How Many ANC Contacts Should I Have?
What is the recommended number of ANC visits and what happens at each one?
18/08/2026
Rwanda's ANC Contact Schedule
Rwanda Ministry of Health follows the WHO 2016 recommendation of eight antenatal care contacts for the best outcomes, with a minimum of four contacts. The recommended timing for the four essential contacts is: Contact 1 — before 12 weeks (first trimester); Contact 2 — around 20 weeks (mid-pregnancy); Contact 3 — around 28–32 weeks (late second/early third trimester); Contact 4 — at 36–40 weeks (final weeks before delivery).
If additional contacts are available at your facility, they are typically timed at weeks 16, 24, 36, and 38. Accept every scheduled ANC contact your facility offers — each one delivers monitoring and interventions that improve your and your baby's outcomes.
Contact 1 (Before 12 Weeks): The Foundation Visit
The first contact is the most comprehensive. It establishes your complete health history, confirms your gestational age, performs a full physical examination, and orders the core panel of blood and urine tests (HIV, syphilis, haemoglobin, blood type, urine protein, urine glucose). You receive your ANC card, iron and folic acid supplements, a first dose of IPTp-SP if eligible, and your first tetanus toxoid vaccination.
The first contact also sets the tone for your entire care relationship. Ask all your questions here — about symptoms you are experiencing, about supplements, about what to expect in your pregnancy. Your health provider is your partner throughout pregnancy.
Contact 2 (Around Week 20): Growth and Development Check
The second contact focuses on your baby's growth and the progression of your pregnancy. Your provider measures fundal height (the distance from your pubic bone to the top of your uterus) to assess whether your baby is growing at the expected rate. Blood pressure and urine protein are carefully checked, as preeclampsia becomes more likely after 20 weeks.
A second dose of IPTp-SP is given. If you have not had an anatomy ultrasound, a referral may be made. You should be able to feel your baby moving by this visit — if not, discuss this with your provider. You will be asked about your folic acid and iron supplement compliance and counselled on nutrition.
Contact 3 (Around Weeks 28–32): Monitoring Complications
The third contact is a critical monitoring point. From week 28, the risk of preeclampsia and gestational diabetes is at its peak. Blood pressure and urine tests are performed with particular attention. A third dose of IPTp-SP is given. Your haemoglobin is rechecked — if anaemia has worsened despite iron supplementation, your dose may be increased or you may be referred for more intensive management.
This is the visit to begin your birth plan discussion in earnest. Discuss with your provider: which facility will you deliver at, what are the warning signs of labour, what symptoms would require immediate hospital attendance before labour begins, and how will you get to the facility?
Contact 4 (Weeks 36–40): Birth Readiness
The final scheduled contact prepares you for delivery. Your provider checks your baby's position — head-down (cephalic) is normal for delivery, and if your baby is in a different position at 36 weeks, you may be referred to a hospital that can perform a caesarean if needed. Your cervix may be assessed. A final blood pressure and urine check is done.
Your birth plan should be complete by this visit. Review it with your provider — they will confirm that your chosen facility is appropriate for your risk level, confirm your transport plan, and review the specific signs of labour and emergency warning signs. Ensure your ANC card is in your delivery bag. At this contact, you are ready for delivery.
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