We would like to provide you with some information about what to expect during your pregnancy and after your baby is born.
We date your pregnancy from the first day of your last period (LMP). This gives us an estimate of your baby's age in weeks, and so the estimated date of delivery (EDD).
What your antenatal care entails:
What the Midwife or GP does
1. Blood pressure and urine check - for protein and infection.
2. Maternity benefits (form FW8 for free dental and prescription service) and MAT BI (from 20 weeks).
3. Dietary / lifestyle advice.
4. Referral to your preferred hospitals (please see end of document)
What the Practice Nurse does
1. Gives you your prenatal pertussis (whooping cough) vaccination at 16 weeks; this vaccination protects your baby from getting whooping cough.
2. Flu jab, it's recommended that you have the flu vaccine, whatever stage of pregnancy you're at - the flu jab will help to protect you and your baby.
What the hospital does
When you are seen at the hospital, you will be given notes that you must take to all your appointments. You will be asked questions about your health, previous pregnancies, family history of medical problems, smears, smoking, diet, alcohol use, screening tests (combined blood and nuchal translucency) quadruple test (only for women who booked after 14/40, otherwise serum screening and nuchal before that time 11-13+6 weeks), blood group and Rhesus group (also anaemia, rubella, sickle cell, thalassaemia checks). Please bring urine sample to all appointments.
The hospital will do a risk assessment on you, looking at medical risks (e.g. if you have heart problems), delivery risks (e.g. if you have had surgery on your womb), social risks and mental health risks. They will also assess your risk of a DVT (e.g. higher if you have undergone recent surgery) and give advice on Nutrition in Pregnancy and Infant Feeding. They advise on Breastfeeding and antenatal classes. At your first appointment you should receive a personal care plan for this pregnancy.
Diabetes in Pregnancy
Risks for diabetes in pregnancy include; obesity, previous baby of more than 4.5Kg, previous diabetes in pregnancy, and family history of diabetes your GP will consider your risks.
Symptoms and Possible Complications
- Vaginal bleeding - you need to notify your Midwife or GP straight away.
- Common symptoms - tiredness, nausea, haemorrhoids, mood changes.
- Complications include - high blood pressure, signs might be headaches or spots before your eyes. Pre-eclampsia can be recognised by high blood pressure, swelling of hands/feet and protein in the urine.
- Severe itching - especially of hands and feet, this can be caused by a liver condition called obstetric cholestasis.
- Thrombosis (clotting of blood) - the risk is higher if you smoke, if you are over 35 years old, are overweight, or if you have a family history of thrombosis. Signs could include pain or swelling in your legs or pain in your chest.
If you have any of these symptoms contact you're booking hospital / midwife ASAP
In a routine antenatal appointment, the following is checked (please remember to bring with you your hand held notes to all your appointments):
- Blood pressure, urine (to check you have no urine infection, no diabetes and no protein)
- Listen to baby's heart - using a Sonicaid
- Check position of baby
- Measure baby
You may need additional care if you have any long term health issues, or if there were any problems in previous pregnancies.
Dietary and Lifestyle Advice
1. Food - try to eat a variety of foods. Avoid pate, raw eggs, shellfish, sushi and unpasteurised cheese (Listeriosis), liver, peanuts. Ensure meats are cooked well; keep cooked and uncooked meats separate in the fridge. Avoid food past sell-by date. Avoid too much caffeine (max 4 cups per week) and avoid too much alcohol.
2. Vitamins - Vitamin D needs to be supplemented. Those as greatest risk are South Asian, African women or those housebound or who do not eat much food containing Vit.D; such as egg and cereal, avoid Vitamin A supplements. Folic acid should be taken daily 400 micrograms per day for at least 8 weeks before pregnancy and up to 12 weeks during the pregnancy. You can buy this from the pharmacy many ladies use Pregnacare (however, if your BMI is over 30, you will need a larger dose of folic acid of 5mg)
3. Medication - Paracetamol is safe, but many medications are not, so please check before using any medicines.
4. Exercise - maintain regular exercise; intercourse is safe.
5. Care with cats - do not change litter tray, unless using gloves (Toxoplasmosis risk)
6. Weight - try to maintain a healthy weight if your BMI is higher than 30 you will have a higher risk of diabetes and pre-eclampsia.
- go to our website www.francisgrovesurgery.co.uk
and complete and return by email our travel questionnaire and the practice nurse will advise you on what vaccination you can safely have. Some airlines will not let you travel towards the end of your pregnancy and you may require a letter from your GP.
8. Smoking - can adversely affect growth we can help with smoking cessation, including use of NRT.
St. Helier Hospital
Chelsea and Westminster
369 Fulham Road
The antenatal pathway
If you are having shared care with a GP please make appointment five weeks in advance for the following checks (24, 32, 34, 38 and 40 weeks). All of these checks can be done with midwives rather than a GP.
There are usually 10 appointments for a first baby and 7 if you have had children before. Each hospital may have a slightly different schedule.
8-10 weeks booking and bloods
11-13 weeks Nuchal scan
16 weeks Prenatal pertussis vaccination
18-20 weeks Anomaly scan
24 weeks See GP or midwife
28 weeks Bloods, urine may need iron if low Haemoglobin Anti-D given if Rhesus negative, measure baby and discuss infant feeding.
34 weeks Blood pressure, urine, growth may need Anti-D 2nd dose.
38 weeks Routine review for blood pressure and urine, measure, discuss options for prolonged pregnancy.
40 weeks See Midwife if first time baby.
After the birth Vitamin K to baby
Home from Hospital
When you get home from hospital you will be visited by your midwife to check your baby and you after you are discharged from her care you will be seen by the Health Visitor who will normally visit you at home at around day five.
The practice should be notified by the hospital that you have been discharged. Please come in and register your baby within 4 weeks of birth and we arrange your baby's first vaccinations which are due at 8 weeks.
You should have your postnatal check about 6 weeks after your baby's birth to make sure that you feel well and are recovering properly. Please contact us about 5 weeks before your postnatal check is due so we can make you a routine appointment.
Before your baby can have their first vaccination they must see the Health Visitor at 6 weeks in the health visitor clinic to be weighed and measured. At the Patrick Doody Clinic, 79 Pelham Rd, Wimbledon, SW19 1NX. Tel 020 8254 8310. Mondays and Fridays 9.30am-3.30pm.
At 8 weeks your baby will have their first vaccination at the surgery. Follow-up vaccinations will be arranged at this appointment.