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Prenatal care: 1st trimester visits

Pregnancy and prenatal care go hand in hand. During the first trimester, prenatal care includes blood tests, a physical exam, conversations about lifestyle and more.

Prenatal care is an important part of a healthy pregnancy. Whether you choose a family physician, obstetrician, midwife or group prenatal care, here's what to expect during the first few prenatal appointments.

The 1st visit

When you find out you're pregnant, make your first prenatal appointment. Set aside time for the first visit to go over your medical history and talk about any risk factors for pregnancy problems that you may have.

Medical history

Your health care provider might ask about:

• Your menstrual cycle, gynecological history and any past pregnancies
• Your personal and family medical history
• Exposure to anything that could be toxic
• Medications you take, including prescription and over-the-counter medications, vitamins or supplements
• Your lifestyle, including your use of tobacco, alcohol, caffeine and recreational drugs
• Travel to areas where malaria, tuberculosis, Zika virus, mpox — also called monkeypox — or other infectious diseases are common

Share information about sensitive issues, such as domestic abuse or past drug use, too. This will help your health care provider take the best care of you — and your baby.

Your due date is not a prediction of when you will have your baby. It's simply the date that you will be 40 weeks pregnant. Few people give birth on their due dates. Still, establishing your due date — or estimated date of delivery — is important. It allows your health care provider to monitor your baby's growth and the progress of your pregnancy. Your due date also helps with scheduling tests and procedures, so they are done at the right time.

To estimate your due date, your health care provider will use the date your last period started, add seven days and count back three months. The due date will be about 40 weeks from the first day of your last period. Your health care provider can use a fetal ultrasound to help confirm the date. Typically, if the due date calculated with your last period and the due date calculated with an early ultrasound differ by more than seven days, the ultrasound is used to set the due date.

Physical exam

To find out how much weight you need to gain for a healthy pregnancy, your health care provider will measure your weight and height and calculate your body mass index.

Your health care provider might do a physical exam, including a breast exam and a pelvic exam. You might need a Pap test, depending on how long it's been since your last Pap test. Depending on your situation, you may need exams of your heart, lungs and thyroid.

At your first prenatal visit, blood tests might be done to:

• Check your blood type. This includes your Rh status. Rh factor is an inherited trait that refers to a protein found on the surface of red blood cells. Your pregnancy might need special care if you're Rh negative and your baby's father is Rh positive.
• Measure your hemoglobin. Hemoglobin is an iron-rich protein found in red blood cells that allows the cells to carry oxygen from your lungs to other parts of your body. Hemoglobin also carries carbon dioxide from other parts of your body to your lungs so that it can be exhaled. Low hemoglobin or a low level of red blood cells is a sign of anemia. Anemia can make you feel very tired, and it may affect your pregnancy.
• Check immunity to certain infections. This typically includes rubella and chickenpox (varicella) — unless proof of vaccination or natural immunity is documented in your medical history.
• Detect exposure to other infections. Your health care provider will suggest blood tests to detect infections such as hepatitis B, syphilis, gonorrhea, chlamydia and HIV , the virus that causes AIDS . A urine sample might also be tested for signs of a bladder or urinary tract infection.

Tests for fetal concerns

Prenatal tests can provide valuable information about your baby's health. Your health care provider will typically offer a variety of prenatal genetic screening tests. They may include ultrasound or blood tests to check for certain fetal genetic problems, such as Down syndrome.

Lifestyle issues

Your health care provider might discuss the importance of nutrition and prenatal vitamins. Ask about exercise, sex, dental care, vaccinations and travel during pregnancy, as well as other lifestyle issues. You might also talk about your work environment and the use of medications during pregnancy. If you smoke, ask your health care provider for suggestions to help you quit.

Discomforts of pregnancy

You might notice changes in your body early in your pregnancy. Your breasts might be tender and swollen. Nausea with or without vomiting (morning sickness) is also common. Talk to your health care provider if your morning sickness is severe.

Other 1st trimester visits

Your next prenatal visits — often scheduled about every four weeks during the first trimester — might be shorter than the first. Near the end of the first trimester — by about 12 to 14 weeks of pregnancy — you might be able to hear your baby's heartbeat with a small device, called a Doppler, that bounces sound waves off your baby's heart. Your health care provider may offer a first trimester ultrasound, too.

Your prenatal appointments are an ideal time to discuss questions you have. During your first visit, find out how to reach your health care team between appointments in case concerns come up. Knowing help is available can offer peace of mind.

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• Lockwood CJ, et al. Prenatal care: Initial assessment. https://www.uptodate.com/contents/search. Accessed July 9, 2018.
• Prenatal care and tests. Office on Women's Health. https://www.womenshealth.gov/pregnancy/youre-pregnant-now-what/prenatal-care-and-tests. Accessed July 9, 2018.
• Cunningham FG, et al., eds. Prenatal care. In: Williams Obstetrics. 25th ed. New York, N.Y.: McGraw-Hill Education; 2018. https://www.accessmedicine.mhmedical.com. Accessed July 9, 2018.
• Lockwood CJ, et al. Prenatal care: Second and third trimesters. https://www.uptodate.com/contents/search. Accessed July 9, 2018.
• WHO recommendations on antenatal care for a positive pregnancy experience. World Health Organization. http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/anc-positive-pregnancy-experience/en/. Accessed July 9, 2018.
• Bastian LA, et al. Clinical manifestations and early diagnosis of pregnancy. https://www.uptodate.com/contents/search. Accessed July 9, 2018.

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What to expect at your first prenatal appointment

Your kickoff prenatal visit sets the stage for the rest of your pregnancy. Here's what to expect at this information-packed first appointment and how you can prepare.

When to schedule your first prenatal visit

When will your first appointment be, what happens at the first prenatal visit, how to prepare for your first prenatal appointment, what questions to ask at the first prenatal visit.

As soon as you get a positive result on a home pregnancy test , book an appointment with an obstetrician, family physician, or midwife . Depending on the practice, it's normal for another provider in the office, like a nurse practitioner or physician assistant, to handle your first visit.

If you haven't yet chosen a healthcare provider for your pregnancy, that's okay. It's still important to see someone now to start your prenatal care. You can always switch to another provider later. 

Many healthcare providers will schedule your first visit for when you're about 8 weeks pregnant . Some will see you sooner, particularly if you have an existing health condition, had problems with a pregnancy in the past, or are having new or severe symptoms such as vaginal bleeding or abdominal pain .

If you're taking any medications or think you may have been exposed to a hazardous substance, let your provider know as soon as possible.

The first visit will probably be the longest of your prenatal appointments (unless you have complications with your pregnancy along the way). At this and all future visits, don't be afraid to raise any questions or concerns you've been wondering about – it helps to keep a running list between appointments.

Here's what your provider will likely do during your first prenatal visit.

Take your health history. Your provider will ask questions about your gynecological health, personal medical history, and lifestyle habits. Topics commonly covered include:

• Whether your menstrual cycles are regular and how long they tend to last
• The first day of your last period (to determine your due date )
• Symptoms or problems you've noticed since your last period, whether they're related to pregnancy or not
• Current or past gynecological conditions, including sexually transmitted infections
• Details about previous pregnancies
• Current or past diseases and conditions
• Past surgeries or hospitalizations
• Mental health difficulties and diagnoses
• Whether you are being or have been abused , or have another situation that could affect your safety or emotional well-being
• Smoking, drinking, and drug use
• Medications, supplements, vitamins, and herbal drugs you take
• Drug allergies

Your healthcare provider will also ask about your family medical history. Many genetic issues and birth defects are at least partly hereditary, so learning about your family history helps your medical team keep an eye out for potential issues. Let your provider know whether a relative in your or your partner's family has a chromosomal or genetic disorder, had developmental delays, or was born with a structural birth defect.

It's also important to mention any potential exposure to toxins, especially if you live or work near toxic materials.

Check you out and run some tests. You can expect a number of standard exams and tests at your first prenatal visit. Some healthcare providers will do an ultrasound , but if you don't have any medical problems or concerns, it may not be part of the routine. Here's what's typical:

• A thorough physical exam
• A pelvic exam, including a Pap smear (unless you've had one recently) to check for infections such as chlamydia and gonorrhea or abnormal cells that could indicate cervical cancer
• A urine sample to test for urinary tract infections and other conditions

Your provider will also order blood tests to:

• Identify your blood type and Rh status
• Look for anemia
• Check for HIV, syphilis, hepatitis B and, in certain cases, hepatitis C
• Determine immunity to rubella (German measles) and chickenpox

Discuss any high-risk pregnancy concerns. Many people are considered to have high-risk pregnancies , meaning there's a higher-than-average chance of health issues during pregnancy, labor, and birth. High-risk groups include those who:

• Become pregnant for the first time at age 35 or older
• Become pregnant for the first time before age 18
• Have certain medical issues that develop during pregnancy, such as preeclampsia and gestational diabetes
• Have certain preexisting health problems, such as high blood pressure , thyroid disease , or type 1 or type 2 diabetes

High-risk pregnancies need extra care. While many potential complications are treatable or temporary, some can be dangerous to both you and your baby. Your provider will talk through the risks at your first visit and throughout your pregnancy – and don't be afraid to ask questions at any point.

Explain your options for prenatal genetic testing. Your provider will offer you various prenatal screenings that can give you information about your baby's risk for birth defects and chromosomal conditions. These tests include:

• Noninvasive prenatal testing (NIPT) , also called cell-free fetal DNA testing. Performed at 9 weeks or later, it's used to examine the little bits of your baby's DNA present in your blood.
• A first trimester screen, also called a first-trimester combined test. Typically done between weeks 11 and 13, it consists of a blood test and a type of ultrasound called a nuchal translucency .
• A carrier screening if you haven't had one already. It's a simple blood or saliva test done to see whether your baby is at risk for any of 100 genetic disorders such as cystic fibrosis, sickle cell disease, thalassemia, and Tay-Sachs disease.

Finally, if you're high-risk, there are invasive genetic diagnostic tests that can tell you for sure whether your baby has Down syndrome or certain other conditions. These tests include chorionic villus sampling (CVS) , generally performed at 10 to 13 weeks, and amniocentesis , usually done at 16 to 20 weeks.

CVS and amniocentesis are invasive and may carry a small risk of miscarriage , so women who choose to have these procedures are usually those with a higher risk for genetic and chromosomal problems. Some moms-to-be choose to wait for the results of screening tests before deciding whether to have one of these diagnostic tests.

For more information, your provider can refer you to a genetic counselor .

Give you advice and let you know what's ahead. Your healthcare provider will give you information about eating well , foods to avoid , healthy weight gain , and prenatal vitamins . They'll also give you a heads-up about the common discomforts of early pregnancy and let you know which pregnancy symptoms require immediate attention .

Your emotional health is very important. Your provider may screen you for signs of depression during pregnancy . But don't wait to be asked. If you're feeling depressed or anxious, let your provider know so they can refer you to someone who can help.

The dangers of smoking , drinking alcohol, using drugs, and taking certain medications will be a topic of discussion, as well. If you need help quitting smoking or any other substance, your provider can recommend a program or counselor.

Other topics include the do's and don'ts of exercise , travel , and sex during pregnancy ; environmental and occupational hazards that can affect your baby; and how to avoid certain infections, such as toxoplasmosis . Your provider will also discuss recommended vaccinations , like the flu shot and the COVID-19 vaccine .

To help your visit go as smoothly as possible, try taking the following steps.

Review your medical history. Brush up on your health status so you can better answer questions. This includes information about your:

• Overall physical and mental health
• Current and past diseases, conditions and other health issues
• Current medications, including prescriptions, supplements, vitamins and herbal supplements and teas
• Fertility and pregnancy history
• Family medical history
• Partner's medical history

If possible, bring documentation along, such as immunization records or a list of your medications. You may even want to bring a baggie containing the medications themselves.

Take your partner, a family member, or friend. Another person can write down notes, ask questions, and provide emotional support during this information-dense first visit.

Get there on time or a little early. This can be helpful for filling out forms and reviewing your insurance. Make sure to bring your insurance information and cash or a credit card for any necessary co-pays.

Just as your provider will ask you questions at your first prenatal visit, it's a good idea to come prepared with a list of questions for your provider. Ask anything – and don't be shy. Again, try to keep a running list in the weeks before the appointment, so nothing important slips your mind.

Here are some questions to consider if your provider doesn't bring up the topic first.

• How much weight gain is healthy for me? The first prenatal visit is a great opportunity to learn about how your body will change. It's also a good time to ask about nutrition, including which foods to prioritize in your diet.
• What are the foods I should avoid ? Raw fish and unpasteurized cheeses are long-established no-no's for pregnant people, but ask your provider for a full list of what to skip, since the accepted wisdom has changed over the years. Ask about caffeine and alcohol, too. Coffee is typically alright in limited doses, but no amount of alcohol is considered safe when you're having a baby.
• Are prenatal supplements a good choice? Your provider will likely recommend a prenatal vitamin containing folic acid and iron, both of which are needed more during pregnancy.
• Can I exercise? What about sex? With some exceptions, both are usually okay when you're pregnant. They're important to discuss, however, since certain conditions may complicate matters.
• Is it safe to keep working? If you have a physically or emotionally demanding job , you may want to ask how you can ease the effects on your body and mind.
• Is travel okay? While planes, trains, and automobiles are typically safe well into pregnancy, people with particular complications may need to limit or avoid traveling.
• Which medications are safe to take? Ask about your current prescriptions, herbal products, teas, supplements, and any over-the-counter drugs you may use, such as pain relievers and cold medicines. Non-steroidal inflammatory drugs (NSAIDs) like ibuprofen and naproxen are not recommended, for example.
• What are common symptoms of pregnancy? Your provider can tell you what to expect and how to cope. Remember to ask what symptoms are uncommon, too, and what red flags to watch for.
• What should I do in an emergency? Find out who to contact and where to go if you begin to experience new, unusual, severe, or long-lasting symptoms.
• Who will treat me over the course of my pregnancy? If your provider is part of a group practice, you may see other members of the group during appointments. They may even deliver your baby.
• Do you recommend taking prenatal classes? Whether they're in a hospital, at a university, online, or somewhere else, prenatal classes can be invaluable learning experiences for parents-to-be. On top of the usual childbirth classes you hear about, you can also find courses in everything from stress management to good nutrition and even breastfeeding.

Last but not least, ask about your next visit and schedule the appointment before leaving the office. Until your 28th week of pregnancy, you'll likely see someone every four weeks or so.

You may also want to ask whether future visits will be in-person or virtual. Certain practices offer virtual visits for low-risk patients, those whose providers aren't close by, or even higher-risk patients that need to be evaluated more often.

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Prenatal visits: What to expect and how to prepare

What happens at second trimester prenatal appointments

NIPT (Noninvasive prenatal testing)

Chorionic villus sampling (CVS)

BabyCenter's editorial team is committed to providing the most helpful and trustworthy pregnancy and parenting information in the world. When creating and updating content, we rely on credible sources: respected health organizations, professional groups of doctors and other experts, and published studies in peer-reviewed journals. We believe you should always know the source of the information you're seeing. Learn more about our editorial and medical review policies .

March of Dimes. 2017. Prenatal Care Checkups.  https://www.marchofdimes.org/pregnancy/prenatal-care-checkups.aspx Opens a new window  [Accessed March 2024]

MedlinePlus. 2022. Prenatal care in your first trimester.  https://medlineplus.gov/ency/patientinstructions/000544.htm Opens a new window  [Accessed March 2024]

Mayo Clinic. 2022. Prenatal care: 1 st  trimester visits.  https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/prenatal-care/art-20044882 Opens a new window  [Accessed March 2024]

American Pregnancy Association. (2021). Your First Prenatal Visit.  https://americanpregnancy.org/healthy-pregnancy/planning/first-prenatal-visit/ Opens a new window  [Accessed March 2024]

Kids Health. 2022. Prenatal Visits: First Trimester.  https://kidshealth.org/en/parents/tests-first-trimester.html Opens a new window  [Accessed March 2024]

Mount Sinai. 2021. Prenatal care in your first trimester.  https://www.mountsinai.org/health-library/selfcare-instructions/prenatal-care-in-your-first-trimester Opens a new window  [Accessed January 2024]

Centers for Disease Control and Prevention. 2022. Recommended Clinician Timeline for Screening for Syphilis, HIV, HBV, HCV, Chlamydia, and Gonorrhea.  https://www.cdc.gov/nchhstp/pregnancy/screening/clinician-timeline.html Opens a new window  [Accessed March 2024]

Alabama Perinatal Excellence Collaborative. 2015. APEC Guidelines for Routine Prenatal Care.  http://apecguidelines.org/wp-content/uploads/2016/07/Routine-Prenatal-Care-6-30-2015.pdf Opens a new window  [Accessed March 2024]

Kids Health. 2019. Toxoplasmosis.  https://kidshealth.org/en/parents/toxoplasmosis.html Opens a new window  [Accessed March 2024]

NIH: Eunice Kennedy Shriver National Institute of Child Health and Human Development. 2017. What is a high-risk pregnancy?  https://www.nichd.nih.gov/health/topics/pregnancy/conditioninfo/high-risk Opens a new window  [Accessed March 2024]

Kids Health. 2022. What's a “High-Risk” Pregnancy?  https://kidshealth.org/en/parents/high-risk.html Opens a new window  [Accessed March 2024]

NIH: Eunice Kennedy Shriver National Institute of Child Health and Human Development. 2018. What are some factors that make a pregnancy high risk?  https://www.nichd.nih.gov/health/topics/high-risk/conditioninfo/factors Opens a new window  [Accessed March 2024]

March of Dimes. 2020. Prenatal Tests.  https://www.marchofdimes.org/pregnancy/prenatal-tests.aspx Opens a new window  [Accessed March 2024]

American College of Obstetricians and Gynecologists. 2022. Carrier Screening.  https://www.acog.org/womens-health/faqs/carrier-screening Opens a new window  [Accessed March 2024]

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Office on Women's Health. 2021. Prenatal care and tests.  https://www.womenshealth.gov/pregnancy/youre-pregnant-now-what/prenatal-care-and-tests Opens a new window  [Accessed March 2024]

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Your Prenatal Care Appointments

If you're pregnant, especially if it's for the first time, you may be wondering what will happen at your prenatal care appointments with your doctor or midwife . Here's a rundown of everything you can expect at each appointment, including tests and exams.

Your First Prenatal Care Appointment

Your first prenatal appointment will probably be your longest one. Here you will give your doctor, midwife, or nurse your complete health and pregnancy history. This information is important because it will give your practitioner a good idea of how healthy you are and what type of problems you are most likely to experience during your pregnancy. You will learn what your estimated due date is as well.

There are many areas that may be checked during your physical exam, including:

• Blood pressure
• Breast exam
• Pelvic exam
• Pregnancy test
• Ultrasound (if you're having pain or bleeding or underwent fertility treatments)
• Urine screen for protein and sugar

You will probably be seen for your first appointment between 8 and 10 weeks gestation, though you may be seen earlier if you're having problems or if it's your doctor or midwife's policy.

Your Second Appointment

Your second prenatal appointment usually takes place about a month after your first appointment, unless you're having problems or need specific prenatal testing that is best performed in a specific time range. Here is what will most likely happen during this visit:

• Blood pressure check
• Listen to a fetal heartbeat using a Doppler
• Record your weight
• Urine screen for sugar and protein

Your baby's first heartbeat can usually be heard with a Doppler between 8 and 12 weeks gestation. If you have trouble hearing the baby's heartbeat, you will probably be asked to wait until your next visit when your baby is a bit bigger. Sometimes an ultrasound will be ordered as well.

Additional Testing

Additional testing may be performed at this appointment as needed. There are some optional tests you, your doctor, or your midwife may request:

• Chorionic villus sampling (CVS) (diagnostic test for many genetic diseases)
• Early amniocentesis (diagnostic test for many genetic diseases)
• Nuchal fold test (screening for Down syndrome)

Be sure to discuss all of your options regarding these tests, including the risks and benefits, how the test results are given, and whether the test is a screening test or a diagnostic test.

Your Third Appointment

Towards the third prenatal visit, you're most likely around 14 to 16 weeks pregnant. You're probably feeling better and the most dangerous part of pregnancy is over. You are now probably feeling more confident in your pregnancy and sharing your good news .

It has been about a month since you've seen the midwife or doctor. Here's what this appointment may look like:

• Check your blood pressure
• Listen for baby's heartbeat
• Measure your abdomen, called "fundal height," to check baby's growth
• Urine sample to screen for sugar and protein

Optional Testing

You may also have the following prenatal testing done if you request it:

• Amniocentesis (diagnostic test for many genetic diseases)
• Neural tube defect (NTD)/Down syndrome screening by way of maternal blood work (several tests can be used including alpha-fetoprotein (AFP), triple screen, and quad screen)

Your Fourth Appointment

You are most likely between 16 to 20 weeks at this point, and it has been about a month since your last appointment. You probably feel like you've grown a lot since your last appointment and you may now be wearing maternity clothes and possibly even feeling your baby move . Here's what this visit may involve:

• Measure your fundal height to check baby's growth

You may also have a  mid-pregnancy ultrasound screening  if you request it or if it's your doctor or midwife's policy.

Your Fifth Appointment

Between 18 to 22 weeks you'll likely have your fifth prenatal care visit. Here's what this appointment may involve:

• Check for swelling in your hands and feet
• Listen to the baby's heartbeat

Your Sixth Appointment

Your next prenatal care appointment will likely be between 22 to 26 weeks of pregnancy . You are probably still being seen monthly. Here's what this appointment may look like:

• Listen to the baby's heartbeat
• Measure your fundal height to check baby's growth
• Questions about baby's movements

Your Seventh or Eighth Appointment

Between 26 to 28 weeks of pregnancy , you'll likely have another prenatal care appointment. Here's what may happen:

• Check blood pressure
• Questions about baby's movements

Other Testing and Information

You may have other tests or procedures ordered, like the glucose tolerance test (GTT) used to screen for gestational diabetes or the RhoGam , shot around 28 weeks of gestation for women who are Rh-negative. Your doctor or midwife may also give you information on screening for preterm labor on your own.

Your Eighth, Ninth Appointments and Beyond

Your next appointment will likely be between 28 to 36 weeks of pregnancy. In fact, you're likely to have at least two prenatal visits during this period because you're now being seen every other week. Here's what these appointments may involve:

• Palpate to check baby's position (vertex, breech, posterior, etc.)

Screening for Group B strep (GBS) will normally be done between weeks 34 to 36. This involves rectal and vaginal swab. You will continue to be seen every other week until about the 36th week of pregnancy. At this point, your visits will likely be fairly routine with very few extra tests being performed.

Weekly Visits

Between 36 to 40 weeks of pregnancy, you're usually seen every week. Here's what these visits may entail:

You will continue to be seen every week until about the 41st week of pregnancy, at which point you may be seen every few days until your baby is born. Your visits are most likely fairly routine, with very few extra tests being performed.

You may also have an ultrasound to determine what position the baby is in at this point. Your doctor will also try to predict the size of your baby , but this is usually not very accurate. Because of this tendency for inaccuracy, it's not a great idea to have an induction of labor based on the predicted size of your baby.

If you're having a home birth , you may have a home visit during this time frame if your midwife doesn't do her normal prenatal visits there. You will be able to give her a tour of your home and answer questions she may have about where everything is located.

Overdue Pregnancy Visits

At 40 or 41 weeks of pregnancy, you may begin to see your midwife or doctor every few days. Here is what these visits may look like:

Since you are officially past your due date, your midwife or doctor may want to watch you and your baby more carefully until labor begins. This may include the following tests:

• Non-stress test (NST)
• Biophysical profile (BPP)

These tests will help determine if your practitioner needs to intervene with an induction of labor for the health of your baby or let your pregnancy continue.

National Institute of Child Health and Human Development. What Happens During Prenatal Visits ?

National Institute of Child Health and Human Development. What are some common complications of pregnancy ?

American College of Obstetricians and Gynecologists. How Your Fetus Grows During Pregnancy .

Mayo Clinic Staff.  Prenatal Care: 1st Trimester Visits . Mayo Clinic.

By Robin Elise Weiss, PhD, MPH Robin Elise Weiss, PhD, MPH is a professor, author, childbirth and postpartum educator, certified doula, and lactation counselor.

First Prenatal Visit: What Happens & How to Prepare

The first prenatal care visit is an exciting time but you may not know what to expect or how to prepare. Here’s an overview of what to expect.

• Written by Genevieve Howland
• Updated on May 24, 2019

From the time you pee on that pregnancy test to actually going to your first prenatal visit seems like an eternity. It. is. BRUTAL! I remember calling my midwife all giddy when I told her that I was pregnant and she said “I’ll see you in 10 weeks.” TEN WEEKS?!?! Are you crazy? What if something happens to the baby? What happens if I mess something up? What? Wha? Wha?

Then I remembered to breath… and I realized that there really isn’t anything a midwife could do to “save” my baby in these very precious early weeks. And so I surrendered. And waited. And wondered. What do I need to bring to my first prenatal visit? Can I prepare in any way? And what exactly goes on during the first prenatal visit?

Here’s what you can expect and how you can prepare.

When is my first prenatal visit?

Typically women see their healthcare provider for prenatal care between 8 and 12 weeks. If you are seeing a midwife they may suggest you wait until 10 – 12 weeks for your first appointment. This is because this is about the time when you can hear your baby’s heartbeat on a doppler. Don’t be sad or scared if they still can’t find the heartbeat, as it is really more like 12-14 weeks for a definite reading.

Many OBs and even family doctors expect you to schedule your first prenatal care appointment much earlier than this though.

An ultrasound can pick up a heartbeat as early as 6-7 weeks, and some women are led to believe that an early ultrasound is necessary for a healthy pregnancy. This analysis shows that routine ultrasound does not improve perinatal outcomes while this analysis shows no improvement in maternal outcomes.

Here’s a post dedicated to the risks vs. rewards of baby ultrasounds .

Another reason that some doctors want you to schedule an earlier appointment is for a full pelvic exam. The reasoning is that, for some women, prenatal care is their first or only chance to see a doctor and undiagnosed STDs can be dangerous for the baby.

Your provider may also take the opportunity to do a pap smear to check for cervical cancer. However, vaginal exams do carry a small risk of infection, so if you are relatively healthy and don’t have a history of ectopic pregnancy or other serious concerns, then you are probably fine to wait until around 12 weeks.

What should I expect at my first prenatal visit?

What happens during the first visit will vary from provider to provider, but for the most part you can expect to do four main things.

1. Build a relationship

One of the advantages to using midwives is that you have continuity of care, meaning that the midwife you see at each (or most) appointments will be the one who attends your birth. Even in a larger office with multiple midwives, at least each appointment was nice and long with plenty of time to talk and bond with these awesome ladies. By the end of my pregnancy, I knew I was in good hands no matter which midwife was on call and this is a very good feeling!

At the first prenatal visit you can get to know your midwife or doctor, learn about her background, and begin to build a relationship of trust. You can ask questions and get information on good books to read or specialists you may want to see during your pregnancy, such as a chiropractor or lactation consultant .

If you are using a family doctor, then you may have a similar continuity of care. With OBs in hospitals you aren’t likely to be able to choose the OB that attends your birth, so a prenatal visit won’t always focus on this kind of relationship building.

2. Assess your health

Your midwife will ask about your health history, family health history, and present health to get a baseline for what is normal for you. She will counsel you on nutrition, exercise and holistic healing and wellness. She will address common pregnancy complaints and offer holistic, natural remedies.

She will also ask if you are having unusual symptoms that may be a sign of something serious. Headaches are common in early pregnancy, but can also be a very early sign of preeclampsia. Your midwife will want to know if you are having headaches or other symptoms and will keep a record of them.

3. Routine tests

Your midwife will order a different blood tests that will tell her your blood type, red and white blood cell counts, hematocrit, hemoglobin, and platelet count. Your midwife needs to know your blood type for your safety, but the other tests should be optional.

These blood tests will also tell your midwife if you are Rh positive or negative. If you are positive (or you are negative and your partner is negative) you have nothing more to do. If you are negative and your partner is positive or you don’t know, your midwife may discuss your receiving an Rhlg shot to prevent any complications.

Your midwife will also tests for various Sexual Transmitted Diseases like syphilis, gonorrhea, chlamydia, which could harmfully affect your pregnancy if not treated. She will also take your blood pressure, pulse, weight, and check the baby’s heartbeat if you are ok using a doppler, which contains ultrasound waves. I chose to use the doppler for the first appointment so I could really believe I was pregnant and then waited till 20 weeks to use the fetoscope for the baby’s heartbeat.

She may palpate your abdomen to check the fundal height (a measure of the size of your uterus). She will rule out any medical problems that may affect your pregnancy and assess whether a homebirth or birth center birth is safe for you (it usually is).

You will also be asked to test your urine for the presence of protein (a sign of toxemia), sugar (a sign of gestational diabetes), or bacteria (a sign of Group B Strep positive). You will pee into a cup and dip a test strip in. Depending on the brand of test strips you will read it after 60 second or immediately. You will do this test at every appointment until birth.

4. Paperwork

At your first prenatal visit you will probably have some paperwork to sign and your midwife or doctor’s office will probably need a copy of your health insurance card. Many midwives will give you an estimate costs for your pregnancy and birth care, so you are both on the same page in terms of cost.

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How can I prepare for my first prenatal visit?

Prepare your questions.

Your first prenatal care appointment may be the first time you meet your midwife or doctor, so it’s a good idea to have questions prepared in order to get a feel for your provider’s background and philosophy. If you are seeing a doctor, ask what her thoughts are about: labor induction , ultrasounds, the glucola drink, treating GBS+ during birth, and natural childbirth in general. You can use these questions as a guide to see if your healthcare provider is a good fit for you.

If you’ve already interviewed your practitioner, you still may have some questions about what to expect during your pregnancy, what symptoms or concerns you may have, or how many weeks pregnant you may be.

I wrote down questions beforehand so that I wouldn’t forget anything during the actual appointment (between excitement, nervousness and pregnancy brain , I had a feeling I would forget a thing or two!)

Gather health info

Ask family members about pregnancy related health concerns that may run in the family. Write down any patterns of health you notice. Also take note of your partner’s family health history, especially genetic diseases. My mom had two c-sections so I wanted to get my midwife’s thoughts on if she thought I could have a vaginal birth.

Write down any past gynecological history, like an abnormal pap smear or a previous pregnancy or miscarriage. Write down any medications you are taking.

If you don’t know your due date, use our due date calculator before your appointment. If you do know your due date and want to know when you most likely conceived, use our reverse due date calculator . And here’s an article for you if you’re unsure  how many weeks pregnant you are .

Do your research for prenatal care

Do your best to pick the practitioner who is right for you. But if you go to your first visit and don’t like him or her, remember that you can change at any time! My dear friend changed her care at 34 weeks! And she was so happy that she did.

Your midwife needs to know your blood type for your safety, but the other tests should be optional. A good practitioner will let you know at each appointment what tests or procedures will be coming up at the next appointment so you can have time to research and decide what’s best for you.

A good practitioner should also be able to guide you and answer any questions you have about tests and procedures.

Best wishes for your first prenatal visit!

The first prenatal care visit is an amazing and nerve-wracking time. You may get to hear the heartbeat for the first time! That’s why I would encourage your partner to come along for that first prenatal visit. Hearing your child’s heartbeat for the first time, together as parents, is truly a special and sacred moment. Plus, you now have more “proof” that you really are pregnant.

Knowing what to expect and how to prepare should ease your mind and let you enjoy the excitement of your pregnancy!

• https://www.emedicinehealth.com/complete_blood_count_cbc/article_em.htm
• Beech, BL. Ultrasound unsound? Association for Improvements in the Maternity Services. 1996

Read This Next…

• Constipation in Pregnancy: Natural Ways to Get Things Moving
• 9 Signs You’re Having a Girl (Plus How Accurate They Really Are!)
• Cramps During Pregnancy: What’s Normal? And What’s Not?
• How Accurate Are Pregnancy Tests?
• When Will My Baby Be Born? How Accurate Is Your Due Date?
• See 4 Comments

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About the author.

Genevieve Howland is a childbirth educator and breastfeeding advocate. She is the bestselling author of The Mama Natural Week-by-Week Guide to Pregnancy and Childbirth and creator of the Mama Natural Birth Course . A mother of three, graduate of the University of Colorado, and YouTuber with over 130,000,000 views, she helps mothers and moms-to-be lead healthier and more natural lives.

Meghan Quinn Jan 18 at 10:57 pm

Thank you for this info on what to expect! It eases my mind a bit.

Taylor Bishop Oct 26 at 11:22 am

I just wanted to thank you for going over what to expect for a prenatal visit. I didn’t know that it could be beneficial to maybe schedule this maybe 6-7 weeks in a pregnancy. My sister has been thinking of getting pregnant, so this could be good for her to know in the future.

Kendal Mar 12 at 8:52 pm

Thank you–I just had my first prenatal appointment, and this was really helpful! So glad I found your blog at the right time! I also was having trouble believing I was really pregnant, so it was relieving to see you wrote that same thought, and it helped me not feel so bad about also wanting the doppler to hear the heartbeat. Amazing!!

Sarah F. Feb 24 at 11:39 am

My first prenatal appointment led me to calling a local birth center for a meet and greet. My doctor, who I adore, suddenly became very pushy about flu shots. My (shy and quiet) husband had to argue with her about why I don’t get flu shots because after I told her I didn’t want it (they make me horribly sick, and I’d already been sick with bronchitis for 6 weeks), she ordered it anyway, until the husband put his foot down for me. I was on edge about hospital delivery before I even became pregnant, but it worries me that I couldn’t get my own doctor to listen to me over a flu shot. And there was no conceivable way for me to meet with more than 2 of the midwives and none of the OBs before I deliver in August! Hopefully everything clicks at the birth center and I can deliver there. Everyone I know who’s gone there has been thrilled with the care, and the hospitals around here seem quite notorious for C-sections. I wish my doctor had made me feel more confident, but I’m so much more comfortable with the idea that birth is normal and not a medical emergency.

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Your First Midwife Appointment: What To Expect & What To Ask

What Is A Booking Appointment And How To Prepare?

What will happen at the appointment, what will happen after the appointment.

So your first midwife appointment is coming up and you have no idea what to expect.

Worry not, we're here to walk you through the whole appointment. Find out why pregnant women are offered a booking appointment, what usually takes place at one and what questions you should ask your midwife or doctor.

If this is your first pregnancy you might be nervous about your first appointment with the midwife. There is no need to be worried as the point of all these appointments is to ensure that your pregnancy progresses as smoothly as possible.

If you have any worries or concerns, don't keep them to yourself, make sure to let your midwife know so she can help put your mind at rest.

Pregnancy is such an exciting time, so congratulations and read on to find out what to expect at your first midwife appointment. To learn more, why not read our article about [di di twins] or our guide to finding a doula in the UK?

A booking appointment is your first midwife appointment in your pregnancy and it usually takes place within the first 10 weeks of pregnancy.

Pregnant women are advised to book in to see their midwife or doctor as soon as they realise they are pregnant, in order to arrange a booking appointment.

A booking appointment is important because it gives your midwife or doctor the opportunity to carry out some important tests, find out about you, your situation, and your pregnancy, and offer you information and support.

You don't need to do anything to prepare for your first antenatal appointment and don't worry, you won't need to have an internal exam of any kind at your first appointment! You won't have your first scan at this appointment, and it is unlikely that you will have the chance to hear baby's heartbeat at this appointment either.

These are all exciting milestones to come in future appointments!

If you have only just found out you're pregnant and you've gone past 10 weeks, make sure to contact your doctor as soon as possible, so they can book you in for your first appointment.

At your first antenatal appointment, your midwife or doctor will want to find out about yourself and your situation and will ask you questions so that they can tailor their care to suit both your and your unborn child's needs.

Your first appointment with a midwife might take place in your GP surgery, a children's centre, a hospital maternity unit, or your own home.

Your appointment should last about an hour, as this will give the midwife ample time to ask questions, take your medical history, carry out some tests, and listen to any questions you may have.

Your midwife is sure to ask what might seem like a lot of questions. Some of the questions might not seem relevant to you, but questions on different topics can help your midwife work out the risk of your baby contracting certain genetic diseases.

If you don't know much about your or your baby's dad's health history, don't worry. Just give whatever information you can.

Your midwife or doctor will want to find out about your personal circumstances before all else. They will want to know about any other children you may have, any health issues you may have or any family history of illness, your living situation and who you live with, and whether or not you have a partner.

Your midwife will want to know how you feel about your pregnancy and if you require additional emotional support during your pregnancy. They will want to know about your mental health requirements and if you have supportive people around you or not.

If you are experiencing any problems with your partner or family, this is your opportunity to tell your midwife, and they will be able to help. They will want to know about your baby's father and his circumstances, and if you are together or not.

Your midwife will then take some tests. She'll get you to take a urine sample for signs of pre-eclampsia which is a condition that affects the arteries carrying blood to your placenta.

Next should come your screening tests. Your healthcare professional will take some blood tests to check for HIV, syphilis, and hepatitis B. Tell your midwife if you are worried about having your blood taken as she will be able to reassure you and tell you exactly what to expect before doing anything to you.

During your first antenatal appointment, you will have your blood pressure taken and your midwife will measure your height and weight to work out your body mass index.

You might be offered a blood test to check for sickle cell if your midwife thinks it is worth screening for, depending on your risk factor.

Questions To Ask Your Midwife At A Booking Appointment

So what questions might you think of asking at your first appointment with your midwife? Feel free to ask your midwife whatever is on your mind, so you can get the information you need to be able to relax and enjoy your pregnancy.

1. You might want to ask your midwife if and how any health conditions you may have could affect your baby.

2. You might want to know if anything you did before realising you were pregnant could have impacted your baby.

3. You might want to disclose information about your personal situation for which your midwife could provide support. For example, if you are in an abusive relationship, or feel conflicted about the pregnancy in any way. Your midwife is there to support you and any information you provide is strictly confidential.

4. You might want to ask questions about the other appointments, scans, and screenings you will have coming up, your schedule for your upcoming midwife appointments, and the availability of antenatal classes in your area.

After your first midwife appointment at 7 weeks or thereabouts, you will be offered a dating scan. This is a scan that aims to determine your due date and might allow you the chance to hear your baby's heartbeat!

This scan usually takes place at around 12 weeks and is used for screening for conditions such as Down Syndrome. The scan will assess your baby's development, to make sure everything is going smoothly.

As your baby develops you will be offered more antenatal NHS appointments and scans throughout your pregnancy.

It is important to go to all your screening tests and antenatal appointments as these NHS appointments with your community midwife are important for tracking your baby's development. Antenatal appointments and screening tests can identify problems with development or issues with positioning which could make birth more difficult.

If there are issues, it's best for them to be identified early on as your antenatal care can be adapted to suit your baby's development and your physical and mental condition.

At 16 weeks pregnant you will be offered another scan which will take place within the following month. At this antenatal care appointment, you will have your blood pressure checked and have a urine test.

At your 20 week scan, you will be offered an ultrasound to check on your baby's development again, in addition to this, a whooping cough vaccine will also be offered to you.

If this is your first pregnancy you will be offered another appointment at 25 weeks pregnant. You will have your health checked, your blood pressure will be taken, your uterus will be measured and your urine tested for protein.

At 28 weeks you'll have your blood pressure taken, urine tested, uterus measured and you'll be offered some more screening tests.

At 31 weeks you will go over the results of your screenings and have the same health checks carried out again. You will have the same again at 36 weeks, and your NHS health professional should give you information on what to expect when you give birth.

At 36 weeks you will be given information on all sorts of things related to birth and the care of your baby. You will talk about breastfeeding and bottle feeding, caring for a newborn, postpartum depression, and newborn screening tests. At 38 weeks your blood pressure and urine will be checked and your uterus measured again.

The same checks will be carried out at 40 weeks if this is your first pregnancy. If this isn't your first pregnancy then your next antenatal care appointment will likely be at 41 weeks, if you haven't given birth yet, when you will be offered a membrane sweep.

You will also discuss induction options in the event that baby doesn't feel like making an entrance any time soon!

If you found this article helpful, then why not take a look at our tips for early pregnancy anxiety , or what to do if you're [feeling cold during pregnancy]?

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Prepping for Your First Prenatal Visit? Ask Your Doc These Questions

Table of Contents

Questions about your body and your health, questions about your doctor & delivery.

Early pregnancy often feels very abstract—all you have to show for it are two pink lines on a stick . Once you call your doctor’s office to tell them you’re pregnant (the receptionist is probably the first person you’ll tell besides your partner), they probably won’t have you come in until you’re somewhere between seven and ten weeks along. This is to ensure your appointment is far enough along to hear a heartbeat, but it also means you’ll have a lot of time to prep for that exciting and nerve-wracking first prenatal appointment, where it all starts to feel a little more real.

So how do you prepare for your first prenatal appointment? There’s not a ton you need to do, but there are a few things that will help ensure it goes as smoothly as possible. First, think about when your last period started—your pregnancy begins on the first day of your last period (so for the first two-ish weeks of your official pregnancy, you actually aren’t pregnant—weird).  

You’ll also want to inventory any medications or supplements you take and think about anything from your medical history that may not be clearly outlined in your chart. For example, maybe your mom gave birth prematurely, you have irregular periods, or you’ve had a previous chemical pregnancy. But most of all, you’ll want to prep some questions to ask at your first prenatal visit. While your mind is spinning with excitement and your growing to-do list, we’re here to help you check off that last box. 

You don’t need to ask all of these questions at your first appointment—you can pick and choose which are most relevant to you and decide what you need to know now versus what can wait for your next appointment. But it’s good to look over all of them, so you can be prepared to get answers, especially for things that are non-negotiables for you. For example, if you’re hoping for a VBAC (vaginal birth after cesarean) and your doctor or hospital is hesitant to do them, it’s probably time to look for a new provider. And the earlier you can do that, the better.

Read on for a comprehensive look at the questions you may want to consider asking at your first prenatal appointment, whether it’s your first pregnancy or your fifth.

How should I think about my exercise routine during my pregnancy? 

If your doctor so far has been Google, you will know that there are conflicting takes about basically every type of exercise and pregnancy . ( No hot yoga during pregnancy! But do all the exercise you normally do! ). So, it’s helpful to get a medical professional’s insight on how much you should be exercising and how your routine should or shouldn’t change. 

What should I know about sex during pregnancy?

Your doctor’s advice may change by trimester, but it’s good to start having the conversation early. They’ll probably tell you anything goes (as long as you’re comfortable), but in cases where there’s a history of certain conditions like placental issues or pre-term labor, your doctor may want you to exercise caution or abstain (sorry!).

Based on my medical history, does it appear that I’m at risk for any complications?

It’s better to have all the information you need upfront, right? For example, certain things like having frequent migraines, diabetes, or polycystic ovary syndrome may put you at an increased risk of preeclampsia 1   . Your doctor will be able to give you the broad strokes during this first visit of what you should and—even more importantly—shouldn’t worry about based on your history. 

How long can I travel? And can I go on an international trip?

I had to reschedule a trip to Mexico when I was pregnant with my son because my doctor felt it was planned for a time that was too late in my pregnancy. I’m very glad I asked at that first appointment and had plenty of time to make changes.

What symptoms are not considered normal and warrant an immediate call to your office?

Many women (myself included) will have the urge to call their doctor over every little cramp and twinge. While you should feel empowered to ask your doctor anything and everything, there are some pregnancy symptoms they will definitely want you to contact them about, like bleeding or pain. They can also give you guidelines on the things you might experience that could cause you concern, especially if this is your first, but that are perfectly normal during pregnancy. 

What medicine can I take?

You may be surprised by which medications are pregnancy-safe and which are not. You can (and probably should) Google before you take any medication, but the internet can be a confusing place, so it’s good to have a doctor’s sign-off, especially on any regular meds you take.

What foods do I really need to avoid? What is okay in moderation?

If you’re like me, you’ll have lots of questions like, “I know sushi is generally a ‘no,’ but what if it’s from a high-quality restaurant? And do I really need to give up Brie?” Your doctor will be able to give you guidelines on the foods that could put you and your baby at risk of listeria or toxoplasmosis (aka definitely don’t eat), and the ones that are on the avoid list, but that, if they do make you sick, will be no worse for you than it would be if you weren’t pregnant. 

What beauty products should I steer clear of? 

Sorry, but your retinol will probably have to take a backseat. Your doctor will explain any skincare ingredients to avoid and sneaky places they may be hiding.

Can I clean a litter box? Garden? Dye my hair?

There are a variety of activities that everyone talks about avoiding during pregnancy. Take a look at your normal habits and ask your doctor about anything that you’re concerned about. They can give you guidelines on what you do and don’t need to change. 

What is your stance on the occasional drink?

If you survey your parent friends, you’ll probably find that some completely avoided alcohol for all 40 weeks, while others had an occasional beer or glass of wine later in pregnancy. (French women, yada yada). Depending on how by the book your doctor is, they may give you the ACOG answer 2   (there is no safe amount of alcohol during pregnancy) or something a little more nuanced about how it’s impossible to study alcohol and pregnancy, so they don’t know for sure. Either way, it’s a good idea to get their opinion before you make the decision that’s right for you.

What are weight gain expectations for this pregnancy? Does it change if I didn’t shed all the weight from the first pregnancy?

Your doctor will be able to address all your questions about weight and pregnancy, including any complications associated with gaining too little or too much. The first appointment is a good time to set expectations for future conversations about weight, whether it’s not wanting to know the number on the scale (something I’m really glad I asked for) or opting out of weight checks altogether.

What can I do for constipation and hemorrhoids?

Just trust me, you’re going to want to know.

What do you recommend I do to prepare for birth?

Sure, this is your first appointment, but it’s never too early to start getting ready for the big day. Your doctor may recommend specific books, exercises, Instagram accounts they like, or even a doula or birth class. It’s a good idea to start figuring out your options early so that you have plenty of time to do the birth-prep exercises or start interviewing doulas. 

What is the best way for me to contact you with non-urgent questions?

You’re going to have a lot of questions, and not all of them need to be answered right away. Does your doctor like to be messaged through the patient portal? Would they prefer you leave a message with the receptionist? How long should you expect to wait to get an answer? And what should you do for urgent questions?

Does your doctor have any travel planned?

Now’s the time to find out if your doctor has an African safari planned around your due date. If they do have vacation or extended time off on the calendar during your pregnancy, it’s important to know who you’ll see instead and what the practice’s plans are for coverage.

Who will deliver my baby if you are not on call?

So much of having a good birth experience is feeling comfortable with your team. For that reason, it can be nice to get to know the other doctors in the practice who could potentially deliver your baby or at least familiarize yourself with who it could be.

How much past 40 weeks will you allow me to go?

Doctors have many different stances on how long past 40 weeks they’ll allow patients to go, so this question is important to ask. Some research shows 3   that inducing after 41 weeks lowers the risk of stillbirth and other complications, like meconium aspiration (when babies breathe in their waste). Some will insist on inducing earlier than 41 weeks, and some may let you go up to 42 weeks. It’s good to know their policy regardless, but if you have a specific preference, you will want to make sure your doctor’s policies are in alignment.

What is your policy on _______?

Pick and choose the questions on policies that are meaningful for you here. Some doctors, for example, are not trained on instrument-assisted deliveries, so in the event that you would need one (if you fatigue from pushing or the baby is in distress), you’d instead have an emergency C-section. (I did not think to ask this question myself, but I will if I have future pregnancies, as my son was born assisted by vacuum when his heart rate began to drop). Some situations to consider asking about: 

Scheduled c-sections

Pain management

Episiotomies

Intermittent vs continuous monitoring

Instrument-assisted deliveries (forceps or vacuum)

VBACs (This will only be relevant to you if you’ve previously had one or more caesareans and are hoping for a vaginal delivery)

What is the cadence of my appointments?

Your ob-gyn practice may set up all your appointments, or at least all of them through 20 weeks, at that very first prenatal appointment. Generally, you’ll go monthly up until about 28 weeks, then every other week until 36 weeks when you begin weekly appointments. But this is a good time to let the office know if a certain day or time doesn’t work for you and how they handle scheduling. 

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Expectful uses only high-quality sources, including academic research institutions, medical associations, and subject matter experts.

National Institutes of Health .  " Who is at risk of preeclampsia? " ,  https://www.nichd.nih.gov/health/topics/preeclampsia/conditioninfo/risk#:~:text=Preeclampsia%20is%20also%20more%20common,diabetes%2C%20and%20sickle%20cell%20disease. .

The American College of Obstetrics and Gynecologists .  " Alcohol and Pregnancy " ,  https://www.acog.org/womens-health/infographics/alcohol-and-pregnancy .

Institute for Quality and Efficiency in Health Care .  " Pregnancy and birth: When does labor need to be induced? " ,  Sep 24, 2008 ,  https://www.ncbi.nlm.nih.gov/books/NBK279570/#:~:text=In%20other%20words%3A%20The%20research,aspiration%20(breathing%20in%20meconium). .

Grace Gallagher, MFA, Hunter College

Grace Gallagher is a freelance writer based in Portland, Oregon. Her work focuses on parenting, health, and beauty and has appeared in Parents, Romper, Pregnancy & Newborn, Shape, InStyle, and more.

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In order to minimize the risk of exposure to the coronavirus and to keep our clients, staff, and community safe, we are implementing safety protocols.

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• Pregnancy & Childbirth

Start Prenatal Care

If you are ready to start your prenatal care with The Midwife Center, you are in the right place! If you'd like to learn more about prenatal, childbirth, and postpartum care at The Midwife Center, please visit Pregnancy & Childbirth.

Our goal is to offer you high-quality, client-centered pregnancy and wellness care. To ensure a smooth entry into starting prenatal care with us, we ask that you take the steps below before your first prenatal appointment. If you've seen us for gynecological care or for a prior pregnancy, please follow these steps as well.

If you would like to transfer into care from another health care provider, please scroll down for some additional steps below.

1. ensure that care at the midwife center is right for you.

More than 80% of individuals are low-risk for complications for pregnancy and birth, so most people are good candidates for midwifery and birth center care. We ask that you take an active role in your care by working with The Midwife Center staff to keep healthy and low risk for your entire pregnancy and birth by:

• Attending all appointments
• Eating a healthy, well-balanced diet
• Continuing to exercise in preparation for birth and recovery
• Attending required classes as necessary
• Asking questions during prenatal visits
• Taking advantage of community resources

To learn more about receiving care at The Midwife Center, please click here to read our Frequently Asked Questions. 

2. Schedule an orientation

If you are planning your first out-of-hospital birth or if you're unsure where you'd like to have your baby, please attend one of our required orientations. If you've attended orientation in the past you are welcome, but not required, to attend again. You can attend orientation via Zoom or in-person - view our class calendar for dates.

Please note that you are welcome to fill out our Start Prenatal Care Form (see step below) before attending orientation.

3. Fill out the Start Prenatal Care Form

Please fill out the Start Prenatal Care Form.  It may take up to 2-3 business days for our staff to respond to your request to establish care. Please click the button below to fill out the form.

4. Fill out your health history

Once we receive your request to start prenatal care we will email you* with next steps, which include filling out your health history in our electronic health record. This information will help our providers prepare for your first appointment, so please be as detailed as possible. You must fill this out again even if you've received care at The Midwife Center before.

If you are transferring from another provider, please fill out a form releasing your records from them to us .

*Please call us at 412.321.6880 x211 if email is not the best form of communication for you.

5. Review and sign your financial estimate agreement

After we receive notification that your electronic health record is complete, we'll provide you with a financial estimate agreement. This estimate will include your out-of-pocket expenses based on your insurance plan's coverage for maternity care (prenatal and birth). We ask that all estimated out-of-pocket expenses be satisfied by the 32nd week of pregnancy. We will work with you to establish a payment plan if needed. 

Click here to learn more about the insurance and payments we accept.

6. Scheduling your first appointment

Our Front Office staff will contact you within five business days after you've received your Financial Agreement to schedule your first appointment. We ask that you set aside at least one and a half hours for your first appointment.

If you are transferring from another practice, you must also do the following:

1. provide your medical records for tmc to review.

If you are 20 weeks pregnant or more, we must review medical records from your current provider before we can schedule your first prenatal appointment. This process can be lengthy at times. We recommend physically obtaining your records and bringing/faxing them to TMC as soon as possible.

Please fill out a form releasing your records from them to us.

2. If you're past 32 weeks pregnant

Because of the personal nature of our relationship with clients and the care we provide, we will accept a limited number of clients who are past 32 weeks pregnant after a screening process with the Clinical Director. Please complete the Start Prenatal Care Form  and complete the release of records form to initiate this process.

If you have questions about our intake process, please contact us at 412.321.6880 x211

3. Please continue to go to your prenatal care with your current provider

And complete all needed ultrasounds and lab work. Regular prenatal care and necessary labs and ultrasounds are very important and will be considered as we look to accept families for transfer.

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• Pregnancy |
• Scans and Tests

First midwife appointment: everything you need to know

Once you’ve got your positive pregnancy test you’ll need to contact a GP or midwife to book your very first midwife appointment. This is also known as the ‘booking appointment’ and it should take place before you’re 10 weeks pregnant , as you’ll be offered some tests that should be done before this period. If you are more than 10 weeks pregnant and haven't made your first midwife appointment, don’t worry, just call up a GP or midwife as soon as you can.

This is another exciting step in your magical journey and it won’t be long until your 12 week scan , where you’ll get to see your baby for the very first time. Here’s everything you need to know about your first midwife appointment, from the questions you’ll be asked during it, to how long it will last and the tests that will take place.

What happens in the first midwife appointment?

Your midwife will ask you quite a few questions ranging from your medical history, to details about your lifestyle, your family’s health and any medical conditions you may have. It may seem like a lot, and a little full on, but it’s only to find out what care you need and if there are any risks for you or baby.

Some questions you may think don’t even sound relevant. For example they may ask you about the baby’s father or about your ethnic group. The reason for this is because some ethnic groups are at a higher risk of having some medical conditions. They may also ask about your mental health or if you’re feeling depressed or anxious as, if managed, you’re less likely to experience postnatal depression . It’s important to know your midwife is there to help and support you, not judge you.

Other topics you may be asked include whether or not you’ve experienced any domestic abuse, whether you smoke and your alcohol consumption, as well as questions around your job and what support you have around you.

You’ll also find out about the tests and scans you’ll receive throughout your pregnancy journey, information on antenatal classes to help prepare you for pregnancy and birth , what’s not safe to eat during pregnancy and the best foods to eat . The benefits you can receive when you’re pregnant (free eye and dental care), your baby’s month by month development , as well as exercises that are good to do throughout pregnancy, such as pelvic floor exercises .

The first midwife appointment, and any other antenatal checks , are where you can ask questions about your pregnancy too and any concerns you may have.

Where does the first midwife appointment take place?

It can be a variety of places including a hospital, your local GP surgery, a children’s centre or even in your own home.

Test that take place at your first midwife appointment

Blood tests: your midwife will do this to make sure you don’t have any infectious diseases that can be passed onto your baby. These include: HIV, syphilis and hepatitis B . If you already know you have any of these then you’ll need specialist appointments earlier. You’ll also be tested for blood disorders that can be passed onto your baby. These include: sickle cell and thalassaemia .

Blood pressure: this will be measured (along with a urine sample) to check that you aren’t showing signs of pre-eclampsia. This is a condition that causes high blood pressure, usually during the second half of your pregnancy at 20 weeks or after labour.

Weight and height: this is to figure out your BMI (body mass index).

How long is the first midwife appointment?

The appointment usually takes an hour. However, in some areas the appointment may be split into two shorter appointments.

Maternity notes

You will be given these at the end of your appointment in either a folder or book. Within these notes are records of your health, appointments you’ve had and your test results during your pregnancy. There will also be numbers for your maternity unit or midwife team.

The NHS advises you to keep these records with you at all times until your baby is born. This is so if you ever need urgent medical care, then the staff can easily read about your pregnancy health.

Need to talk? Call 1800 882 436. It's a free call with a maternal child health nurse. *call charges may apply from your mobile

Is it an emergency? Dial 000 If you need urgent medical help, call triple zero immediately.

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Your first antenatal visit

7-minute read

• Antenatal visits check the wellbeing of you and your baby during pregnancy.
• During your first visit, your doctor or midwife will check your health.
• They will also work out when your baby is due to be born.
• During your visit you will learn how to keep healthy during your pregnancy.
• Regular antenatal care is likely to positively affect the health of you and your baby.

Antenatal visits check the wellbeing of you and your baby during pregnancy. Antenatal care throughout your pregnancy is likely to positively affect the health of you and your baby.

Your first antenatal care appointment is an important one. During your visit, your doctor or midwife will:

• confirm your pregnancy
• check your health
• give you some information that you will need in the months ahead

You will also be able to talk about the type of care you want during your pregnancy.

When should I make my first appointment?

It’s best to have your first antenatal visit before 10 weeks into your pregnancy. Ideally this will happen when you are about 6 to 8 weeks pregnant. This is because there are lots of things to learn about. Also, some tests are recommended early in your pregnancy.

Your first appointment may be with a midwife or your doctor. It may be at a clinic or hospital — you can choose.

What does an antenatal visit involve?

Taking your medical history.

During the visit, your doctor or midwife will ask about your health. This includes finding out about:

• any prior pregnancies
• any illnesses or operations you’ve had
• what medicines you’re taking, including those from a pharmacy or supermarket
• if you have any current health problems
• if you are allergic to any medicines

Your doctor or midwife will ask you if you:

• drink alcohol
• take recreational drugs
• are stressed
• have any signs of depression or anxiety
• about the support you may get from people at home and work

These questions aren’t to judge you. The more your doctor or midwife knows about you, the better they can support you during your pregnancy.

It’s up to you whether you answer these questions. Anything you say will be kept in confidence.

If you are experiencing family violence you should let them know. It’s important to get professional help and they can support you to do this.

Your family medical history

Finding out about the health of your family is also important because it may affect you or your baby. This includes any family history of:

• genetic conditions
• chronic illnesses such as diabetes

You may wish to do screening tests for certain genetic conditions . You can talk about this with your doctor or midwife.

What tests will I have?

Your doctor or midwife will check your health and measure your:

• blood pressure

They may suggest a urine (wee) test to see if you have a urinary tract infection (UTI) or any kidney problems.

You will also be offered a blood test to check your blood group and rhesus factor. They will also check for:

• infectious diseases — rubella
• sexually transmitted infections (STIs)
• bacteria that may affect your baby — group B streptococcus
• infections that can be passed on through blood-to-blood contact — hepatitis C and HIV

Some STIs that can affect your pregnancy don’t have any symptoms. It’s possible to have an STI and not know.

Find out more about the check-ups, tests and scans you can have during your antenatal visits.

If you have any questions about these tests, ask your midwife or doctor.

Finding out about your baby

Your doctor or midwife will work out how many weeks you have been pregnant. This will let them work out the due date of your baby.

If you’re not sure when your last period was, they may book a dating scan . This is an ultrasound that will help figure out which week of pregnancy you are in.

Tests are available to check for some problems that may affect your baby. You don’t have to have these tests — it’s up to you. Your midwife or doctor will tell you about the tests and how much they will cost.

Discussing your antenatal care options

During your first appointment, your midwife or doctor will give you information about antenatal care. They will talk with you about which model of care you would like for your pregnancy and birth. You'll be able to discuss:

• who will be your main maternity carer
• where you would like to receive your antenatal care
• how many antenatal visits you will have and when
• where you would like to give birth
• where to find local antenatal classes or education sessions

How can I have a healthy pregnancy?

Your midwife or doctor will talk to you about keeping healthy during your pregnancy. They will also ensure you have good support and care.

This may cover:

• help to stop smoking or stop drinking alcohol (if needed)
• advice about healthy eating , exercise and weight gain
• advice on which vitamins and minerals you should take during pregnancy
• referrals to support services if you need them

They will answer questions about any issues that worry or concern you.

If this is your first pregnancy, The Australian Pregnancy Care Guidelines advise you have 10 antenatal care visits. If there are complications with your pregnancy, you may need to have more visits.

If you’ve been pregnant before, The Australian Pregnancy Care Guidelines advise you have 7 antenatal care visits. Again, if you have any complications with your pregnancy, you may need more visits.

Speak to a maternal child health nurse

Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call . Available 7am to midnight (AET), 7 days a week.

Learn more here about the development and quality assurance of healthdirect content .

Last reviewed: November 2022

Related pages

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Checkups, tests and scans available during your pregnancy

• Antenatal classes

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25 Important Questions to Ask A Midwife

You have now come to terms with the fact you are pregnant. Congratulations! It is starting to feel more real every day and at this time there is one person an expectant mom can rely on and that is her midwife.

But this can unleash a lot of fears, misconceptions, and worries in the build-up to that first meeting.

Everyone talks about how amazing their midwife is or how they wished they had gone with someone different.

It is important to remember that you are paying for a person to guide you through the most spectacular time of your life so building a bond and sometimes friendships can help you to relax throughout the process.

Ultimately they could be the very first person to see and hold your darling baby, not to mention be a scaffold of support for you during these crazy hormonal times.

With this in mind, we have put together some important questions to ask a midwife to help put your mind at rest.

In this article

Questions To Ask

Question to ask in this appointment, questions to ask at this appointment, question to ask, why do i need to ask my midwife questions, when do i see my midwife, what do i need to know about midwifery care, the final thought, first meeting with your midwife.

The time has come, you are on your way to meet your midwife for the first time. This is making your pregnancy seem a little more real and you may have some nerves about what to expect.

Will they be nice? Are they professional? Will they be qualified enough to deal with any outcome?

Having these questions ping around in your head is completely normal in these first few weeks and you want to make sure you have the right person for the job!

• How long have you been practicing for?
• What is your training?
• How many appointments will I have?
• What are your fees?
• How do I contact you?
• What should I expect?
• Should I make any lifestyle changes?
• How many scans do I have?

These are questions your midwife should answer without you having to ask, however many midwives have been on the job for years so don’t feel awkward if one of your questions hasn’t already been covered, just ask they won’t mind.

Midwife training is an important factor to consider, at the end of the day, they are going to be your main guru throughout this enormous life change.

It is vital that you understand who and what you want from your midwife as there are many different certified credentials, such as CNM, CM, or CPM.

CNM – Certified Nurse-Midwives have completed their training courses as well as their nursing. Hospitals are their routine place of work. 

CM – Certified Midwives complete their training without the nursing aspect. So whilst these individuals are qualified they would have completed a direct to midwifery course rather than nursing first. 

CPM – Certified Professional Midwives complete the rigorous training as the staff above but they have a more hands-on stance in the community.

Experienced at delivering babies in and out of hospital settings, this may be the way you want to head if you are planning a home birth.  It is also vital to clarify what lifestyle changes you need to make.

You have the obvious toxins such as, tobacco use, drugs, and alcohol but your midwife should be talking to you about what foods will benefit and help you through your pregnancy and also any vitamins that will help your little one develop. 

Meeting your midwife is an exciting first step in your pregnancy journey. Whilst it is their job, your midwife will become an important role and friend throughout. 

Meeting Your Midwife At 24 Weeks

Usually, at this point you would have had your dating scan, around 12 weeks, giving you a better indication of how far you are in your pregnancy.  It is at 24 weeks you can meet your midwife again and touch base about any concerns you may have and how you are feeling. 

• What tests should I expect at this point? Glucose? Bloods?
• How big am I measuring?
• Can I hear the heartbeat?
• When should I visit my chosen birthing place?
• What antenatal classes are there?
• How long should I work for?

It is important that you be honest with your midwife and express any concerns or pains at this point. Pregnancy changes your body in extreme ways and if this is your first pregnancy then every little niggle no matter how small is a big deal for you.

Your midwife should be understanding of this and help to settle your fears. They should be able to complete the necessary growth checks at this appointment. 

If your midwife feels you need more tests done to rule out any concerns then always ensure that it is included in the cost as you don’t want to receive a surprise bill at the end!

Antenatal classes are an important role when becoming a parent. Whether it is for the first time or not these classes, if you choose to participate, can be invaluable for supporting you after the baby has arrived.

Your midwife should be able to point you in the right direction for these.

Working whilst pregnant is dependent on what you do for a living. Your midwife may ask you about any particular health and safety risks or precautions your employer is considering whilst you are still at work.

Essentially, how long you work will be your choice, be it at a financial decision or a health-related issue many moms find that they want to try and work for as long as possible. This way they can appreciate the time off more when their baby is born. 

Meeting your midwife at 28 weeks

By this point you are heading towards your third trimester, the home stretch is in sight. For 28 weeks you have been checking every movement, every pain, to ensure your baby is growing healthy. At this point, your focus may be shifting to the delivery. 

• What symptoms should I expect at this stage of pregnancy?
• Is my weight gain normal?
• When should I start thinking about my birthing plan?
• When do I worry about pregnancy-related disorders – preeclampsia?
• How can I treat back pain?

The fact you are now carrying an extra load can have extra pressures on your body. Your midwife should be able to go through the symptoms of this trimester and suggest ways to make you feel more comfortable.

From heartburn remedies to elevating your puffy ankles and feet. There are many ways you can alleviate the pressures of third-trimester symptoms. Just remember to ask!

Your midwife may have been keeping an eye on your weight and fundal height throughout your pregnancy.

This is to rule out anything pointing to gestational diabetes and to ensure that your expanding belly is within the normal range for the stage of pregnancy. 

It was at this stage my midwife found I was measuring two weeks ahead with my daughter and when she discussed this with me we both agreed to have another scan just to check on my baby’s growth.

Rest assured she had an early growth spurt!

Your birthing plan may come into the conversation in this meeting. Time to think about where what, and who you want there for the birth . Your midwife can go through your options regarding pain relief and locations.

They may also discuss that your birthing plan is a rough guide of what you wish to happen.

Lord knows that sometimes our bodies and unborn children have minds of their own and may warrant for things to happen in different ways to what you have imagined.

With this in mind, you may want to plan for events in an emergency, but this is only as a precaution.

As you grow you may be finding your back pain unbearable, don’t suffer in silence your midwife has probably seen loads of women in the same place as you and can suggest easy and helpful tips to ease the pain. 

At the end of your pregnancy

Near the end of the pregnancy you may be filled with excitement, nerves, and many moms can fear the storm (labor) before the rainbow! It is important you talk about these feelings and allow yourself to transition into the final stage of pregnancy.

• Who do I contact if I think labor is starting?
• What pain relief will I have immediate access to?
• Is my baby in the correct position?
• What happens if my labor slows down?
• What are the reasons for a hospital transfer?
• What care will me and my baby get after the birth?

At this point giving birth can be imminent. It is important by this point to have your hospital bag ready with all your wishes and hopes in toe. This appointment is where your midwife can give you the things to look out for if you think you are going into labor. 

You should have some knowledge of the pain relief you want and your midwife can be prepared for this as you would have it stated in your birthing plan.

For weeks you have been kicked, punched, and stopped in your tracks with your baby’s movements. It is clear that he/she is running out of room. If not already done, remember to ask about your baby’s position.

An ideal position would be your baby’s head down in your pelvis, facing your back. Any other position and your midwife may discuss turning your baby to encourage a good position for delivery.

In some circumstances, babies don’t play by the rules and remain in other positions, such as feet first. If faced with this your midwife may suggest a cesarean section for the health of your baby during delivery.

After the birth, you may feel a bit daunted about the new role you are taking on. You have the care and safety of another actual life! A little person who will depend on you for years to come!

As it stands you may not have this at the forefront of your mind but it could be a good idea to ask your midwife what happens afterward.

How many times you see your midwife after the birth can vary and many times they will come back and visit you in your home just to check on you both and ensure that baby is well and you are recovering.

Questions and answers can help boost your confidence when progressing through pregnancy and labor. Having a midwife answer any questions you have can help make you feel comfortable as you progress through the trimesters. As well as give you confidence in your midwife.

If you are well and healthy the normal time you would expect to see your midwife would be at around 10 weeks. It is at this appointment they can book you on ready for a dating scan at 12 weeks.

Midwifery care is based on you as a woman and centered with your best interests at heart. It is normal for a pregnant lady to lean on their midwife for emotional and physical support.

Every woman wants a positive birthing experience. This is a time you will never forget, a time where your life changed forever. It doesn’t hurt to be a ‘nagging Nancy’ with all your questions.

You will feel better prepared and focused on the job at hand. Your midwife is there for anything you need. It is vital that you choose the right person for the job!

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Your antenatal appointments

You'll have a number of antenatal appointments during your pregnancy, and you'll see a midwife or sometimes an obstetrician (doctor specialising in pregnancy).

They'll check the health of you and your baby, give you useful information and answer any questions.

Pregnant employees have the right to paid time off for antenatal care.

This page lists the appointments you'll be offered and when you should have them.

If you're pregnant with your first baby, you'll have more appointments than those already with children.

First contact with midwife or doctor

Contact a GP or midwife as soon as possible after you find out that you're pregnant.

They should give you information about:

• folic acid supplements
• nutrition, diet and food hygiene
• lifestyle factors – such as smoking, drinking and recreational drug use
• antenatal screening tests 

You should be told about the risks, benefits and limits of these tests.

Screening for sickle cell disease and thalassaemia should be offered before 10 weeks.

This is so you can find out about all your options and make an informed decision if your baby has a chance of inheriting these conditions.

It's important to tell your midwife or doctor if: 

• there were any complications or infections in a previous pregnancy or delivery, such as pre-eclampsia or premature birth
• you're being treated for a long-term condition, such as diabetes or high blood pressure
• you or anyone in your family has previously had a baby with a health condition (for example, spina bifida)
• there's a family history of an inherited condition (for example, sickle cell or cystic fibrosis)
• you know that you're a genetic carrier of an inherited condition such as sickle cell or thalassaemia – you should also tell the midwife if you know the baby's biological father is a genetic carrier of these conditions
• you have had fertility treatment and either a donor egg or donor sperm

8 to 12 weeks: booking appointment

It's best to see your midwife or doctor as early as possible to get the information you need to have a healthy pregnancy.

Some tests, such as screening for sickle cell and thalassaemia, should be done before you're 10 weeks pregnant.

Your midwife or doctor should give you information about: 

• how the baby develops during pregnancy
• nutrition and diet
• exercise and pelvic floor exercises
• antenatal screening tests
• your antenatal care
• breastfeeding, including workshops
• antenatal education
• maternity benefits
• your options for where to have your baby

Your midwife or doctor should:

• give you your handheld notes and plan of care
• see if you may need additional care or support
• plan the care you'll get throughout your pregnancy
• identify any potential risks associated with any work you may do
• measure your height and weight, and calculate your body mass index (BMI)
• measure your blood pressure and test your urine for protein
• find out whether you're at increased risk of gestational diabetes or pre-eclampsia
• offer you screening tests and make sure you understand what's involved before you decide to have any of them
• offer you an ultrasound scan at 11 to 14 weeks to estimate when your baby is due
• offer you an ultrasound scan at 18 to 21 weeks to check the physical development of your baby and look for 11 rare conditions
• ask about your mood to assess your mental health
• ask about any past or present severe mental illness or psychiatric treatment

This appointment is an opportunity to tell your midwife or doctor if you're in a vulnerable situation or if you need extra support.

This could be because of domestic abuse or violence, sexual abuse or female genital mutilation (FGM) .

FGM can cause problems during labour and childbirth, which can be life threatening for you and your baby.

It's important you tell your midwife or doctor if this has happened to you.

11 to 14 weeks: dating scan

This is the ultrasound scan to estimate when your baby is due, check the physical development of your baby, and screen for possible conditions, including Down's syndrome.

16 weeks pregnant

Your midwife or doctor will give you information about the ultrasound scan you'll be offered at 18 to 21 weeks.

They'll also help with any concerns or questions you have.

Your midwife or doctor should: 

• review, discuss and record the results of any screening tests
• consider an iron supplement if you're anaemic

18 to 21 weeks

You'll be offered an ultrasound scan to check the physical development of your baby. This is also known as the 20-week scan .

Screening for HIV, syphilis and hepatitis B will be offered again by a specialist midwife if you opted not to have it earlier in pregnancy.

These tests are recommended as they greatly reduce the risk of passing infection from you to your baby.

From 16 weeks, you'll be offered the whooping cough vaccine . The best time to have this vaccine is after your scan, up to 32 weeks. 

But if for any reason you miss the vaccine, you can still have it up until you go into labour.

25 weeks pregnant

You'll have an appointment at 25 weeks if this is your first baby.

• use a tape measure to measure the size of your uterus
• talk about your baby’s movements. If you have any concerns or your baby is moving less than usual, you’ll be advised to contact maternity services straight away.
• use a tape measure to measure the size of your uterus
• offer more screening tests
• offer your first anti-D treatment if you're rhesus negative
• discuss how to prepare for your labour and birth
• talk to you about active labour
• discuss what happens after the birth, including how to care for your new baby and feed them
• tell you about about the vitamin K injection your baby is recommended to have
• ask about your baby's movements

You'll have an appointment at 31 weeks if this is your first baby.

• review, discuss and record the results of any screening tests from the last appointment

Your midwife or doctor should give you information about preparing for labour and birth, including how to recognise active labour, ways of coping with pain in labour, and your birth plan.

• offer your second anti-D treatment if you're rhesus negative

Your midwife or doctor should give you information about caesarean section. This discussion may take place at the 34-week appointment, or at another time during your pregnancy.

They'll discuss with you the reasons why a caesarean might be offered, what the procedure involves, the risks and benefits, and the implications for future pregnancies and births.

Your midwife or doctor should give you information about:

• breastfeeding
• caring for your newborn baby
• vitamin K and screening tests for your newborn baby
• your own health after your baby is born
• the "baby blues" and postnatal depression

Your midwife or doctor will also:

• check the position of your baby
• offer external cephalic version (ECV) if your baby is in the breech position

Your midwife or doctor will discuss the options and choices about what happens if your pregnancy lasts longer than 41 weeks.

• continue to discuss your labour and birth options with you
• ask about your baby’s movements

You'll have an appointment at 40 weeks if this is your first baby.

Your midwife or doctor should give you more information about what happens if your pregnancy lasts longer than 41 weeks.

• offer a membrane sweep
• discuss the options and choices for induction of labour

If you have not had your baby by 42 weeks and have chosen not to have an induction, you should be offered increased monitoring of the baby.

Time off for antenatal appointments

Find out more about pregnant employees' rights .

Page last reviewed: 21 April 2023 Next review due: 21 April 2026

Culturally safe midwives to birth First Nations babies at Shoalhaven Hospital

Each time Emma Ardler has given birth in hospital it has been with a midwife she has never met before.

This is despite having a trusted midwife she spent months forging a connection with.

"I have gone through two pregnancies where I have had to retell my story again and again," Ms Ardler said.

"I felt scared, isolated, left in the dark."

The soon-to-be mother-of-three chooses privately employed midwives from local Aboriginal women's health organisation Waminda to support her culturally as a First Nations woman.

Up until this week, Ms Ardler's privately employed midwives have been restricted and only able to provide pre and post-natal care due to being employed outside the hospital.

Now, weeks away from giving birth to her third child, the Wreck Bay woman from Yuin Country on NSW's South Coast will become one of the first in the country to have her culturally safe midwife birth her baby in Shoalhaven Hospital.

"It means bridging gaps, it means being supported, it means having my spiritual needs met," Ms Ardler said.

Her midwife and Tasmanian Palawa woman, Tahlia Avolio, will become one of the nation's first privately employed endorsed midwives to provide the service, ensuring continuity of care for women throughout pregnancy.

"It's going to change everything," Ms Avolio said.

'This is the resistance'

Waminda is the country's first Aboriginal Community Controlled Health Organisation to enact the model of care grounded in culture aimed at improving health outcomes.

Its endorsed midwives are expected to help deliver about 90 First Nations babies this year through the program at Shoalhaven Hospital.

Waminda executive and Jerrinja Cullunghutti Wandandian woman Hayley Longbottom said it would allow First Nations women to reclaim their birthing rights.

"This is why we do what we do. Nothing is more important than our women birthing in a safe, self-determined space," Ms Longbottom said.

"This is the resistance and this is the fight."

A 2020 Closing the Gap report revealed that First Nations babies were nearly twice as likely to be born too soon, and to die during pregnancy, soon after birth or in their first year of life.

Around 49 per cent of child deaths are due to perinatal trauma, including complications of pregnancy derived from the impacts of colonisation. 

According to the Australian Institute of Health and Welfare, First Nations women are three to five times more likely than non-Indigenous women to die in childbirth.

Waminda's Birthing on Country aims to give power to community to change those figures.

"It's really important that we're able to do what we know is right for our people," Ms Longbottom said.

Partnership with hospital

Waminda began lobbying for Birthing on Country eight years ago.

An access agreement between Waminda and the Illawarra Shoalhaven Local Health District (ISLHD) has been signed to allow Waminda endorsed midwives "visiting rights" to Shoalhaven Hospital to birth babies.

ISLHD maternity manager Angela Jones said it had never been done before and should fix what she described as a "broken pathway".

"The women had antenatal and post care with Waminda but that is where that continuity stopped," she said.

"This is the first model of its kind in Australia, and I suppose this now will be a seamless flow."

Ms Jones said having one consistent, trusted midwife throughout the entire journey was the "gold standard of care".

"You have reduced interventions, better outcomes for women, improvements in birth weights, improvements in breastfeeding and psychosocial wellbeing," she said.

The landmark service is provided for First Nations babies, including those of non-Aboriginal mothers.

Overcoming barriers

Dharawal and Gumbaynggirr woman Melanie Briggs is Waminda's senior endorsed midwife and the first Aboriginal endorsed midwife in NSW.

She said the service has had to navigate many barriers, including insurance and institutional racism.

"We've had to work with the government to try and formulate intrapartum insurance for the midwives that are employed here and it's very expensive," Ms Briggs said.

She said Waminda "headbutted" a lot of racism along the way, but what Birthing on Country had achieved would make maternity safer for all women.

"This will change the way our women and our babies are treated," Ms Briggs said.

"And what works for our women will work for everybody."

The midwifery program is part of a larger plan to build a birthing centre next year to enable First Nations women to birth away from hospital settings and allow ceremony back into the practice.

Ms Briggs expects the first sod to be turned at the South Nowra site early next year.

"We've designed it … the DA [development application] will go to council this month."

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Peace or war, midwives keep delivering

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Millions of lives each year rely on the expertise and care of midwives and yet a global shortage is squeezing the profession like never before, the UN sexual and reproductive health agency UNPFA said on Sunday, marking the International Day of the Midwife . 

This year the vital role of midwives during the ongoing climate crisis is in the spotlight. 

Every two minutes, a woman or girl dies due to pregnancy-related complications, a figure that climate change threatens to exacerbate said UNFPA , underscoring the crucial role that midwives play in mitigating these risks. 

“When crisis strikes, midwives are often first on the scene, especially in remote communities. They know that babies arrive no matter a childbearing woman’s circumstances  – whether she’s resting at home or fleeing it due to conflict or disaster,” UNFPA chief Dr. Natalia Kanem  said in a statement marking the Day . 

Alongside their immediate task of attending births, midwives deliver up to 90 percent of other sexual and reproductive health services.

When war strikes

The importance of midwives as critical healthcare providers has soared during a time when conflict seems to be proliferating. Their role goes far beyond assisting women in labour, extending to vital psychological support for women and children in distress.

The UN World Health Organization ( WHO ) marked the day with a video, showcasing Samar Nazmi Muwafi, the staff midwife and head nurse at the Al-Emarati hospital in Gaza. 

Despite the enormous workload – up to 500 female patients go through the hospital’s emergency room every day – she stays strong by focusing on patient care. 

“I learned to smile. I always draw my smile to make the patients feel comfortable,” says Samar Nazmi Muwafi.

Acute deficit

There is a severe shortage of around a million midwives globally . Challenging working conditions, gender discrimination contributing to low wages and reports of harassment, have deterred many from entering the profession. 

According to UNFPA data from 2023, 287,000 women continue to lose their lives giving birth each year. Around 2.4 million newborns die and an additional 2.2 million are stillborn. 

Universal access to midwives offers the best and most cost-efficient solution to end preventable maternal deaths, UNFPA says. By closing the deficit in the number of midwives, two thirds of maternal and newborn deaths could be prevented , saving over 4.3 million lives a year by 2035.

UNFPA has already helped countries educate and train over 350,000 midwives in line with international standards to help improve the quality of care they provide, and the work continues.