At your first antenatal appointment, known as the booking appointment, your midwife will tell you about the different tests and checks on offer, including the reasons they give them. This will include ultrasound scans and other screening and diagnostic tests to check your baby’s development.
The same tests are offered to all pregnant women and birthing people. Your doctor or midwife will explain what they involve and how they can help you. It is your choice whether to have any of the tests. Talk to your midwife if you have any questions or worries about the tests.
Routine tests in pregnancy
These tests are done at your antenatal appointments to check your health and find any health problems. They are very important because they can pick up illnesses that are dangerous for your baby but that are showing no signs or symptoms.
Remember that you do not have to wait for an appointment if you are concerned about your symptoms during pregnancy. Call your midwife or doctor. Do not worry if you have talked about it before and do not be concerned about whether you are wasting anyone's time. This is your pregnancy. If you feel something is not right it is important to trust your instincts.
Blood pressure checks
Your midwife will check your blood pressure at each of your antenatal appointments. They use a cuff that is wrapped around your upper arm. Blood pressure checks should ideally be done on the same arm every time.
Your first reading will give your antenatal team an idea of what your blood pressure normally is. They can then see whether your readings change during your pregnancy.
Raised blood pressure can affect your baby’s growth and be a warning sign of pre-eclampsia.
You will be asked to give a sample of your urine (wee) at each antenatal appointment to check for protein, which can be a sign of pre-eclampsia.
You may also be asked to give a urine sample If you show any symptoms of having a urinary tract infection at any time during your pregnancy.
It is important to give a sample that is ‘midstream’ – this means it is taken halfway through weeing. This is the best way to tell if there is an infection in your bladder.
Your midwife will offer you blood tests at your booking appointment and later in your pregnancy. You may be offered more blood tests if there’s a chance you may have a health condition.
Talk to your midwife if you are worried about having the tests or you don’t like needles. They may be able to reassure you and can support you to make an informed decision about having the tests.
At your booking appointment, you will be offered a blood test to check:
- your blood group and rhesus status
- whether you have an infection, such as hepatitis B, HIV or syphilis
- whether you have iron-deficiency anaemia (not enough iron in the blood)
- whether you carry the gene for sickle cell anaemia or thalassaemia.
You may be offered more blood tests at 28 weeks to check:
- your iron levels again
- whether you have developed gestational diabetes or if you are at risk
- whether you have developed anti-D antibodies, if you are rhesus-negative. The NHS website has more information about this.
Measuring your baby’s growth
From 24 weeks your midwife will start to measure your growing bump to check that your baby is growing well. This is done using a tape measure. They will measure your bump, in centimetres, from your pubic bone to the top of the uterus. This will be plotted on a graph in your notes. The measurement is usually the same as the number of weeks you are, give or take 1–2 cm.
If the measurement is higher or lower than expected, your midwife may refer you for an ultrasound scan to check your baby’s size.
Abdominal palpation (feeling your womb)
At about 36 weeks, your midwife will feel your bump to check which position your baby is in. If your baby has their bottom or feet downwards, your midwife will refer you for an ultrasound scan to get a clearer idea of their position. This is because it may affect your labour and birth.
Find out more about getting your baby into the best birth position.
Your baby’s movements
From the second half of your pregnancy your midwife will also ask you about your baby’s movements.
Feeling your baby move is a sign that they are well. Be aware of your baby’s usual pattern of movements and if you notice that they have slowed down, changed or stopped, it may be a sign that your baby is not well.
Contact your midwife or maternity unit immediately if you notice any changes to your baby’s movements. This could save your baby’s life. There are staff on the hospital maternity unit 24 hours a day, 7 days a week.
Find out more about your baby’s movements.
Group B Strep test
Group B Strep (GBS) is a type of bacteria called streptococcal bacteria that lives in the body. Between 1 and 2 out of every 5 women (20-40%) has this bacteria and it doesn’t usually cause any health problems.
The GBS bacteria do not produce any symptoms in women during pregnancy and your baby will usually be born healthy. However, there's a small risk it could spread to your baby during labour and make them ill. There’s also a very small risk you could have a miscarriage.
Group B Strep is not routinely tested for but may be found during tests carried out for another reason, such as a urine test or vaginal swab.
If you're worried about group B strep, speak to your midwife or GP for advice. Routine testing isn't currently recommended and tests are rarely done on the NHS, but you can pay for one privately.
Find out more about Group B Strep in pregnancy.