Women's and Neonatal Services

Routine Antenatal Care

Your First Pregnancy Appointment (booking appointment)

At your first pregnancy appointment, which is also known as your ‘booking’ appointment, the midwife will ask you about your obstetric, medical and social history. The midwife will also discuss with you the type of care available to you, which is dependent on a number of risk factors.

For women who are likely to have an uncomplicated pregnancy, you will be able to choose whether you would like your care to be only with the GP, only through the midwife or a combination of both (Midwifery Led Care). If you are at higher risk of complications, your care throughout pregnancy and birth will be from an obstetric team within the hospital (Maternity Team Care)

This first appointment is a good opportunity for you to ask any questions and normally takes about an hour. Anything you say to the midwife will be discussed in confidence. 

Routine Blood Screening Tests

We will ask your permission to take a blood sample for routine screening. This is so that we can check your blood group and also test for a variety of conditions including:

  • Anaemia
  • Diabetes
  • Sickle cell and thalassemia disease
  • HIV
  • Hepatitis B
  • Syphilis
  • Rubella (German Measles)

You can read more about these tests in the leaflet (click on the leaflet to download the PDF version)

» View an electronic version or versions in other languages

 
 
 
 
Ultrasound Scans 326532

You will be offered two scans:

  • one early in pregnancy between approximately 11–14 weeks (combined screening scan) 
  • and another at 18–21 weeks (anomaly scan) to check the growth and development of your baby

You are welcome to bring someone with you when you come for your scan. Further scans are only arranged if there is a clinical need, either the doctor or midwife will explain if this should occur. The Ultrasound Department is based next to the Antenatal Clinic on the ground Floor of the maternity building. 

Antenatal Screening for Down’s Syndrome

Screening for Down’s Syndrome is offered to all pregnant women of all ages. The screening tests provide information about the chance of a baby having Down’s Syndrome. These tests use blood samples taken from the mother and measurements taken from ultrasound scans, to work out this chance. The test you will be offered depends on how many weeks pregnant you are. This will either be a combined screening test or a quadruple test.

If you do receive a higher risk result from a screening test, your midwife or doctor will give you further information and support. You will be offered a diagnostic test that can tell you definitely whether your baby has Down's Syndrome or not.

There are two diagnostic tests available:

  • Chorionic Villus Sampling (CVS) which is usually performed between 12 and 14 weeks and
  • Amniocentesis: which is usually carried out from 16 weeks.

Further information is available from the Screening Tests for You and Your Baby leaflet. It is important that you read this leaflet and discuss these screening tests with your midwife, GP or obstetrician.

Further Appointments (follow-up appointments)

After your first ‘booking’ visit, you will be asked to make future antenatal appointments. If for any reason you cannot make an appointment or want to change the time, it is very important that you telephone the appointment line to let them know so that the appointment can be offered to someone else and you can rearrange your appointment. The telephone number is: 01923 217971

Schedule of Care

When a pregnancy is uncomplicated, there is good evidence to suggest that there is no need for you to see your midwife or GP very often. If everything is normal during your pregnancy, we will see you at the following times

Weeks of Pregnancy First Baby / Subsequent Baby What to Expect at each appointment Who you will see
Before 8 weeks All women

Referral to our Maternity Service, either by:

  • On-Line self referral
  • GP referral
  • Children’s Centre referral
GP/Children’s Centre team
6-10 weeks All women ‘Booking appointment’ with a midwife Midwife
11-14 weeks All women ‘Dating scan’ or combined screening for Down’s Syndrome. Local pregnancy club information given Scanning/Phlebotomist (at Watford General Hospital (WGH))
16 weeks All women Blood pressure, urine, wellbeing of mum and baby. Offer and organise ‘Quadruple test’ if missed combined screening. Midwife
18 - 21 weeks All women Detailed scan of baby, looking at: head, face, body, limbs and internal organs. (‘Anomaly scan’) Scanning (at WGH)
24 weeks First time mothers Blood pressure, urine, wellbeing of mum and baby Midwife
28 weeks
All women As 24 weeks. Repeat blood test for anaemia, diabetes and antibodies*  Midwife
31 - 32 weeks
First time mothers As 24 weeks plus breastfeeding discussion Midwife
34 - 36 weeks All women As 24 weeks plus discuss labour, birth and postnatal care. Final decision about where your baby will be born GP or Midwife
38 weeks All women As 24 weeks plus information about ‘Induction of Labour’ session at Watford
Midwife
38 weeks All women As 24 weeks Midwife
40 weeks First time mothers
As 24 weeks Midwife
41 weeks All women As 24 weeks plus offer membrane sweep and arrange induction of labour for overdue babies GP or Midwife

*If you are Rhesus (Rh D) negative you will require anti-D at 28 and 34 weeks. Your midwife will discuss this with you during your early appointments and plan your care with you.

If your pregnancy is more complex, your midwife and obstetrician will develop an individualised plan of care for you.

Maternity Notes

You will be given these at your booking appointment to keep with you during your pregnancy. You should always take them with you when you see your midwife, GP or attend the hospital for any reason. Midwives and doctors will write about each visit you have and ensure your test results are available to you.
Your notes are a confidential record of your care, but you are welcome to write in them and to comment on aspects of your pregnancy and treatment. After your baby is born, your notes will be retained by West Hertfordshire Hospitals NHS Trust.

Antenatal classes

A positive experience will mean different things to different people. Our aim is to help you understand labour and birth. Go to the website for further information.
If you can understand the reasons for the choices you are making, it can help you feel in control of labour and your baby's birth. Understanding a situation and retaining some control, can help towards achieving a positive experience, even if it was not the option you had originally planned. 

>> Click here to find out more information about the courses we run.

The Pregnancy Club is a monthly session for ALL pregnant women. Women can come from very early in pregnancy up to when the baby arrives. The Club includes a variety of topic talks about health in pregnancy to life with a new baby and everything in between, with a variety of other topics covered from guest speakers.
Clubs are in local Children’s Centres, to find out when and where your nearest one is call 01923 217686.

Tours of the Maternity Unit

We hold regular tours of the Maternity unit. These are informal and allow you to view the unit and ask any questions you may have regarding the birth of your baby. If you would like to join a tour please telephone 01923 217686 to make a booking. Our online tour is also available. Please go to www.westhertshospitals.nhs.uk and follow links to ‘Our Services’ Women’s Services’ and then Parent Education.

Midwifery Led Care

Your first appointment will be with a midwife who will complete an assessment interview of your needs. Midwives will then make ongoing assessments as your pregnancy continues. Once you go into labour you will be cared for by midwives from the birthing centre, by midwives from the community team if you have requested a home birth, or by midwives working on the delivery suite if you are booked for a hospital birth.

The complete midwifery package includes all antenatal appointments with the midwives, ultrasound scans and all routine blood tests as required. The midwives are available 24 hours a day for advice.

Maternity Team Care

Maternity Team Care is provided for those women for whom Midwifery Led Care is not advised. This could be for a number of reasons which your midwives will discuss with you at the time of your first appointment.

With this package of care you will be seen by an obstetric team following your initial assessment, and this will be undertaken at the hospital. An individualised care plan will be explained to you but this will include all of the ultrasound scans and routine blood tests as required.

Once you go into labour you will be cared for by the maternity team within the hospital, which will include midwives and doctors. There is a consultant obstetrician available 24 hours daily.

For those women who have certain pre-existing medical conditions, such as diabetes or epilepsy, we offer a combined obstetric / medical clinic where there is a consultant obstetrician and physician present to manage your care.

Next: After Your Baby is Born »

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