Your Antenatal Care Pathway on the Isle of Man

How to access antenatal care

Since January 2024, the Isle of Man has offered an antenatal self-referral system. You can refer yourself directly for antenatal care through the Manx Care maternity website, without needing to visit your GP first. This system is expected to free up more than 600 GP and community midwife appointments per year.

Ideally, you should refer yourself when you are 6 to 7 weeks pregnant. If you find out later, refer yourself as soon as you can. You can also still go through your GP if you prefer.

For step-by-step guidance on getting started, see our guide to booking a midwife on the Isle of Man.

Booking appointment (8–10 weeks)

Your first hospital visit is your booking appointment with a midwife at the Jane Crookall Maternity Unit. This appointment lasts about one hour and covers a lot of ground. The midwife will:

• Take a detailed medical history, including any previous pregnancies, operations, and family medical history
• Check your blood pressure, height, and weight
• Test your urine
• Measure your carbon monoxide level
• Ask about your physical and mental health and wellbeing
• Take blood samples for routine screening tests
• Discuss your care plan and options, and answer your questions

There is not routinely a scan at the booking appointment. You will be given a date for your next visit, usually at around 13 to 16 weeks.

Blood tests and screening

Blood tests taken at or around the booking appointment screen for:

• Blood group and Rhesus status — if you are Rhesus negative, you will be offered anti-D injections during pregnancy to prevent complications
• Full blood count — to check for anaemia and other conditions
• Hepatitis B
• HIV
• Syphilis
• Rubella immunity — to check whether you are protected against German measles
• Sickle cell and thalassaemia — inherited blood disorders

You will also be offered combined screening for Down's syndrome, Edwards' syndrome, and Patau's syndrome. This combines a blood test with measurements taken at your dating scan.

Dating scan (11–14 weeks)

Your first ultrasound scan — the dating scan — takes place at around 12 weeks of pregnancy. This scan:

• Confirms your due date by measuring your baby
• Checks that the pregnancy is developing normally
• Checks whether you are carrying more than one baby
• Measures the fluid at the back of your baby's neck (nuchal translucency) as part of combined screening for chromosomal conditions

The scan is carried out at Noble's Hospital and usually takes around 20 minutes. You may be asked to drink water beforehand to help produce a clear image.

Review appointment (13–16 weeks)

By this appointment, the maternity team will have your medical history, blood results, and scan findings. They will:

• Discuss your blood test results and screening results
• Agree a plan for your ongoing antenatal care
• Decide whether you need any additional monitoring or specialist input

This is also a good time to ask about the whooping cough vaccination, which is recommended from 16 weeks.

Anomaly scan (18–21 weeks)

Your second routine ultrasound — the anomaly scan (also called the 20-week scan) — is a detailed check of your baby's development. The sonographer will examine:

• Your baby's brain, face, and spine
• Heart and major blood vessels
• Stomach, kidneys, and bladder
• Arms, legs, hands, and feet
• The placenta and amniotic fluid levels

The scan usually takes around 30 minutes and is carried out at Noble's Hospital. If any concerns are found, you will be referred for further investigation.

Routine antenatal care on the Isle of Man funds two scans during pregnancy (the dating scan and the anomaly scan). Additional scans may be arranged if clinically needed.

Regular midwife appointments (25–40 weeks)

After your anomaly scan, you will have regular appointments with your community midwife at your GP practice. The frequency depends on whether this is your first or subsequent pregnancy:

This schedule is based on the NICE-recommended pathway, which the Isle of Man generally follows. Your individual schedule may vary — your midwife will discuss your specific care plan with you.

At each appointment, your midwife will typically check your blood pressure, test your urine, measure your bump (from around 25 weeks), and discuss how you are feeling. From around 36 weeks, they will also check your baby's position.

Some women may be seen more frequently at the hospital if their pregnancy requires additional monitoring. Your midwife will discuss your individual care plan with you.

Growth scans

If there are any concerns about your baby's growth or development, you may be offered additional growth scans in the third trimester. These are not part of the routine pathway for all women but may be recommended if:

• Your bump is measuring smaller or larger than expected
• You have a medical condition such as diabetes or high blood pressure
• You had complications in a previous pregnancy
• You are carrying twins or multiples

Health visitor appointment (around 35 weeks)

A health visitor appointment is arranged automatically by Manx Care at around 35 weeks of pregnancy. The health visitor will discuss:

• What to expect after your baby is born
• Feeding options and support
• Your emotional wellbeing
• Services available to you and your family on the Isle of Man

How IoM antenatal care compares to UK NICE guidelines

The Isle of Man's antenatal care pathway broadly follows the NICE (National Institute for Health and Care Excellence) guidelines used across the UK. Key similarities include:

• Same routine screening tests and blood tests
• Same scan schedule (dating scan at 12 weeks, anomaly scan at 20 weeks)
• Same appointment frequency recommendations
• Equivalent clinical standards of care

Key differences from the UK:

• Self-referral is new — the antenatal self-referral system was introduced in January 2024. Previously, a GP referral was required (and this route is still available)
• One maternity unit — all hospital-based care is at the Jane Crookall Maternity Unit at Noble's Hospital. There is no choice of hospital
• Manx Care, not the NHS — healthcare is delivered by Manx Care, a separate organisation from the UK's NHS
• Shared care model — antenatal care is shared between the hospital and your GP practice

For a full comparison, see our Isle of Man vs UK pregnancy guide.

Contact the Jane Crookall Maternity Unit

To self-refer for antenatal care, use the referral form on the Jane Crookall Maternity Unit page, ideally at 6 to 7 weeks of pregnancy. For details of the clinics themselves, see the Manx Care antenatal clinics page.

Further information

You may also find our other guides helpful:

• How to book a midwife on the Isle of Man
• Vaccinations in pregnancy on the Isle of Man
• Dental care during pregnancy on the Isle of Man
• Newborn screening tests on the Isle of Man
• Maternity preparation checklist
• Frequently asked questions

Sources

• Jane Crookall Maternity Unit — gov.im
• Antenatal Clinics and Self-Referral — gov.im
• Children and Families Health Visiting — gov.im