NHS antenatal appointment schedule

The calendar nobody hands you

Antenatal care is a schedule, and for most of pregnancy you experience it as a series of appointments that appear one at a time. You leave one having been told when the next is, with no sense of the shape of the whole thing. That makes it hard to plan work, childcare, travel or anything else around it.

The shape exists and is published. NICE plans ten routine appointments if this is your first baby and seven if it is not, at gestations it names precisely. Put your due date in and you can see the whole year.

Why a first baby gets three more

The extra appointments are at 25, 31 and 40 weeks. They exist because pre-eclampsia and gestational hypertension are both more common in a first pregnancy, and because there is no previous pregnancy to reason from. If you have had a baby before, your history does some of the work that extra surveillance would otherwise have to.

NICE also says to offer additional or longer appointments where they are needed, and separately flags twin and triplet pregnancies, existing medical conditions, hypertension and diabetes as reasons for a different pattern. So seven or ten is a baseline, not a limit.

The booking appointment is the one that matters most

It is also the one most often left late. NICE says the first antenatal appointment should happen by 10 weeks, and that if a woman books late, staff should ask why — because the reason may itself need addressing.

Two things are lost by a late booking, and neither can be recovered. Aspirin for pre-eclampsia starts at 12 weeks, and the dating scan window closes at 14 weeks and 1 day. Booking at 15 weeks means missing both. There is also a great deal of ordinary content in that appointment: blood tests, blood group and rhesus status, blood pressure on a validated monitor, and the risk assessments that decide almost everything that follows.

Windows, not dates

The two scans are given as windows and it is worth knowing them exactly. The dating scan runs from 11 weeks and 2 days to 14 weeks and 1 day. The anomaly scan runs from 18 weeks and 0 days to 20 weeks and 6 days. A scan anywhere inside those is on time, and a scan at 20+5 is not a scan that was nearly missed.

The dating scan does more than one job: it establishes gestational age, detects a multiple pregnancy, and carries the first-trimester screening for Down's, Edwards' and Patau's syndromes if you choose it. The anomaly scan looks at the baby's structure and also records where the placenta is, which is what decides whether you need another look later.

If your due date changes

It very often does. The date from your dating scan replaces the one worked out from your last period, because measuring the baby is more accurate than dating from a period whose timing you may be estimating. If your scan date differs from your period date, use the scan date in this tool, and expect every appointment on the list to shift with it.

The 28-week appointment does more than it looks

This is where the second set of bloods happens: full blood count, blood group and antibodies. It is also where anti-D prophylaxis is offered if you are rhesus D negative. And it is where the conversation turns towards the birth — preparing for labour, recognising active labour, and the postnatal period, including vitamin K for the baby.

If you have a risk factor for gestational diabetes, the glucose tolerance test also sits in this part of the pregnancy: NICE NG201 says refer for it to take place between 24+0 and 28+0 weeks. Tick the box in the calculator and the window appears on your dated list.

What happens at the ordinary appointments

The appointments without a scan attached can feel thin, and it helps to know they are not. Each one updates your history — general health, mental health, domestic abuse, anything you want to raise — reassesses the plan of care, and checks whether you need anything extra. Test results from the previous appointment are reviewed. Blood pressure, urine and, from 24 weeks, fundal height and fetal movements are all covered.

NICE also puts specific conversations at specific points. Sleeping position is discussed by 28 weeks, with the advice to avoid going to sleep on your back after 28 weeks and to talk about ways to hold a side position. Preparing for labour, recognising active labour and the postnatal period start at 28 weeks. Breech presentation is checked by abdominal palpation from 36 weeks onwards.

What happens at every appointment from 24 weeks

Two things become routine. Your bump is measured — symphysis fundal height — and plotted on a growth chart rather than merely written down, unless you are having regular growth scans. And your baby's movements are discussed every single time, with the standing instruction to ring maternity services at any hour about any concern or any reduction.

That instruction is not a formality and it does not have an out-of-hours version. Waiting until morning is the thing it exists to prevent.

The last appointment on the list

The 41-week appointment is for anyone who has not yet given birth, and it is where a membrane sweep and induction of labour are discussed. If you are heading towards it, the Bishop score calculator explains the number that decides which induction method is offered first.

This tool converts NICE's gestational windows into your calendar. Your maternity service books the real dates and may run a different local pattern, and nothing here replaces your midwife.