Antenatal care
Just a brief overview of what can happen during a routine antenatal check up with me, depending on your gestation ~
Friendly & unhurried appointments in the comfort of your home. Having a cuppa, chats, pregnancy care planning and birth preparation…to name but a few. Basically getting to know you and your family and building a mutual trusting relationship. Involving your partner, your children and even extended family.
Overall holistic well-being assessments of emotional, psychological and physical health of you and the well-being assessments of your unborn baby.
A clinical assessment including taking your blood pressure, pulse, urinalysis, abdominal palpation and fundal height measurement. Auscultation of the fetal heart will be offered and all findings documented in your maternity notes. A review of your care plan at regular intervals incase any changes are recommended depending on findings. Reviewing scan reports and blood results and making referrals to other HCPs if required.
Chatting about thoughts and feelings around your pregnancy and conversations around birth preparation and your birth preferences including reviewing your previous experiences if applicable. Antenatal education, infant feeding discussion, preparation for the postnatal period and answering any questions or concerns you may have are all covered. No topic off limits!
Discussing optimal positions for pregnancy, labour & birth and maybe demonstrating some of these positions and techniques that may be recommended for you such as using the rebozo.
I am trained in pregnancy massage and aromatherapy in childbirth so a lovely relaxing massage later in your pregnancy may be just what you need.
All antenatal reviews will be tailored to you, your baby and your needs.
Some of the assessments you will be offered during your antenatal check ups ~
Fetal assessment
There are various methods for us to use to listen and assess your baby’s heart rate…Fetoscope, pinnard, sonicaid/Doppler.
When we listen in to your baby we are not only identifying a fetal heart beat, but also assessing the baseline rate and bpm (usually between 110-160), are there accelerations? (rise in heart rate from baseline often with movement) or any decelerations (decrease in heart rate from baseline).
If there are any irregularities and deviations from the norm audible it may be advised to have a review in the maternity unit for a tracing of baby’s heart rate (CTG) and a medical review.
We always ask about your baby’s movements, as an active baby is a good indicator of fetal well-being. Movements can start to be felt from around 16 weeks up to 24 weeks for most women and may not start to be regular until after 24 weeks. Once you start to feel regular movements we advise that if you experience any change to your baby’s normal pattern of movements to speak to your Midwife or contact your maternity unit for advice.
Women with an anterior placenta (located on the front of your uterus and detected at scan) often don’t start to feel movements until after 20 weeks and may be only experienced as gentle movements as the placenta cushions what is felt by the Mother.
Performing an abdominal palpation gives us lots of useful information such as the lie (longitudinal, oblique or transverse), the position (which direction baby is facing) and presentation of your baby (head, bum or limb 1st) and engagement.
Also by identifying where your baby is lying makes locating your baby’s heartbeat easier.
Usually by 36 weeks of your pregnancy most baby’s will settle into the head down (cephalic) position and can start to engage into your pelvis although engagement may not occur until in labour if you have had a baby before. If your baby isn’t head down at term we can have discussions around your options.
Knowing all of this information is really useful as you are approaching the end of your pregnancy and before labour starts. If there are any concerns with any of the findings or if your baby isn’t in an optimal position we can try and rectify this before labour.
Assessing baby’s growth during the pregnancy is important so we can assess if there’s any unusual accelerated growth, static or reduced growth that may need further investigations. You may be having serial growth scans or having regular fundal height measurements. The measurements of baby will be plotted on your customised growth chart where we have a visualisation of baby’s predicted growth and what percentile baby is following. Any deviations from the norm can be followed up.
Maternal assessments
We dip test your urine to see if there are any signs of infection, dehydration, blood, protein and glucose. An occasional change in the absence of any other concerns or clinical signs can be normal due to the physiological changes in your kidneys and urinary tract in pregnancy. Recurrent or a sudden change with other symptoms can form part of a bigger picture as to what may be going on in your body, such as infection, diabetes or pre eclampsia and may warrant further investigation or tests.
So why do we check blood pressure?
We like to check at every antenatal contact from booking until birth so we have your normal baseline and can observe for any rise in your BP.
An increase in BP can indicate more concerning underlying or developing health problems associated with pregnancy that may warrant further investigations and treatment.
