You should get in touch with your doctor as soon as you know you are pregnant. They will arrange your booking appointment—your first midwife appointment—for you or explain how to do it, depending on the resources available in your area. The booking appointment involves a mixture of planning, education, and information gathering, as well as some blood tests and physical checks. It happens around eight weeks of gestation in the UK, as the screenings for sickle cell and thalassaemia are best done before ten weeks to ensure early (potentially life-saving) intervention if necessary. If you haven’t had your booking appointment scheduled and believe you are more than eight weeks pregnant, it’s important to reach out to your GP as soon as possible.

The appointment will take at least an hour. You will be given a book or a folder to document every aspect of your pregnancy. These are called your pregnancy notes and should be kept in a safe place, as you will need to bring them to all future appointments and scans.

The goal of this first appointment is to map out how you will be cared for over the course of your pregnancy. These plans are subject to change as your baby grows, and it is extremely important to attend all your scheduled appointments in pregnancy, regardless of how comprehensive the notes you leave the booking clinic with appear. Fun fact: in the US, the booking appointment is simply called your first antenatal or first OB appointment.

What questions will I be asked at my booking (first midwife) appointment?

There are lots of questions to address at this appointment! You can expect to be asked about your personal medical history and the baby’s father’s medical history, as well as that of both your families. Try not to be offended if the questions come across as invasive; each is conceived so that your team can provide the best and most appropriate care available for you and your baby. For this reason, it is extremely important to be honest and accurate with your answers.

Midwives are not there to judge you—Unii’s met them, and they really have seen and heard everything before—so do not be afraid to say potentially embarrassing things in plain language. Bring or write down any medication you are on, as well as notes on your general health if you think you may forget or become emotional (which is completely normal; pregnancy is beautiful but can be extremely intimidating), and ensure you are clear on the contact information you have for them before you leave. You will be asked about any previous pregnancies, including any history of miscarriages or birth injuries, which are always hard to talk about. Again, this is very important for the planning of your care. Any previous experience of female genital mutilation (FGM) will also be covered.

You will be asked if you work and what kind of work you do so how this may affect your pregnancy can be assessed. Your home life, including whether you have anyone to support you or are at risk of domestic violence, will also come up.

You may be asked where you’d like to give birth, but don’t worry if you don’t know at this stage; there is plenty of time to research your options and work out what is right for you.

What will I learn at my booking (first midwife) appointment?

Health and lifestyle advice

A healthy pregnancy requires a number of diet, exercise, and lifestyle behaviours you’ll hear about at your booking appointment. Good hygiene—including sexual hygiene—and oral care are extremely important in pregnancy. Again, the midwife won’t be trying to offend you with any of the information he or she shares, some of which you will probably already know. We all have blindspots when it comes to our health, and a precious few of us are pregnancy experts. A little overcommunication is no bad thing!

You will be asked whether you are already taking any antenatal supplements and told whether what you're taking and the doses are right for your health profile and your pregnancy.

You will be advised about vaccines in pregnancy—RSV, whooping cough, flu, and COVID—and where you can get them.

You will be asked about your lifestyle and advised to quit smoking, drinking, and doing any illegal drugs, as well as told to moderate your caffeine intake. You may be offered addiction support if needed.

If you have a chronic condition, there will be some discussion about how well it is managed and whether you need to see a specialist.

Stress is a real risk to your health and that of your baby in pregnancy. If there’s any reason you may have trouble managing yours, it’s important that you see additional support from your healthcare team. The same is true of any mental health issues to which you may be vulnerable.

How your baby is growing

You’ll learn all about how your baby will grow in the coming months, as well as about the tests and scans you’ll have in the coming months.

You may also be told a bit about pelvic floor health in pregnancy and taught how to do pelvic floor exercises. Antenatal classes can fill up fast in some areas, so you may be told about what’s available and advised to book in for your late second trimester as early as possible. If you work, your employer is obliged to let you take time off for antenatal education as well as all your midwife and doctor appointments in pregnancy.

Managing any conditions that may be of risk to your pregnancy is extremely important. If you had any uninvestigated symptoms prior to falling pregnant or have experienced anything unusual since you learned you are expecting, it is important to volunteer this information so your healthcare team can either reassure you or look into it.

What tests will I have at my booking (first midwife) appointment?

A set of booking blood tests will investigate:

Your Rhesus D status. This will be checked even if you already know what it is. It’s important that you are checked because if you are Rhesus D negative and your baby is positive, your body will create antibodies that attack their blood cells, which could cause jaundice and anaemia. The sooner your healthcare team knows about this, the easier it is to intervene.
A full blood count. This is a broad screening test to help ascertain your general health. It will check your iron levels and whether you need supplementation. If you’re getting enough iron from your diet, you don’t need to take any in pregnancy.
Your blood type.
Unexpected antibodies that may have developed as a result of a blood transfusion or previous pregnancy.
Whether you may have HIV, syphilis, or Hepatitis B.

In addition, if you’re at high risk of developing gestational diabetes, you may have an oral glucose tolerance test scheduled for earlier in your pregnancy than is typical (between 24 and 28 weeks). If you are at risk of developing pre-eclampsia, you will be advised to take low-dose aspirin for the rest of your pregnancy. Please ask any questions about aspirin or any other pain medication you may be taking or may want to take. When it comes to medication in pregnancy, Unii’s advice is always to ask your doctor or midwife before taking anything, even if it's over the counter and/or you have used it for years.

What are the next steps after the booking (first midwife) appointment?

You’ll also be given notice of when you’ll need to come back in. The number of appointments will vary according to your care needs and whether this is your first pregnancy. It is up to you to call and book your midwife for these weeks. Usually, the appointments can be booked through your GP. Consultant obstetrician appointments at the hospital, if you’re having them, are made by your healthcare team, and you will usually be notified by post or email from the hospital’s online portal.

What questions should I ask at my booking (first midwife) appointment?

It is very important to avoid stress as much as possible when you are pregnant, so try to make sure you ask your midwife any questions on your mind before you leave. These could include:

Any questions you have about what’s safe to eat or drink
How to take your supplements (especially if you are struggling with pregnancy sickness)
How to cope with pregnancy symptoms
Who to call first if you’re worried
What do early signs of miscarriage or ectopic pregnancy look like?
Any questions related to your age, health, lifestyle, or family history you may be worried about
Whether the kind of exercise you prefer is safe to continue
How you can get help to quit smoking, drinking, or drugs
How you can get help with eating better
How you can get help with your emotional or mental health
Who you can talk to about financial management in pregnancy or planning for a baby
Any questions you have about pregnancy and work
Any questions about where you’d like to be cared for in pregnancy?

Your due date will be estimated at another appointment, known as the dating scan, which usually takes place between weeks ten and twelve of your pregnancy.

What should I bring with me to my booking (first midwife) appointment?

Your GP’s surgery or hospital may advise you to bring any letters or reports you’ve received about your pregnancy. Some other things you may wish to take with you include:

Notes on your medical history, that of the baby’s father, and those of your families. Inheritable diseases and chronic conditions like diabetes are of particular relevance. These could include the results of any genetic testing you’ve had done.
Any medication you are taking, as well as supplements or natural remedies you may use. Natural does not always mean safe for your health in pregnancy.
Your personal notes on any symptoms you’ve experienced you think may be related to your pregnancy.
A list of your own questions—the booking appointment can be overwhelming, and these may fly out of your head.
Your baby’s father or a friend or relative can usually attend with you. Remember that you are likely to be sharing lots of personal information, and be certain to bring someone you trust. Your midwife may ask to speak to anyone you bring with you before the appointment begins to ensure your safety and privacy.

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

For more information on being safe and healthy in every week of pregnancy, check out Unii's Pregnancy Journey with Dr. Shree Datta.

What will happen at my booking (first midwife or first antenatal) appointment?

Unii covers what to expect and what to ask at this first appointment.