Antenatal care in India: the MoHFW schedule and your options
Antenatal care (ANC) in India sits at the intersection of a robust government public health system and a large private healthcare sector. Most urban, educated families end up navigating both, often starting with a private OB/GYN while also being entitled to free government services they may not know about. This article gives you a clear picture of the recommended care schedule, what is available for free, the cash benefits you can claim, and the key tests and scans to expect.
The MoHFW recommended antenatal schedule
The Ministry of Health and Family Welfare (MoHFW) updated its antenatal care guidelines in 2023 to align with World Health Organization recommendations. The updated guidelines recommend a minimum of 8 antenatal contacts during pregnancy, up from the previous standard of 4.
The contacts are spread across your pregnancy, with visits becoming more frequent as your due date approaches. In private practice, most OB/GYNs in Indian cities schedule:
- Monthly visits in the first and second trimesters
- Fortnightly visits from around 28 to 36 weeks
- Weekly visits in the final weeks before your due date
Your doctor may schedule more or fewer visits depending on whether your pregnancy is low-risk or high-risk. Always follow your doctor's specific advice over any general schedule.
Key tests and scans during pregnancy
At your first antenatal visit, your doctor will typically order a set of baseline blood tests. Over the course of the pregnancy, the standard tests include:
- Blood group and Rh factor (important for detecting Rh incompatibility)
- Haemoglobin (anaemia is very common in Indian pregnancies; iron supplementation is usually started early)
- Blood sugar (gestational diabetes screening, usually done around 24 to 28 weeks with an oral glucose tolerance test)
- Urine routine and microscopy (to check for infections and protein in urine)
- TORCH screen (toxoplasmosis, rubella, cytomegalovirus, herpes, and others) at the first visit
- NT scan (nuchal translucency scan) at 11 to 14 weeks, used alongside blood tests to screen for chromosomal conditions
- Anomaly scan (TIFFA scan) at 18 to 22 weeks, which checks the baby's anatomy in detail
- Growth scan in the third trimester (timing varies by doctor)
At government health facilities, many of these tests are available free of charge under JSSK (see below). At private hospitals, costs vary widely.
Free government antenatal care: JSSK
The Janani Shishu Suraksha Karyakram (JSSK) is one of the most significant but under-utilised entitlements for pregnant women in India. Under JSSK, all pregnant women are entitled to:
- Free antenatal consultations at government health facilities
- Free diagnostic tests (blood tests, urine tests, ultrasound where available)
- Free medicines, including iron and folic acid (IFA) tablets for a minimum of 180 days
- Free delivery (normal or caesarean section) at government hospitals
- Free postnatal care and medicines
- Free referral transport to a higher facility if needed
- Free care for a sick newborn up to 30 days after birth
There is no means test for the basic ANC entitlements. Any pregnant woman, regardless of income, can access free care at a government hospital. The scheme operates at primary health centres (PHCs), community health centres (CHCs), district hospitals, and medical college hospitals across India.
PM Surakshit Matritva Abhiyan (PMSMA)
On the 9th of every month, the government runs free antenatal clinics at government health facilities under the Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA). These clinics bring in specialist doctors, including obstetricians, to see pregnant women who may otherwise have limited access to specialist care.
The PMSMA clinic includes a comprehensive ANC checkup, blood pressure measurement, abdominal examination, and blood and urine tests. It is available to all pregnant women at government facilities, not just those below the poverty line.
Cash benefit under PMMVY
The Pradhan Mantri Matru Vandana Yojana (PMMVY) provides a cash benefit of ₹5,000 for the first living child, transferred directly to your Aadhaar-linked bank account in instalments. The benefit is conditional on registering your pregnancy early, attending ANC visits, and delivering at a health facility.
To register, visit your local Anganwadi centre or government health facility and fill in the PMMVY application form. You will need your Aadhaar card and a bank account linked to your Aadhaar. Your husband or a family member can also register on your behalf.
Iron and folic acid supplementation
Anaemia is a major concern during pregnancy in India. The MoHFW recommends that all pregnant women take iron and folic acid (IFA) tablets for a minimum of 180 days during pregnancy. These are available free at government facilities under JSSK. Your private OB/GYN will also typically prescribe IFA or a combined prenatal supplement from your first visit.
The PCPNDT Act: why you cannot find out the sex of your baby
If you have asked your sonographer the sex of your baby and been refused, this is because the law requires it. The Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act 1994 makes it illegal for any doctor, hospital, or diagnostic centre to disclose the sex of a foetus at any point during pregnancy. This applies to ultrasound scans, blood tests, and any other diagnostic technique.
The law exists to address the serious problem of sex-selective abortions and the skewed sex ratio in India. Violating the Act is a criminal offence. Any clinic or individual found to have disclosed the foetal sex can face imprisonment and loss of licence.
Private antenatal care: what to expect
Most urban families in India choose private OB/GYNs for at least part of their antenatal care. Costs at private clinics vary significantly:
- Private OB/GYN consultation: approximately ₹500 to ₹3,000 per visit depending on the city and doctor
- Ultrasound scans: ₹800 to ₹3,000 depending on the type and diagnostic centre
- Hospital delivery: ₹20,000 to ₹2,00,000 or more depending on hospital tier, city, and type of birth
Health insurance covering maternity is available but typically comes with a waiting period of 2 to 4 years. If you have maternity cover, check the waiting period, sub-limits, and whether day-care procedures are covered well before your due date.
Frequently asked questions
How many antenatal visits do I need in India?
MoHFW guidelines recommend a minimum of 8 antenatal contacts during pregnancy. In practice, most private OB/GYNs in Indian cities schedule more visits than this, with monthly appointments in the first and second trimesters and more frequent visits in the third trimester. Always follow your doctor's specific recommendation.
Is antenatal care free at government hospitals in India?
Yes. Under the JSSK scheme, all pregnant women are entitled to free consultations, tests, medicines (including iron and folic acid tablets), and referral transport at government health facilities. The scheme also covers free delivery and postnatal care. There is no income test for the basic antenatal entitlements.
What is JSSK and am I eligible?
JSSK stands for Janani Shishu Suraksha Karyakram. It entitles all pregnant women in India to free and cashless antenatal care, delivery, and postnatal care at any government health facility. Any pregnant woman can access it, regardless of income or BPL status.
What cash benefits can I claim during pregnancy in India?
The Pradhan Mantri Matru Vandana Yojana (PMMVY) provides ₹5,000 for your first living child, paid in instalments into your Aadhaar-linked bank account. You register at your local Anganwadi centre or government health facility. The benefit is linked to early pregnancy registration, ANC attendance, and institutional delivery.
What is the PCPNDT Act and why can I not find out the sex of my baby?
The PCPNDT Act 1994 makes it illegal for any doctor or diagnostic centre to disclose the sex of a foetus. This applies to all scans and tests throughout pregnancy. The law exists to address sex-selective abortions and the skewed sex ratio in India. Violations are a criminal offence.