Your week 6 instalment from Natural Childbirth in their Pregnancy Week by Week series, this week Dr Lindsay Reid  talks about your booking visit or first assessment.

Week 6 after conception is, in a way, a ‘landmark’ week: it’s the week of your second missed menstrual period.  According to calculations taking  pregnancy from the date of your LMP, you would be in your eighth week of pregnancy. If you go back to our Week by Week Introduction article you can have a refresher on this. I frequently look, to check that I’ve got it right.

It’s also good to remember that when you are thinking of your baby’s expected birth date, known officially as the Expected date of Delivery (EDD) , this date is very flexible and can be at least two weeks either way of any EDD.

The booking visit

Today it’s appropriate to discuss the first assessment or, booking visit. This is the one when you and your midwife get together, get to know each other and find out how you are and how you have been. It’s often arranged for around week ten.

Where will the Booking visit happen?

This visit with your midwife is usually quite a long one and could quite easily take place at home where you are at your most relaxed. If you don’t want this for any reason, just say and your midwife will have a place for you to talk quietly together.

What’s the booking visit for?

It’s really seen as an important introduction for you, to maternity care. The midwife will give you an opportunity to talk about what is best for you. It’s an important day, hopefully a good one too.

What will happen?

The Booking visit really is a chat between you and your midwife about you. The midwife will have a form to go into your confidential documents which you will be able to see and access (see ‘handheld’ documents, below) and which she will complete as you talk.

She will want to assess your levels of health to give her a ‘baseline’ of how you are at the beginning of your pregnancy so that any changes in any aspect of your health,  for example, blood pressure, will be measured against how you were at the beginning.

So, she will take a ‘history’ of:

• how you are now: she will record your blood pressure, test urine, take a blood specimen for testing, growth and development of your baby – although if your booking visit is before 12 weeks then it is unlikely that she will be able to feel your uterus. It’s still tucked in below the pelvic brim. Don’t worry – it won’t be long before it will rise above and be ‘palpable’ and then visible too.
• your past menstrual history: were your periods regular , heavy, or slight?
• whether or not you have been pregnant before and how you were then
• your medical history: allergies, operations, illnesses.
• your family history: anything at all that you feel that you want to talk about.
• your background in general. This will give her an overall picture of you and your family. It’s the beginning of a new partnership.
• anything that might be concerning you regarding your pregnancy, health, other pregnancies. She’s there to listen to you as well as anything else.
• she will also want to give you advice to do with pregnancy so that you and your baby are as healthy as possible.
• she will also want to help you to be a partner in your care, so that you can make decisions about your care with her support and information to help you. She’ll tell you what your options are for care in pregnancy, where you could consider having your baby, antenatal classes, what’s available in your area. You’ll then be able to make choices that suit you.

Handheld records

Until the 1980s pregnant women did not usually have access to their records. Instead they carried a card in which the midwife wrote very briefly any observations at antenatal appointments which the mother was supposed to carry until it was required again. It built up a useful skeleton picture of maternal and fetal health in pregnancy. But, the records were left in a consulting room or hospital. There could even be one set of records with midwife or GP and one set at a maternity unit written by someone else. Not a good recipe for continuity of care. The mother did not see them.

Good sense eventually prevailed. Now, handheld records are usual. This means that the mother carries her records of pregnancy and takes them to any appointment she may have where they are updated and results of tests added. This makes for much improved continuity of care. Anyone looking at the records knows immediately what has been happening. Equally importantly, you have access to your own records – after all they are all about you and your baby and you should know what is going on.

If you go on holiday, take your records with you just in case you need them.

And the baby….

Six weeks after conception (eight weeks into official pregnancy) the arms and legs which started as limb-buds, are growing longer and are moving although you still won’t be able to feel this. Foot ‘plates’ are present and little fingers are beginning to take shape. The outer ear – the bit that looks like a shell – is forming and even the baby’s eyes can be seen. He or she has an upper lip and the nose is well seen now. Length is measured from the crown of his head to bottom (called crown to rump) and around this stage will be approximately 1.3cm. Growth is rapid just now and development amazing. If you were to have an ultrasound scan this week the embryo would be visible.

Being pregnant is a huge life event, and some people find it difficult to cope and feel guilty and unhappy.  In week seven  we’ll have a look at some  very common emotions.

If you’d like to speak about any pregnancy concerns, queries or to discuss your stage of pregnancy, you can speak to Sarah Buchanan, founder of NaturalChildbirth via her Greatvine profile, now!