The moment you learn you’re pregnant, you’ll probably be keen to tell the father or another person likely to be concerned about your wellbeing, and this is as it should be. However, it is still important to let your doctor know as soon as possible so you can get booked in for your first antenatal appointment.

How soon should I start with an antenatal clinic?

The first twelve weeks of pregnancy are thought to be the highest risk period for miscarriage, and, of those, the risk is most significant in the first six weeks, when some women may not even know they are pregnant. Getting medical advice and monitoring as soon as you can is the best decision for you and your baby, but how do you choose the right antenatal clinic? Firstly, not everyone will have much of a choice. If your pregnancy care is state-funded, restricted by your insurance policy, or you live some distance from a variety of providers, you may be limited to one or two options, but the following questions should be considered as far as is possible in order to properly manage your pregnancy experience.

Which professionals do you want to be with when you give birth?

In a low-risk pregnancy with no complications, it is likely that a woman in the UK will be cared for by midwives throughout her pregnancy, and, depending on where she chooses to give birth, they may also be the only healthcare professionals in attendance during her delivery. Ideally you will be seen by the same midwife throughout your care, as research shows that this has great outcomes for mums, but even if this isn’t always possible, you can. An obstetrician typically works in a hospital in collaboration with midwives. Choosing the right obstetrician for you can be based on a variety of factors ranging from experience and reputation to age, gender, and personality. It is most important that you feel comfortable, secure, and supported throughout your pregnancy. You may also seek care from a doula, hypnotherapist, or other childbirth professional in pregnancy. However, it’s worth mentioning that they aren’t qualified to oversee your birth unless they are also an obstetrician or midwife, and if you want them to attend your birth at a midwife-led centre or hospital, your midwife or doctor will need to be told in advance.

Where do you want to give birth?

This is an important question, but in the UK you can actually change your mind until relatively late in the game (when you’re in labour), so don’t need to worry if you feel you need time to decide. In this country there are four options: home birth, birth in a hospital, and birth in a freestanding birth centre or a birth centre attached to a hospital. The one benefit of deciding early is that you may be able to get to know the person (or people) who will be present at your birth through your antenatal appointments, from midwives to your obstetrician and even the anaesthesiologist, though you will probably have to request a meeting with that last one as it is not routine. Your risk of intervention is least likely at home, though you can’t have an epidural there, and your risk of intervention is highest in the hospital, but that’s also often the safest place to be if your pregnancy is high-risk. Further, if you are induced (which can take a long time to progress to established labour, especially if you are a first-time mum), you will likely need to be on a labour ward so will want to choose the one with the nicest environment. It’s all very subjective to the woman and the pregnancy, and while it’s important to fully understand your healthcare team’s recommendations, nobody (with the possible exception of your baby—we're thinking of Seth Meyers “lobby baby") can make you give birth anywhere you do not want to be.

How do you want to prepare for labour and birth?

Some women arrive at the hospital very open-minded, while others know they want aromatherapy, reflexology, or some other alternative therapies in labour and will need to check availability through their antenatal clinic. You may not be able to get the number of antenatal appointments you feel you need in some settings. You may also want specific forms of pain relief that are not available in a particular setting. There’s also something to be said for respecting the vibe that makes you most comfortable. Things are far more likely to progress smoothly—with both pregnancy care and labour and birth—where you can make yourself feel safe, comfortable, and at home.

What do the safety and other inspections say?

In the UK, the Care Quality Commission is an independent healthcare regulator that makes a clear statement about what they believe maternity care should look like and looks at five key areas during inspections of hospitals, birth centres, and other providers. Their reports are available for your review and based on the following questions:

Is this provider well-led?
Is this provider safe?
Is this provider caring and compassionate?
Is this provider responsive to patients’ needs?
Is this provider effective?

Other bodies perform similar roles in different countries, though the federal structure of the US makes healthcare regulation complex.

What do the patient reviews say?

Other women’s birth stories matter, especially if they’ve delivered in the same place you want to or with the same doctor or private midwife (you typically won’t be able to see a review of an individual NHS midwife unless he or she also has a private business). Read reviews carefully—they don’t always tell the whole story, the doctor, etc. can’t really answer back while respecting a patient’s privacy, and pregnancy and birth are often unpredictable—but be mindful of the mothers’ experiences. They are you, in some measure, and it’s generous of them to share their life-changing experiences.

For more advice on taking care of yourself in pregnancy, labour, and birth, check out Unii’s Antenatal Course, with prenatal video episodes taught by senior NHS midwives, an award-winning obstetrician and gynaecologist, and six other leading healthcare experts. Coming soon to unii.com.

Choosing The Right Antenatal Clinic: What to Consider