I'm in Ontario, Canada. Here's a run down at what is done and discussed at each midwifery visit... Sometimes things get switched around a bit due to time but In the 3 midwifery practices I did placements at this was the standards "schedule" of what would be done at each visit..... My experiences with Ob's was quite different... Each appt would be about 5 minutes long after the initial history which was only about 10 minutes long and the appointments consisted of just B/P check, SFH measurement, uterine palpation, hand me a req for whatever needed to be done (lab work, etc) without even discussing what the lab tests were for, then he'd be out the door...
Anyways, here's what happens at midwifery appointments:
I had my booking appointment at 7 weeks (went over my dates, my health history and previous births, discussed midwifery, reasons to page, hospital protocols re: place of birth, obstetrical and anesthesia coverage, gbs, postdates, induction. Also discussed community resources, playgroups etc. She gave me a binder full of info, I was offered genetic screening, I signed a consent for her to order my pap from my doctor (otherwise she would have offered to do one at the next appt) She booked me an emerge scan for later that day for spotting and lower left abdonimal pain) The appt was about an hour long - the appt's afterwards tend to be around 30 minutes.
12 Week appt - Listened to baby's heart beat, had blood pressure taken, had blood drawn, discussed nausea and diclectin, discussed the last u/s, discussed dating, discussed water birth, reviewed my health history and discussed my previous birth histories with me (this was a different midwife then last time... Midwives here work in groups of 1-4... 3 is average)
16 Week appt (next week) - It's typical for most midwives to get you to pee on a stick to check for glucose and protein, B/P check, FHR check, a brief physical (check heart and lungs for abnormalities, discuss varicosities, signs and symptoms of DVT, offer of breast exam, thyroid check. Then they'll discuss diet and nutrition, exercise, intent to breastfeed.)
18-20 Weeks anatomy ultrasound is booked - Mine is for 19 weeks
20 Weeks appt (they will discuss the u/s, urine will be sent away for asymptomatic bacteriuria, b/p check, FHR, occasionally they'll start measuring SFH. Typical discussions at this time include fetal movement and circumcision.)
24 Week appt (B/P, FHR, SFH measurement, POAS glucose/protein test, they will discuss gestational diabetes screening, signs and symptoms of preterm labour and what to do)
-If rH negative appt for blood draw at 27 weeks.
28 Week appt (B/P, FHR, SFH, POAS glucose/protein test, Glucose screen (unless it was declined), Blood drawn for repeat CBC to check for anemia, discuss signs and symptoms of pre-eclampsia, Rhogam given if rh-). Fetal kick counts and recommendations discussed.
30 Week (B/P, FHR, SFH, POAS, discuss choice of birthplace)
32 Week (B/P, FHR, SFH, POAS, discuss breastfeeding, discuss GBS)
34 Week (B/P, FHR, SFH, POAS, weight check, discuss labour pain managment both non-pharmaceutical and pharmaceutical methods, discuss normal labour progress and abnormal labour progress, discuss management of third stage and delayed cord blood clamping)
36 Week (Home visit, B/P check, SFH, FHR, POAS discuss when to page in labour, coping strategies for early/latent/prodromal labour, optimal fetal positioning, baby stuff (eg back to sleep and sids prevention, plogiocephaly prevention, what to expect in the first few days, car seat safety), what to bring to hospital/what to get for homebirth, breatfeeding/initiating first latch review, discuss birth "emergencies" and how they are handled (abnormal fetal heart rate, should dystocia, postpartum hemorrhage, prolapsed cord, etc), who will be present at the birth, has childcare arrangement been made for older siblings? GBS swab (unless declined)). This visit tends to take around an hour.
37 Weeks (B/P, FHR, SFH, POAS, discuss newborn vitamin K, erythromycin (eye ointment), metabolic screening and hearing screen)
38 Weeks (B/P, FHR, SFH, POAS, discuss natural ways to encourage labour)
39 Weeks (B/P, FHR, SFH, POAS, discuss postdate managment, offer to do stretch and sweep at next appt, review fetal kick counts)
40 Weeks (B/P, FHR, SFH, POAS, stretch and sweep (unless declined), postdates discussed further, induction offered at 41 weeks, otherwise BPP booked for 41 weeks, then every 48 hours until the birth. review fetal kick counts)
41 Weeks (B/P, FHR, SFH, POAS, stretch and sweep offered again, review postdates and natural induction methods, revisit option of medical induction, discuss BPP's, offer to make additional appts for stretch and sweeps during the week, review fetal kick counts)
42 Weeks (B/P, FHR, SFH, POAS, mandatory consult with ob made re: postdates)
Ofcourse the midwives leaves you time to ask any questions, review any lab results that came back and will follow up on issues that arose in the previous visit at each visit.
And whenever the oppertunity arises where you are not with your partner she'll question whether or not your in a safe healthy relationship and what your living situation is like, etc, etc
