Your ANC Journey: What Happens at Each Visit?

What is the purpose of each antenatal care contact, and what should you expect?

18/08/2026

Your ANC Journey: What Happens at Each Visit?

How Many ANC Visits Should You Have?

Rwanda Ministry of Health recommends a minimum of four antenatal care contacts during pregnancy, timed at approximately weeks 12 (or earlier), 20, 28–32, and 36–40. The WHO 2016 guidelines recommend eight or more contacts for the best outcomes, and Rwanda is working toward increasing the number of contacts women receive.

Each visit has a specific purpose and builds on the information gathered at the previous one. Missing any visit means missing critical monitoring opportunities — particularly blood pressure checks, which are essential for detecting preeclampsia, the leading cause of maternal death in Rwanda.

The First ANC Contact (Before 12 Weeks)

The first visit is the most comprehensive. Your health provider will take your full medical history, calculate your due date, measure your blood pressure, weight and height, test your blood (HIV, syphilis, haemoglobin, blood type), test your urine, and prescribe iron, folic acid, and other supplements. You will receive your ANC card and a malaria bed net if needed.

If you are HIV-positive, treatment begins immediately. If your syphilis test is positive, treatment with penicillin is started at the same visit. These treatments are free at all public health facilities in Rwanda through the national PMTCT programme.

The Second ANC Contact (Around Week 20)

The second ANC contact typically occurs around week 20. Your provider will measure your blood pressure and test your urine for protein, check your weight, review your haemoglobin and supplement use, and assess your baby's growth by measuring the fundal height (the distance from your pubic bone to the top of your uterus).

If you have not yet had an ultrasound, this visit may include a referral for an anatomy scan, which checks for structural abnormalities in your baby. Your provider will give you the next dose of IPTp-SP (malaria prevention) and check your tetanus vaccination status.

The Third ANC Contact (Around Week 28–32)

The third contact is important because preeclampsia and gestational diabetes become more likely to appear in this period. Your blood pressure and urine will be carefully checked. From this week, you should begin counting your baby's daily movements — a reassuring sign of wellbeing.

If your haemoglobin is low at this visit, your iron dose may be increased. Your provider will check the baby's position and give another dose of IPTp-SP. This visit is also an opportunity to begin discussing your birth plan — where you will deliver, your transport plan, who will support you, and when to go to the facility.

The Fourth ANC Contact (Weeks 36–40)

The fourth and final scheduled ANC contact occurs in the final weeks of pregnancy. Your provider will assess the baby's position (head-down is normal for birth), check your cervix, perform a final blood pressure and urine check, and review your birth plan. This visit includes a discussion of labour signs — when to go to the facility, what to expect during labour, and warning signs requiring immediate hospital attendance.

If your baby is in a breech position (bottom-down) at week 36, your provider will discuss options including referral to a hospital equipped for caesarean delivery. Your ANC card should be complete and must accompany you when you go into labour.

You're Pregnant: What Should You Do First?

The first actions you take after confirming a pregnancy set the foundation for your entire care journey. Here is what Rwanda Ministry of Health recommends you do immediately.

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