Outpatient clinic appointments during pregnancy

The ultrasound screening examination in early pregnancy is performed either vaginally or from the top of the abdominal wall. The bladder should be empty. The examination will provide us with more information on the duration of the pregnancy, the due date, the number of fetuses, and the fetal heart rate. We will also examine the general structure of the fetus. We can also perform a nuchal translucency scan associated with screening for chromosomal aberrations which may be a first indication of a structural abnormality of the fetus.

The structural ultrasound examination will be performed from the top of the abdominal wall. We will determine the structure and growth of the fetus, the volume of amniotic fluid, and the location of the placenta in the uterus. A fetal sex determination is not part of the examination, but we can try to determine the sex of the fetus, if the parents so desire.

At this point, you can already feel the movements of the fetus, which will have become more distinct. The baby may already grab its toes or put a finger in its mouth. If the position of the fetus is favorable, the ultrasound examination may even allow us to admire the baby's side profile.

The screening for chromosomal disorders (Down syndrome and Edwards syndrome) is based on a risk calculation that also takes into account your age. In the combined screening, we will take a blood sample from you during pregnancy weeks 9–11 and use an ultrasound scan to measure the size of your fetus (crown-rump length) and the nuchal translucency during pregnancy weeks 11–13+6.

The maternity clinic (neuvola) will make you a referral for a laboratory test for pregnancy week 10+0, as estimated by your menstrual cycle. The ultrasound examination will be scheduled for 11+5 to 13+0 weeks of pregnancy. With the combined method, we can find up to 80% of chromosomal aberrations.

Any further examinations in the Uusimaa region will be conducted in the Fetomaternal Medical Center (FMC) at Women's Hospital.

• Hypertension
• Plural pregnancy
• Premature contractions
• Abnormal presentation, such as the fetus being in breech presentation
• Glucose metabolism disorder (gestational diabetes)
• Assessment of the delivery method when the previous childbirth has been a Cesarean section or when there is a suspicion that the fetus is growing to be too big
• Need for special support for social, mental, or substance-related reasons.

​In the maternity outpatient clinic, we provide information on the effect of gestational diabetes on the baby and on the long-term risks for the mother. During the appointment, we provide guidance on the home monitoring of blood glucose and the treatment of gestational diabetes with diet and medication. Our treatment team includes a midwife and a physician.

Treatment and monitoring objectives:

• Normalization of blood glucose levels during pregnancy
• Home monitoring of blood glucose and the success of any drug therapy
• Adopting healthy eating habits and increasing physical activity
• Preventing further complications resulting from gestational diabetes
• Reducing the risk of developing type 2 diabetes.

At the appointments for mothers with substance abuse and drug problems (HAL), we provide information on the effects of alcohol and drugs on the fetus and on the course of the pregnancy, as well as provide motivation for a substance-free life. Our treatment team includes a physician, midwife, and social worker. HAL appointments are offered at the maternity outpatient clinics in Women's Hospital and Jorvi and Hyvinkää hospitals.

Treatment and monitoring objectives:

• Ending or reducing substance use, referral to detoxification
• Diagnosing and treating diseases and nutritional disorders threatening the mother's pregnancy
• Identifying fetal developmental and growth disorders caused by substance abuse
• Assessing the mother's ability to care for the newborn
• Assessing the need for child protection
• Assessing the potential for continuing a pregnancy
• Providing support for growth as a parent.

A midwife's or physician's appointment for fear of childbirth enables you to discuss issues causing anxiety or fear. We provide information and assistance in preparing for childbirth. For an appointment due to fear of childbirth, you need a referral which can be made by a physician or a nurse at the maternity clinic (neuvola) or by a private physician. If necessary, we can consult other occupational groups, such as experts in psychology.

Childbirth causes some nervousness and fear in nearly all people. A small amount of nervousness can even be beneficial, because it raises the adrenaline level and helps to prepare for childbirth. Actual fear of childbirth is when the fear interferes with normal life and overshadows the joy of pregnancy. This level of fear is experienced by 5–6% of women.

Nyytti group

​In addition to the discussion support provided by maternity clinics (neuvola) and clinics for fear of childbirth, we arrange special Nyytti support groups for those suffering from fear of childbirth. The Nyytti group is especially suited for you, if you are pregnant for the first time, you are nervous about childbirth, you want to talk with other expectant mothers about issues related to pregnancy and childbirth, and you want to learn how to relax under the guidance of a psychologist.

The groups are primarily intended for first-time mothers in Women's Hospital and the Espoo hospitals, and you can attend the groups starting from pregnancy week 25 onwards. However, your maternity clinic (neuvola) can refer you to the group already at an earlier stage of your pregnancy. When we get a referral, our midwife will call you and direct you to the right group.

One group can accommodate six first-time mothers at a time. Spouses can attend one of the group's meetings, and when the babies are born, the group will meet one more time.

The Nyytti group is led by a psychologist specialized in pregnancy and childbirth issues. One of the meetings will be held in a delivery room under the guidance of a midwife specialized in the fear of childbirth. You can get the required referral from your maternity clinic (neuvola).

Syli special prenatal training

We offer Syli special prenatal training classes for first-time mothers who experience a mild or moderate level of fear of childbirth. The training lasts for three hours, and one group has a maximum of eight mothers participating. The training is led by a midwife and a nurse. You can bring a spouse or support person with you. During the training, we go through the course of childbirth, pain relief, a sense of being in control, as well as relaxation when the labor begins and progresses. We also discuss the first days after childbirth.  

The nurse at your maternity clinic (neuvola) will refer you to a Syli prenatal training group if necessary.

Sometimes when pregnant, you may need inpatient monitoring at hospital. The problem may be, for example, high blood pressure, threat of premature delivery, or abnormal bleeding. Inpatient care may also be required due to the wellbeing of the fetus.

We will plan your treatment individually in cooperation with the obstetricians and midwives. Family and other loved ones are welcome to visit you on the ward, but staying overnight on the ward is not possible.

​A pregnancy is post-term when it has lasted more than 42 weeks. Follow-up visits in late pregnancy are started when the duration of the pregnancy is 41 weeks and 5 days (41+5). You can book an appointment for a post-term checkup by calling either the induction unit or the maternity outpatient clinic at the maternity hospital.

In general, you can wait quite patiently for labor to start naturally. The purpose of post-term appointments is to monitor that late pregnancy is progressing safely and to detect any risks associated with an overdue pregnancy, such as insufficiency of the placenta.

During a late-pregnancy appointment, we will check the heart rate of the fetus by conducting a cardiotocogram (CTG) and an ultrasound examination. We will measure your blood pressure and proteinuria, and discuss how you are feeling. In some cases, we may start ripening the cervical canal, either mechanically or medicinally during the late-pregnancy monitoring appointments. In the case of mechanical ripening, you may usually still return home, but after medicinal ripening, you must stay in hospital care. Due to a post-term pregnancy, the induction of labor will be initiated at the latest after 42+1 weeks of pregnancy.