Pregnancy & Antenatal Care
Discovering that you are pregnant can be an exciting and worrying time. The following information is to help you know what to expect and answer some of your questions.
If you suspect they are pregnant you can check this with a home testing kit which can be obtained from the pharmacy. Some chemists offer a pregnancy testing service. We do not offer a pregnancy testing service except in exceptional circumstances.
Your Initial GP Consultation
Once you know that you are pregnant it is important to make an appointment with your GP. This first appointment will normally take place when you are between 5 to 9 weeks pregnant (as determined by your last menstrual period). At this consultation the following may be discussed:
- Whether you wish to continue with your pregnancy. If not your doctor will discuss the options available to you.
- Any medical problems you may have such as high blood pressure, diabetes, allergies and the implications of any medication you may currently be taking
- Your past history of pregnancies if any and any problems associated with them such as miscarriages, premature births or very large or very small babies
- Aspects of your personal care including smoking, drinking, exercise and diet
- The consultation will help us to assess the relative risks of your pregnancy to yourself and your baby.
Initial Antenatal Care
If everything indicates a healthy uncomplicated pregnancy you will normally be referred to Epsom hospital for antenatal care. You may request to go elsewhere if you have a preference. If early potential problems are diagnosed we will refer you to an obstetric or medical obstetric team. Early scans can also be arranged.
Early Pregnancy Unit (EPU)
At Epsom General Hospital there is an early pregnancy unit which you can contact directly should you have any concerns for the health of your baby. You can self refer to this or be referred by your GP or via A&E departments.
To be seen in the EPU you must:
- Have a positive pregnancy test
- Be in early pregnancy – up to 20 weeks gestation
- Have vaginal bleeding or pain
- There telephone number is 01372 735155 and the clinic is open Monday to
- Friday 1.30pm – 4pm. However, you can speak to someone after 11am.
- Antenatal Care at 12-14 weeks
A nuchal scan is offered at 12 – 14 weeks and a blood test is performed at this time also. This scan together with the result of the blood test identifies the risk of the baby being born with Down’s syndrome. Around this time also you will have an appointment with a midwife often in you own home to discuss the pregnancy so far and your ongoing antenatal care. She will advise you on lifestyle issues, (see later) listen to the baby’s heartbeat and answer any questions you may have. She will also provide you with details of the plan you will receive covering your further antenatal care including:
- An ultrasound scan of the baby at 20 weeks
- Routine blood tests and screenings
- Routine GP or Community Midwife appointments up to the birth of your baby
Routine Antenatal Appointments
These will be identified in your care plan and will be at your surgery either with the GP or a midwife. However if you develop complications in your pregnancy these are likely to take place at hospital. Routine appointments last for 10 minutes and involve check on:
- Your blood pressure
- Testing you urine for sugar, blood and protein (which if present could indicate potential problems)
- Your stomach for an estimate of the size of your baby and to check the baby is growing and which way it is lying (head or bottom down)
- The baby’s heartbeat
You can ask questions about the health of your baby and it’s delivery at these appointments.
You will also receive your own obstetric notes to take to all antenatal appointments. These notes are important to always carry with you especially if you are away from home and need routine or urgent care. They will inform any doctor or midwife of your condition. You will receive these normally after your second scan.
The Delivery Of Your Baby
You will probably have attended antenatal classes to learn about aspects of your pregnancy and what to expect when labour starts.
When you fell that labour is beginning you need to contact the delivery suite to discuss whether you would be better to stay at home for a while. Every labour and delivery is an individual experience so if you have any specific questions regarding your pregnancy then discuss this with your GP and midwife.
After The Birth Of Your Baby
The GP will be notified of the birth of your baby by the hospital or midwife. The community midwife will visit you at home over the first few days to check on you and your baby’s health and advice on issues such as feeding. If you have any postnatal problems which cannot be dealt with by the midwife then your GP will be happy to see you Health visitors attached to the surgery will begin to see you and your baby about 2 weeks after the birth.
Your GP will see you for this check about 6 weeks after the baby is born. We will try and answer any questions relating to the birth and any areas of concern following the delivery. We will check that abdominal muscles are coming back together and discuss contraception and smear tests. Most women usually want to ask questions about their new baby relating to sleeping, feeding, winding etc and we are happy to discuss these as well.
There are a number of things you can do to stay healthy while you are pregnant.
You can continue or start moderate exercise before or during pregnancy. Some vigorous activities such as contact sports or vigorous racquet games may carry risks such as joints strain or falls. Scuba diving should be avoided during pregnancy as it can cause problems in the unborn baby.
Excess alcohol can harm your unborn baby. If you decide to drink during your pregnancy limit yourself to one standard unit of alcohol a day (small glass of wine, half pint of beer, cider or lager, or a single measure of spirits).
Smoking increases the risk of your baby being underweight or born too early and these affect your baby’s health. The risks can be reduced if you give up smoking or smoke less while you are pregnant. Advice and support about stopping smoking you can contact The NHS pregnancy smoking helpline. The phone number is 0800 169 0 169
The effects of cannabis on the unborn baby are unknown. It may be harmful to your baby.
Bacterial infections such as listeriosis and salmonella that can be picked up from food can harm your unborn baby. In order to avoid them while you are pregnant it is best:
- If you drink milk, to keep to pasteurized or UHT milk
- To avoid eating mould-ripened soft cheese such as Brie or Camembert and blue-veined cheese (hard cheese such as cheddar and cottage cheese or processed cheese present no risk)
- To avoid eating pate
- To avoid eating uncooked or under cooked ready prepared meals
- To avoid eating raw or partially cooked eggs or food containing them (such as mayonnaise)
- To avoid raw or partially cooked meat especially poultry
- To avoid tuna/shark and swordfish as they may contain unacceptable levels of mercury and this can be harmful to you unborn baby
- To limit the amount of caffeine you drink during your pregnancy
- To avoid chill cabinet prepared salads especially those with mayonnaise and dressings as they can be contaminated with listeria.
Toxoplasmosis is an infection that does not usually cause symptoms in healthy women. Very occasionally it can cause problems for the unborn baby of an infected mother. It is picked up from undercooked or uncooked meat (such as salami, which is cured) and from faeces of infected cats or contaminated water or soil.
To avoid this infection it is best to:
- Wash your hands before you handle foods
- Wash all fruit and vegetables, including ready prepared, before you eat them
- Ensure you thoroughly cook raw meats and ready-prepared chilled meats
- Wear gloves and wash your hands thoroughly after gardening
- Avoid contact with cat faeces in litter or soil
Download the pdf version of this information Pregnancy Care and Antenatal Care