first midwife appointment

By the time you are two months pregnant, you should have the first midwife appointment, also known as booking appointment.

At this point, there is a lot of hustle and bustle in your womb, where the embryo is getting ready to evolve into a foetus. Pregnancy symptoms may not give you a break and you may just need some answers to keep all that stress under control. Well, that's what the midwife booking appointment is about, at least partially. When you found out that you were pregnant, you probably had a first visit either with your GP or midwife that covered details like healthy habits when expecting a baby or why taking folic acid is necessary.

After that initial experience, your GP or midwife will plan your booking appointment for any time between 8 weeks pregnant and 12 weeks pregnant, when the risk of miscarriage is a lot lower. So what is the first midwife appointment, then? It is the first official antenatal appointment that you'll have throughout these 9 months, and it's aimed at laying the groundwork for what to expect, according to your health, medical history and other relevant information about you. It's usually provided by a hospital or the local health trust where you are supposed to give birth, but you can change that later on your pregnancy (though in such a case, you may need an extra booking appointment).

What will the midwife ask me in my first midwife appointment? 

In the booking appointment, you can expect to be 'bombarded' with many questions and useful information regarding tests and antenatal care. These are some of the regular aspects that you may be asked about in the first midwife appointment:

  • Date of your last period: it'll help your midwife figure out your due date.

  • Family history of certain diseases: she'll ask you some questions about genetic conditions and a medical family history of heart disease, diabetes and mental health problems, among others. Keep in mind that, depending on your ethnic background, you may be offered a blood test to rule out conditions such as sickle cell disease, which affects people of African descent.

  • Previous births, abortions and miscarriages: if you had an abortion or a miscarriage in the past, it may not be easy for you to talk about it, but remember that it's necessary. Your midwife will need as much information as possible about your past experiences, in order to determine the proper maternity care and birth choices.

  • Your job: she will probably ask you about your job, in case you are currently working. The reason? Because there are certain jobs, especially those that require a lot of physical activity, that can carry risks for your growing baby.

  • Your lifestyle: similar to what you were told in the first visit, your midwife will want to hear about your diet and, above all, if you've given up smoking and drinking alcohol, along with the amount of caffeine you have every day.

  • Your birth choice: whether you want to give birth at a hospital, a birth centre or at home. Of course, you don't need to make a decision now if you're considering more than one option, and you can change your mind. The range of options may get reduced if pregnancy complications arise.

  • Nursing: your midwife may also want to know how you intend to feed your baby, so that she can give you the right information about either breastfeeding or formula feeding. Like with your birth choice, your decision at this point doesn't have to be final.

What will she test and measure in the first midwife appointment? 

Besides gathering your information, your midwife will test and measure your: 

  • Blood: she'll take two samples of your blood to have them sent to the lab to check your blood group, iron levels, rhesus status, your immunity to German measles, HIV and hepatitis B.

  • Blood pressure: you'll also have your blood pressure checked. Your midwife will write down both the higher figure and the lower figure, which should be ideally less than 120/80 mmHg. Bear in mind that if you are diagnosed with hypertension in pregnancy, you are more likely to suffer from preeclampsia later on.

  • Urine: she'll look for protein, sugar and white cells in your urine, which could be a sign of potential diseases to develop throughout pregnancy, such as preeclampsia, gestational diabetes and Urinary Tract Infection (UTI).

  • Height and weight: it's necessary to calculate your body mass index (BMI). If it's too high, more than 30, it means that you are at risk of complications like gestational diabetes, whereas a low BMI, under 18, can lead to low birth weight.

  • Tummy: your midwife may take advantage of the booking appointment to measure the distance between the top of your pubic bone and the top part of your uterus. That measurement is called the 'height of fundus', and it can help her determine whether your baby is growing at the right pace. However, the height of the fundus is usually measured from 25 weeks pregnant on.

If you have the first midwife appointment at a hospital, you could have a dating scan (also known as 12 week scan) at the same visit. This can provide you with accurate information about your due date and, as a result, for how long you have been pregnant. If you can't have it the same day, your midwife can book it for you, generally between 11 and 13 weeks pregnant.

What information will I be given in the first midwife appointment?

When you leave the first midwife appointment, you'll also have fresh information regarding screening for Down syndrome, which is offered to all pregnant women either through a combined test or a quadruple test.

In addition, you'll learn your maternity rights, in terms of maternity leave, and additional advice related to antenatal classes, exercise in pregnancy, healthy eating and the necessary vitamin supplements.

What will happen next?

During the first midwife appointment, you can expect to be counselled about the antenatal care that's offered in the area where you live. You'll find out whether you'll have to keep visiting her or another midwife or if the booking appointment will be at the same place or not. Your next antenatal appointments will be at 16 weeks, 25 weeks (if it's your first pregnancy), every three weeks until you are 34 weeks pregnant, and then every other week until the 40th. You'll have an extra prenatal appointment if you haven't given birth by week 41.

Basically, the first midwife appointment sheds light on what your pregnancy should be like, considering how you feel at the time and how your little one is developing. Just think that you need to respect the antenatal care calendar up to a certain point, because you can contact your midwife at any time if you are concerned about something. The goal is for both you and your baby to be alright.