Your booking appointment: what happens at your first antenatal visit
The booking appointment is the first formal antenatal appointment you will have with a midwife on the NHS. It usually takes around an hour and covers a wide range of checks, questions and practical arrangements. Knowing what to expect before you go makes the whole experience feel far less daunting, and helps you use the time well.
When the booking appointment takes place
The NHS aims to offer a booking appointment before you reach 10 weeks of pregnancy, though it may happen as late as 12 weeks in some areas. Booking early matters because it allows time to arrange important screening tests, including the combined screening test for conditions such as Down's syndrome, which is offered between 11 and 13 weeks. If you are not sure how to access midwifery care, contacting your GP is usually the simplest starting point.
Physical checks carried out at the appointment
The midwife will carry out a series of routine health checks during the appointment. These give a baseline picture of your health at the start of pregnancy and help identify anything that might need closer attention. The checks typically include:
- Blood pressure measurement
- A urine sample to check for infections and protein levels
- Weight and height measurements so your BMI can be calculated
- A blood sample, which is used for several different tests
These are all standard and take only a few minutes each. If anything unusual comes up, the midwife will let you know and explain the next steps.
Blood tests offered at the booking appointment
The blood tests taken at the booking appointment cover several important areas. Your blood group and rhesus factor are checked so that, if needed, anti-D treatment can be arranged later in pregnancy. A full blood count is done to look for anaemia, which is common in pregnancy and can affect how you feel day to day. The blood is also tested for a range of infections, specifically HIV, syphilis, hepatitis B and rubella immunity. All of these tests are offered as standard to every pregnant woman. Results are not usually available immediately, and the midwife will tell you when and how you will receive them, typically at a follow-up appointment.
Questions you will be asked
The booking appointment involves a thorough conversation as well as the physical checks. Your midwife will ask about your medical history, any medications you are currently taking, and any previous pregnancies. They will also ask about your family history, including any conditions such as diabetes, genetic disorders or mental health difficulties that run in the family. These questions are not there to judge you; they help your midwife understand your circumstances and plan the right level of care for you throughout your pregnancy.
Your midwife will also ask about your mental health and general wellbeing. Questions about anxiety, depression or previous mental health conditions are a routine part of the appointment. Being honest here is important, as it allows any additional support to be put in place early if it would be helpful. You may also be asked about your lifestyle, including whether you smoke, drink alcohol or have any concerns about your diet.
Carbon monoxide screening
If you smoke, or if your midwife has any reason to think you may have been exposed to carbon monoxide, you will be offered a carbon monoxide screening test at the booking appointment. This is a simple breath test. If the result suggests a concern, your midwife can talk you through support available to help you stop smoking, which is one of the most beneficial things you can do for your pregnancy.
Referral for the dating scan
At the booking appointment, your midwife will refer you for your first ultrasound scan, often called the dating scan or 12-week scan. This scan is offered between 10 and 14 weeks of pregnancy. It confirms how far along you are, checks that the pregnancy is developing as expected, and looks at certain physical features as part of early screening. Having the referral arranged at the booking appointment means you should receive the scan invitation in good time.
What you receive at the booking appointment
By the end of the appointment you will have your maternity notes, either in a paper booklet you carry with you or in a digital format depending on your area. These notes contain a record of all your antenatal care and are important to bring to every appointment and to have with you when you go into labour.
Your midwife will also arrange a Maternity Exemption Certificate, known as a MatEx. This entitles you to free NHS prescriptions and free NHS dental treatment for the whole of your pregnancy and for 12 months after your baby is born. It is worth applying for this as soon as it is arranged, as it can save you a meaningful amount of money during pregnancy.
The MATB1 form, which is the certificate you need to claim statutory maternity pay or maternity allowance from your employer or through the benefits system, is issued separately. You will typically receive this at around 20 weeks of pregnancy, once your pregnancy is more advanced.
Frequently asked questions
When does the booking appointment happen?
The NHS aims to offer a booking appointment before 10 weeks of pregnancy, though it can happen up to 12 weeks. Booking early means your screening tests can be arranged in time, including the combined screening test at 11 to 13 weeks.
What blood tests are taken at the booking appointment?
Blood is taken to check your blood group and rhesus factor, screen for anaemia, and test for infections including HIV, syphilis, hepatitis B and rubella. These tests are offered to all pregnant women. Results are usually discussed at a follow-up appointment.
What is the Maternity Exemption Certificate?
Your midwife will arrange a Maternity Exemption Certificate (MatEx) at your booking appointment. It entitles you to free NHS prescriptions and free NHS dental treatment throughout your pregnancy and for 12 months after your baby is born.
Do I need to prepare anything for the booking appointment?
It is helpful to know your last period date, your medical history, any medications you take, and your family history of conditions like diabetes or genetic conditions. You do not need to bring anything specific, but any previous medical letters or pregnancy-related test results can be useful.
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