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Hong Kong Prenatal Care Schedule

This is a general overview of the prenatal visits many people in Hong Kong are offered during pregnancy, drawn from public guidance by the Hong Kong Department of Health and the WHO. Every pregnancy is different — your own care provider decides which checks and timing are right for you. It's here for reference and orientation, not as medical advice.

Disclaimer: BabyBerry is for general information and self-tracking. It is not a medical device and does not provide medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider.
  1. First Booking Visit (MCHC Registration) — Weeks 8–10
  2. NT Scan / OSCAR Screening — Weeks 11–13
  3. 16-Week Review Visit — Week 16
  4. Anomaly Scan / Structural Ultrasound — Weeks 18–22
  5. Diabetes Screening and Routine Review — Weeks 24–28
  6. Vaccines and Routine Check — Weeks 28–30
  7. 30-32 Week Routine Visit — Weeks 30–32
  8. GBS Screening and Birth Preparation — Weeks 35–37
  9. Birth Plan Finalization — Weeks 36–37
  10. Fetal Monitoring — Week 38
  11. Term Review and Labour Planning — Weeks 39–40

First Booking Visit (MCHC Registration)

First prenatal visit · Weeks 8–10

Full registration, baseline bloods, thalassaemia screening, hepatitis B, HIV, syphilis, blood group/Rh, rubella antibody, urine, medical history

Good to know: The first booking visit in Hong Kong is typically at a Maternal and Child Health Centre (MCHC), which is part of the Department of Health. You will be registered in the shared-care system, meaning some visits will be at the MCHC and some at the hospital antenatal clinic. Thalassaemia screening is arguably the most significant difference in Hong Kong prenatal care — about 1 in 12 people in the local population are carriers, making this screening essential. Hepatitis B screening is also especially important given the high carrier rate. Unlike the UK, Hong Kong tests for rubella antibodies at booking. All screening is voluntary, and the MCHC staff will explain each test so you can make informed decisions.

Common checks

  • Height, Weight, and BMI — Your nurse will measure your height and weight to calculate your body mass index (BMI). BMI helps assess your risk for gestational diabetes, pre-eclampsia, and other pregnancy complications. Hong Kong uses BMI thresholds adapted for the Asian population — a BMI of 23 or above is considered overweight and warrants additional monitoring. Your baseline weight is also used to track healthy weight gain throughout pregnancy.
  • Blood Pressure — Blood pressure is measured at every antenatal visit. This first reading establishes your baseline. A rise in blood pressure later in pregnancy, particularly combined with protein in the urine, could indicate pre-eclampsia. Hong Kong's humid climate and dietary habits (high sodium intake) can contribute to blood pressure fluctuations, making regular monitoring especially important.
  • Urine Test (Protein, Glucose, Infection) — A urine sample is tested for protein, glucose, and signs of urinary tract infection. Protein in the urine can indicate kidney problems or, later in pregnancy, pre-eclampsia. Glucose in the urine may suggest gestational diabetes and will prompt further testing. This quick test is performed at every antenatal visit throughout your pregnancy.
  • Full Blood Count (FBC / CBC) — A full blood count measures your haemoglobin, red blood cells, white blood cells, and platelets. It checks for anaemia, which is common in pregnancy — particularly important in Hong Kong where thalassaemia trait is prevalent and can cause a lower-than-normal haemoglobin. If your haemoglobin is low, further investigation will determine whether it is due to iron deficiency or thalassaemia trait before iron supplements are prescribed.
  • Thalassaemia Screening — Thalassaemia screening is one of the most important blood tests in Hong Kong prenatal care. About 8-9% of the local population are thalassaemia carriers (alpha or beta). A complete blood count with MCV (mean corpuscular volume) and MCH (mean corpuscular haemoglobin) is used as the first step. If MCV is below 80 fL or MCH below 27 pg, haemoglobin electrophoresis or HPLC is performed. If you are identified as a carrier, your partner will also be tested. If both parents are carriers of the same type, there is a 25% chance the baby could have severe thalassaemia, and genetic counselling and diagnostic testing (CVS or amniocentesis) will be offered.
  • Blood Group and Rh Status — This test determines your blood group (A, B, AB, or O) and Rh status (positive or negative). Rh-negative blood type is relatively rare in the Chinese population (less than 1%, compared to about 15% in Caucasians). If you are Rh-negative, you will be offered anti-D immunoglobulin injections at 28 weeks and after delivery to prevent your immune system from producing antibodies that could harm an Rh-positive baby in this or future pregnancies.
  • Hepatitis B Surface Antigen (HBsAg) — Hepatitis B screening is critical in Hong Kong, where approximately 7-8% of the population are chronic carriers. Hepatitis B can be transmitted from mother to baby during birth. If you test positive, your baby will receive the hepatitis B immunoglobulin (HBIG) injection and the first dose of the hepatitis B vaccine within 12 hours of birth, followed by a complete vaccination series. This strategy is over 95% effective at preventing mother-to-child transmission. Your viral load will also be checked to determine if antiviral treatment during pregnancy is needed.
  • HIV Screening — HIV screening is offered to all pregnant women in Hong Kong as part of routine antenatal blood tests. If detected early, antiretroviral treatment during pregnancy can reduce mother-to-baby transmission to less than 1%. The test is confidential and performed with your consent. Hong Kong has a low but non-zero prevalence, and early detection protects both mother and baby.
  • Syphilis (VDRL / RPR) Screening — Syphilis screening is a routine part of booking blood tests. Untreated syphilis during pregnancy can cause miscarriage, stillbirth, premature birth, or congenital syphilis in the baby. If detected early, syphilis is effectively treated with penicillin, and early treatment prevents harm to the baby. A VDRL or RPR test is used for screening, with confirmatory testing if positive.
  • Rubella Antibody (IgG) — A blood test checks whether you have immunity to rubella (German measles). Rubella infection in early pregnancy can cause serious birth defects including deafness, heart problems, and intellectual disability. If you are not immune, you will be advised to avoid contact with anyone who has rubella and to receive the MMR vaccine after delivery. The vaccine cannot be given during pregnancy.
  • Mental Health and Social Assessment — The MCHC nurse will assess your mental health and social circumstances, including any history of depression, anxiety, domestic violence, or substance use. Hong Kong's fast-paced lifestyle and high-pressure environment can contribute to perinatal mental health challenges. This assessment helps identify women who may benefit from counselling, social worker support, or referral to psychiatric services. All discussions are confidential.

How to prepare

  • Know the first day of your last menstrual period (LMP) — this is essential for estimating your due date.
  • Bring your HKID card and any referral letter from your GP or private doctor.
  • Gather medical history from both parents' families, especially thalassaemia carrier status, diabetes, hypertension, and genetic conditions.
  • List all medications, vitamins, and supplements you are currently taking, including Traditional Chinese Medicine (TCM).
  • Prepare questions about the shared-care model and how your visits will be scheduled between MCHC and hospital.

Tips

  • The first booking visit at MCHC can take 2-3 hours, including waiting time. Bring water, snacks, and something to read.
  • Start taking folic acid 400mcg daily if not already. The Department of Health recommends taking it from before conception through the first 12 weeks.
  • If you or your partner has a family history of thalassaemia or is known to be a carrier, mention this immediately — it will prioritize the screening process.
  • The MCHC provides services in both Cantonese and English. If you need an interpreter for other languages, request one in advance.
  • Ask about the Comprehensive Social Security Assistance (CSSA) or other financial support if needed — the MCHC social worker can help with applications.

NT Scan / OSCAR Screening

Visit 1 · Weeks 11–13

Nuchal translucency scan, OSCAR (One-Stop Clinic for Assessment of Risk) for Down syndrome, first trimester combined screening

Good to know: OSCAR is a standard first-trimester screening approach in Hong Kong, combining the NT scan and blood test in a single assessment. Result timing varies by provider: some private or specialist services may report quickly, while public services may notify you later. Hong Kong also offers NIPT (non-invasive prenatal testing using cell-free fetal DNA) as a follow-up for screen-positive results or as a first-line test if you choose to pay privately. The detection rate for Down syndrome using the combined first-trimester screening is approximately 85-90%. If you miss the OSCAR window (after 14 weeks), second-trimester serum screening may be offered between 15-20 weeks.

Common checks

  • Dating Ultrasound (Crown-Rump Length) — The ultrasound measures your baby's crown-rump length (CRL) to accurately determine gestational age and your estimated due date. This scan also confirms the number of babies, checks for a heartbeat, and provides a basic structural check. If your dates do not match the ultrasound, your due date will be adjusted based on the CRL measurement, which is more accurate than dates based on your last period.
  • Nuchal Translucency (NT) Measurement — The sonographer measures the fluid-filled space at the back of your baby's neck (nuchal translucency). An increased NT measurement may indicate a higher chance of Down syndrome (trisomy 21), Edwards syndrome (trisomy 18), Patau syndrome (trisomy 13), or other chromosomal abnormalities. The measurement must be done between 11 weeks 0 days and 13 weeks 6 days, when the CRL is between 45-84mm. This is combined with blood markers for a more accurate risk assessment.
  • OSCAR Blood Test (PAPP-A and Free Beta-hCG) — The OSCAR (One-Stop Clinic for Assessment of Risk) is Hong Kong's primary first-trimester screening method for Down syndrome. A blood sample measures PAPP-A (pregnancy-associated plasma protein-A) and free beta-hCG. These levels, combined with the NT measurement, your age, and other factors, produce a risk estimate. In Hong Kong, a risk of 1 in 250 or higher is generally considered "screen positive." If your risk is high, you will be offered further testing — either NIPT (non-invasive prenatal testing) or invasive diagnostic testing (CVS or amniocentesis).

How to prepare

  • The OSCAR appointment may be at the hospital rather than MCHC. Check your appointment details carefully.
  • You may need a partially full bladder for the scan — drink a glass of water about an hour beforehand.
  • No fasting is required. The blood test and scan are usually done at the same visit.
  • Decide in advance whether you want screening for Down syndrome — it is optional. Discuss with your partner and family.

Tips

  • OSCAR is usually offered through the public hospital system free of charge. Private clinics also offer it but at a cost.
  • A "screen positive" result does not mean your baby has Down syndrome. Most women with a positive screening result go on to have unaffected babies. Further testing will help clarify.
  • If you are over 35 years old, the background risk is higher, but screening is still valuable as it provides a personalized risk estimate rather than an age-based one.
  • NIPT is available privately in Hong Kong from about 10 weeks. It has a detection rate of over 99% for Down syndrome but is a screening test, not a diagnostic test.

16-Week Review Visit

Visit 2 · Week 16

Review screening results, AFP (alpha-fetoprotein) if indicated, blood pressure, urine, general wellbeing

Good to know: The 16-week visit is a shorter review appointment, but it is important for following up on screening results and planning next steps. If thalassaemia carrier status was identified for you, your partner should have been tested by now. If both parents are carriers of the same type (both alpha-thal carriers or both beta-thal carriers), genetic counselling will be arranged promptly. In the Hong Kong shared-care system, this visit may be at either the MCHC or the hospital antenatal clinic, depending on your assigned schedule.

Common checks

  • Blood Pressure — Routine blood pressure check to monitor for any upward trend from your booking baseline. Consistent readings are reassuring; any significant increase will be investigated further.
  • Urine Test — A quick urine test to check for protein, glucose, and infection markers. Persistent proteinuria or glucosuria at this stage will prompt further investigation.
  • Review of Screening Results — Your doctor or nurse will discuss the results of all blood tests and OSCAR screening. If the thalassaemia screening found you are a carrier, your partner's testing status will be reviewed. If any results need further action — such as a high-risk OSCAR result requiring NIPT or amniocentesis — this will be arranged. This is a good time to ask questions about anything you did not understand.
  • AFP (Alpha-Fetoprotein) Test — If Indicated — If you did not have OSCAR screening or if additional screening is indicated, an AFP (alpha-fetoprotein) blood test may be offered around 15-18 weeks. Elevated AFP can indicate neural tube defects such as spina bifida, while low AFP may suggest chromosomal abnormalities. This test is not routinely done for everyone in Hong Kong if OSCAR was already performed.

How to prepare

  • Bring your antenatal record book to every appointment.
  • Write down any questions about your screening results or symptoms you have been experiencing.
  • If your partner was referred for thalassaemia testing, bring the results if available.

Tips

  • You may start feeling fetal movements from around 16-22 weeks. First-time mothers usually notice them closer to 20 weeks — they feel like gentle fluttering or bubbling.
  • Ask about antenatal classes — the MCHC and hospitals in Hong Kong offer free classes covering pregnancy, labour, breastfeeding, and newborn care.
  • If you have not started thinking about it yet, consider where you want to give birth — public hospital (free/low cost) or private hospital.

Anomaly Scan / Structural Ultrasound

Visit 3 · Weeks 18–22

Detailed structural ultrasound if arranged, fetal anatomy survey, placenta location, amniotic fluid check

Good to know: The anomaly scan is one of the most important ultrasounds in prenatal care. In Hong Kong, it is commonly done between 18-22 weeks, but in the public system the exact timing and whether it is arranged can depend on hospital policy, risk factors, and service capacity. Private clinics commonly offer detailed structural scans and may add 3D/4D imaging. Importantly, a normal scan does not guarantee a 100% healthy baby — some conditions are too subtle to detect on ultrasound or may develop later. If an abnormality is found or suspected, you will be referred to a fetal medicine specialist for further assessment.

Common checks

  • Fetal Anomaly Scan (Morphology Scan) — The anomaly scan is a detailed ultrasound that systematically examines your baby's brain, spine, face (including cleft lip), heart (four-chamber view), stomach, kidneys, bladder, limbs, and abdominal wall. It screens for major structural abnormalities including neural tube defects, congenital heart defects, abdominal wall defects, and skeletal abnormalities. The scan takes 20-30 minutes. This is a screening scan — it can detect many but not all abnormalities, and some conditions may only become apparent later in pregnancy or after birth.
  • Placenta Location Check — The sonographer notes where the placenta is positioned in the uterus. If the placenta is low-lying (close to or covering the cervix), a follow-up scan will be arranged at approximately 32 weeks. In most cases, the placenta migrates upward as the uterus grows and the issue resolves. True placenta praevia at term occurs in only about 1 in 200 pregnancies.
  • Amniotic Fluid Assessment — The volume of amniotic fluid around the baby is assessed. Too much fluid (polyhydramnios) or too little (oligohydramnios) can indicate conditions that need monitoring. Normal amniotic fluid volume is reassuring and suggests the baby's kidneys and swallowing are functioning well.
  • Cervical Length Measurement (If Indicated) — If you have risk factors for preterm birth — such as a previous preterm delivery, cervical surgery, or multiple pregnancy — a transvaginal ultrasound may be used to measure your cervical length. A shorter cervix may indicate a higher risk of preterm delivery and may prompt preventive measures such as progesterone treatment or a cervical cerclage.

How to prepare

  • Wear loose, comfortable clothing — ideally a two-piece outfit so you can easily expose your abdomen.
  • You may need a partially full bladder. Drink a glass of water about an hour before the scan.
  • The scan takes 20-30 minutes. If the baby is in a difficult position, you may be asked to walk around and come back.
  • Decide beforehand if you want to know the baby's sex.

Tips

  • If the sonographer is quiet during the scan, do not worry — they are concentrating on obtaining precise measurements of many structures.
  • A normal anomaly scan is very reassuring. Remember it is a screening tool — some conditions cannot be detected by ultrasound.
  • If anything concerning is found, try to stay calm. Many findings need further investigation but turn out to be nothing serious.
  • Ask whether printed photos or a digital copy of the ultrasound images are available. Public hospitals may offer this for a small fee.

Diabetes Screening and Routine Review

Visit 4 · Weeks 24–28 · Fasting may be needed

Diabetes screening, OGTT if booked or indicated, FBC recheck if arranged, blood pressure, urine, fundal height

Good to know: A key Hong Kong nuance: GDM is relatively common in the local Chinese population, so OGTT screening is frequently arranged around 24-28 weeks, but it should not be assumed that every public-system patient will receive it automatically. Some public services arrange it by risk factors or local policy, while private and mixed-care pathways often offer it more broadly. If diagnosed with GDM, you will usually be referred to a diabetes team and taught blood glucose monitoring, dietary management, and exercise. Most women manage GDM with lifestyle changes alone; some require medication.

Common checks

  • Blood Pressure — Blood pressure monitoring becomes increasingly important as you enter the third trimester. Rising blood pressure can be an early sign of pre-eclampsia and needs prompt assessment.
  • Urine Test — Routine urine check for protein, glucose, and infection. Combined with blood pressure, this helps screen for pre-eclampsia.
  • Symphysis-Fundal Height (SFH) — From around 24 weeks, the distance from your pubic bone to the top of your uterus is measured with a tape measure. This gives a rough estimate of the baby's growth. If the measurement is significantly above or below the expected range for your gestational age, an ultrasound will be arranged to assess the baby's growth more accurately.
  • 75g Oral Glucose Tolerance Test (OGTT) — A 75g OGTT is commonly arranged between 24-28 weeks to screen for gestational diabetes mellitus (GDM), especially in private care or when public-hospital policy or risk factors indicate it. If the test is booked, you must fast overnight for at least 8 hours. A fasting blood sample is taken first, then you drink a 75g glucose solution, and blood is drawn again at 1 hour and 2 hours. Hong Kong services commonly use WHO or IADPSG-style thresholds: fasting glucose ≥5.1 mmol/L, 1-hour ≥10.0 mmol/L, or 2-hour ≥8.5 mmol/L. GDM is more common in the Chinese population, so many clinicians have a low threshold to arrange testing.
  • Full Blood Count (FBC) Recheck — A repeat full blood count checks your haemoglobin for anaemia, which becomes more common in the third trimester as blood volume increases. If anaemia is found, iron or folic acid supplementation will be prescribed. For women with thalassaemia trait, the haemoglobin may be naturally lower, and the doctor will interpret results in context of your thalassaemia status.

How to prepare

  • If an OGTT is booked, fast overnight for at least 8 hours beforehand. Usually only water is allowed — no food, juice, milk, or sweetened drinks.
  • If you are doing the OGTT, expect it to take about 2-3 hours in total. Bring a book, phone charger, or something to do while waiting.
  • Bring a snack to eat after any fasting blood test is complete.
  • If fasting is required, schedule the appointment early in the morning so most of the fasting period is overnight.

Tips

  • The glucose drink can taste very sweet and may cause nausea. Drink it steadily within 5 minutes. Some women find it easier to drink cold.
  • If you vomit within 30 minutes of drinking the glucose solution, the test may need to be repeated on another day.
  • Do not be alarmed if you are diagnosed with GDM — it is very common in Hong Kong and manageable with proper care. It usually resolves after delivery.
  • If anaemia is found, take iron supplements with vitamin C (e.g., orange juice) to improve absorption. Avoid taking iron with tea, coffee, or milk.

Vaccines and Routine Check

Visit 5 · Weeks 28–30

Pertussis vaccination window, Anti-D for Rh-negative women, review OGTT results if done, blood pressure, urine, fundal height, fetal movements

Good to know: This visit marks the transition into the third trimester, where monitoring becomes more frequent. Fetal movement monitoring is one of the most important things you can do at home — reduced movements can be an early sign of fetal distress and should always be reported promptly. In Hong Kong, you should call the hospital delivery suite if you notice reduced movements. This is also the recommended window for pertussis vaccination, and Rh-negative women should confirm whether Anti-D prophylaxis is needed.

Common checks

  • Blood Pressure — Third trimester blood pressure monitoring. Any new rise is closely assessed alongside urine protein results for signs of pre-eclampsia.
  • Urine Test — Routine urine check for protein, glucose, and infection. Proteinuria combined with rising blood pressure is a red flag for pre-eclampsia.
  • Symphysis-Fundal Height (SFH) — Continued growth monitoring. The fundal height should increase by approximately 1 cm per week in the third trimester. Measurements significantly above or below expected will prompt a growth ultrasound.
  • Anti-D Prophylaxis (Rh-Negative Women) — If you are Rh-negative, you will be offered anti-D immunoglobulin injection at 28 weeks. Although Rh-negative is rare in the Chinese population (less than 1%), it is still important for those affected. The injection prevents your immune system from producing antibodies against an Rh-positive baby's blood cells. Anti-D is also given after any bleeding episode, amniocentesis, or other potentially sensitizing events during pregnancy.
  • Pertussis (Whooping Cough) Vaccination — The Department of Health recommends a pertussis-containing vaccine in every pregnancy, usually between 26-34 weeks. Vaccination during pregnancy helps your body make antibodies that pass to the baby before birth, giving protection during the first months of life before the baby can complete their own vaccinations. If you are unsure whether this is provided at your appointment, ask your MCHC, hospital clinic, or private doctor how to arrange it.
  • Review OGTT Results and GDM Management — If your OGTT was done at 24-28 weeks, the results will be reviewed. If gestational diabetes was diagnosed, your doctor will review your blood glucose monitoring records, discuss dietary management, and assess whether medication is needed. Ongoing care for GDM typically involves regular follow-up with a diabetes nurse and dietitian in addition to your antenatal appointments.
  • Fetal Movement Assessment — Your doctor or nurse will ask about the baby's movements. From 28 weeks, you should be well aware of your baby's usual movement pattern. There is no set number of kicks to count — what matters is knowing your baby's normal pattern and noticing any reduction. If you notice reduced movements at any time, contact your hospital or MCHC immediately — do not wait for the next appointment.

How to prepare

  • Bring your antenatal record book and any blood glucose monitoring records if you have GDM.
  • Start paying close attention to your baby's daily movement pattern so you know what is normal.
  • If you are Rh-negative, be prepared for the anti-D injection at this visit.
  • Ask whether pertussis vaccination is available at this visit or where you should receive it.

Tips

  • Never hesitate to contact the hospital if you are worried about reduced fetal movements. They would always rather check and reassure you than have you wait.
  • Start sleeping on your side from 28 weeks onwards — research shows this reduces the risk of stillbirth compared to sleeping on your back.
  • This is a good time to start thinking about your hospital bag and birth plan, even though delivery is still weeks away.

30-32 Week Routine Visit

Visit 6 · Weeks 30–32

Routine monitoring, blood pressure, urine, fundal height, review any ongoing concerns, fetal growth assessment

Good to know: The 30-32 week visit is a routine monitoring appointment. In Hong Kong's shared-care system, this visit may be at the MCHC or hospital depending on your schedule. If you have GDM, pre-eclampsia, or other complications, your visits may be more frequent and primarily hospital-based. Women with low-lying placenta detected at the anomaly scan will usually have a repeat scan around 32 weeks to check if the placenta has migrated upward. Most women begin attending fortnightly appointments from around 30-32 weeks.

Common checks

  • Blood Pressure — Routine monitoring. Pre-eclampsia can develop at any time in the third trimester and requires immediate attention. Report any headaches, visual disturbances, or sudden swelling.
  • Urine Test — Routine urine check. New-onset proteinuria in the third trimester, especially combined with raised blood pressure, needs urgent assessment.
  • Symphysis-Fundal Height (SFH) — Continued growth monitoring. The growth trend should show a steady upward trajectory. If the measurement plateaus or deviates significantly, a growth scan will be arranged.
  • Growth Ultrasound (If Indicated) — A growth ultrasound may be arranged if the fundal height is outside the expected range, if you have GDM, or if there are other risk factors for growth problems. The scan measures the baby's head circumference, abdominal circumference, and femur length to estimate the baby's weight and assess growth.

How to prepare

  • Bring your antenatal record book and any questions or concerns.
  • If you have GDM, bring your blood glucose diary and any food records.
  • Note any symptoms you want to discuss — swelling, headaches, breathlessness, or sleep difficulties are common in the third trimester.

Tips

  • This is a good time to start packing your hospital bag. Have it ready by 36 weeks.
  • If you are feeling breathless, this is normal — the growing uterus pushes against the diaphragm. Sitting upright and sleeping propped up can help.
  • Continue monitoring fetal movements daily. Report any changes to your hospital immediately.
  • Consider starting antenatal classes if you have not already — they cover labour, birth, breastfeeding, and newborn care.

GBS Screening and Birth Preparation

Visit 7 · Weeks 35–37

GBS (Group B Streptococcus) screening swab if arranged, presentation check, birth plan discussion, blood pressure, urine

Good to know: GBS screening is commonly arranged at 35-37 weeks in Hong Kong. The GBS swab is a simple, quick procedure. If positive, intrapartum antibiotic prophylaxis is given during labour and is highly effective at preventing neonatal GBS infection. The baby's presentation is also assessed around this time. About 3-4% of babies are still breech at term. If your baby is breech, ECV (external cephalic version) may be offered, or a planned caesarean section will be discussed.

Common checks

  • Blood Pressure — Close monitoring continues. Pre-eclampsia is most common from 34 weeks onwards, and any new rise in blood pressure is taken very seriously.
  • Urine Test — Routine urine check. New proteinuria at this stage, combined with elevated blood pressure, is a warning sign for pre-eclampsia.
  • Symphysis-Fundal Height (SFH) — Continued growth monitoring. Any significant deviation from expected growth may prompt a growth scan.
  • GBS (Group B Streptococcus) Screening Swab — A vaginal and rectal swab is commonly taken between 35-37 weeks to screen for Group B Streptococcus (GBS), though the exact arrangement can depend on your hospital or care pathway. About 10-30% of pregnant women carry GBS in the vaginal or rectal area. GBS is usually harmless to the mother but can cause serious infection in the newborn (sepsis, pneumonia, meningitis) if passed during delivery. If you test positive, intravenous antibiotics (usually penicillin) will be given during labour to protect the baby.
  • Abdominal Palpation for Fetal Presentation — Your doctor or midwife will feel your abdomen to determine whether the baby is head-down (cephalic), bottom-first (breech), or lying sideways (transverse). Most babies are head-down by 36 weeks. If breech presentation is suspected, an ultrasound will confirm the position, and external cephalic version (ECV) may be offered to try to turn the baby.
  • Birth Plan Discussion — Your healthcare provider will discuss birth planning including recognising the signs of labour, when to go to hospital, pain management options, and your preferences for delivery. In Hong Kong, pain relief options include Entonox (gas and air), pethidine injection, and epidural anaesthesia. You will also discuss breastfeeding plans and newborn care including vitamin K injection.

How to prepare

  • Your hospital bag should be packed by now. Include items for you and baby, your birth preferences, and your antenatal record book.
  • Think about your birth preferences before this appointment — pain relief, birth companion, breastfeeding, and vitamin K for the baby.
  • If you suspect your baby might be breech, mention it — the doctor can check with ultrasound.
  • Know your hospital's delivery suite phone number and address. Make sure your birth companion knows the route.

Tips

  • The GBS swab is a quick, simple test. It is not painful, just slightly uncomfortable. You may be able to do the swab yourself with guidance.
  • If you test GBS positive, it does not mean you are ill. It simply means antibiotics during labour will protect your baby. It does not affect your birth plan otherwise.
  • If your baby is breech, ECV has about a 50% success rate and is a safe procedure. If it does not work, a planned caesarean section is usually recommended.
  • Rest as much as you can in these final weeks. Nap when possible, eat well, and stay hydrated.

Birth Plan Finalization

Visit 8 · Weeks 36–37

Finalize birth plan, review GBS results, routine checks, presentation confirmation

Good to know: From 37 weeks, the baby is considered "early term" and delivery at this point is generally safe. Hong Kong public hospitals are well-equipped for delivery, and the standard postnatal stay is about 2-3 days for vaginal birth and 3-4 days for caesarean section. If you are GBS-positive, plan to go to hospital as soon as labour starts so antibiotics can be given at least 4 hours before delivery. Pack your hospital bag with your HKID, antenatal record book, baby clothes, and personal items.

Common checks

  • Blood Pressure — Continued close monitoring. Any new rise in blood pressure at this late stage is taken very seriously and may require hospital assessment.
  • Urine Test — Routine urine test. Vigilance for pre-eclampsia signs continues until delivery.
  • Symphysis-Fundal Height (SFH) — Growth monitoring continues. The baby may start to "engage" (drop lower into the pelvis), especially in first pregnancies, which can cause the fundal height to plateau or decrease slightly.
  • Review GBS Screening Results — The results of the GBS swab from 35-37 weeks will be reviewed. If positive, the plan for intrapartum antibiotics will be confirmed, and you will be advised to come to hospital as soon as labour starts (or when waters break) so antibiotics can be started promptly. At least 4 hours of antibiotics before delivery is ideal for maximum protection.
  • Presentation Confirmation — The baby's position is reassessed. If the baby is head-down and engaged, this is ideal for a vaginal birth. If still breech at 37 weeks, ECV will be discussed urgently, or a planned caesarean will be arranged, typically at 39 weeks.
  • Birth Plan Review — Your finalized birth preferences are reviewed, including where you will deliver, pain relief choices, who will be your birth companion, breastfeeding intentions, and any special requests. In Hong Kong public hospitals, one birth companion is typically allowed during labour. Your doctor will also confirm contact numbers and when to come to hospital.

How to prepare

  • Finalize your birth plan and share it with your birth companion.
  • Confirm the hospital delivery suite phone number and know when to call.
  • Double-check your hospital bag. Include HKID, antenatal record book, phone charger, comfortable clothes, and baby items.
  • Ensure your birth companion is available and contactable at all times from now on.

Tips

  • Signs that labour may be starting: regular contractions that get stronger and closer together, waters breaking, a "show" (blood-tinged mucus plug), persistent lower back pain.
  • If your waters break, note the time, colour, and amount, and go to hospital. If the fluid is green or brown-tinged, go immediately as this may indicate meconium.
  • In Hong Kong, you can call the hospital delivery suite 24/7 for advice if you are unsure whether you are in labour.
  • Try to rest as much as possible. Labour can be long, especially for first-time mothers, so entering it well-rested is beneficial.

Fetal Monitoring

Visit 9 · Week 38

Fetal monitoring (CTG if indicated), blood pressure, urine, fundal height, fetal movements, review birth readiness

Good to know: From 38 weeks, you are very close to delivery. Most babies are born between 38-42 weeks. In Hong Kong, weekly or twice-weekly visits are common from this point. CTG monitoring may be done routinely at some hospitals from 38-40 weeks, especially for women with GDM or other risk factors. An important myth to dispel: babies do NOT move less as they run out of room. Any change in your baby's usual movement pattern should be reported immediately to the hospital. Do not "wait and see" or count kicks with a chart — trust your instinct if something feels different.

Common checks

  • Blood Pressure — Close monitoring continues. Any new rise in blood pressure at this late stage needs urgent assessment and may prompt consideration of early delivery.
  • Urine Test — Routine check for protein and glucose. New proteinuria at this stage is treated very seriously.
  • Symphysis-Fundal Height (SFH) — Final growth measurements. The baby may have engaged in the pelvis, causing the fundal height to plateau or decrease slightly. This is more common in first pregnancies.
  • Cardiotocography (CTG) — If Indicated — A CTG (cardiotocography) may be performed if there are concerns about the baby's wellbeing, such as reduced fetal movements, GDM, or other risk factors. The CTG monitors the baby's heart rate pattern and any uterine contractions using external sensors on your abdomen. A "reactive" trace with good variability and accelerations is reassuring. The test usually takes 20-40 minutes.
  • Fetal Movement Review — Your healthcare provider will ask in detail about the baby's movements. Continue monitoring daily and report any changes immediately. Babies do NOT move less near the end of pregnancy — this is a myth. You should feel your baby moving right up until labour.

How to prepare

  • Make sure your hospital bag is packed and your birth companion is on standby.
  • Know the signs of labour and when to go to hospital.
  • Have your hospital's delivery suite number saved in your phone.
  • If you have a planned caesarean, the date is usually confirmed around now (typically at 39 weeks).

Tips

  • Stay active with gentle walking if you feel well — it can help encourage labour to start naturally.
  • Continue eating well and staying hydrated. Rest when you need to — you are almost there!
  • Many first-time mothers go past their due date — this is very normal and not a cause for concern.
  • If you are anxious, talk to your healthcare team. They are there to support you and answer your questions.

Term Review and Labour Planning

Visit 10 · Weeks 39–40

Blood pressure, urine, fundal height, fetal monitoring if indicated, labour signs, due-date and induction planning

Good to know: At 39-40 weeks you are full term, but not necessarily "post-dates" yet. Only about 5% of babies arrive exactly on their estimated due date, and many first-time mothers go a little beyond it. Hong Kong services usually discuss what to do if labour has not started by the due date, including when to return, when fetal monitoring or amniotic fluid checks may be used, and when induction might be recommended. The exact plan varies by hospital and individual risk factors.

Common checks

  • Blood Pressure — Vigilant monitoring. Any rise is taken very seriously at this stage as the pregnancy approaches or passes the due date.
  • Urine Test — Routine urine check. Protein levels are closely monitored alongside blood pressure right up to delivery.
  • Symphysis-Fundal Height (SFH) — Growth monitoring continues. At 39-40 weeks, the baby is full term. The fundal height may plateau if the baby has engaged deep in the pelvis.
  • Cardiotocography (CTG) — A CTG may be performed if there are concerns about the baby's wellbeing, reduced movements, GDM, hypertension, or other risk factors. Some hospitals also use CTG more routinely near the due date. The trace monitors the baby's heart rate and any contractions. A reassuring trace with good variability confirms the baby is well. If the trace is non-reassuring, further assessment or delivery may be recommended.
  • Amniotic Fluid Check (Ultrasound) — An ultrasound may be used to check the amniotic fluid volume. As the pregnancy approaches or passes the due date, amniotic fluid can gradually decrease. A low amniotic fluid index (AFI) or low deepest vertical pocket may prompt consideration of induction of labour.
  • Membrane Sweep (If Offered Near or After Due Date) — A membrane sweep may be offered near or after the due date to help encourage labour to start naturally. During a vaginal examination, the doctor inserts a finger through the cervix and sweeps it around, separating the membranes from the lower segment of the uterus. This releases prostaglandins that can help trigger labour. The procedure can be uncomfortable but is quick. Whether it is offered depends on your cervix, your preferences, and local practice.
  • Due-Date and Induction Planning Discussion — Your doctor will discuss what happens if labour has not started by your due date. In many Hong Kong services, induction of labour is discussed for around 41 weeks if labour has not started spontaneously, though timing depends on your hospital, risk factors, and preferences. The risks and benefits of waiting versus induction will be explained. Induction methods may include prostaglandin gel or pessary, artificial rupture of membranes, and oxytocin drip.

How to prepare

  • Make sure your birth partner is ready and can be contacted at any time.
  • Confirm your route to the hospital, including a backup plan for traffic or bad weather.
  • Continue monitoring fetal movements and report any changes immediately.
  • If you are near or past your due date, ask whether membrane sweep or induction planning is appropriate for you.

Tips

  • Going past your due date is normal and does not mean anything is wrong. Labour will come when it is ready.
  • After a membrane sweep, you may experience cramping, spotting, or a "show." If you develop regular, strong contractions, your labour may be starting.
  • Stay active with gentle walking if you feel well — it can help encourage the baby to engage and labour to start.
  • The decision about induction is yours. Ask your doctor to explain the pros and cons so you can make an informed choice.

Sources

This overview references public guidance from:

Prenatal Care Schedules by Country