Pregnancy

First contacts with services

After discovering they were pregnant, most women wanted to get in touch with their GP or midwife quite quickly, and some went almost at once. Although home pregnancy tests are now very accurate, several people wanted official confirmation. Some were offered another pregnancy test, but several were surprised their GP thought another test was unnecessary. The GP can also help estimate your due date, as the system for working out the length of pregnancy from the day of your last period can be confusing.

A few people chose to wait until 10-12 weeks before making contact, thinking that little could be done in the first few weeks anyway. (With hindsight this mother felt more advice and reassurance earlier in pregnancy would have helped).

NICE guidance (National Institute for Health and Clinical Excellence - Antenatal care CG62) suggests women should have at least one antenatal visit before 10 weeks. Many valued early advice on general health topics such as diet and exercise (see 'Advice on health and lifestyle'), and being given the NHS booklets for pregnant women such as The Pregnancy Book. (See also 'Finding information and support'.)

In addition, it may help to get early information about antenatal screening. The nuchal translucency scan used as part of the combined screening for Down’s syndrome and other chromosomal abnormalities is most effective if done before 14 weeks (it is normally done as part of the dating scan 11 to 14 weeks), women need to know about this option early enough and not delay the dating scan past 14 weeks if they want one, so it is important to see the GP or midwife early enough to discuss whether to have one and to book the appointment. (See the Healthtalk website on 'Antenatal screening' for more information). Miscommunication between their GP and midwife delayed one couple's booking-in appointment, affecting their choices about screening.

Several people were surprised when they first went to their GP that they were not greeted with more celebration or congratulations, and that they were told there would be no further appointments for a few weeks. One mother would have liked more contact in the first few weeks, more for reassurance than for any medical reason. This is especially true in a first pregnancy, when people have no experience to help them know what to expect.

Part of the reason for a low-key response from professionals is the risk of miscarriage in the early weeks. GPs and midwives must try to make sure people have realistic information about the chances of miscarriage without scaring them and spoiling their joy. A few people were distressed by being told very abruptly about the risk of miscarriage.

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Another difficult issue for doctors and midwives is checking sensitively whether the mother is happy to be pregnant. Two young single mothers with unplanned pregnancies explained their contrasting experiences' one felt unable to tell her GP that she was considering a termination, while the other was offended that the midwife who booked her in assumed she might not want to keep the baby, and this spoilt their relationship.

Some people's first contact with health services happened not by choice but as an emergency, for example as a result of bleeding in early pregnancy. Women who had experienced this were generally positive about the care they had received at such an anxious time, especially from Early Pregnancy Units (see 'Bleeding and miscarriage'). People who had a previous history of miscarriage or other problems such as a genetic abnormality were usually seen earlier and more often in their next pregnancies, and found this helpful. One couple had previously had a termination because the baby had a genetic abnormality. When they went to tell the GP about their next pregnancy, they were pleased that he understood they would be feeling anxious and sad.

People were also seen earlier than usual if they had had fertility treatment, or had another condition such as diabetes or epilepsy which might affect the pregnancy. In these cases pregnancy was closely monitored from the start, often in a specialist hospital unit. (See 'Pregnancy with another condition or disability').

See also 'Finding information and support' and 'Maternity care and antenatal visits'.

Last reviewed May 2017.
Last updated
May 2017.

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