Tests and checks you may have

Always ask the reason for tests – they may be routine and straightforward to the health professionals carrying them out, but not to you. All the tests are optional and your midwife will explain to you what they are for. You can then decide to go ahead with them, or not, as you wish.

Routine tests

You will be offered several tests and checks as an important part of your care during pregnancy. These tests are intended to help protect you and your baby’s health. It’s up to you whether you have the tests. The test results are confidential and only you and the healthcare professionals closely involved with your care will be told the results. Nobody else will be told the results without your permission. Your midwife will be happy to
discuss tests currently offered in your area with you.

Routine blood tests

You will be offered at least one blood test in pregnancy, usually taken at your first antenatal appointment, although different regions in Scotland may do this at different times. A blood test just means taking a little blood from a vein in your arm. The blood is drawn up into a syringe or vacuum tube. A blood test shouldn’t be painful but may be uncomfortable, and there may be slight bruising for a day or so afterwards.

The sample will be put in separate test tubes so that a number of different tests can be carried out. The tests are intended to make sure you and your baby are healthy, but it’s up to you whether you have them or not. You will be asked to sign a consent form.

Blood tests can include:

  • full blood count - the full blood count (FBC) is a good all-round measure of health. If it is low it indicates you could be anaemic
  • blood group - this identifies your blood group (A, B, O or AB). It can also identify whether there are any blood group antibodies in your blood
  • rhesus positive or negative -  if you are rhesus positive, no further action will be taken. If you are rhesus negative, you will be offered an injection called anti-D, which help prevent a serious illness for any future babies you may have. One in six women are rhesus negative
  • syphilis - this is a sexually transmitted infection. It can damage your own and your baby's health if it isn't found and treated. It can be treated quickly and simply with antibiotics. People can have syphilis without realising it. 
  • hepatitis B - this is a viral infection that causes liver disease and can be passed from mother to baby during or just after delivery. If you test positive, your baby will receive a complete course of Hepatitis B immunisation  and possibly injections of antibodies called immunoglobulin immediately after the birth
  • HIV - the Human Immunodeficiency Virus (HIV) is the virus that causes Acquired Immunodeficiency Syndrome (AIDS). Infected pregnant women can pass HIV to their babies during pregnancy, childbirth and also through breastfeeding. HIV attacks the body’s immune system and destroys the body’s defences to infection. It can take years for HIV to do enough damage for you to become ill, so usually the only way to tell if you are infected is to take a test. If your HIV result is positive, advice and treatment under the guidance of specialists will be offered. Interventions include treatment with special drugs and advice about the best type of delivery and the best method of feeding your baby to reduce the chance of her also getting the infection. For more information about HIV and AIDS, see Further help.
  • Sickle-cell and thalassaemia disorders - These disorders affect the part of the blood that carries oxygen around the body, called haemoglobin. Some conditions are more serious than others. These are inherited disorders. This means that parents can pass these genes on to their children even though they look and feel perfectly well. They are 'carriers' - but they do not have a disorder themselves. Children can inherit carrier status from a carrier parent. Your baby’s father may also be invited for a blood test, depending on the results of these tests. Having the father of the baby tested makes the results more accurate. If both parents are carriers, there's a chance that their children will have one of the disorders. Testing allows parents to find out if they are carriers and if their baby has a chance of inheriting a disorder so that they can make decisions about the pregnancy and have the right support after the birth.

Test results

You will be told when you can expect your results at the time they are arranged. If there is a problem or anything you should know, you will be contacted as quickly as possible. If you have any questions or concerns about these tests, please ask at your next clinic visit or contact your midwife.

For more information talk to your midwife about screening tests available during your pregnancy or ask for a copy of A Guide to Routine Blood Tests Offered During Pregnancy (external link).

Routine checks

All the checks you'll be offered are for your health and the health of your baby.

Blood pressure

Your blood pressure is checked at most appointments. It is normally taken in early pregnancy to get a baseline and later to make sure you have no signs of pre-eclampsia or pregnancy-induced hypertension.

The midwife wraps a fabric band around your arm and inflates it with a small pump. The band is linked to a blood pressure measure. As it deflates, the midwife uses a stethoscope to listen to changes in your pulse.

A high reading may give cause for concern, so the test may be done again, 10 or 20 minutes later, to make doubly sure.

Carbon Monoxide (CO)

Carbon monoxide is a poisonous gas which you can't see or smell and is dangerous to you and your baby. CO monitors are used to establish how much carbon monoxide is in your body and is measured through a quick and simple breath test.

The results are available immediately. If you are a smoker, or are exposed to high levels of second-hand smoke, your CO level will be high. Your midwife will discuss this with you and refer you for support from the stop smoking services.

Urine

Your urine will be tested for protein and sugar. A special strip is dipped into a sample which you either bring with you or produce at the appointment. Some women develop a particular sort of diabetes that occurs in pregnancy – gestational diabetes. This may show as sugar in the urine. Protein may indicate pre-eclampsia. Infections of the kidney and bladder may show up here too.

Abdomen

Your abdomen (tummy) will be examined at each visit. By moving her hands around the outside of your abdomen, the midwife feels the way your baby is lying, and her size and the height of your uterus.

Screening and diagnostic tests for Down’s syndrome

Most babies are born perfectly healthy, but a few are born with conditions such as Down’s syndrome (see page 40) or other chromosomal abnormalities. There are tests available during pregnancy that can help to detect these rare conditions.


There are two types of screening tests, which are offered to everyone and are intended to show whether there is a low chance or a high chance of your baby having a condition such as Down’s syndrome. Diagnostic tests are further tests which may be offered to confirm a condition depending on the results of the screening test. While screening offers a good way to assess how likely it is that your baby has one of those conditions, it is not perfect and will not detect all problems.  


In most cases further tests show your baby is healthy. However, if the screening test shows a higher chance that the baby has Down’s syndrome, you’ll be contacted by a health professional who will discuss the results with you and answer any questions you may have. The higher chance result usually means that there is a greater chance than one in 150 that your baby is affected. You’ll be offered diagnostic tests that will confirm whether your baby has the condition or not. You can choose whether or not to have these tests, and you may want to discuss this with your midwife.

Screening test

Depending on how far along in your pregnancy you are, you will either be offered a blood test that isused in combination withthe measurement from a NT ultrasound scan or a blood test on its own. The screening tests cannot determine if the baby has a chromosomal disorder but can indicate whether you have a low or high chance of your baby having Down’s syndrome. The test will detect about two out of three Down’s syndrome pregnancies.

Diagnostic tests

These tests are offered to women whose screening tests show they have a higher chance of being a carrier for (or having) sickle cell or thalassaemia or whose baby has a higher chance of having Down’s syndrome. There are two types of diagnostic tests: chorionic villus sampling (CVS) and amniocentesis.Ultrasound scanning is used with CVS and an amniocentesis check, so that the doctor can see the exact position of the baby and the placenta. Scans are also sometimes used to detect some abnormalities.

CVS

CVS can be done from 11 weeks of pregnancy. It’s usually only offered in a specialist centre. With the help of an ultrasound scan, a specialist doctor (obstetrician) will guide a fine needle through your abdomen (tummy) and will take a small sample of tissue from the placenta. There is a 1–2% risk of miscarriage with this test. The main advantage of CVS over amniocentesis is that CVS can be done earlier. A CVS may not be offered locally so you may be referred to a centre outside your area.

Amniocentesis

An ultrasound scan will check your baby’s position in the womb. The specialist doctor (obstetrician) will then guide a fine needle through your abdomen (tummy) into your womb. The doctor can then take a sample of the fluid surrounding the baby (called amniotic fluid). There is a 1% risk of miscarriage, and health professionals will help you decide what to do.

Down’s syndrome

Down’s syndrome is a genetic condition caused by the presence of a full or partial third copy of chromosome 21 in the body’s cells. Children with Down’s syndrome will have some degree of learning diability and need support with their education. Although many have a healthy life, some have problems such as heart defects.

Older mothers are more likely to have a baby with Down’s syndrome. The risk rises from one in every 1,500 births for women aged 20 years or younger, to one in every 900 births for women aged 30 years. It increases to one in every 100 births for women aged 40 years.

You can find more information about Down's syndrome from the Family Support Service at Down's Syndrome Scotland.  You can also phone 0131 442 8840.

Is there a problem?

When tests show there could be a problem, you need more information and support. It’s important to know what the test result shows, whether it’s definite or not, and whether you need to make decisions about labour or birth or the future of your pregnancy. You may need time to consider your options.

Support groups can help you with these difficult decisions (see Further help) and you can ask to talk with your midwife as well as your GP. If the tests indicate a disability, you may want to talk to parents who have a child with a similar condition to find out more about it. No one should try to influence you in any way; the decisions you make based on this information have to be yours and your partner’s.

For more information ask your midwife about screening tests available during pregnancy and for a copy of Your guide to screening tests during pregnancy (external link).

Reviewed 24 February 2012

Last Updated: 22 January 2018
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