First Appointment (8 to 12 Weeks)

Your first midwife appointment, sometimes called the booking appointment, usually takes around an hour. The midwife will ask about your health, last period, previous pregnancies, existing conditions, mental health, lifestyle (including exercise, alcohol and smoking), work, home situation, and ethnic background, to help plan care around your needs — they may also sensitively ask about domestic abuse, sexual abuse, or female genital mutilation to check if extra support could help.

You'll be given information on the screening tests available, your options for giving birth, and how to stay well during pregnancy. Your blood pressure and urine will be checked to screen for high blood pressure, pre-eclampsia, and urine infections, and a blood test will check your blood group. You'll also be given your maternity notes (in an app, book, folder, or on a secure website) — it's important to keep these with you throughout pregnancy in case you need urgent care.

Scans and Later Appointments

Between 11 and 14 weeks, you'll be offered a dating scan to check your due date, your baby's development, and whether you're expecting more than one baby — this is also when combined screening for Down's, Edwards' and Patau's syndrome can be offered, entirely by choice. A 16-week appointment follows up on screening results and checks blood pressure and urine, before an 18 to 21 week scan (the 20-week screening scan) checks your baby's development in more detail; testing for gestational diabetes is offered between 24 and 28 weeks if you're at higher risk.

Further appointments at 25 (first-time parents), 28, 31 (first-time parents), 34, 36, 38, 40 and 41 weeks continue to check your blood pressure, urine, and bump growth, discuss your baby's movements, your mental health, and preferences for birth, with a blood test and an anti-D injection offered around 28 weeks if relevant to protect against rhesus disease. From 36 weeks, appointments also check your baby's position, and from 40 weeks onward, your options if you go past your due date are discussed in more detail.

Why Screening Tests Are Offered

Screening tests, also called antenatal screening, check your health, your baby's development, and signs of specific conditions. They're offered to everyone as part of NHS antenatal care and can help identify certain conditions early, giving you the chance to discuss further tests, choices, and any needed treatment or care with your doctor or midwife.

All NHS screening tests are entirely optional and free — you can choose to have all, some, or none of them, and your midwife or doctor will explain what's offered and why to help you decide. If you decline initially, you can usually still choose to have tests later, though some need to be done within a specific window of pregnancy.

When Tests Happen

Screening for sickle cell and thalassaemia usually happens before 10 weeks, and screening for hepatitis B, HIV and syphilis between 8 and 12 weeks. Between 11 and 14 weeks, the 12-week scan looks for signs of conditions such as spina bifida, alongside combined screening for Down's, Edwards' and Patau's syndrome; a quadruple blood test between 14 and 20 weeks is offered instead if the combined test wasn't possible. Between 18 and 21 weeks, the 20-week scan screens for 11 specific health conditions. If you have a condition such as diabetes or high blood pressure, or previous pregnancy complications, additional tests or monitoring may also be offered, and newborn screening is carried out after your baby is born.

Getting Your Results

You'll be told in advance when to expect your results — ultrasound results are usually given on the day, while blood test results can take longer. Screening tests indicate whether your baby has a lower or higher chance of a condition, rather than giving a certain diagnosis; if a higher chance is found, you'll be offered further information and additional tests, along with support to help you understand your options.