Dr Rahul Sen ~ Long Appointments. Dr Rahul Sen details the reasons behind having long appointments with his patients – from the very first visit through to the final catch up before the birth. It’s about ensuring you have all the information and assurance you’ll need to experience a safe and rewarding birthing experience.
As your pregnancy progresses, the frequency of your visits will increase, in order to check on the wellbeing of both you and your baby. This is particularly important at the end of the pregnancy.
A pregnancy lasts 40 weeks on average, so you will have 10–12 visits with me during this time. At your second visit I shall provide you with an antenatal card. This card contains all your important pregnancy information at a glance, so please carry it with you all the time and bring it to all visits.
Please feel free to bring your partner to the visits, especially your first visit. Children are welcome, and we have toys to occupy them in the waiting room. However, if your child distracts you during a visit, you will get less benefit from the consultation, so it may be better to leave them with another carer.
Most of your visits will last 10-15 minutes, depending on your individual needs. I always try to run on time, however the very nature of obstetrics means that I can be called away suddenly, and also that I may unexpectedly need to give extra time to a patient with an unanticipated problem. I recommend that you call an hour before your appointment to confirm that I am running on time. Please remember if you run late for your appointment, you will make me run late for the rest of the day.
Your first visit
This is often the longest, lasting 45-60 minutes, and usually occurs at around 8 weeks. This is what you can expect during your first visit –
- I shall take a history and perform a physical examination, including blood pressure, breast, thyroid and pelvic (vaginal) examination, as well as a Pap smear if it is due.
- I will perform a dating ultrasound if required – you will need to have a comfortably full bladder. If the pregnancy is difficult to see, especially in very early pregnancy or your bladder is not full or if your uterus is retroverted (tilted backwards), I will need to perform an internal ultrasound.
- I will check or order your blood tests, if they have not already been done
- I shall give you a pregnancy pack and a booking form for either POWPH or RHW.
- We will discuss your plans, expectations and any special needs you may have during the pregnancy and I shall organise any further investigations.
13 to 14-week visit
During this visit I shall check the results of your nuchal translucency scan and Harmony test, if you have had one.
16 to 17-week visit
I shall check that your pregnancy is progressing well, as you will probably not have started to feel movements yet, especially if this is your first pregnancy, or the placenta is at the front. I shall also arrange for your 19 week “morphology” ultrasound, if this has not already been booked. You should have your long (1 hour) appointment with Michele around this time, after your appointment with me.
20 to 21-week visit
I shall discuss the results of your 19 week ultrasound scan, and make sure you have had or booked an appointment with my midwife, Michele.
24 to 25-week visit
I shall give you a referral for your diabetes screening test, as well as your blood count and iron stores.
28 to 29-week visit
I shall discuss the results of your diabetes screen and other tests. You need to book a 3D scan. You should have a whooping cough (Pertussis) booster with your GP or family doctor at 28-32 weeks.
34 to 36-week visit
I shall repeat your blood tests to check your iron stores, if necessary
I shall perform a vaginal-rectal swab test, to screen for Group B Streptococcus. I also recommend a 36 week growth and well-being scan. You may wish to have a second, shorter visit with my midwife.
I shall review the results of your swab test. If it is positive (10-20% of women) you will need intravenous antibiotics in labour, and sometimes oral antibiotics beforehand. I shall also review the results of your 36 week growth scan. If your baby is much bigger or smaller than usual I may need to arrange further monitoring, including extra scans. I shall discuss your plans for birth at this visit.