Pregnancy Week 16: Your Midwife Appointment and Antenatal Classes

8 min read

Quick answer: At 16 weeks you have a routine NHS midwife appointment: your blood pressure and urine are checked, your 12-week blood test and screening results reviewed, and a handheld Doppler may let you hear your baby's heartbeat for the first time. You'll also get information about the 20-week anomaly scan. It's a good week to book antenatal classes, as NCT classes fill up quickly.

What parents need to know

Week 16 brings one of your routine NHS antenatal appointments, and for many parents, the moment they've been quietly hoping for: hearing their baby's heartbeat for the first time. This week is also a good time to start thinking about antenatal classes and how you'd like to prepare for the birth.

The Crib

Your baby at 16 weeks

Key numbers for week 16 of pregnancy

About 11.6cm

Crown to rump

Roughly the size of an avocado

Heart rate: Around 120 to 160 beats per minute

Next scan: 20-week anomaly scan, between 18 and 21 weeks

First movements felt: Usually weeks 18 to 24 in a first pregnancy

Sources: NHS, NCT, Tommy's, Royal College of Psychiatrists. General information, not medical advice.

How big is your baby at 16 weeks?

Your baby is now roughly the size of an avocado — about 11.6cm from crown to rump. From this point onwards, your baby gains weight increasingly quickly, particularly from 28 weeks when fat deposits begin to build up beneath the skin.

What's happening with your baby?

Your baby's eyes, though still sealed, are beginning to make slow side-to-side movements — the early beginnings of sight. Their ears are now in their final position on the sides of the head. Hearing is beginning to develop, and your baby may be able to detect sounds from outside the womb — particularly lower-frequency sounds such as your voice and heartbeat. Research suggests that babies recognise their mother's voice at birth, having heard it throughout pregnancy.

Your baby's circulatory and urinary systems are both working. The heart is pumping approximately 25 litres of blood per day. Toenails are forming, and the skin, while still thin, is developing more layers. Your baby is making coordinated limb movements, though most women don't feel these clearly until weeks 18 to 24 in a first pregnancy.

Close-up of a baby reaching out to hold hands with a caregiver against a dark green background.

Your 16-week antenatal appointment

This appointment with your midwife is typically shorter than the booking appointment but covers several important areas. Your midwife will check your blood pressure and urine, and review the results from your blood tests and any screening you chose at 12 weeks. They will discuss the results of your Down's syndrome screening with you and offer any necessary follow-up if needed.

Your midwife may also use a handheld Doppler device to listen to your baby's heartbeat for the first time. Many parents describe this as a deeply moving moment. The heart at this stage beats at around 120 to 160 beats per minute, a rapid, galloping sound.

You'll be given information about your 20-week anomaly scan, which will be arranged for between 18 and 21 weeks of pregnancy.

Antenatal classes: what are your options?

Antenatal classes prepare you and your birth partner for labour, birth, and the early days of caring for your baby. They can be invaluable for first-time parents in particular. The main options in the UK are:

NHS antenatal classes are offered free by most NHS trusts, usually during the third trimester. Ask your midwife when these are scheduled in your area.

NCT (National Childbirth Trust) classes are run by the UK's largest pregnancy charity and are available in most areas. They aren't free, but many parents find them valuable, particularly for the social connections formed with other local parents who are due around the same time. Contact the NCT to find classes near you.

Hypnobirthing classes teach relaxation, breathing, and mindset techniques to manage labour. They are available privately and increasingly popular in the UK. Many midwives also incorporate hypnobirthing principles.

Online courses are a convenient option if in-person classes are difficult to access. Look for courses accredited by reputable organisations.

Whatever type of class you choose, it's worth booking early, particularly NCT classes, which fill up quickly.

Mental wellbeing in the second trimester

Perinatal mental health — mental health during pregnancy and the year after birth — is something the NHS takes seriously. Anxiety and depression during pregnancy are more common than many people realise. If you've been feeling persistently low, anxious, or overwhelmed, speak to your midwife at your 16-week appointment. They can refer you to specialist perinatal mental health support if needed. You do not have to wait for an appointment: if you're worried about your mental health, speak to your maternity unit or GP. If you need urgent help, call NHS 111 and select the mental health option, or ask for an urgent GP appointment. Call 999 or go to A&E now if you do not feel you can keep yourself safe, or someone's life is at risk.

When to get help

Some symptoms in pregnancy can be a sign of something serious and need checking quickly. This is who to contact, and how soon.

Call 999 if:

you're bleeding from your vagina and the bleeding is heavy (soaking a period pad soon after putting it on), or you also have severe pain in your tummy, pain in your shoulder, or feel sick, faint, dizzy or lose consciousness
you have severe difficulty breathing (you're gasping, choking or not able to get words out) or your chest feels tight or heavy
you have pain and swelling in one leg and you also feel short of breath or have chest pain. A blood clot in the leg can travel to your lungs, which can be life-threatening
you have possible signs of sepsis, such as breathing very fast, being confused or having slurred speech, blue, pale or blotchy skin, a rash that does not fade when you press it, or a very high or very low temperature. Being pregnant makes sepsis more likely
you do not feel you can keep yourself safe (a mental health emergency is as serious as a physical one)

Always call 999 if you think it's a life-threatening emergency, no matter what stage of pregnancy you are.

Call your midwife, maternity unit or early pregnancy unit now if:

your baby is moving less than usual, you cannot feel your baby moving anymore, or there is a change to your baby's usual pattern of movements
you have light bleeding or spotting, even if you have no pain or only mild tummy pain
you have stomach pain that is severe or does not go away after you've rested for 30 to 60 minutes, or stomach pain with regular cramping or tightenings, lower back pain, or pain when you pee
you have a gush or trickle of fluid from your vagina, which could be your waters breaking, or vaginal discharge that's unusual for you
your skin is very itchy (for example, it keeps you awake at night), the palms of your hands or soles of your feet are itchy, or the itching is worse at night. This can be a sign of a liver condition called intrahepatic cholestasis of pregnancy (ICP) that needs urgent treatment
your breathlessness comes on suddenly, you're out of breath when you're lying down, or you're breathless and also have chest pain or feel dizzy
you have pain or swelling in one leg, usually in the calf or thigh. This could be a blood clot (deep vein thrombosis, or DVT), which is more likely when you're pregnant
you have a high temperature (38C or above), or you feel hotter than usual or shivery. A high temperature can be a sign of an infection, so it's important to get it checked

If your baby's movements change, do not wait until the next day: call immediately, even if it's the middle of the night. Do not use a home doppler to check the heartbeat yourself. Even if you hear a heartbeat, this does not mean your baby is well.

If you cannot reach them, or you're not sure what to do, call NHS 111.

Speak to your midwife or GP if:

you have not felt your baby move by 24 weeks. Most people start to feel movements between 16 and 24 weeks. If this is your first baby, you might not feel them until after 20 weeks
you're worried about your mental health, or stress, anxiety or low mood are affecting your day-to-day life. If you need urgent help for your mental health, call 111 and select the mental health option, or ask for an urgent GP appointment

Your week 16 checklist

This week:

Attend your 16-week midwife appointment.
Ask about antenatal classes in your area.
Begin researching NCT classes and book early.
Share any concerns about your mental health with your midwife.
Take a moment to enjoy hearing your baby's heartbeat.

Sources & further reading

General information, not individual medical advice. Speak to your GP, midwife or health visitor about your baby’s needs.