Antenatal visits – what happens at each check-up
What is checked at pregnancy visits in South Africa, which tests are offered and why, what to take with you, and the danger signs that mean go now.
Book early — the first visit does the most
Antenatal care is free at public clinics in South Africa and you do not need a referral. Booking as soon as you know you are pregnant matters more than most people realise: the first visit sets up everything that follows, and several of the things it finds are far easier to act on early.
- Take your identity document, your clinic card if you have one, and a list of any medicines you take.
- You will be given a maternity case record to keep. Bring it to every visit and to the birth — it is the record everyone works from.
- Say if you have any long-term condition, if you take any medicine, or if you have had a difficult pregnancy before.
What is checked, and why
- Blood pressure, at every visit. Rising blood pressure in pregnancy can develop into pre-eclampsia, which is dangerous and has few symptoms early. This single check is the reason the visits are as frequent as they are.
- Urine, for protein and infection. Protein with raised blood pressure is a warning sign; a urine infection in pregnancy needs treating even without symptoms.
- Weight and, later, the size of the uterus, to track the baby's growth.
- Blood tests: haemoglobin for anaemia, blood group and rhesus status, syphilis, and HIV.
- The baby's heartbeat, and later the baby's position.
- How you are feeling, including your mood — depression in and after pregnancy is common and is asked about deliberately.
Commonly supplied or continued during pregnancy:
Folic Acid — Folic Acid Lennon, Folik
Neural tube defect prevention; megaloblastic anaemia; folate supplementation in pregnancy
Ferrous Sulfate — FerroGrad, Ferrous Sulfate Lennon, Ferro-Gradumet, Fefol
Iron deficiency anaemia; iron supplementation in pregnancy
Tenofovir / Lamivudine / Dolutegravir (TDF/3TC/DTG) — Dovato TLD
HIV-1 infection — first-line regimen (alternative FDC)
How often you will be seen
Visits are spaced further apart early in pregnancy and become more frequent towards the end, when blood pressure and the baby's growth need closer watching. Your clinic will give you the schedule and write the next date in your record. If you miss a visit, go as soon as you can rather than waiting for the next scheduled one.
- Ask what to do if you go into labour, and where you should go. Know this well before it happens.
- Ask about the tetanus vaccine and any others recommended in pregnancy.
- Discuss feeding and contraception after birth before the birth, not after.
Danger signs in pregnancy
Common questions
- Is antenatal care free in South Africa?
- Yes, at public clinics, and you do not need a referral. Take your identity document and any medicines you are on, and book as early in the pregnancy as you can.
- Why is my blood pressure checked at every antenatal visit?
- Because rising blood pressure can develop into pre-eclampsia, which is dangerous and often has no early symptoms. That check is the main reason antenatal visits are as frequent as they are.
- What are the danger signs in pregnancy?
- Bleeding, severe abdominal pain, a severe headache, blurred vision, sudden swelling of the face or hands, a fit, a high fever, fluid leaking early, or reduced baby movements. Go to a facility immediately rather than waiting.
Sources
- Guidelines for Maternity Care in South AfricaNational Department of Health, South Africa
- Primary Healthcare Standard Treatment Guidelines and Essential Medicines ListNational Department of Health, South Africa
- National Consolidated Guidelines for the Management of HIV in Adults, Adolescents, Children and InfantsNational Department of Health, South Africa
- Clinical and public health guidanceWorld Health Organization
Last reviewed 11 August 2026.