Your first pregnancy check-up

Whether you are a private or a public patient you may wish to have your first pregnancy appointment with your local GP.

There are many reasons for this, you may feel more comfortable seeing your own doctor to begin with, you may want your doctor to advise you about your maternity care options, it might be more affordable to see your GP in the first instance or it may be a number of weeks before you can get an appointment with your preferred provider or carer.

Your local doctor (GP) can do early routine visits and organise your first tests and investigations.

A GP can:

• do a pregnancy urine or blood test
• talk with you about any concerns you might have about your pregnancy or general health
• discuss and organise early tests and ultrasounds
• talk with you about diet and exercise
• help you to give up smoking and discuss alcohol and drug issues if necessary
• make sure any medications you are taking are safe in pregnancy, including any natural or alternative medicines
• talk with you about your pregnancy care options.

Tests your GP can organise

Your GP can order blood tests to check the following:

• blood group and iron levels
• immunity to rubella (German measles)
• whether you have been exposed to hepatitis (a disease of the liver)
• sexually transmitted diseases such as syphilis and HIV (this test is offered with pre and post-test counselling)
• Thalassaemia (an inherited disorder that affects the production of haemoglobin).
• your risk for having a baby with Down syndrome and other genetic disorders

For women who are at risk a blood test is also offered to check for:

• vitamin D (deficiency that can occur from lack of exposure to sunlight)

• hepatitis C.

Your GP can also do or organise the following tests:

Urine test - to check for infection.

Cervical Screening Test - if you are due, this can be done safely in pregnancy.

Genetic tests

Ultrasound – which can look for a number of problems in your baby like spina bifida, heart and limb defects and to check your due date.

RhD factor and anti-D antibodies

One of the reasons you blood is checked in early pregnancy is because some women have a blood type that is incompatible with the fetus. If you are Rh D negative and the fetus is RhD positive this can cause problems for future pregnancies because the fetus’s blood cells have RhD antigen attached to them, whereas your do not. If small amounts of the fetus’s blood mixes with your blood, you immune system can perceive this difference in blood cells as a threat and will produce antibodies (called anti-D antibodies) to fight against the fetus’s blood. Once your body has made these antibodies they can’t be removed.

This will only be a problem for your current pregnancy if you have been pregnant before and were not given an anti-D injection after the birth. This includes miscarriage or abortion. If you have not been pregnant before, you are not likely to produce anti-bodies during the course of this pregnancy. So your current pregnancy will not be affected.

The antibodies are more likely to impact on future pregnancies because the process of producing antibodies takes time. Women with a negative blood type will be offered an anti-D injection which will stop the antibodies from forming.

Things to discuss with your GP

• When your baby is due.
• Information that may affect your pregnancy such as your family’s health.
• Whether you are likely to have a straightforward pregnancy or whether you have  more complex pregnancy needs.

You will also be asked about your family’s medical history, which might include factors such as diabetes, blood pressure issues, heart problems or a history of twins.

Aside from medical issues, the doctor may also ask about your circumstances such as:

• whether you might be at risk of violence
• whether you have support from family  and friends
• previous miscarriages or abortions and how you are feeling about them.

This is to make sure that all women are offered appropriate information, support and referral.

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