Antenatal appointments

Information for the public

If you already had diabetes before getting pregnant
If you are at risk of or have gestational diabetes

Antenatal appointments

At your antenatal appointments you should get extra care because of your diabetes as well as the normal antenatal care that all pregnant women get. Your care team should check on you and your baby. At each appointment you should be offered information and advice, and have the chance to ask questions and to talk with your midwife or doctor about any concerns you might have.

You should have contact with your care team every 1 to 2 weeks to talk about your blood glucose control.

You may also find the NICE information for the public on antenatal care useful (see other NICE guidance).

If you already had diabetes before getting pregnant

An appointment with a joint diabetes and antenatal care team should be arranged for you straight away when you first get pregnant.

The table below gives a guide to the extra care that you should receive at your antenatal appointments.

Appointment	The extra antenatal care that your care team should offer
Booking appointment – ideally by 10 weeks of pregnancy	Information, advice and support about your blood glucose levels and about how diabetes will affect pregnancy, birth and early care of the baby Ask about your diabetes, current medications and general health Eye examination (unless you have had one in the last 3 months) Kidney test if you have not had one in the last 3 months. HbA1c test At 7 to 9 weeks, check how far along your pregnancy is Advise you to take 75 mg of aspirin daily from 12 weeks until the birth of the baby, to reduce the risk of pre‑eclampsia (high blood pressure in pregnancy)
16 weeks	Eye examination at 16 to 20 weeks if you had diabetic retinopathy at your first visit
20 weeks	Ultrasound scan to confirm that your baby is developing normally, including checks on your baby's heart
28 weeks	Ultrasound scan to check your baby's growth Eye examination
32 weeks	Ultrasound scan If this is your first baby, routine antenatal care that would be given at 31 weeks
36 weeks	Ultrasound scan Information and advice about: planning the birth, including timing and types of birth, pain relief, and changes to your medications changes to your treatments for diabetes during and straight after the birth looking after your baby, including starting breastfeeding and the effects of breastfeeding on your blood glucose follow-up care and contraception Advise you to have your labour induced, or a caesarean section if this is the best option, before 37 weeks if there are complications
37 weeks	Advise you to have your labour induced, or a caesarean section if this is the best option, during week 37 or week 38 if there are no complications
38 weeks (and every week thereafter)	Tests to check your baby's wellbeing if he or she has not been born yet

Treatments for eye and kidney problems

If eye screening shows that you have diabetic retinopathy, this shouldn't affect treatment to improve your blood glucose levels in early pregnancy if this is needed. It also doesn't mean that you can't have a 'normal' (vaginal) birth.

If a kidney test shows that you have diabetic nephropathy, you should be offered treatment and you may be referred to a kidney specialist.

It is possible that you might need extra scans and more detailed checks on your baby's growth and development if you have circulatory or kidney problems.

If you are at risk of or have gestational diabetes

The table below gives a guide to the testing and extra care that you should receive at your antenatal appointments. You should start having extra antenatal care as soon as gestational diabetes is diagnosed.

Appointment	The extra antenatal care that your care team should offer
Booking appointment – ideally by 10 weeks of pregnancy	Test for gestational diabetes if you have had it before and are booking in the first 13 weeks Advice, information, support and treatment if you are diagnosed
16 weeks	Test for gestational diabetes if you have had it before and are booking after 13 weeks Advice, information, support and treatment if you are diagnosed
20 weeks	Ultrasound scan to confirm that your baby is developing normally, including checks on your baby's heart
24 to 28 weeks	Test for gestational diabetes if you haven't had it before but are at high risk of getting it Advice, information, support and treatment if you are diagnosed
28 weeks	Ultrasound scan to check your baby's growth
32 weeks	Ultrasound scan If this is your first baby, routine antenatal care that would be given at 31 weeks
36 weeks	Ultrasound scan Information and advice about: planning the birth, including timing and types of birth, pain relief, and changes to your medications changes to your treatments for diabetes during and straight after the birth looking after your baby, including starting breastfeeding and the effects of breastfeeding on your blood glucose follow-up care and contraception
38 weeks	Tests to check your baby's wellbeing Advise you to have your labour induced, or a caesarean section if this is the best option, before 40 weeks if there are complications
39 weeks	Tests to check your baby's wellbeing Advise you have to have your labour induced, or a caesarean section if this is the best option, before 41 weeks if you haven't had your baby by then

Questions you might like to ask your care team about care during pregnancy

How soon should I contact my diabetes care team once I find that I'm pregnant?
Will pregnancy affect my diabetes and my general health?
Why do I need to have more scans and antenatal appointments than women without diabetes?
When should I test my blood glucose? What are my target levels?
How might my medication change during pregnancy?
Why do I need more or different insulin during pregnancy?
Where should I have my baby? What care might my baby need after birth?