Why check-ups matter
Antenatal care means regular check-ups during pregnancy to follow the baby's growth and the mother's health. Check-ups can find problems such as anaemia, high and pre-eclampsia, and they let you and your doctor plan the birth and the place where it will happen.
No test can predict which woman will have a complication, and a complication can happen in any pregnancy. That is why every pregnant woman is advised to register early and attend all her check-ups.
How many visits, and when
| Visit | When |
|---|---|
| First | Within 12 weeks, as soon as pregnancy is suspected |
| Second | Between 14 and 26 weeks |
| Third | Between 28 and 34 weeks |
| Fourth | Between 36 weeks and the birth |
Four visits is the minimum, and more may be needed depending on the woman's health. WHO advises at least eight contacts: the first within 12 weeks, then at 20, 26, 30, 34, 36, 38 and 40 weeks. A woman who registers late should still be registered and cared for according to how far along she is.
What is checked
- Your weight and , and a check for paleness and swelling
- (a blood test for anaemia) and a urine test for sugar and protein, at every visit
- A feel of your tummy and a listen to the baby's heartbeat, to follow the baby's growth and position
- Where possible, your blood group and Rh factor, and tests for syphilis, HIV and hepatitis B
- A blood sugar test in the first three months and, if it is normal, a glucose tolerance test at 24 to 28 weeks, to look for gestational diabetes
- Advice on food and rest, the signs of labour, the warning signs below, and where you will give birth
Iron, folic acid and tetanus vaccine
Folic acid is advised from before pregnancy and through the first 12 weeks. Iron and folic acid tablets are advised daily from about the fourth month (14 to 16 weeks) to prevent anaemia, and the course is repeated after the birth. Black stools and mild nausea are common with iron and are not serious. Taking the tablets after a meal or at night can ease nausea. Tea, coffee, milk and calcium tablets reduce how well iron is absorbed.
A tetanus and diphtheria (Td) protects mother and newborn. The first dose is given early in pregnancy and the second four weeks later. A woman who had two doses in an earlier pregnancy within the last three years needs one booster dose.
Scans in outline
WHO recommends at least one scan before 24 weeks, to estimate how many weeks pregnant you are and to find twins and some problems in the baby's development. Your doctor will say which scans you need and when. Telling the sex of the baby is illegal in India.
Warning signs: get care at once
Also get care without waiting for your next visit if you have:
- A high temperature (38 degrees Celsius or above), especially with weakness or tummy pain
- Vomiting so much that you cannot keep anything down
- Fluid leaking from the vagina, especially before 37 weeks
- Sudden swelling of the face, hands, legs or feet, or sudden problems with your vision
- above 140/90 found at a check
- Passing very little urine, with high blood pressure
Check-ups are meant to find conditions such as pre-eclampsia (high blood pressure with protein in the urine) and gestational diabetes. Bleeding or pain in the first months also needs to be checked quickly.
Between visits
Do
- Register early and keep your health record with you
- Eat a little more than usual, including iron-rich foods such as green leafy vegetables, pulses, jaggery, eggs, meat or fish
- Take your iron and folic acid tablets regularly, even when you feel better
Do not
- Do not take any medicine in the first three months unless a doctor advises it
- Do not take iron tablets with tea, coffee, milk or calcium tablets
- Do not wait for your next visit if a warning sign appears
Common questions
What if I register late in pregnancy?
Register and start check-ups as soon as you know you are pregnant. If you come later, the national guideline says you should still be registered and given care according to how far along you are.
Do I need to keep taking iron tablets if I feel well?
Yes, unless your doctor says otherwise. The tablets prevent anaemia, and feeling less tired is not a reason to stop. Complete the course as advised, and tell your doctor if the tablets upset your stomach.
Can I take medicines for a cold or pain in pregnancy?
Ask a doctor before taking any medicine in pregnancy. In the first three months especially, the national guideline says no medicine should be taken unless a doctor advises it.
What should I do if the baby seems to move less?
Any change in the baby's usual movements, or no movement, needs care straight away. Do not wait for your next visit. Contact your doctor or go to a hospital.