenatal massage in reducing anxiety and improving sleep.

Key Takeaways for Antenatal Checkups

Low-Risk Pregnancies: Focus on routine monitoring, lifestyle guidance, and emotional support.

High-Risk Pregnancies: Include more frequent visits, advanced testing, and specialist care to manage potential complications.

Antenatal checkups provide the foundation for a healthy pregnancy. Whether low-risk or high-risk, staying informed and engaged with your care ensures the best possible outcome for you and your baby.

UK Resources for Antenatal Care

NHS Antenatal Services:

Comprehensive care, including routine and specialist services for high-risk pregnancies.

Visit NHS Antenatal Services

Tommy’s PregnancyHub:

Offers expert advice and resources tailored to pregnancy complications.

Visit Tommy’s PregnancyHub

National Childbirth Trust (NCT):

Provides antenatal education and support groups.

Visit NCT