Most pregnancies are healthy, and they deserve unhurried care too. From the first positive test to the postnatal check, you see the same consultant, with each visit timed to the tests that matter at that stage and enough time to answer the questions that come up between visits.
Good antenatal care is mostly about doing the right things at the right weeks: confirming the due date, screening for the conditions that are common in Indian women such as anaemia, thyroid problems, gestational diabetes and thalassaemia trait, checking the baby’s growth, and preparing for labour with a clear idea of your options.
Deliveries take place at Divine Women’s Hospital in Gota, Ahmedabad, an NABH-accredited hospital with round-the-clock obstetric, anaesthesia and neonatal cover, and a water-birth facility for women who are suitable for it. Dr. Devang Patel has been involved in more than 13,000 deliveries, and consultations are in Gujarati, Hindi or English.
Your antenatal schedule, trimester by trimester
Visits are usually every four weeks until 28 weeks, every two weeks until 36 weeks, and weekly after that. Each visit includes BP, weight, a urine check and, from about 24 weeks, measuring the bump and listening to the baby’s heart.
| Weeks | Main tests and scans | What is discussed |
|---|---|---|
| 6–10 | Dating scan; blood group, Hb, thyroid, sugar, HIV, hepatitis B, VDRL, urine culture, thalassaemia screening | Folic acid, nausea, diet, medicines, risk factors |
| 11–14 | NT scan with first-trimester screening | Screening results, whether further testing is wanted |
| 18–22 | Level II anomaly scan | Iron and calcium, exercise, travel |
| 24–28 | Glucose tolerance test, Hb, anti-D if Rh negative (at 28) | Baby’s movements, tetanus-diphtheria (Td) vaccine |
| 32–36 | Growth scan where indicated, repeat Hb | Birth preferences, pain relief, signs of labour |
| 37–41 | Weekly checks; CTG and fluid scan if past due date | Induction if pregnancy continues beyond 40–41 weeks |
Common symptoms and what helps
- Nausea and vomiting: small frequent meals, dry snacks on waking, ginger; medicines are safe if it is severe
- Heartburn: smaller meals, not lying down soon after eating, raising the head of the bed
- Constipation: water, fibre from vegetables, fruit and isabgol; iron tablets can contribute
- Back and pelvic pain: posture, gentle exercise and a support belt later in pregnancy
- Leg cramps and swollen feet: stretching, calcium, feet up in the evening
- Tiredness: common in the first and third trimesters; anaemia is checked if it persists
Diet, supplements and activity
Weight gain depends on where you start: roughly 11–16 kg for a woman of healthy weight, less if you start overweight. Most of it comes in the second half of pregnancy, and there is no need to eat for two; about 350 extra calories a day in the second trimester and 450 in the third is enough.
Folic acid is taken from before conception until at least 12 weeks. Iron and calcium usually start after the first trimester, taken at different times of day because calcium reduces iron absorption. Vitamin D is checked or supplemented where needed.
A Gujarati vegetarian diet can meet pregnancy needs well with attention to protein: dal, chana, rajma, sprouts, paneer, curd, milk, soya and nuts at each meal. Avoid unpasteurised milk products, raw papaya in large amounts, and alcohol and tobacco in any form. About 30 minutes of walking or prenatal yoga most days is helpful for most women.
Recognising labour
True labour pains come regularly, grow stronger and closer together, and do not settle with rest. Practice tightenings (Braxton Hicks) are irregular and fade. A show of mucus streaked with blood can come days before labour.
For a first baby, come in when contractions are about every five minutes and lasting a minute, or earlier if you live far away. Come immediately if your waters break, if there is fresh bleeding or if the baby is moving less.
Labour has three stages. The first, as the cervix opens to 10 cm, often lasts 8–18 hours for a first baby and less for later ones. The second, pushing, usually takes up to two to three hours for a first baby. The third, delivery of the placenta, is helped with an injection and takes a few minutes.
During labour the baby’s heartbeat is checked at regular intervals, or continuously with a CTG if there is a reason. You are encouraged to move, change position, drink fluids and empty your bladder regularly.
Reduced baby movements are never something to wait on overnight. Come in the same day for a check.
Normal delivery and caesarean section
Most healthy women can expect to labour and give birth vaginally. A caesarean is recommended when there is a clear reason - for example, placenta praevia, a breech baby who does not turn, two or more previous caesareans, or concern for the baby during labour that cannot be resolved quickly.
If you have had one caesarean before, a vaginal birth after caesarean (VBAC) is often possible; this is covered in detail on the normal delivery and VBAC page.
| Vaginal birth | Caesarean section | |
|---|---|---|
| Hospital stay | Usually 1–2 days | Usually 3–4 days |
| Recovery | Walking within hours; most normal activity in 2–3 weeks | Walking the next day; no heavy lifting or driving for about 6 weeks |
| Main risks | Perineal tear, need for assisted delivery | Infection, bleeding, clots, longer recovery; placenta problems in future pregnancies |
| Baby | Lower chance of breathing difficulty at term | Slightly higher chance of breathing difficulty if planned before 39 weeks |
| Future pregnancies | No added scar risk | Future births need planning around the scar |
Pain relief in labour
Options range from movement, upright positions, warm water and breathing techniques to medicines. A labour epidural, given by an anaesthetist once labour is established, provides effective relief for most women while allowing them to stay awake and push.
An epidural may slightly lengthen the second stage of labour and can cause a temporary drop in BP, itching or fever; severe headache and nerve problems are rare. It does not increase the chance of caesarean. Water birth is available for suitable low-risk pregnancies, with suitability checked again in labour.
Induction and going past your due date
Only about one in twenty babies arrives on the due date. Most come between 38 and 41 weeks. After 41 weeks the risk of stillbirth begins to rise gradually, so induction of labour is usually offered between 41 and 42 weeks, or earlier for medical reasons.
Induction starts with softening the cervix using a tablet, gel or a balloon catheter, followed by breaking the waters and, if needed, a drip to strengthen contractions. Most induced labours end in vaginal birth.
Induction can take a day or more for a first baby, particularly when the cervix is not yet soft, so it helps to come prepared for a wait. The reasons, the method and the alternatives are explained before you decide.
After the birth
Skin-to-skin contact and breastfeeding in the first hour are encouraged whenever mother and baby are well, including after a caesarean when possible. Help with latching and positioning is offered on the ward.
Exclusive breastfeeding for the first six months is recommended. Iron and calcium are usually continued for at least three months after birth, and a nutritious diet with plenty of fluids supports milk supply; traditional foods such as methi, ajwain and dry-fruit preparations are fine in sensible amounts.
Over the following weeks, bleeding (lochia) gradually lightens over four to six weeks. Feeling tearful in the first week is common; persistent low mood beyond two weeks should be mentioned. The six-week check covers healing, BP, Hb, pelvic floor exercises, contraception and any question about the next pregnancy, ideally spaced at least 18 months apart.
Your say in how you give birth
From around 32–34 weeks you will talk through pain relief, labouring positions, who will be with you and your preferences for the baby’s first hour. If the plan has to change during labour, the reason is explained before anything is done.
At Divine Women’s Hospital, 24×7 obstetric, anaesthesia and neonatal cover means that if labour takes an unexpected turn, the people and facilities needed are already in place.
Your care, step by step
- First visit and dating scanYour history, the due date and baseline blood tests are set up between 6 and 10 weeks.
- Screening scansThe NT scan and level II anomaly scan are booked at the right weeks and explained in the same visit.
- Regular checksBP, weight, urine, sugar testing and the baby’s growth are followed through each trimester.
- Birth planningPain relief, birth preferences and signs of labour are discussed from about 32 weeks.
- Delivery and postnatal careLabour and birth at Divine Women’s Hospital, followed by feeding support and a six-week check.
When to book a visit
- You have a positive pregnancy test
- You are planning a pregnancy and want a pre-conception check
- You had a caesarean before and would like to discuss VBAC
- You are past 40 weeks and have not gone into labour
- You want to discuss pain relief, epidural or water birth before your due date
Warning signs - get same-day care
- Vaginal bleeding at any stage
- Waters breaking, especially if the fluid is green or brown
- Reduced or absent baby movements
- Severe headache, blurred vision or swelling of the face and hands
- Regular contractions before 37 weeks
- Fever, or heavy bleeding or foul discharge after delivery
Labour and emergency care are available 24 × 7. Call the hospital and come in directly.
Myths and facts
Myth: An epidural always leads to a caesarean.
Good evidence shows an epidural does not increase the chance of caesarean, though it may slightly lengthen the pushing stage.
Myth: Eating ghee in the last month makes labour easier.
Extra ghee adds calories and weight but has not been shown to ease labour. A balanced diet and staying active help more.
Myth: Once a caesarean, always a caesarean.
Many women with one previous caesarean can safely attempt a vaginal birth, after an individual assessment.
Myth: Babies move less near the end of pregnancy.
The pattern may change, but the amount of movement should not reduce. Fewer movements always need a check.
Frequently asked questions
When should I book my first visit?
Ideally between 6 and 8 weeks of pregnancy, or as soon as you have a positive test if you have a medical condition or a previous complication.
How many scans are needed in a normal pregnancy?
Usually three key scans: a dating scan in early pregnancy, the NT scan at 11–14 weeks and the anomaly scan at 18–22 weeks. A growth scan later is added when there is a reason.
Is a labour epidural safe?
For most women, yes. It is given by an anaesthetist once labour is established. Side effects and the rare complications are explained beforehand so you can decide.
Who can have a water birth?
Women with a healthy single pregnancy, the baby head-down at term, and labour progressing normally. Suitability is checked again when you arrive in labour.
How do I know labour has started?
Contractions become regular, stronger and closer together and do not settle with rest. Waters breaking or a bloody show can also signal labour. Call the hospital if you are unsure.
What happens if I go past my due date?
You will be monitored with a check of the baby’s heart and fluid. Induction is usually offered between 41 and 42 weeks because the risks of continuing rise gradually after that.
How long is the hospital stay after delivery?
Usually one to two days after a normal delivery and three to four days after a caesarean, depending on how you and the baby are doing.
Can my husband or mother be with me in labour?
Having a birth companion is encouraged. Who can be present is discussed during birth planning so the family knows what to expect.
When can I exercise after delivery?
Gentle walking and pelvic floor exercises can start within days. After a normal delivery, most women return to regular exercise around six weeks; after a caesarean, it is built up more gradually.
How soon can I plan my next pregnancy?
A gap of at least 18 months between delivery and the next conception is advised, as shorter intervals are linked with more complications. Contraception is discussed at the postnatal check.