The fourth should be the final visit of the basic component and should take place between weeks 36 and 38.

Review individualised birth plan, prepare women and their families for childbirth such as selecting a birth location, identifying a skilled attendant, ensuring social support, planning for costs of transportation and supplies for her care and the care of her newborn.
Complication readiness: develop an emergency plan which includes transportation, money, blood donors, and designation of a person to make a decision on the woman's behalf and person to care for the family while she is away.
Re-inform women and their families of the benefits of breastfeeding and contraception as well as the availability of various methods at the postpartum clinics.
Perform relevant examination.
Review special care and treatment for HIV-positive women according to the Guidelines for PMTCT of HIV in Ethiopia.

Review relevant issues of medical history as recorded at the three previous visits.
Note intercurrent diseases, injuries or other conditions since the third visit.
Note intake of medicines other than iron and foliate.
Ensure compliance with iron intake.
Note other medical consultations, hospitalisation or sick-leave since the third visit.

Final review of obstetric history relevant to any previous delivery complications. Record symptoms and events since the third visit. Ask about:

Vaginal discharge and/or bleeding.
Dysuria, frequency, urgency during micturition.
Severe or persistent headache or blurred vision.
Difficulty breathing.
Fever.
Severe abdominal pain.
Foetal movement; note time of first recognition in the medical record.
Other specific symptoms or events such as opportunistic infections in HIV-positive women.
Changes in body features or physical capacity, observed by the woman herself, her partner, or other family members.

Measure and record vital signs (BP, PR, weight, temperature or RR)
Measure uterine height and record on the graph.
Check for multiple foetuses.
Confirm foetal lie and presentation (head, breech, transverse).
Check for foetal heart sound(s) and record.
Check for generalised oedema.
Check for other signs of diseases like shortness of breath, cough, etc.
If there is bleeding or spotting, never do vaginal examination (see section on APH).

Repeat the advice given at previous visits.
Give advice on measures to be taken in case of the initiation of labour or leakage of amniotic fluid.
Give advice on breastfeeding.
Give time for free communication and answer and questions.
Reconfirm written information on what to do and where to go (place of delivery) in the case of labour or any other need.
Schedule appointment, if the woman does not deliver by the end of week 41 (state date and write it on the ANC card).
Schedule appointment for a postpartum visit.
Provide recommendations on lactation and contraception.

Complete the FANC part of the integrated client card.
Complete the registration log book.
Give the appointment card to the client and advise her to carry with her to the hospital or any appointments site for the necessary health services.