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Nine Months : Antenatal Checks

Every time you visit the midwife or the doctor for your routine antenatal visits, you will find that they carry out some or all the procedures mentioned below. Click on each procedure to find out more.


When? Every visit

Why? The urine sample is tested for a number of things but most importantly for sugar, proteins and ketones.

Sugar: Although it is normal for pregnant women to have sugar in their urine from time to time, presence of sugar in repeated samples could be a sign of diabetes. It is important to check for diabetes and if the condition is found, it can be controlled by change in diet and(or) insulin.

Proteins: Proteins(or albumin) in urine could be a sign of an infection or even hypertension.

Ketones: Presence of ketones in urine may be an indication that your kidneys are being adversely affected by pregnancy.


* It is best to collect the first urine in the morning to provide as a sample.

* You must use a sterile container for collecting the sample. If you are re-using a container, make sure that you rinse it well with washing-up liquid and use it only when it is clean and dry.

* Always provide a mid stream urine sample.

* It is in your own interest to provide a sample at every ante-natal visit.


When? Every visit

Why? If you suddenly gain weight, it could be a sign of pre-eclampsia.


* Not all doctors or midwives weigh every time. They may weigh you every now and then.

* Average weight gain in pregnancy is between 10-12.5kg (22-28 lbs) but it varies considerably from one individual to another.

* It is normal to even lose weight in the first three months of pregnancy due to excessive morning sickness.

* A lot of weight gain does not necessarily mean that your baby will be healthier and heavier.

* Your baby will be healthy based on what you eat and not really on how much you eat.



First visit

Why? Your height provides a rough estimate to the size of your pelvis and gives a general idea if your pelvis is big enough to enable a vaginal birth.


* Most babies are in proportion to the mothers who carry them.

* If your pelvis is too small, you may need to discuss the birth issue with your doctor or midwife.

* If you are over 152 cms or 5 ft tall, you are unlikely to have problems unless you are carrying an unusually large baby.

Blood Tests

When? Blood tests are carried out about three or four times during a normal pregnancy. The exact time table depends on the ante-natal care schedule of your hospital and surgery. Generally they will be carried out at first visit, around 15 weeks, 26 weeks and 34 weeks.

Why? The blood test taken at first visit checks for blood group, Rhesus factor, blood count, anaemia, immunity to rubella, syphilis, hepatitis B, HIV, sickle cell anaemia and thalassaemia.

The blood test between 15-20 weeks will be specifically for Down's syndrome and Spina bifida.

All later blood tests will be standard primarily to check whether or not you are anaemic and may be carried out at your surgery if that is more convenient for you.


* You may show up as anaemic in later blood tests even though your haemoglobin level was fine in the first test. Some women tend to develop anaemia as the pregnancy progresses.

* You will be tested for sickle cell anaemia and thalassaemia only if you and your partner are of an ethnic origin.

* If you are found to have syphilis, it is important that your treatment is completed by the end of the 20th week.

General Physical Examination

When? First visit

Why? A general physical examination is carried out by the doctor to ensure that you are in good health.

What? A general examination will include:

* checking heart and lungs

* examination of breasts to check for inverted nipples and to ensure that there are no lumps in your breasts.

* you will be asked about your dental health and will be encouraged to go for a free dental check

Internal Examination

When? First visit and (or) when the doctor or midwife thinks it necessary.

Why? An internal examination is required to:

* confirm the pregnancy stage (although an ultrasound scan is a preferred way of confirming baby's age)

* check pelvis for abnormalities ensure that the cervix is tightly closed

* have a smear test if you have not had one in the last 3 years

How? An internal examination does not hurt you or the baby but it may be a little uncomfortable. You will be asked to lie down on your back with your legs bent and knees apart. The doctor or midwife will put two fingers of one hand into your vagina and press the other hand on your abdomen gently.


* An internal examination is only required occasionally during pregnancy.

* Always discuss with your doctor why an internal examination is required.

Legs, Ankles and Hands

When? Every visit

Why? Excessive swelling of hands and feet could be sign of pre-eclampsia and hence needs to be monitored at every visit. The legs are also checked for varicose veins.


A little swelling (or oedema) in the later stages of pregnancy is normal and is not a cause of concern.


When? Every visit

Why? Palpation or feeling the abdomen is a good way to determine: the top of the womb (fundus) to roughly determine the baby's progress how the baby is lying and moving whether the baby is head-down in later weeks whether the baby has engaged into the pelvis in the final weeks


* The fundus can be felt low down (below your navel) in early pregnancy.

* Towards the end of pregnancy, it can be felt just under your breasts.

Listening to the baby's heartbeat

When? Every visit (after week 14)

Why? This is used to ensure that the baby is doing fine and is not distressed.

How? The midwife will rub some jelly on your abdomen. She will then try and locate the baby's heart (roughly) and use her instrument (sonicaid) to listen to the heartbeat. As a sonicaid amplifies sound, you will be able to hear your baby's heartbeat very clearly.


* As baby's are always moving, it may be very difficult (or even impossible) at times to be able to hear a constant heartbeat.

* The sonicaid sometimes picks up your pulse instead of the baby's heartbeat causing it to have a lower reading.

* A baby's heart beats about twice as much as an adult's.

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