Your first midwife appointment: what happens at the booking appointment?
You may have heard that some unusual questions come up at the booking appointment, like “Are you related to your partner?” or “Is your partner the father of the baby?”. These surprise a lot of people, but they’re there to help us tailor your care to your needs.
Whatever you’ve heard about the booking appointment, I’ll share the essentials with you so you know what happens and why it’s done that way.
Before your appointment
There’s not much to prepare, but once your appointment date is confirmed, a few things can help the visit run smoothly:
- A photo ID, to verify your identity.
- A rough idea of when your last period started, so we can work out how many weeks pregnant you are.
- Any relevant medical records, such as medications, diagnoses, ultrasound scans or reports from previous births. These can save everyone a lot of time.
If you’ve set up Macha, its onboarding asks many of the same questions you’ll be asked at booking, so you’ll have most of your answers ready.
You’re welcome to bring your partner or someone close to you, but bear in mind that some sensitive questions will come up during the visit.
Building your booking history
A big part of the appointment is spent asking you questions to build a full picture of your health and your care. These include:
- Your medical and obstetric history: any previous diagnoses, long-term conditions, medications, surgeries, allergies and previous pregnancies.
- Your family history: conditions in your first-degree relatives (parents, brothers, sisters and children) that might affect your pregnancy risk assessment.
You might wonder how a relative’s health could affect yours. Family history can point to an inherited genetic tendency, shared environmental or lifestyle factors, or a mix of both. For example, a family history of diabetes, high blood pressure or blood-clotting disorders may change how your pregnancy is assessed, and whether extra monitoring, screening or preventive treatment should be considered.
Several routine measurements and screening tests are also done on the day:
- Vital signs, such as blood pressure and pulse, to give us a baseline to compare against later
- A urine test, to check for signs of infection and other abnormal markers
- Blood tests, for your blood group, rhesus status, anaemia, infectious diseases and some inherited conditions
- Your weight, height and BMI
Once I have all this, I use a number of risk assessment tools to flag anything that needs closer attention. Having done countless booking appointments, I’ve noticed that women often worry that anything flagged as a risk means something dangerous. What helps is to turn the question around and ask: what does this particular risk actually mean for me and my baby, in this pregnancy? Your midwife should be able to explain that to you in plain language.
Deciding on your care pathway
Next, I work out what kind of care will suit you best. For most women, that means midwife-led care, which simply means your midwife stays your main point of contact throughout the pregnancy. If certain risk factors come up, your care might be shared with an obstetric consultant, and you may be referred to another specialist team as well. For example, a woman with a higher BMI might be referred to a dietitian, an obstetrician and an anaesthetist before the birth, alongside her usual midwifery care.
It’s also worth asking your midwife about continuity of carer, which many maternity services offer (you may hear it called caseloading). It means you could see the same midwife or small team of midwives throughout pregnancy, birth and the weeks after. In practice, you’re not repeating your story to someone new each time, and you get the kind of continuity every woman deserves. This model of care has been shown to improve outcomes for both mother and baby, and it can still be offered if your care is shared with an obstetric team.
Why we ask what feels like too much
Some of the questions at booking go into much more personal territory than a typical medical questionnaire: your mental health history, your home circumstances, whether you feel safe where you live, and any previous losses. It’s a lot to be asked by someone you’ve probably only just met, and I’m always aware of that when I ask them.
What I want women to know is that pregnancy is a life-changing event, and it’s easy to underestimate how much your circumstances, such as a difficult relationship, money worries or a stressful home life, can affect both your wellbeing and your baby’s, often before either of you notices. These questions help me make sure nothing gets missed that could be picked up and supported early. Being honest means your care can be as thorough as possible, and we can plan it together around what you actually need.
The questions are yours too
Booking is a chance for me to learn about you, and it’s just as much a chance for you to learn about yourself in this pregnancy. In my clinics, the same few questions come up again and again: is it safe to eat cheese on pizza, is it normal to feel this exhausted, can I keep running? My honest answer is that a first booking appointment has more information packed into it than anyone can take in at once. I always recommend writing your questions down as they come up and bringing them to your next appointment.
Along with your care plan, I’ll usually give you a lot of information on diet, supplements, safe exercise, your benefits and screening tests. You’re not expected to take it all in on the day. It’s there for you to come back to whenever you need it, and Macha covers many of the same topics if you’d rather look things up on your phone.
One last piece of advice: it’s never too early to start thinking about the birth and the weeks after, even at your first appointment. Pregnancy moves faster than most people expect. Looking into antenatal or parenting classes early gives you time to find out what’s available near you and make choices based on real information. The booking appointment is where the conversation about your pregnancy begins.
Sources
- National Institute for Health and Care Excellence (NICE). Antenatal care (NG201): recommendations on the booking appointment, information to give, and risk assessment.
- NHS.uk: Your antenatal appointments.