Pregnancy Monitoring and Childbirth

Antenatal care is the medical follow-up in which the health of the expectant mother and the baby is assessed at regular intervals from early pregnancy until after birth.

What does antenatal care involve?

Antenatal care covers the regular assessment of the mother’s general health and the baby’s growth and development from the first weeks of pregnancy until delivery. It includes clinical examination, ultrasound scans, blood and urine tests and trimester-specific screening tests. The aim is to follow the course of the pregnancy, recognise possible risks early and plan care where needed.

How often are check-ups scheduled?

For an uncomplicated pregnancy, visits are commonly planned monthly until week 28, every two weeks between weeks 28 and 36, and weekly after week 36. The World Health Organization recommends a minimum of eight antenatal contacts. The actual schedule is tailored by the physician to the woman’s age, medical history, previous pregnancies and the course of the current pregnancy.

Main assessments by trimester

• First trimester (weeks 0–13): confirmation and dating of the pregnancy, blood group, full blood count, urine analysis, infection screening and the nuchal translucency scan with first-trimester screening between weeks 11 and 14.
• Second trimester (weeks 14–27): the detailed anatomy scan between weeks 18 and 23, gestational diabetes screening at weeks 24–28, repeat blood count and blood pressure monitoring.
• Third trimester (week 28 to birth): assessment of fetal growth, amniotic fluid and presentation, fetal heart-rate monitoring (NST) where indicated, and planning of the timing and mode of delivery.

How is the mode of delivery decided?

Birth may take place vaginally or by caesarean section. The appropriate option is decided jointly by the physician and the expectant mother on the basis of medical criteria such as the baby’s presentation and estimated weight, the position of the placenta, previous births, coexisting conditions and the course of the pregnancy. Where there is no medical contraindication, vaginal birth is the preferred route; caesarean section is a surgical procedure performed when medically indicated.

Postpartum follow-up

The first six weeks after birth are important for the mother’s physical and emotional recovery. Bleeding, healing of stitches or the incision, breastfeeding, family planning and mood are reviewed. A postpartum visit is usually scheduled at six weeks; heavy bleeding, fever, foul-smelling discharge or marked mood changes require earlier assessment.

When to seek care without delay

• Vaginal bleeding or leakage of fluid
• Severe or persistent abdominal pain
• Severe headache, blurred vision, sudden swelling of hands and face
• Marked reduction in fetal movements (especially after week 28)
• Fever of 38 °C or higher, burning on urination