Antenatal appointments

Question 1

Offer a first antenatal (booking) appointment with a midwife to take place by …?

Answer 1

Offer a first antenatal (booking) appointment with a midwife to take place by 10+0 weeks of pregnancy.

Question 2

If women contact or are referred to maternity services later than 9+0 weeks of
pregnancy, offer a first antenatal (booking) appointment … when?

Answer 2

If women contact or are referred to maternity services later than 9+0 weeks of
pregnancy, offer a first antenatal (booking) appointment to take place within 2 weeks if possible.

Question 3

If a woman books late in pregnancy, ask about the reasons for the late booking because it may reveal social, psychological or medical issues that need to be addressed.

Answer 3

If a woman books late in pregnancy, ask … ?

Question 4

Offer midwife-led care to…

Answer 4

Offer midwife-led care for all uncomplicated pregnancies (involving 10 appointments over the course of a pregnancy for nulliparous women and 7 if it is a second pregnancy.)

Question 5

Offer obstetrician-led care if…

Answer 5

Offer obstetrician-led care If women are classed as higher risk including multiple pregnancy, maternal health problems and consists of all the midwifery appointments PLUS joint clinics to cover mental health, haematological issues, diabetes etc.

Question 6

Woman with pregnancy may be regarded as having complex social factors if:

Answer 6

• women who misuse substances
• recent migrants, asylum seekers or refugees, or women who have difficulty
• reading or speaking English
• young women aged under 20
• women who experience domestic abuse.

Question 7

If … within the past 2 weeks, offer a referral to NHS Stop Smoking Services.

Answer 7

If the woman or her partner smokes or has stopped smoking within the past 2 weeks, offer a referral to NHS Stop Smoking Services.

Question 8

If the woman or her partner smokes or has stopped smoking within the past 2 weeks, offer…

Answer 8

If the woman or her partner smokes or has stopped smoking within the past 2 weeks, offer a referral to NHS Stop Smoking Services.

Question 9

What two things do you do or ask the woman about in a kind and sensitive manner at the antenatal booking appointment?

Answer 9

• Ask the woman about domestic abuse in a kind, sensitive manner at the first antenatal (booking) appointment, or at the earliest opportunity when she is alone.
• Assess the woman’s risk of and, if appropriate, discuss female genital mutilation (FGM) in a kind, sensitive manner.

Question 10

Ask the woman about domestic abuse in a kind, sensitive manner at … or … ? [when]

Answer 10

Ask the woman about domestic abuse in a kind, sensitive manner at the first antenatal (booking) appointment, or at the earliest opportunity when she is alone.

Question 11

…[do what?]… if there is a concern about cardiac conditions based on the pregnant woman’s personal or family history.

Answer 11

Refer the woman for a clinical assessment by a doctor to detect cardiac
conditions if there is a concern based on the pregnant woman’s personal or
family history.

Question 12

At every antenatal appointment, carry out a risk assessment as follows:
- …
- …
- …
- …
- …

Answer 12

• ask the woman about her general health and wellbeing
• ask the woman (and her partner, if present) if there are any concerns they
  would like to discuss
• provide a safe environment and opportunities for the woman to discuss
  topics such as concerns at home, domestic abuse, concerns about the birth
  (for example, if she previously had a traumatic birth) or mental health concerns
• review and reassess the plan of care for the pregnancy
• identify women who need additional care.

Question 13

At the first face-to-face antenatal appointment, offer to measure … [parameters]?

Answer 13

At the first face-to-face antenatal appointment, offer to measure the woman’s height and weight and calculate body mass
index.

Question 14

At the first face-to-face antenatal appointment, offer a blood test to check …, … and … .

Answer 14

At the first face-to-face antenatal appointment, offer a blood test to check full blood count, blood group and rhesus D status.

Question 15

At the first antenatal (booking) appointment, discuss and share information
about, and then offer, the following screening programmes:
- …?
- …?
- …?

Answer 15

At the first antenatal (booking) appointment, discuss and share information
about, and then offer, the following screening programmes:
- HIV, syphilis
and hepatitis B
- sickle cell and thalassaemia
- Down syndrome, Edward syndrome, Patau syndrome