Antenatal Care: What to Expect at Every Visit
A visit-by-visit guide to antenatal care in Kenya — what happens at each appointment, which tests matter, and the warning signs that mean you should be seen straight away.
Why antenatal care matters
Antenatal care is the routine check-up you attend through pregnancy. Its purpose is simple: to catch problems early, while they are still easy to treat. Most complications of pregnancy give warning signs long before they become emergencies, and most of those signs are things a midwife or clinician can spot in a ten-minute appointment.
The World Health Organization recommends at least eight antenatal contacts across a pregnancy, and Kenya's Ministry of Health follows the same schedule. That is more than many mothers expect. The extra visits are not routine box-ticking — the evidence shows that pregnancies with eight or more contacts have measurably better outcomes for both mother and baby.
When to book your first visit
Book as soon as you know you are pregnant, ideally before 12 weeks. An early first visit allows accurate dating of the pregnancy, which affects every decision that follows, and gives time to correct anything that needs correcting — low iron, an untreated infection, a medication that should be changed.
If you are already past 12 weeks, come anyway. Starting late is far better than not starting.
What happens at the first visit
The first appointment is the longest, usually around 45 minutes. It covers:
- A full medical and obstetric history, including previous pregnancies and any long-term conditions
- Blood pressure, weight and height
- Blood tests: haemoglobin, blood group and rhesus factor, HIV, syphilis and hepatitis B
- A urine test for protein, sugar and infection
- An ultrasound scan to confirm dating and check the pregnancy is in the right place
- A conversation about nutrition, supplements and what to expect
None of these tests are there to catch you out. Each one changes what we do next. Knowing your rhesus status, for example, determines whether you need an injection later in pregnancy to protect a future baby.
The visits that follow
Later appointments are shorter and follow a rhythm. At each one we check:
- Blood pressure — the single most useful measurement in pregnancy, because rising blood pressure is the earliest sign of pre-eclampsia
- Urine — protein in the urine alongside raised blood pressure is the combination we watch for
- Fundal height — the size of the uterus, to track your baby's growth
- The baby's heartbeat, from around 12 weeks with a handheld monitor
- Your own account of how you feel — this matters as much as the measurements
From around 24 weeks we will also ask about fetal movements, and from 36 weeks we check the baby's position in preparation for birth.
Supplements and vaccinations
Three things are offered to nearly every mother:
- Iron and folic acid, taken daily. Folic acid reduces the risk of neural tube defects and is most important in the first trimester. Iron prevents the anaemia that affects a large proportion of pregnancies in the region.
- Tetanus-containing vaccination, which protects both you and your newborn against tetanus in the first weeks of life.
- Malaria prevention, where you live or travel in a malaria-endemic part of Kenya. Malaria in pregnancy carries real risks and is straightforward to prevent.
Take supplements with food if they upset your stomach, and tell us if you cannot tolerate them — there are alternatives.
Signs that need attention the same day
Most pregnancies are uncomplicated. But a small number of symptoms should never wait for your next scheduled appointment. Come in, or call us, if you experience any of the following:
- Vaginal bleeding
- A severe headache, especially with blurred vision or flashing lights
- Swelling of the face or hands that comes on suddenly
- Severe abdominal pain
- Fever
- Fluid leaking from the vagina before 37 weeks
- A noticeable reduction in your baby's movements, or no movement at all
- Persistent vomiting that stops you keeping fluids down
If you are unsure whether a symptom is serious, treat that uncertainty as a reason to call. We would far rather reassure you over the phone than see you later than we should have.
Preparing for birth
From about 32 weeks the conversation turns to delivery: where you plan to give birth, who will be with you, how you will get there, and what to do if labour starts at night. Having those answers settled in advance removes a great deal of stress from the day itself.
We will also talk through feeding, newborn care and family planning, and we will make sure you know the signs of labour and when to come in.
Booking with us
Midhill Hospital runs antenatal clinics throughout the week, and our maternity team cares for mothers from the first visit through to delivery and the postnatal period. If you are newly pregnant, or transferring your care to us, you can book an appointment online or call the hospital directly.
*This article is general health information and is not a substitute for advice from your own doctor or midwife, who knows your history. If something about your pregnancy worries you, please speak to a clinician.*
Book an antenatal appointment
Our maternity team cares for mothers from the first visit through to delivery and beyond.