You are pregnant! Now what?

So you've just had a positive pregnancy test? Congratulations!

Firstly, sit down and take the news in. It's a big change in your life, and a surprise however hard you've been trying to become pregnant.

Secondly, this is your body, and your pregnancy. So you need to get informed, get knowledgable, and make your own decisions for you and the baby.

There are some things you will want to get on to right away. For example, if you've not been taking folic acid, now's the time to start. Folic acid is important to prevent growth problems such as spina bifida, and it's particularly important at the beginning of a pregnancy.

You might want to buy a guide to pregnancy - I got the "What to Expect When You're Expecting" which is a great guide to what is happening to your body and the baby every week of the pregnancy. It also advises about diet, clothes, medical appointments, and labour.

Getting in touch with the midwife and doctor

In the UK, the National Health Service (NHS) recommends that you get in touch with your local midwifery service immediately.

If you haven't already started, you should take folic acid daily as soon as you find out you are pregnant.

If you live in London, you can do this directly by looking up your post code on the NHS website, and making an appointment. Outside London, ring your General Practioner (GP) and ask for the contact number for the midwife.

The First Appointment

The midwife will give you a "booking-in" appointment. This will last some time, up to a couple of hours.

The appointment might be at a local clinic, your GP's surgery, or in a hospital - it depends on the midwifery rota and how the local service is run.

Expect to be asked a lot of questions about your own health and that of your baby's father, and of both your families' medical histories. It might well be a good idea to ask your partner / husband before the appointment to check the details, including his blood group (whether rhesus postitive or negative).

The midwife will give you a large booklet. This will include sections that will be filled in during the initial appointment, such as your name, date of birth, address, GP, height, weight, etc.

It will also have sections for future appointments with the midwife, GP, ante-natal clinic, and scans. You will be talked through the various options for blood tests, scans, etc, so you can decide which you want to have.

You will also have the chance to ask questions about your pregnancy, health, etc. It's worth thinking about before you go, so you know what you might want to talk about.

The midwife will also give advice on diet, alcohol and smoking issues, and can refer you to stop-smoking services if appropriate.

Other things likely to be discussed are exercise, food preparation, where to have your baby, breastfeeding, ante-natal classes, and maternity benefits.

Later appointments

Later midwife visits won't be as long. They will usually involve the midwife checking your weight, urine, and blood pressure, and filling those details into your booklet.

The midwife will also, later on in the pregnancy, feel your stomach and listen to the baby's heartbeat. Altogether, you will probably have 10 appointments (if this is your first pregnancy) or 7-8 (if you have already had a child).

If you have pre-existing health concerns such as diabetes, asthma, obesity, epilepsy, or anything else, you are likely to be seen by a doctor early in the pregnancy at the ante-natal clinic. This will mean that your pregnancy will be monitored carefully to make sure your health isn't affected.

Other medical tests and scans

Most women are offered two ultrasound scans. The first is between 10 and 13 weeks, and checks the baby's heartbeat, that there is only one baby, and often for markers for Down's Syndrome, in combination with blood tests.

The second scan is usually called the anomaly scan, and checks in some detail the baby's body to see if there are any problems. You can often find out the baby's sex as well, if you want to, although some hospitals have a policy of not telling parents. This scan is usually at 18 to 22 weeks.

The anomaly scan isn't about getting a woman to have an abortion if there is something "wrong" with the baby. It's about planning and getting the right care if there is a problem. If the placenta is low down, or the baby growing slowly, these are things which need to be monitored later in the pregnancy.

If there are issues with the baby, the right medical care can be arranged ahead of time for when the baby is born.

You will also have blood tests. Early in pregnancy, the test checks for blood group and rhesus status, red blood cell development, and anaemia. Tests are also done for all sorts of illnesses, such as HIV, syphilis, hepatitis A, B and C, and German Measles (plus others). These blood tests are important, for your health and the baby's.

Look after yourself, and the baby, and the best of luck for a healthy pregnancy and easy delivery.