You’ve just discovered you are pregnant for the first time and you want to know EVERYTHING about how things go and what way things work with antenatal appointments and scans and delivery. Firstly, I hope you find my blog helpful as I’ve covered a lot about pregnancy already especially childbirth. What I want to do in this post is give a quick run through of antenatal care in Ireland and what to expect. Antenatal care does vary from hospital to hospital and I’m covering general public care here as opposed to private or high-risk pregnancy care.
Step 1 – You’re pregnant! What now?
You’ll more than likely be somewhere between 5 and 10 weeks pregnant when you get your positive test. Pregnancy is measured in weeks from the first day of your last menstrual period (LMP for short) so even though you might be only around 4 weeks pregnant from when you conceived, this is classed at 6 weeks pregnant as far as doctors and midwives and your notes are concerned. And a normal pregnancy lasts around 40 weeks. You may not be sure of your dates or have irregular periods, that’s ok, a scan can be done to confirm your dates. The first thing to do is take a moment, pregnancy is a big thing and not always welcome news for some people, Make an appointment with your GP, if you know your dates then usually around 6-8 weeks is when you should be seen so that a referral can be sent to the hospital for your 12 week scan and booking appointment.
Step 2 – First GP Antenatal Appointment
At this appointment, the GP will ask you for a urine sample which they do a pregnancy test on and check for any urine infections. These tests are not as sensitive as the ones you can buy in the shops. You may have gotten a positive test at home but if you’re very early then it may still be negative at the GP. This is why you’re as well to wait until your period is at least a week late. The GP will do a blood pressure check and go through your medical history in case there are any reasons this pregnancy is high risk (eg diabetes, high blood pressure, etc). They will take antenatal blood samples also at this appointment so the results are available when you have your first hospital appointment. Then they will send a referral to your hospital of choice for antenatal care. You should also ask to be signed up to the maternity and infant care scheme so that all your scheduled GP antenatal appointments will be free in your pregnancy as well as a check for you and baby at 6 weeks after birth.
Step 3 – Hospital Booking / Dating Scan
Unfortunately, not all hospitals provide dating scans. If your hospital does them, then they are usually between 10 and 14 weeks. You’re hospital booking appointment is a long one so be prepared. Usually there’s a bit of waiting around to be seen to start with too. At this appointment, a midwife will go through all your pregnancy details so far, your full medical history, family medical history, previous pregnancies if applicable and give you a million and one leaflets about everything pregnancy related. Even breastfeeding will be talked about at this stage. They will also check your urine, your blood pressure, your height and your weight. It will be ascertained whether you have any risk factors for conditions such as gestational diabetes and whether you need any other tests. Your blood results will be reviews and you may be advised to take iron supplements. Or if bloods haven’t already been done, they will be done at this appointment. You may have already decided on what care you want in your pregnancy – consultant led (private care), midwife led or shared care between GP and hospital (public and therefore free). If not, you will need to decide now but you can change your mind at a later date if you want.
Step 4 – Further Antenatal Appointments
At each antenatal appointment, you will be told when to return for your next appointment either with your GP or the hospital (assuming shared care for now). Under the shared care, you are appointed an obstetric consultant but you may not ever see the consultant as they have registrars working on their team who will see the low risk women. If there are ever any concerns, you will be seen by a consultant if necessary. At each appointment (hospital and GP) your urine will be checked (always a good idea to bring a sample with you each time) and your blood pressure. Your abdomen will usually be palpated and measured to check that baby is growing as expected, then the baby’s heartbeat will be listened to by a sonicaid so you can hear it as well as the doctor. Please don’t panic if it takes a bit of searching to find the heart beat – this is why it’s not recommended to use one at home, even us professionals sometimes take a while to find it. The appointments will be well spaced out up until the third trimester and then get much more frequent.
Step 5 – The Anomaly Scan
Around 20 weeks, you will be offered an anomaly scan (although I believe there are still some Irish hospitals not providing this service and you may have to book a scan privately). This scan is hugely important; it checks all the baby’s organs are present and growing normally. It checks all the baby’s measurements. In short, they are checking for any abnormalities so that a plan can be put in place for delivery if your baby needs any extra care. You can also find out the sex of the baby at this scan if you wish.
Step 6 – Getting near and past your due date
There comes a time in every pregnancy where you’d really prefer not to be pregnant and you just want your baby out! You feel huge and awkward and you can’t sleep properly – check out how to enjoy the third trimester here! Antenatal appointments will be the same as earlier in the pregnancy but will also be more frequent and feature the following discussions – mode of delivery, induction of labour and membrane sweeps. On some occasions, it might be recommended that you have a planned C Section due to baby in breech position or some other reason. However, in most cases the planned mode of delivery is normal vaginal delivery and your baby doesn’t always get the memo about due dates and is quite comfortable where they are. If you go past your due date by at least 10 days, you will be offered an induction of labour. This is usually discussed when you are attending your 41 week appointment if you haven’t had your baby by then. This is also the appointment when you should be offered a membrane sweep on your first baby. However, some practitioners offer one at the 40 week appointment. The research suggests that with the first baby, a membrane sweep is more likely to be effective at 41 weeks. You may have heard the term before but you might have been reluctant to ask what exactly a membrane sweep is. So I will tell you! It is a vaginal examination where the practitioner attempts to reach the cervix and if possible sweep a finger around the membranes that surround the baby. This can stimulate hormones to start labour. It is worth a try and worked for me personally but you have the option to decline this if you wish. It shouldn’t be painful but can be uncomfortable especially if you are tense and anxious. I would liken it to a cervical smear without the speculum.
So there you have it, what happens at antenatal appointments in Ireland! If you want some great labour tips check this post out! And if you want to have a laugh with your other half about labour then here’s one on men in the labour ward!