When you first learn you are pregnant, it’s important to contact an NHS professional as soon as possible.
You can book an appointment directly with your community midwife as soon as you know you are pregnant. Your GP surgery will be able to put you in touch with your community midwife.
If you have special health needs, your midwife, GP or other doctors may take shared responsibility for your maternity care.
Your first meeting with your midwife, sometimes known as the booking appointment, will last for up to two hours and could take place either at a hospital, GP surgery or at your home. Here your midwife will ask you many questions about your health, the health of your family, and your preferences in order to give you the best pregnancy care. Your midwife will order a number of tests and scans, some of which will be done throughout your pregnancy. The results of these tests may affect your choices later in pregnancy so it’s important not to miss them.
Staying healthy during pregnancy is very important – for both you and your baby.
The NHS Choices website has a huge range of helpful tips and advice on how to stay healthy during pregnancy. Please visit their site: NHS Choices - Your health during pregnancy
If you are smoking when you see your midwife, they will check your CO2 levels and will refer you to our local stop smoking service who will offer you support.
Your mental health
Most women go through pregnancy and the first year after giving birth without any mental health problems, but some women do have problems. These are the same as for other people, but they can develop differently at this time.
There is help and support, so don't be afraid to talk about how you are feeling with your midwife, GP or psychiatrist – they will be happy to discuss your particular problem and care with you.
Women may feel more vulnerable and anxious while pregnant and after the birth, so your midwife, GP and health visitor should ask you about your mental health. This will give you the opportunity to talk about any concerns and to get help if necessary.
If you have a mental health problem during pregnancy or in the first year after giving birth, you may need more urgent care and treatment than usual, because of the possible effects on your baby, your own health and your other children.
The NHS Choices website has a range of helpful advice on mental health during pregnancy.
Time to Change is England's biggest programme to challenge mental health stigma and discrimination. We have pledged to support this initiative.
More help and support
If you need help and advice regarding your mental health during pregnancy, you may find it helpful to get in touch with one of the following:
Let's Talk provides free, completely confidential support and advice for times when you are feeling stressed, anxious or depressed. You can call them between 9am and 5pm on 0800 073 2200 or visit www.talk2gether.nhs.uk
Samaritans offer a confidential listening service. You can call them at any time on 116 123 about whatever’s getting to you or visit www.samaritans.org
Tommy's provides a midwife-led telephone line from 9am until 5pm, Monday to Friday on 0800 0147 800 www.tommys.org/mentalhealth
The Association for Post Natal Illness
The Association for Post Natal Illness runs a helpline and provides information as well as a network of volunteers who have experienced post natal depression. Contact them on 0207 386 0868 between 10am and 2pm or visit www.apni.org
PANDAS supports anyone, including fathers and partners, suffering from pre (antenatal) and postnatal illnesses. Their helpline is open from 9am until 8pm (including weekends) on 0843 28 98 401 or visit www.pandasfoundation.org.uk
Support to stop smoking
Protecting your baby from tobacco smoke is one of the best things you can do to give your child a healthy start in life.
When you are pregnant, your midwife will talk to you about the risks of smoking while pregnant and offer you support to give up. You will be referred to our local stop smoking service, which is a new Healthy Lifestyles service
Using e-cigarettes during pregnancy
Take a look at this useful information about using e-cigarettes during pregnancy.
Healthy lifestyles service
People are four times more likely to give up smoking when they access specialist smoking cessation teams. From this year, there is a new Healthy Lifestyles service in Gloucestershire. Their team is on hand to help and support you. We can work with you to identify small changes that you can make, as well as supporting you to achieve them.
Whether you’re giving up smoking, getting more active or just improving your overall well-being, they are there to help you. You can also contact them yourself on 0800 122 3788.
IMPORTANT: Your maternity notes
At your first appointment, when you are approximately eight weeks pregnant, your midwife will give you your maternity notes.
This is a record of the care that everyone gives you during your pregnancy, birth and after birth, and helps us to communicate with each other. It is very important that you bring it with you to all your appointments. Please take these with you to all health appointments including your GP and hospital. These notes remain the property of the maternity unit and your midwife will need to return them to the unit once your maternity care is completed.
Antenatal appointments with your midwife
You will have regular appointments with your midwife throughout your pregnancy and your midwife will explain this process to you. Your midwife will ask you if you smoke and can offer you support to quit- read more.
Tests and screening
700,000 women get pregnant in the UK every year. Over 95% of these pregnancies result in the birth of a healthy baby. However, in a few cases, screening aims to detect problems that may affect you or your baby.
For more information on screening, please see the National Screening Committee website.
For more information on testing, visit this page on the NHS Choices website.
NHS antenatal classes
Antenatal classes can help you to prepare for your baby’s birth, as well as looking after and feeding your baby. They can also help you to keep fit and well during pregnancy. All pregnant women and their partners are offered a range of antenatal classes, either in our units or in the community in health centres, for example.
The classes you will be offered will include the following topics:
- Giving birth
- Feeding your baby and the early days
Breastfeeding gives your baby the best start in life, so it is a good idea to be prepared by finding out about how to breastfeed. You can do this by attending hospital antenatal classes (your midwife will tell you about these) or those run by other organisations.
Your community midwife will be able to explain to you exactly what classes are available to you in your area.
Maternity advice line
Midwives based in the ambulance hub in Almondsbury take all urgent maternity-related phone calls to triage during the hours of 8am - 8pm (7 days per week). This includes issues such as reduced fetal movements or if you think that you are in labour and are due to give birth on the main delivery suite.
The number for Women/GP’s to ring for the maternity advice line is 0300 422 5541- the telephone number gets through to the midwives answering the calls in the ambulance hub. At other times of day the telephone will be answered by a midwife at the hospital.
By ensuring the midwives are dedicated to taking the telephone calls only and not trying to give clinical care at the same time, they have time to understand the requirements of the women ringing the advice line and therefore triage women to the most appropriate place – Right Women in the Right Place cared for by the Right Professional. This reduces travel for women across the county who may be able to visit a department or drop-in clinic nearer their home. There are still the same number of midwives in the triage department who will now be able to increase the amount of time they can spend with each woman who presents to our service. We also hope to reduce waiting times for women who do need to come in.
Your birth plan
A birth plan is a way of communicating with midwives and other health care professionals. It tells them how you would like to give birth. Although it is impossible to know in advance what kind of experience you'll have, it can be a good idea to think about some of the options you might face. It allows you to make decisions about the management of your childbirth experience so that you won't have to make them during labour.
Carefully word your birth plan and try not to make it sound like a list of demands. Use it as your chance to explain things that really matter to you. But remember, the best birth plans acknowledge that things may not go according to plan.
What you could include
Your birth plan can include factors such as where you would like to give birth and what kind of delivery you would like.
If you have a disability and require any special treatment, note this in your birth plan. You should also note down if you have any particular religious needs or if you require a special diet whilst in hospital.
Your midwife will be able to give you more advice on your birth plan and you can discuss any concerns you have with them.
For more information and a useful online birth plan creator, please visit the NHS Choices website
Most women who suffer from Hyperemesis Gravidarum (HG) are now looked after as day cases.
HG is a complication of pregnancy characterised by extreme levels of nausea and vomiting starting in early pregnancy and persisting for many months. Women with the condition can become quickly dehydrated and frequently need hospital treatment.
Between 50 and 70 women each year in the county are admitted to hospital with the condition. Prior to the day case unit being opened, the average length of stay used to be 2-3 days. Now, most women are being treated as day cases on Ward 9A of the Tower Block at Gloucestershire Royal Hospital, with just a few requiring overnight admission. The HG Day Unit sees women being treated with rapid IV re-hydration in recliner chairs, allowing them return home the same day.
The benefits to women include:
- No waiting for a ward bed, which means there is no delay in starting treatment
- Treatment in a quiet and comfortable area with recliner chairs
- Dedicated nursing staff who are able to reassure and offer advice on how to cope with and control their symptoms
- Minimal disruption to the patient’s home life because admission and treatment can be planned in advance, allowing them to plan and organize work commitments, child care and transport and therefore reducing stress and anxiety.
Movements matter - reducing stillbirth
Parents-to-be should be aware of their baby’s movements throughout their pregnancies. Although stillbirth rates have fallen over recent years, current rates indicate that one in every 200 babies is stillborn - that's more than 3,600 nationally every year.
We know that every stillbirth is a tragedy for the families involved and we would like to see a reduction in these sad events at our hospitals. During pregnancy, feeling your baby move reassures you that they are well. In some cases, a baby's normal pattern of movements may change because they are unwell - around half of women who had a stillbirth felt that their baby's movements had slowed down or stopped.
We're using the simple acronym ACT - 'Active, Change in movements and Tell someone' to raise awareness among women and to ensure that movements are discussed in a consistent way at every contact with a health professional. We have developed our own posters and leaflets to support the campaign.
The national Saving Babies Lives guidance brings together four key elements of care based on best practice and evidence in order to help reduce stillbirth rates: these themes include further support for women to help reduce smoking in pregnancy (a major factor in stillbirth), increasing surveillance of babies growth during pregnancy, providing specialist advice and information around babies movement in pregnancy and monitoring of baby's heart rate during labour.