Subsequent antenatal visits

If you have not watched the video Antenatal clinic visit and obstetric exam by Dr Deralie Flower then now is a good time to watch this video: click to play, right click to download 

After the initial booking visit, in a healthy pregnancy, there are usually monthly visits with the LMC until 28 weeks. Between 28-36 weeks, visits should occur every two weeks. From 36 weeks, visits should occur every week. Visits are an opportunity to monitor ongoing progress in pregnancy, identify any problems, and to revise the pregnancy care plan accordingly. 

Antenatal education is given throughout these visits with discussion of diet and exercise, smoking, and alcohol taking place. First time mothers are encouraged to also attend antenatal classes for education and support during pregnancy. Some women may also benefit from seeing a social worker if issues with income, housing, etc develop during pregnancy.

Women will begin to feel movements from 16-22 weeks of gestation. At each visit, it is important to ask the mother about the baby’s movements as this is an important marker of fetal wellbeing. We advise women that from 28 weeks they should spend some time each day focussing on their baby's movements and noticing the pattern of movements. We also ask women about unusual vaginal discharge, leakage of liquor or fluid, vaginal bleeding, and the presence of lower abdominal pain and tightenings. At every visit, women should also be asked about the symptoms of preeclampsia and UTI. 

At Each Visit we also:

• Measure the blood pressure

• Look for oedema

• Examine the abdomen including listening in to the fetal heart with doppler, examination of the fetal lie and presentation (from 24 weeks) and measure the fundal height 

• Test the urine – glucose, protein, leucocytes, nitrites

Each antenatal visit is also an opportunity to ensure the woman and her family understand and agree to the management plan for pregnancy.

Summary of clinical examination at booking and later visits 

At booking                                                                                                                     At each visit