The antenatal care schedule in Ireland

What you are entitled to

If you are pregnant and ordinarily resident in Ireland, you can get free maternity care from the HSE under the Maternity and Infant Care Scheme. You get it even if you do not have a medical card or a GP visit card. This is the single most important thing to know, and the reason to register with the scheme early: without registering, you may be charged for GP visits that would otherwise be free.

The scheme is shared care. Some of your antenatal appointments are with your GP, and the rest are at your maternity unit or hospital.

How many appointments you get

• First pregnancy: usually 6 antenatal appointments with your GP and 6 at your maternity unit or hospital.
• Second or subsequent pregnancy: usually 7 with your GP and 5 at your maternity unit or hospital.

Your first examination is carried out by your GP, ideally before week 12. Further examinations alternate between GP and hospital visits. The HSE notes you will see your GP at least five times during your pregnancy.

You will have more appointments if you are diagnosed with a pregnancy-related condition such as high blood pressure or gestational diabetes, or if you are expecting twins or more. Those additional appointments are covered by the scheme. Appointments for illnesses unrelated to your pregnancy — a urinary tract infection or a chest infection, for example — are not covered.

If you have a significant illness such as diabetes or hypertension, you may get up to 5 additional GP visits. You also get 2 postnatal GP visits after the birth.

The appointments, in order

Before 12 weeks — your first GP visit

Your GP does the antenatal checks — blood pressure and a urine check — helps you estimate your due date, and gives information on having a healthy pregnancy. Expect a conversation about folic acid, exercise and healthy eating.

Vaccines are discussed here. You will be offered a free flu vaccine during one of your appointments (flu season runs October to the end of April); the appointment is free, but you may be charged an administration fee for the flu vaccine itself if you do not have a medical card. Between 16 and 36 weeks you will be offered the whooping cough (pertussis) vaccination, which is free of charge.

8 to 12 weeks — the booking visit

Your first hospital or maternity unit appointment is with a midwife and usually takes place between 8 and 12 weeks. It lasts approximately two hours. You will be asked about your medical history, family history and any previous pregnancies. Your blood pressure and urine are checked, blood is taken, and you are offered a dating scan. You get information about antenatal classes and breastfeeding, and can be referred to physiotherapists, dietitians, smoking or alcohol cessation specialists, or social workers.

In some hospitals you have an ultrasound at this first visit; in others it is at around 20 weeks. If your pregnancy is normal, follow-up visits are much shorter.

20 to 22 weeks — the anatomy scan

You will be offered a fetal anatomy scan (anomaly scan) at the hospital. Be aware of a real difference across Ireland: some hospitals offer this to every pregnant woman and others can only offer it to women with higher-risk pregnancies. If an anomaly is detected you are referred to an obstetrician specialising in fetal anomalies.

From 28 weeks

Hospital appointments continue to check your baby's growth, development and position, and whether you have signs of high blood pressure or other complications. The height of your womb may be measured, your baby's heart rate checked, and you will be asked about your baby's movements. It may not be necessary to have another scan after the 20-week anomaly scan unless you are advised otherwise. Your midwife or obstetrician will also talk to you about preparing for the birth, breastfeeding and preparing for parenthood.

At every follow-up visit, whoever you see, your blood pressure is checked, you give a urine sample, and you are examined.

Your right to time off work

If you are employed, you are entitled to paid time off work to attend antenatal appointments. Tell your employer in writing, with medical evidence of your pregnancy, and give at least two weeks' written notice of the date and time. If you cannot give that notice for reasons outside your control, you keep the entitlement provided you write to your employer with an explanation within one week of the appointment. For any visit after the first, your employer may ask to see your appointment card. The entitlement to paid time off for medical visits continues for 14 weeks after the birth, including any period on maternity leave.

You are also entitled to paid time off for antenatal classes: one set of classes across all your pregnancies while in employment, excluding the last three in a set. Expectant fathers have a once-off right to attend the two classes immediately before the birth.

After the birth

Most women and babies are discharged within three days. A domino scheme, where a midwife visits you at home, may let you go earlier, and some hospitals run early transfer home schemes with discharge usually 12 to 36 hours after birth. When you get home a public health nurse visits within 72 hours. Your GP or practice nurse examines your baby at 2 weeks, and your GP examines both you and your baby at 6 weeks. Under the Maternity and Infant Care Scheme these postnatal visits are free.

If you are not registered, or the schedule does not fit

If you do not have a GP, contact your local maternity unit or hospital directly for an appointment — do not simply wait. Register for the Maternity and Infant Care Scheme with a participating GP as early as you can, because that is what makes the visits free.

Your schedule can be changed by your GP or hospital obstetrician depending on your situation, and both the HSE and Citizens Information are explicit that the schedule differs between pregnancies. If you want more contact than you are being offered, ask. You can also choose semi-private or private care, which is paid for and typically means seeing the same consultant — but the public Maternity and Infant Care Scheme covers the full clinical schedule at no cost.

Where to get help

The HSE is the governing authority and publishes the antenatal appointment schedule at www2.hse.ie, along with guidance on public, semi-private and private care options. HSE Live is on freephone 1800 700 700, Monday to Friday 8am to 8pm and Saturday 9am to 5pm. Citizens Information covers your employment rights around antenatal appointments and classes, and the HSE's mychild.ie carries pregnancy, birth and parenting information.