Every NHS appointment from booking to birth. When they happen, what they check, and what questions to ask.
NHS antenatal care includes around 10 routine appointments for first pregnancies. According to Nuhah's pregnancy guide, key ones include the booking appointment (week 8-12), dating scan (week 11-14), and anomaly scan (week 20).
Navigating the NHS antenatal system can feel confusing, especially for first-time parents. Here's a clear timeline of every appointment you can expect, what happens at each one, and the questions worth asking.
In England, your antenatal care is led by a community midwife. You'll see them regularly throughout pregnancy for check-ups, tests, and support. If your pregnancy is straightforward, you'll have around 10 appointments for a first pregnancy and 7 for subsequent pregnancies. If complications arise, you'll see additional specialists.
Your care is free, and you're entitled to it regardless of your circumstances.
Weeks 6-8: Contact your GP or self-refer. As soon as you know you're pregnant, contact your GP surgery or self-refer to your local maternity unit (many areas now allow this). They'll get you into the system and book your first midwife appointment.
Weeks 8-12: Booking appointment. This is your longest appointment (45-60 minutes). Your midwife will take a full medical history, discuss your options for care, check your blood pressure and BMI, take blood and urine samples, and calculate your estimated due date. They'll also discuss screening tests and give you your maternity notes (keep these with you at all times from now on).
Weeks 11-14: Dating scan. Your first ultrasound. This confirms your due date by measuring your baby's crown-rump length, checks for multiple pregnancies, and offers the combined screening test for Down's syndrome, Edwards' syndrome, and Patau's syndrome (if you choose it). You'll see your baby for the first time.
Week 16: Antenatal check. Your midwife reviews your blood test results, checks blood pressure and urine, and discusses the results of any screening tests. This is a good time to ask questions about the anomaly scan coming up.
Weeks 18-21: Anomaly scan. The detailed mid-pregnancy ultrasound. Your sonographer checks your baby's organs, bones, brain, heart, and overall growth. You may find out the sex. This scan screens for 11 specific conditions.
Week 25 (first pregnancy only): Antenatal check. Blood pressure, urine, and bump measurement. Your midwife will measure your symphysis-fundal height (from pubic bone to top of uterus) to track baby's growth.
Week 28: Blood tests and check. Another blood test to check your haemoglobin levels and blood group antibodies. If you're rhesus negative, you'll be offered an anti-D injection. Blood pressure, urine, and bump measured. You may also be offered the glucose tolerance test if you have risk factors for gestational diabetes.
Week 31 (first pregnancy only): Antenatal check. Blood pressure, urine, bump measurement. Review blood test results from week 28.
Week 34: Antenatal check. Blood pressure, urine, bump. Your midwife will discuss your birth plan, labour preparation, and what to expect in the final weeks. If you're rhesus negative, you'll have your second anti-D injection.
Week 36: Antenatal check. Blood pressure, urine, bump. Your midwife checks baby's position. If baby is breech (bottom-down), they'll discuss options including external cephalic version (ECV) to turn baby. Discussion about birth options, pain relief, and when to go to hospital.
Week 38: Antenatal check. Blood pressure, urine, bump. Discussion about what happens if you go past your due date, including options for induction. Your midwife will check baby's position again.
Week 40 (first pregnancy): Membrane sweep offered. A membrane sweep is a vaginal examination where your midwife separates the membranes around your baby from your cervix. It can encourage labour to start naturally. It's optional and can be uncomfortable but is generally safe.
Week 41: Induction discussion. If you haven't gone into labour, your midwife will discuss induction. NICE guidelines recommend offering induction between 41 and 42 weeks. You'll discuss the options, risks, and your preferences. Another membrane sweep may be offered.
At most routine appointments, your midwife will:
Check your blood pressure (watching for signs of pre-eclampsia), test your urine (for protein, glucose, and infection), measure your bump from week 25 onwards, listen to baby's heartbeat with a Doppler, ask about baby's movements, and check how you're feeling physically and emotionally.
At any appointment, you can ask:
Is my blood pressure and urine test normal?
Is baby measuring on track for their age?
Is baby in a good position?
Are there any concerns I should know about?
What should I be looking out for before my next appointment?
How am I doing emotionally? (Your midwife is trained to support mental health too)
Write questions down before each appointment - you already have a lot on your mind and you could forget them in the moment. Bring your maternity notes to every appointment. Don't be afraid to ask your midwife to explain anything you don't understand. And remember: you're entitled to respectful, informed care at every stage. If something doesn't feel right, speak up.
First-time parents typically have around 10 appointments. If you have had a baby before, you will have around 7. Additional appointments are arranged if you have any health conditions or complications.
Your midwife takes a full health history, checks blood pressure and urine, arranges blood tests, discusses screening options, and plans your care pathway. It usually happens between weeks 8-12 and takes about an hour.
You will have two routine scans: the dating scan at weeks 11-14 and the anomaly scan at around week 20. Additional scans may be offered if your midwife has any concerns.
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