Section 7: ANC Visit & Screening Calendar (India)
Medical disclaimer: Educational content only, not medical advice. Visit frequency and test timing vary by facility protocol, risk category (PMSMA high-risk), and individual clinical findings. This page re-indexes timing already covered in Section 2 and the Family Journey hub — it does not replace clinician judgment.
Evidence tags: See the Evidence Rating Key on the Deep Research overview.
Overview
Use this calendar alongside your antenatal card and ASHA/ANM guidance. High-risk pregnancies (PMSMA categories) require more frequent specialist visits (a) — see Stage 2 PMSMA framework.
India protocol anchors: Aim for WHO’s eight antenatal contacts where feasible; India’s NHM programmes have historically used a minimum four-visit framework and increasingly encourage additional contacts (PMSMA, high-risk pathways). Confirm your state ANC card schedule. Also: DIPSI GDM screening, TIFFA anomaly scan, Rh anti-D at 28 weeks, Td immunization, IFA/calcium from 14 weeks (a).
Preconception (Before Stopping Contraception)
| Timing | Action | Detail |
|---|---|---|
| 3–6 months before | Folic acid, chronic disease optimization, rubella immunity | Section 1 · Stage 2 §1 |
| When planning | HPLC thalassemia screening (FOGSI universal) | Stage 2 §1C |
| If not conceiving | Fertility evaluation at 12 mo (<35) or 6 mo (≥35) | Section 2 — Infertility workup |
Trimester 1 (Weeks 1–13)
| When | Visit / test | Purpose (a) |
|---|---|---|
| As soon as pregnancy confirmed | Register ANC; PMSMA high-risk screening | Stage 2 §3 |
| Before 10–12 weeks | First ANC visit — baseline labs | Hb, blood group/Rh, TSH, HPLC, HIV/HBsAg/VDRL/Rubella IgG, urine C/S, DIPSI 75g (early GDM screen if indicated) · Stage 2 checklist |
| Weeks 6–9 | Dating/viability ultrasound | Confirm intrauterine pregnancy, heartbeat, EDD |
| Weeks 11–14 | First-trimester combined screening / NIPT | Where available (b) · Section 2 T1 |
| Weeks 12–16 | Low-dose aspirin | If high preeclampsia risk — clinician-directed (a) |
| Ongoing | Td-1 at first ANC registration | Td-2 four weeks later (a) · Stage 2 vaccination matrix |
Red flags: bleeding, severe pain, hyperemesis unable to retain fluids — Stage 2 warning signs
Trimester 2 (Weeks 14–27)
| When | Visit / test | Purpose (a) |
|---|---|---|
| From week 14 | Start IFA + calcium supplementation | Stage 3 Master Schedule |
| Weeks 18–22 (to 24) | TIFFA / Level II anomaly scan | Structural anatomy; placental location; PCPNDT compliance (a) · Stage 3 §4 |
| Weeks 24–28 | DIPSI GDM repeat (if first test negative) | 75g OGTT; ≥140 mg/dL at 2h = GDM (a) · Stage 3 §3 |
| Weeks 24–28 | Rh-negative: repeat ICT | Stage 3 §5 |
| Week 28 | Rh-negative unsensitized: Anti-D 300 mcg | Stage 3 §5 · Section 2 Rh patch |
| Each visit | BP, weight, Hb (as indicated), fundal height | Preeclampsia/anemia surveillance (a) |
Red flags: painless bleeding, preterm contractions, severe headache — Section 2 T2 red flags
Trimester 3 (Weeks 28–40+)
| When | Visit / test | Purpose (a) |
|---|---|---|
| Weeks 28–32 | Growth scan (EFW, AFI, placenta) | Many Indian centres offer routine late scan (a) · Stage 4 §1 |
| Weeks 28–32 | Repeat Hb | Anemia may worsen in late pregnancy (a) |
| From week 28 | Fetal movement pattern tracking | Stage 4 §2 |
| ~36 weeks | Growth/placental position scan (if indicated) | Common Indian practice (a) · Section 2 T3 |
| Weeks 35–37 | GBS screening | Not universal in India — hospital-dependent (a) · Stage 4 §3 |
| Each visit | BP, urine protein, symptom review | Late preeclampsia surveillance (a) |
| Week 34–36 | Birth preparedness | Hospital bag, transport plan (a) · Stage 4 §5 |
Red flags: reduced movements, bleeding, PPROM, preeclampsia symptoms — Stage 4 caution block
Intrapartum & Immediate Postpartum
| When | Action | Reference |
|---|---|---|
| Labour / delivery | Fetal monitoring, Rh-positive baby → Anti-D within 72h if Rh-negative mother | Section 8 |
| First 48 hours | Pre-discharge checklist (lochia, vitals, latch, contraception counselling) | Stage 5 §1 |
| 6 weeks postpartum | EPDS/mood screen; GDM OGTT if had GDM; contraception plan | Stage 5 §5a · Section 5 |
Postpartum & Newborn Home Visits (ASHA HBNC)
| Setting | Schedule (a) |
|---|---|
| Institutional delivery | Days 3, 7, 14, 21, 28, 42 |
| Home delivery | Days 1, 3, 7, 14, 21, 28, 42 |
Full detail: Stage 5 HBNC table
High-Risk Pregnancy — Extra Monitoring (Summary)
Refer to specialist OB-GYN when PMSMA flags apply (a). Additional surveillance may include:
- More frequent growth scans and Doppler (a)
- Cervical length (if prior preterm birth) (a)
- Monochorionic twin TTTS surveillance from ~16 weeks (a)
- Tighter GDM glucose monitoring (a)
- Maternal-fetal medicine referral for previa/accreta, IUGR, recurrent loss (a)
Detail: Section 2 — High-risk markers · Stage 2 PMSMA
Quick Reference — Where Full Protocol Lives
| Topic | Primary page |
|---|---|
| First ANC labs | Stage 2 |
| IFA / calcium / supplements | Stage 3 |
| DIPSI GDM | Stage 3 · Section 2 T2 |
| TIFFA / PCPNDT | Stage 3 |
| Labour prep & warning signs | Stage 4 |
| Postpartum & schemes | Stage 5 |
| Trimester deep detail | Section 2 |
← Section 6: Toxicology | Deep Research Index | Section 8: Labor & Delivery →