What Does A Midwife Look For During An Antenatal Check?

Antenatal checks are an important part of tracking your baby's health and development.

During pregnancy, you are seen regularly by your midwife for your antenatal checks. 

You bring in your sample of urine, wait for a while (hopefully not too long) and are seen.  A lot of people don’t really give it a second thought, but that short visit is vital in ensuring all is well with you and your baby.

So, what is your midwife checking and why? 

Urine

Your wee tells a huge amount about you and can be the first indicator of issues both big and small.  Urine is a waste product. After travelling around our bodies, blood heads to the kidneys where all the waste products are filtered out and made into urine.

The midwife will take the sample and before anything, visually examine it. Normal urine should be clear. If it’s cloudy, very dark or has a nasty smell this could be a sign, amongst other things, of a urinary tract infection.

It’s also good for you to see your own wee! If its darker than normal, then it’s your body telling you that need to drink more water!

Next, the midwife will use a small stick and dip it into your sample. This amazing little stick is able to pick up very small particles of things like ketones, blood, protein and other substances.

This simple test is both accurate and very fast in telling the midwife if there might be some underlying pregnancy-related health issues.

For example, if protein is picked up, it can be the first indicator of pre-eclampsia, a serious pregnancy complication. If anything is detected, the sample will be sent off to the lab for further testing. In most cases, all is well and it’s a reassuring sign that all is as it should be.

Pregnant woman in a field
During pregnancy, you are seen regularly by your midwife for your antenatal checks.

Blood
pressure

Blood pressure issues in pregnancy are one of the most common problems. Growing a baby, carrying around all the extra fluid and the strain that puts on your general system can force your heart and blood vessels to work overtime. In early pregnancy, feeling faint might indicate low blood pressure.

However, further into your pregnancy, it’s more likely high blood pressure could be an issue. It’s Important to note that just because you get a high blood pressure reading, it doesn’t automatically indicate a problem.

There is a thing called “white coat syndrome” and it’s very real. It means that when someone, particularly a medic checks your blood pressure, it appears to be higher than it is because you are nervous. 

Lots of people have this, and then when more detailed tests are done it turns out that everything is fine. High blood pressure is easily treated in pregnancy and once it is recognised it is carefully monitored to avoid it becoming a huge cause for concern.

Abdominal
Palpation

Your midwife will measure your tummy to check that your baby is growing as it should and that there is not too much or too little fluid around your little one.

She will also feel the baby’s position and if it’s toward the end of your pregnancy, your midwife will also make sure that the head is down and feel how deep in the pelvis it is.

(I cannot tell you the HOURS and HOURS I spent as a student midwife learning this skill. It’s so important to be able to tell this information by touch).

After finding out whereabouts your baby is lying, the midwife will listen in to the baby’s heartbeat. She might use a pinard stethoscope, which is a small instrument that kind of looks like a funnel.

Pregnant woman standing in a garden
Antenatal checks are an important part of tracking your baby's health and development.

Nowadays, a doppler is more commonly used and if so, you’ll be able to hear the heartbeat too.  A foetal heartbeat is a lot faster than ours and sounds like a little train. It’s such a lovely reassuring sound to hear and without a doubt, a healthy heartbeat is the nicest sound in the world!

‘How are you
doing?’

More than any checks, this is such an important question. When your midwife asks it, be as honest as you can.  It doesn’t just mean how you are feeling physically; it also relates to how you are feeling in general.

If you are anxious, if you have any worries, if you feel something isn’t right, if you need some support, if you have any questions, I cannot stress how important it is to say it during your appointment. 

I know how busy the clinic may seem, or sometimes how busy the midwife might look but the absolute vast majority of midwives really do care about you and your baby and the well-being of both of you. If you don’t tell them what’s going on, they won’t be able to help you.

Pregnancy is tough, both physically and mentally and your caregiver is there to look after you in all aspects.  If there are any issues whatsoever, then speak up.

A handy trick that I tell anyone that’s pregnant is to keep a little notebook and write anything down that you wish to discuss, so you don’t forget to say it!

I truly believe ‘Baby Brain’ starts in pregnancy so it's so easy to walk out of the clinic and go “damn I forgot..”

In fact, I still have baby brain over a year later after having Felix - well, that’s my excuse and I’m sticking to it!

For more
information:

https://www2.hse.ie/wellbeing/child-health/antenatal-and-maternity-care-options/appointments.html

http://www.irishhealth.com/article.html?con=293

https://www.enherts-tr.nhs.uk/patients-visitors/our-services/maternity/health-and-well-being-in-pregnancy/

Avril Flynn

Avril is a Registered Midwife, Childbirth Educator, Hypnobirth Practitioner, Podcast and Live Event presenter and mother of one.

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