What Happens During an ANC Visit?
What are the procedures and checks carried out at a typical antenatal care appointment?
18/08/2026
Registration and Review of Your ANC Card
Every ANC visit begins with your ANC card being reviewed by your health provider. The ANC card (sometimes called a maternal health booklet) is the single most important document in your pregnancy — it contains a complete record of every measurement, test, and treatment from every visit. This continuity is critical: a health provider seeing you at week 32 who has not seen you before can immediately understand your entire pregnancy history from your ANC card.
Always carry your ANC card to every appointment — not just ANC visits, but to any health facility visit during pregnancy. If you go into labour or need emergency care, your ANC card tells the receiving team everything they need to know about your pregnancy.
Physical Measurements
Your provider will measure and record your weight, blood pressure, pulse, and temperature. If it is your first visit, your height will also be measured. Your abdomen will be palpated (felt externally) to assess uterine size, check the baby's position (from week 28), and from week 24 onward, fundal height is measured with a tape measure — this measurement tracks your baby's growth and is compared against standard growth curves.
From week 20, your provider will also use a Pinard horn or a handheld Doppler device to listen to your baby's heartbeat. A normal fetal heartbeat rate is 110–160 beats per minute. Hearing your baby's heartbeat is reassuring — but a heartbeat that cannot be found is not necessarily an emergency; it may simply require repositioning or a referral for ultrasound assessment.
Urine and Blood Tests
A urine sample is tested at each ANC visit for protein (a warning sign of preeclampsia), glucose (a screen for gestational diabetes), and signs of infection. You may be asked to collect a clean-catch midstream urine sample — your provider will explain how.
Blood tests are typically done at the first visit (full baseline panel) and again at around week 28 (haemoglobin recheck, glucose if indicated). If you are HIV-positive and on ART, viral load tests may be ordered at specific intervals to monitor your treatment response.
Treatments and Preventive Interventions
At each ANC visit, you may receive one or more of the following treatments depending on your gestational age and previous doses: iron and folic acid supplement refill; IPTp-SP (malaria prevention tablet, given at each visit from 13 weeks in malaria-endemic areas, with at least 4 weeks between doses); tetanus toxoid vaccination (series of 2–5 doses depending on your vaccination history); deworming tablet (mebendazole, given once at mid-pregnancy); and an insecticide-treated bed net if not yet received.
All of these are provided free at government health facilities in Rwanda. If you have been given a prescription, ask your provider exactly how and when to take each medication, and what to do if you experience side effects.
Counselling and Education
Every ANC visit includes structured health education and counselling. Topics covered include nutrition and weight gain, danger signs requiring emergency attendance, HIV status disclosure and partner testing, breastfeeding preparation, birth preparedness and delivery planning, family planning options for after delivery, and newborn care.
This is your opportunity to ask questions. Write down anything you want to ask before the appointment — the visit can feel rushed, and questions you forget in the moment may remain unanswered until the next visit weeks away. No question is too small. Your health provider is there to support you.
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