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Singapore Prenatal Care Schedule

This is a general overview of the prenatal visits many people in Singapore are offered during pregnancy, drawn from public guidance by KKH 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 (Registration) — Weeks 8–10
  2. NT Scan / First Trimester Combined Screening (OSCAR) — Weeks 11–14
  3. 16-Week Review Visit — Week 16
  4. Anomaly Scan (Structural Ultrasound) — Weeks 18–22
  5. OGTT and Blood Recheck — Weeks 24–28
  6. Anti-D and Routine Check — Weeks 28–30
  7. 32-Week Routine Visit — Week 32
  8. Presentation Check and Birth Planning — Weeks 34–36
  9. Fetal Monitoring and Birth Readiness — Week 37
  10. Routine Check and Membrane Sweep Discussion — Weeks 38–39
  11. Post-Dates Assessment — Week 40

First Booking Visit (Registration)

First prenatal visit · Weeks 8–10

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

Good to know: The first booking visit in Singapore is typically at a public restructured hospital (KKH Women's and Children's Hospital, NUH, SGH, or NTFGH) or a private OB-GYN clinic. Public hospitals offer subsidized care, with costs further reduced through Medisave. Thalassaemia screening is one of the most important blood tests in Singapore prenatal care — the country's multi-ethnic population (Chinese, Malay, Indian) means various forms of thalassaemia are prevalent. Hepatitis B screening is also critical, although prevalence has dropped significantly since the introduction of universal neonatal vaccination in 1985. All screening is explained and offered — ask questions if anything is unclear.

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. Singapore uses Asian-specific BMI thresholds — a BMI of 23 or above is considered overweight and 27.5 or above is obese, warranting additional monitoring. Your baseline weight is used to set a target weight gain range for your pregnancy based on your pre-pregnancy BMI category.
  • 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. Singapore's tropical climate and dietary habits (higher sodium from hawker food and condiments) 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. Urinary tract infections are more common in pregnancy and in tropical climates, so early detection is important. This quick test is performed at every antenatal visit.
  • 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. This is particularly important in Singapore's multi-ethnic population, where thalassaemia trait prevalence varies — about 3-5% in the Chinese population, up to 5% in Malays, and varying rates in Indian Singaporeans. If your haemoglobin is low, further investigation will determine whether it is due to iron deficiency or thalassaemia trait before supplements are prescribed.
  • Thalassaemia Screening — Thalassaemia screening is a critical part of prenatal care in Singapore due to the high carrier prevalence in Southeast Asian populations. The initial screen uses MCV (mean corpuscular volume) and MCH (mean corpuscular haemoglobin) from the full blood count. If MCV is below 80 fL or MCH below 27 pg, haemoglobin analysis (HPLC or electrophoresis) is performed. If you are identified as a carrier, your partner will also be tested. If both parents carry the same type of thalassaemia, genetic counselling will be offered, as there is a 25% chance the baby could have a severe form requiring lifelong transfusions.
  • 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 uncommon in Singapore's predominantly Asian population (less than 1% in Chinese and Malays, slightly higher in Indians). 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 essential in Singapore, where the carrier rate has dropped significantly thanks to the universal vaccination programme introduced in 1985 but remains relevant, particularly among older generations and immigrants. Hepatitis B can be transmitted from mother to baby during birth. If you test positive, your baby will receive hepatitis B immunoglobulin (HBIG) and the first dose of the hepatitis B vaccine within 12 hours of birth. Your viral load will also be checked to determine if antiviral treatment during pregnancy is needed to further reduce transmission risk.
  • HIV Screening — HIV screening is offered to all pregnant women in Singapore 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. Singapore has a low prevalence but early detection is critical for protecting both mother and baby.
  • Syphilis (VDRL / RPR) Screening — Syphilis screening is a mandatory part of antenatal blood tests in Singapore. 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 prompt 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). Singapore has high MMR vaccination coverage, but immunity can wane over time. 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.
  • Medisave and Financial Counselling — At the booking visit, the hospital will help you register to use Medisave for your prenatal expenses. Under the Medisave Maternity Package, you can claim up to $900 for pre-delivery expenses (antenatal visits, scans, and blood tests) and additional amounts for delivery and post-delivery care. If you are delivering at a public hospital, government subsidies further reduce out-of-pocket costs. The financial counsellor will explain what is covered and help with any MediShield Life or private insurance claims.

How to prepare

  • Know the first day of your last menstrual period (LMP) — this is essential for estimating your due date.
  • Bring your NRIC or FIN card, referral letter (if any), and proof of marriage (for Medisave claims).
  • 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) or Ayurvedic remedies.
  • Check your Medisave balance and bring your CPF details for financial counselling.

Tips

  • The first booking visit at a public hospital can take 2-4 hours, including registration and waiting. Bring water, snacks, and something to read.
  • Start taking folic acid 400mcg daily if not already. The Health Promotion Board 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.
  • Public hospitals in Singapore provide services in English, Mandarin, Malay, and Tamil. Interpreters for other languages can be arranged in advance.
  • Book a dental appointment early in pregnancy — oral health is linked to pregnancy outcomes, and Singapore emphasizes dental checks during pregnancy.

NT Scan / First Trimester Combined Screening (OSCAR)

Visit 1 · Weeks 11–14

Nuchal translucency scan, first trimester combined screening (OSCAR) for Down syndrome, dating scan confirmation

Good to know: The first trimester combined screening is the standard approach in Singapore public hospitals, combining the NT scan and blood test — often done in a single visit with results available within days. This screening is subsidized for patients at public hospitals. NIPT (non-invasive prenatal testing using cell-free fetal DNA) is also available in Singapore from around 10 weeks but is self-pay and typically costs $800-$1,500. NIPT has a detection rate of over 99% for Down syndrome but remains a screening test, not a diagnostic test. If you are over 35 or have a high-risk screening result, your doctor will discuss the options including NIPT, CVS, and amniocentesis.

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 overview. If your dates do not match the ultrasound measurement, your due date will be adjusted based on the CRL, which is more accurate than dates based on your last menstrual 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 measurement is combined with blood markers for a more accurate risk assessment.
  • First Trimester Combined Screening Blood Test (PAPP-A and Free Beta-hCG) — The first trimester combined screening (also called OSCAR at some Singapore hospitals) measures PAPP-A (pregnancy-associated plasma protein-A) and free beta-hCG from a blood sample. These levels, combined with the NT measurement, your age, and other factors, produce a personalized risk estimate for Down syndrome and other chromosomal conditions. In Singapore's public hospitals, this screening is subsidized. A risk of 1 in 250 or higher is generally considered "screen positive," and further testing — either NIPT or invasive diagnostic testing (CVS or amniocentesis) — will be offered.

How to prepare

  • The combined screening appointment may be at the hospital's fetal medicine unit. 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

  • First trimester combined screening is subsidized at public hospitals. Private clinics offer it at a higher cost but often with shorter waiting times.
  • 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 considering NIPT, some private labs in Singapore offer it from 10 weeks. Discuss with your doctor whether it is appropriate for your situation.
  • If you miss the first trimester window (after 14 weeks), a second trimester quadruple test can be offered between 15-20 weeks as an alternative.

16-Week Review Visit

Visit 2 · Week 16

Review screening results, routine check, blood pressure, urine, general wellbeing, dental health reminder

Good to know: The 16-week visit is a shorter review appointment but important for following up on screening results and planning next steps. If thalassaemia carrier status was identified, your partner should have been tested by now. If both parents carry the same type, genetic counselling will be arranged. Singapore places strong emphasis on dental health during pregnancy — the Health Promotion Board recommends at least one dental visit during pregnancy. This visit is also a good time to ask about parentcraft classes offered by hospitals like KKH and NUH, which cover pregnancy, labour, breastfeeding, and newborn care.

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 will discuss the results of all blood tests and the first trimester combined screening. If the thalassaemia screening found you are a carrier, your partner's testing status will be reviewed. If any results require further action — such as a high-risk screening result requiring NIPT or amniocentesis — this will be arranged. This is a good time to ask questions about anything you did not understand from your results.
  • Dental Health Assessment — Your doctor will ask about your dental health and remind you to schedule a dental check-up if you have not already. Pregnancy hormones can cause gum inflammation (pregnancy gingivitis), and poor oral health has been linked to preterm birth and pre-eclampsia. In Singapore, dental care during pregnancy is encouraged, and polyclinics offer affordable dental services. Routine dental cleaning and check-ups are safe throughout pregnancy.

How to prepare

  • Bring your antenatal record book (health booklet) 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 parentcraft classes — KKH, NUH, and other hospitals offer classes covering pregnancy, labour, breastfeeding, and newborn care.
  • Schedule a dental appointment if you have not already. Pregnancy gingivitis is common and preventable with good dental care.
  • If you have not started thinking about it yet, consider where you want to give birth — public hospital (subsidized) or private hospital/clinic.

Anomaly Scan (Structural Ultrasound)

Visit 3 · Weeks 18–22

Detailed structural ultrasound screening, 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 Singapore's public hospitals, it is typically performed between 18-22 weeks. Private clinics may offer additional detailed scans including 3D/4D imaging at extra cost. 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. You can usually ask to know the baby's sex at this scan — most hospitals in Singapore will tell you if you ask.

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 function are working 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 for printed photos or a digital copy of the ultrasound images. Some hospitals may charge a small fee for printouts.

OGTT and Blood Recheck

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

Oral glucose tolerance test (OGTT) for gestational diabetes, FBC recheck for anaemia, blood pressure, urine, fundal height

Good to know: Singapore offers universal OGTT screening for all pregnant women, not just those with risk factors. This is because GDM prevalence is high in Singapore's multi-ethnic population — approximately 1 in 5 pregnancies are affected. The 75g OGTT with three time points (fasting, 1-hour, 2-hour) using WHO criteria is the standard test. If diagnosed with GDM, you will be referred to an endocrinologist or diabetes team and taught blood glucose monitoring, dietary management, and exercise. Most women manage GDM with lifestyle changes; about 10-20% require insulin or metformin. Medisave can be used to cover the OGTT and related blood tests.

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) — The OGTT is offered universally to all pregnant women in Singapore between 24-28 weeks to screen for gestational diabetes mellitus (GDM). 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. Singapore follows WHO criteria: fasting glucose ≥5.1 mmol/L, 1-hour ≥10.0 mmol/L, or 2-hour ≥8.5 mmol/L. GDM is common in Singapore's population, affecting approximately 20% of pregnancies, with higher rates among Indian and Malay women.
  • 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 the context of your thalassaemia status.

How to prepare

  • You MUST fast overnight for at least 8 hours before the OGTT. Only water is allowed — no food, juice, milk, coffee, or sweetened drinks.
  • The OGTT takes about 2-3 hours in total. Bring a book, phone charger, or something to do while waiting.
  • Bring a snack to eat after the test is complete — you will be hungry!
  • Schedule the appointment early in the morning so the fasting period is mostly 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 Singapore 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.

Anti-D and Routine Check

Visit 5 · Weeks 28–30

Anti-D for Rh-negative women, review OGTT results, blood pressure, urine, fundal height, fetal movements

Good to know: This visit marks the transition into more frequent monitoring as you enter the third trimester. 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 Singapore, you should call the hospital delivery suite if you notice reduced movements. From around 28-30 weeks, visits become fortnightly (every 2 weeks) at most hospitals. If you have GDM, your visits may be more frequent with additional monitoring by the diabetes team.

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. Rh-negative is uncommon in Singapore's predominantly Asian population (less than 1% in Chinese and Malays), but it is still critical for those affected. The injection prevents your immune system from producing antibodies against an Rh-positive baby's blood cells, which could cause haemolytic disease in this or future pregnancies. Anti-D is also given after any bleeding episode, amniocentesis, or other potentially sensitizing events.
  • 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 (adapted to Singapore's food culture — rice portions, hawker food choices), and assess whether medication is needed. Ongoing GDM care typically involves regular follow-up with an endocrinologist or diabetes nurse educator in addition to your antenatal appointments.
  • Fetal Movement Assessment — Your doctor 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's delivery suite 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.

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.
  • If you have GDM, download a food calorie app or ask your diabetes educator about managing portions when eating at hawker centres.

32-Week Routine Visit

Visit 6 · Week 32

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

Good to know: The 32-week visit is a routine monitoring appointment. In Singapore, you are now attending fortnightly visits. If you have GDM, pre-eclampsia, or other complications, your visits may be even more frequent and may include additional ultrasound monitoring. Women with a 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. If you are at a public hospital, ensure your follow-up appointments are booked — slots can fill up quickly.

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 to your doctor.
  • 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 from expected, 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 trajectory.

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.
  • Sign up for parentcraft classes at your hospital if you have not already — they cover labour, birth positions, breastfeeding, and newborn care.

Presentation Check and Birth Planning

Visit 7 · Weeks 34–36

Presentation check, birth plan discussion, blood pressure, urine, GBS risk-factor assessment

Good to know: A key difference in Singapore: there is no universal GBS screening swab. Instead, Singapore uses a risk-factor based approach to decide who receives intrapartum antibiotics during labour. This is the same approach used in the UK. If you have specific risk factors (previous GBS-affected baby, GBS in urine, preterm labour, prolonged rupture of membranes, or fever in labour), antibiotics will be given during delivery. The baby's presentation is assessed around this time — about 3-4% of babies are still breech at term. If breech, ECV may be offered at 37 weeks, 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 at this stage.
  • 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.
  • Abdominal Palpation for Fetal Presentation — Your doctor 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 at 37 weeks to try to turn the baby.
  • GBS Risk-Factor Assessment — Singapore does not perform universal GBS screening (unlike Hong Kong or the US). Instead, a risk-factor based approach is used, similar to the UK. Risk factors that would trigger intrapartum antibiotics include: previous baby with GBS infection, GBS detected in urine during this pregnancy, preterm labour (<37 weeks), prolonged rupture of membranes (>18 hours), or fever during labour. Your doctor will review your history and document any relevant risk factors.
  • 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 Singapore, 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 and newborn screening tests. Singapore strongly promotes breastfeeding through the Baby-Friendly Hospital Initiative.

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

  • Even without universal GBS screening, your medical team will assess your risk factors during labour and give antibiotics if needed. This approach is evidence-based and widely used.
  • 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 — especially important in Singapore's hot and humid climate.
  • Consider attending a hospital tour or parentcraft class if your hospital offers one — it helps you feel more prepared for delivery day.

Fetal Monitoring and Birth Readiness

Visit 8 · Week 37

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

Good to know: From 37 weeks, the baby is considered "early term" and delivery at this point is generally safe. Singapore's public hospitals are well-equipped for delivery, with the standard postnatal stay being about 2-3 days for vaginal birth and 3-4 days for caesarean section. Weekly visits are standard from 36-37 weeks until delivery. If you have GDM, your doctor may discuss the timing of delivery — induction at 38-39 weeks is sometimes recommended for GDM patients on insulin. Pack your hospital bag with your NRIC/FIN, 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 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 as a potential sign of pre-eclampsia.
  • 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.
  • Presentation Confirmation — The baby's position is reassessed by abdominal palpation or ultrasound. 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, or a planned caesarean section will be arranged, typically at 39 weeks.
  • Cardiotocography (CTG) — If Indicated — A CTG 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.
  • Birth Readiness Review — Your doctor will confirm your finalized birth preferences, including delivery location, pain relief choices, birth companion, and breastfeeding intentions. In Singapore's public hospitals, one birth companion is typically allowed during labour. You will review the signs of labour, when to go to hospital, and emergency contact numbers. If you have a planned caesarean, the date will typically be confirmed for around 39 weeks.

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.
  • 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.
  • 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.

Routine Check and Membrane Sweep Discussion

Visit 9 · Weeks 38–39

Blood pressure, urine, fundal height, fetal monitoring, membrane sweep option, birth readiness

Good to know: Most babies are born between 38-42 weeks. In Singapore, weekly visits are standard at this stage. 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 delivery suite. Do not "wait and see" — trust your instinct if something feels different. If you are past 39 weeks and your cervix is favourable, a membrane sweep may be offered before considering formal induction of labour.

Common checks

  • Blood Pressure — Vigilant monitoring continues. Any rise is taken very seriously at this stage as the pregnancy approaches 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 38-39 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 at 38-39 weeks, especially if there are risk factors such as GDM or reduced fetal movements. The trace monitors the baby's heart rate and any contractions. A reassuring trace confirms the baby is well. If the trace is non-reassuring, further assessment or expedited delivery may be recommended.
  • 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 begins.
  • Membrane Sweep Discussion (If Offered) — A membrane sweep may be offered around 39-41 weeks to help encourage labour to start naturally. During a vaginal examination, the doctor sweeps a finger around the cervix, separating the membranes from the lower uterine segment. This releases prostaglandins that can help trigger labour. It increases the chance of labour starting within 48 hours by about 20%. The procedure can be uncomfortable but is quick. Your doctor will discuss whether a sweep is appropriate for you and when it might be offered.

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.
  • Continue monitoring fetal movements and report any changes immediately.
  • If you are offered a membrane sweep, be prepared — it can be done at this visit. Wear comfortable clothing.

Tips

  • Going past your due date is normal and does not mean anything is wrong. Many first-time mothers deliver after 40 weeks.
  • 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.
  • Stay hydrated in Singapore's heat — dehydration can cause Braxton Hicks contractions that mimic real labour.

Post-Dates Assessment

Visit 10 · Week 40

Blood pressure, urine, fundal height, fetal monitoring, post-dates management discussion, membrane sweep, induction planning

Good to know: Going past your due date is very common, especially for first-time mothers — only about 5% of babies arrive exactly on their estimated due date. In Singapore, the standard approach is to offer induction of labour at around 41 to 41+3 weeks if labour has not started naturally. Before induction, membrane sweeps may be offered to encourage spontaneous labour. If you go past your due date, you will typically be seen more frequently (every 2-3 days) with CTG monitoring and amniotic fluid checks. The decision about induction is always discussed with you — your doctor will explain the evidence-based reasons for their recommendation, and you can ask questions before deciding.

Common checks

  • Blood Pressure — Vigilant monitoring. Any rise is taken very seriously at this stage as the pregnancy reaches 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 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 is commonly performed at 40 weeks in Singapore, especially if the pregnancy has reached or passed the due date. The trace monitors the baby's heart rate and 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) — A membrane sweep may be offered at 40-41 weeks 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 uterine segment. This releases prostaglandins that can help trigger labour. It increases the chance of labour starting within 48 hours by about 20%. The procedure can be uncomfortable but is quick.
  • Post-Dates Management Discussion — Your doctor will discuss what happens if your pregnancy goes past your due date. In Singapore, induction of labour is typically offered between 41 and 41+3 weeks if labour has not started spontaneously. The risks of continuing beyond this point — including a small increase in the risk of stillbirth and placental insufficiency — will be explained. Induction methods include prostaglandin gel or pessary, Foley catheter balloon, 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.
  • Continue monitoring fetal movements and report any changes immediately.
  • If you are offered a membrane sweep, be prepared — it can be done at this visit. Wear comfortable clothing.

Tips

  • Going past your due date is normal and does not mean anything is wrong. Labour will come when it is ready.
  • The decision about induction is yours. Ask your doctor to explain the pros and cons so you can make an informed choice.
  • Stay active with gentle walking if you feel well — it can help encourage the baby to engage and labour to start.
  • If you are anxious about going past your due date, talk to your healthcare team. They are there to support you and answer your questions.

Sources

This overview references public guidance from:

Prenatal Care Schedules by Country