First visit – preferably before 12 weeks, usually done by GP

• Discuss/order/perform routine investigations and genetic counselling
  Bloods – >group and antibodies, FBC, Vitamin D, syphilis, hepatitis B&C, rubella, HIV and urine dipsticks/MSU
  Antenatal screening – >Nuchal Translucency + bloods at week 11-13+6, NIPT
• Diagnostic morphology 18-20 weeks
• Offer pap smear if due
• Discuss normal breast changes/examination
• Send hospital referral. Note interest in birth centre care if applicable
• Discuss folate and iodine supplementaion

12-18 week midwife booking in visit

• Confirm expected date of birth
• Discuss preferred model of care
• Commence smoking/alcohol cessation counselling
• EDS (EPDS)
• Discuss recommended weight gain/nutrition & PPSA tool
• Discuss reasons to breast feed
• Offer antenatal classes

20 week visit

• Discuss Anti D prophylaxis
• Review Bloods/scan results
• Discuss skin to skin contact
• Discuss initiation of breast feeding/baby led feeding
• Discuss positioning and attachment of baby

Notes

• Fetal Morphology
• Book GTT
• Information about fetal movements

Subsequent visits – a minimum of every 4 weeks until 28 weeks

• Discuss benefits of rooming-in (baby/mother staying together)
• Discuss exercise and rest
• Week 26-28: Obtain GCT/FBC/Antibodies (GGT when indicated)
• Review Blood results
• Week 28: Provide first dose of Anti D if applicable

Notes

• GTT

30-32 week visit with midwife

• Discuss birth preferences
• Discuss discharge planning including post-natal supports
• Discuss exclusive breast feeding for 6 months
• Whooping cough vaccine

34 week visit

• Week 34: Provide second dose of Anti D if applicable
• Discuss expressing breast milk and safe storage
• Review EDS (EPDS) – If required

36 week visit – then as clinically indicated every 1-2 weeks until 41 weeks

• Book elective caesarean section (if applicable)
• Review Blood results
• Review breastfeeding information

Notes

• GTT

41 week hospital visit

• Discuss induction of labour for week 40+10-14 days
• Monitoring if indicated as per current fetal surveillance guidelines