How many antenatal visits?
India’s national guidelines call for at least four antenatal check-ups, including one in the first trimester. The WHO now recommends at least eight contacts for a positive pregnancy experience, and most private obstetricians see women monthly until 28 weeks, every two weeks until 36 weeks and weekly after that. Under the Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA), pregnant women can get a free check-up by a doctor on the 9th of every month at government health facilities.
The timeline at a glance
| Weeks | What happens |
|---|---|
| 6–10 | First visit, registration, MCP card, routine blood & urine tests, dating scan |
| 11–13+6 | NT scan + double marker (first-trimester combined screening) |
| 14 onwards | Iron-folic acid and calcium daily; albendazole once after the first trimester |
| 15–20 | Quadruple marker if first-trimester screening not done |
| 18–22 | Anomaly (Level-II / TIFFA) scan |
| 24–28 | 75 g OGTT for gestational diabetes; haemoglobin re-check |
| 27–36 | Tdap / Td vaccination as advised |
| ~28 | Anti-D injection if Rh-negative |
| 28–32 | Growth scan ± Doppler |
| 36–40 | Weekly visits, baby’s position, birth planning |
| 40–41+ | Monitoring (NST, AFI) and discussion of induction |
Use the due date calculator to see the exact dates of each window for your pregnancy.
The main ultrasound scans
Dating / viability scan (6–9 weeks)
Confirms the pregnancy is in the uterus, checks the heartbeat, counts babies and measures crown-rump length to date the pregnancy accurately. Often done transvaginally.
NT scan (11w 0d – 13w 6d)
Measures the fluid at the back of the baby’s neck (nuchal translucency). Combined with the double marker blood test (PAPP-A and free β-hCG) and your age, it estimates the chance of Down syndrome and some other chromosomal conditions. It is a screening test – a higher-chance result is followed by further tests, not a diagnosis.
Anomaly / Level-II / TIFFA scan (18–22 weeks)
A detailed check of the baby’s brain, face, spine, heart, kidneys, limbs, placenta and fluid. It is the most important scan of pregnancy for detecting structural problems.
Growth scan (28–32 weeks, sometimes later)
Estimates weight, checks fluid levels and position, and may include Doppler studies of blood flow.
Under the PCPNDT Act, 1994, revealing or determining the sex of the fetus is a punishable offence in India. Scan centres must not disclose it – and parents should not ask.
Blood and urine tests
- First visit: complete blood count/haemoglobin, blood group and Rh type, blood sugar, thyroid (TSH), HIV, hepatitis B (HBsAg), syphilis (VDRL), urine routine; sometimes thalassaemia screening (HbA2/HPLC), rubella and hepatitis C.
- Gestational diabetes: India’s national guideline recommends a 75 g glucose test (2-hour value ≥140 mg/dL indicates GDM) at the first visit and again at 24–28 weeks.
- Every visit: blood pressure, weight, urine protein and sugar.
Vaccines and supplements
- Td (tetanus-diphtheria): two doses four weeks apart in the first pregnancy, or one booster if vaccinated in a pregnancy within the last three years.
- Tdap: many obstetricians recommend it at 27–36 weeks to protect the newborn from whooping cough.
- Influenza vaccine: recommended in any trimester during flu season by many doctors.
- Folic acid in the first trimester; iron-folic acid (60 mg iron + 500 mcg folic acid) daily from the second trimester for at least 180 days; calcium 1 g daily in two doses.
Frequently asked questions
Is the NT scan compulsory?
It isn’t compulsory, but it is strongly recommended as part of first-trimester screening. It must be done between 11 weeks and 13 weeks 6 days.
What is a TIFFA scan?
TIFFA stands for Targeted Imaging for Fetal Anomalies – another name for the detailed anomaly (Level-II) scan at 18–22 weeks.
Are antenatal check-ups free in India?
Yes, at government facilities. PMSMA offers a free specialist check-up on the 9th of every month, and JSSK covers free delivery, medicines, tests and transport in public hospitals.
Medical disclaimer: The results and information on this page are estimates for general education only. They are not a diagnosis and do not replace advice from your gynaecologist, obstetrician or midwife. If you have pain, bleeding, reduced baby movements or feel unwell, contact your doctor or call 108 immediately. Read the full disclaimer.
Sources & further reading
- Ministry of Health & Family Welfare, Government of India. Maternal health guidelines, PMSMA and Anemia Mukt Bharat. nhm.gov.in
- World Health Organization. WHO recommendations on antenatal care for a positive pregnancy experience (2016). who.int
- Diabetes in Pregnancy Study Group India (DIPSI) & MoHFW. National Guidelines for Diagnosis & Management of Gestational Diabetes Mellitus (2018).
- Federation of Obstetric and Gynaecological Societies of India (FOGSI). Clinical practice recommendations. fogsi.org