The Government of Nepal, through the Ministry of Health and Population – Family Welfare Division, recommends 8 antenatal care (ANC) visits during pregnancy. These are ideally scheduled around the 12th, 16th, 20–24th, 28th, 32nd, 34th, 36th, and 38–40th weeks of gestation.
Similarly, the World Health Organization (WHO) also advises that pregnant women should have at least 8 ANC contacts, with the first contact occurring within the first 12 weeks, followed by visits at 20, 26, 30, 34, 36, 38, and 40 weeks. Evidence shows that increasing ANC contacts from 4 to 8 can significantly reduce perinatal deaths—by up to 8 per 1,000 births.
It’s important to note that different hospitals may follow slightly different ANC schedules based on their clinical practices. The schedule I’ve recommended here integrates both global guidelines and national protocols while ensuring that essential tests and interventions are done at the most appropriate time during pregnancy. This approach aims to provide comprehensive and timely care for both the mother and the baby.
ANC Visit Schedule and Key Interventions
1st Visit: 6–12 Weeks
– Confirm pregnancy
– Baseline lab tests: CBC, Blood Group, Urine routine, HIV, HBsAg, VDRL, Thyroid (if indicated)
– First ultrasound: Confirm intrauterine pregnancy, fetal viability, rule out ectopic/molar pregnancy
– Start folic acid
2nd Visit: 11–13 Weeks
– NT (Nuchal Translucency) Scan
– Dual Marker Test (β-hCG & PAPP-A)=Blood test for Down syndrome screening
– Start Iron and Calcium supplements along with folic acid from 13–14 weeks
– Continue these supplements till 45 days postpartum
3rd Visit: 16–17 Weeks
– First dose of Tetanus (TT/Td) vaccine
– Schedule the second dose after 4 weeks
4th Visit: 20–22 Weeks
– Detailed Anomaly Scan (Level II): Fetal anatomy, placenta, amniotic fluid, congenital anomalies. 18- 22 weeks anomaly scan can be done but the best time is 20 weeks.
5th Visit: 24–28 Weeks
– Oral Glucose Tolerance Test (OGTT) for gestational diabetes
– Repeat Hemoglobin
6th Visit: 30–32 Weeks
– Ultrasound for fetal growth, amniotic fluid, and movement
– Monitor BP, weight, fetal heart rate
7th Visit: 34–36 Weeks
– Growth scan
– Pelvic examination if indicated
– Counseling on labor signs, birth plan, and hospital readiness
8th Visit and Beyond: 36–40+ Weeks
– Weekly or biweekly visits
– Monitor BP, fetal heart rate and movements
– Watch for signs of labor or complications
– WHO recommends visits at 36, 38, and 40 weeks
Note* in every ANC visit, check Blood pressure, weight of the mother, and check urine albumin and urine glucose
