Once a pregnant woman has been assigned to a General Practition (GP), midwife and obstetrician and has booked in with her hospital, she is entitled to regular antenatal checks. There are choices as to the type of antenatal care a woman wishes to receive and where to give birth too: women are entitled to give birth at home if they wish, even if they have previously had a c-section; women are entitled to give birth in a hospital, taking with them a birth plan to advise of her wishes regarding pain relief etc; women are entitled to share their care between a midwife and a GP. Ultimately, women are given the freedom of choice when it comes to having their baby. All women are entitled to pay time off work to attend antenatal appointments.

For those women who do seek the full antenatal care routinely offered by the National Health Services (NHS), the following should be offered:

• A booking in appointment with a GP or midwife to take a full medical history; previous pregnancies and births will also be discussed.
• A series of routine physical examinations: weight and height to assess physical fitness; regular growth assessment of the baby; regular blood pressure checks; examination of the baby’s position and regular checks of the baby’s heart beat.
• Routine urine tests:  these are for early detection of protein (an indication of pre-eclampsia); glucose (indication of diabetes) and bacteria (indication of a urinary infection).
• Routine blood tests: these are to determine the blood group; to check for anaemia; to check Rubella status; to check for haemoglobin disorders and to check for infections.
• Routine ultrasound scans: two are normally offered - a dating scan at 12 weeks and an anomaly scan at 20 weeks. Earlier scans can be given if there are concerns or if there is a history of miscarriage. Later on, growth scans may be offered if there are concerns about the development of the baby.
• Screening for Down’s Syndrome: there is more than one test that may be offered: a combined screening involves a blood test taken at the same time as the dating scan and a nuchal translucency scan between 11 weeks, 2 days and 14 weeks, 1 day of pregnancy; a serum screening is a blood test which takes place between 14 weeks, 2 days and 20 weeks of pregnancy. Every woman has the right to refuse these tests.
• Diagnostic tests for Down’s Syndrome: should the screening test results return with a high risk, all women will be offered an amniocentesis or a Chronic Villus Sampling. Again, women are entitled to refuse either of these procedures.

All women are perfectly within their rights to refuse all tests and screening and these wishes need to be respected by all medical staff involved.

If a patient misses one of the diagnostic tests, she may not be able to re-book due to the delicate timings that are so important for obtaining accurate results. If a women has not been offered the tests or if she has been persuaded to refuse them, there are steps that can be taken. Likewise, not all hospitals offer the same tests. Women are able to book private tests which may give more comprehensive results due to the fact that private clinics also check for other chromosome abnormalities, Edwards’ Syndrome and Patau’s Syndrome. The Patient Liason Service (PALS) exists to assist patients if they wish to make complaints or if they have concerns about their healthcare provision. Their site has lots of information: http://www.pals.nhs.uk .

At any time during her pregnancy, a woman is able to call her midwife 24h hours a day, to receive advice and support. Women can also call the out of hours GP service to speak to a GP, although this will be whichever doctor is on duty at that time. Alternatively, she can contact NHS Direct, either by their website (http://www.nhsdirect.nhs.uk/default.aspx) or by calling. In addition, all women are provided with the number for both the early pregnancy unit and maternity triage at the hospital where they plan to give birth. There are schemes in place to help women to give up smoking, or to control alcohol consumption. There are schemes to help women learn about healthy eating and there are hospital run parent-craft classes which are excellent for first time mothers. These schemes are optional and may not always be offered as matter of course; women are entitled to ask for any additional support they feel is necessary.

This is all before the baby is born and this is all completely free to all women resident in the UK. There are private maternity hospitals where additional scans (such as 4-D) can be performed but these services must be paid for.

In addition to the antenatal care, pregnant women are also entitled to free prescriptions and free dental care with the issue of an NHS Maternity Exemption card. This card lasts until the baby’s first birthday. These cards are issued after a form is filled in, which will be given to the patient by their GP.

Find out more information on your rights:

Maternity Care Patient's Rights (UK version)

Maternity Care Patient's Rights - Guidelines for Medical Professionals (UK version)

Maternity Care Patient's Rights - While in Labour (UK version)

Maternity Care Patient's Rights - After Birth (UK version)

Sources:

• The official NHS site (http://www.nhs.uk/Pages/HomePage.aspx)
• The Association for Improvements in the Maternity Services (AIMS: http://www.aims.org.uk/)
• NICE (http://www.nice.org.uk/) .
• http://www.nice.org.uk/
• http://www.adviceguide.org.uk/nireland/healthcare_ni/healthcare_nhs_healthcare_e/nhs_patients_rights.htm#Maternityservices
• http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_113689.pdf
• http://www.aims.org.uk/