<h1>Antenatal appointments schedule</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/10/1.1.6.jpg" alt="Midwife measuring pregnant woman's bump with a tape measure" width="650" height="406" class="alignnone size-full wp-image-3346" />

<span style="font-weight: 400;">Once referred to a hospital, you can expect to see a midwife between 8 to 10 weeks of pregnancy.</span>

<span style="font-weight: 400;">If your pregnancy is straightforward, these are the appointments you should expect to have. Certain medical or pregnancy needs may result in you needing more appointments than this.</span>

<span style="font-weight: 400;">Appointments will normally be with a midwife, GP or obstetrician. The appointments at 25, 31 and 40 weeks are extra appointments for women having their first baby.</span>

<span style="font-weight: 400;"> At every appointment your midwife will ask you about how you are feeling, and give you the opportunity to ask any questions or raise any concerns you might have.</span>

<span>At certain points in the pregnancy your baby's growth will be measured. How a baby grows is different for each person, and your midwife will do a growth check at each antenatal visit.</span>

<span>One way growth is measured is by measuring the size of your womb or baby bump. This is known as fundal height. The measurements are recorded on a growth chart and can be used to check that your baby is growing well.</span>

<span>You might also be offered a growth scan. If you are offered a growth scan, your midwife will explain why. Read more in the section Small baby (fetal growth restriction).</span>

<span style="font-weight: 400;">You can bring your partner, friend or family member to your antenatal appointments. However, the midwife may request to see you alone for at least one appointment during your pregnancy.</span>
<div data-cat="submenu" class="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/08/booking-appointment-8-12-weeks/">Booking appointment (8-12 weeks)</a>

<a href="https://admin.mumandbaby.uk/2018/08/08/dating-scan-11-14-weeks/">Dating scan (11-14 weeks)</a>

<a href="https://admin.mumandbaby.uk/2018/08/08/16-weeks/">16 weeks</a>

<a href="https://admin.mumandbaby.uk/2018/08/08/anomaly-scan-18-21-weeks/">Anomaly scan (18-21 weeks)</a>

<a href="https://admin.mumandbaby.uk/2018/08/08/25-weeks-first-pregnancy-only/">25 weeks (first pregnancy only)</a>

<a href="https://admin.mumandbaby.uk/2018/08/08/28-weeks/">28 weeks</a>

<a href="https://admin.mumandbaby.uk/2018/08/08/31-weeks-first-pregnancy-only/">31 weeks (first pregnancy only)</a>

<a href="https://admin.mumandbaby.uk/2018/08/08/34-weeks/">34 weeks</a>

<a href="https://admin.mumandbaby.uk/2018/08/08/36-weeks/">36 weeks</a>

<a href="https://admin.mumandbaby.uk/2018/08/08/38-weeks/">38 weeks</a>

<a href="https://admin.mumandbaby.uk/2018/08/08/40-weeks-first-pregnancy/">40 weeks (first pregnancy only)</a>

<a href="https://admin.mumandbaby.uk/2018/08/08/41-weeks/">41 weeks</a>

</div>
<div data-cat="goto" class="goto">

<a href="https://admin.mumandbaby.uk/2018/08/08/screening-tests-and-ultrasound-scans/" internal="true">Screening tests and ultrasound scans</a>

</div>

Antenatal appointments schedule

<h1>Getting help during pregnancy/Emergencies</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/10/1.1.10-1.jpg" alt="Pregnant woman looking at her mobile phone screen" width="650" height="406" class="alignnone size-full wp-image-3428" />

<span>For non-urgent enquiries about your health during pregnancy contact your GP, named midwife or local antenatal clinic. For more urgent concerns, explore the tiles below to find out what to do.</span>
<span>Check which signs to call your maternity unit about immediately here:</span>

<a href="https://www.mamaacademy.org.uk/wp-content/uploads/2015/02/A3-Poster-SIGNS-TO-LOOK-OUT-FOR-1.pdf">Mama Academy: symptoms to act upon</a>

<div class="submenu" data-cat="submenu">
<a href="https://admin.mumandbaby.uk/2018/08/08/before-18-20-weeks-gestation/">Before 18-20 weeks gestation</a>

<a href="https://admin.mumandbaby.uk/2018/08/08/after-18-20-weeks-gestation/">After 18-20 weeks gestation</a>

<a href="https://admin.mumandbaby.uk/2018/08/08/after-37-weeks-gestation-when-expecting-labour/">After 37 weeks gestation/when expecting labour</a>

</div>

<span>For any urgent concerns regarding your emotional and mental health at any stage in pregnancy, see advice on who to contact for support:</span>
<div data-cat="goto" class="goto">
<a href="https://admin.mumandbaby.uk/2018/08/09/improving-your-emotional-wellbeing-in-pregnancy/" internal="true">Improving your emotional wellbeing in pregnancy</a>
</div>


Emergencies

<h1>Having twins or triplets</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.1.9.jpg" alt="Pregnant woman holding two pairs of baby shoes across her pregnancy bmup" width="650" height="406" class="alignnone size-full wp-image-1025" />

<span>Finding out you are having more than one baby can be exciting and special, but also sometimes overwhelming.</span>

<span>All multiple pregnancies have a higher risk of complications, and therefore you will have extra appointments and scans to make sure you and your babies are well.</span>

<span>If your babies share a placenta, it will be recommended that you have scans every two weeks, and if they each have their own placenta scans will be every four weeks.</span>

<span>You are likely to have your babies earlier than 40 weeks.  Many twins are born vaginally although it may be recommended that they are born by caesarean section.</span>

<span>You will have plenty of support from your maternity team throughout pregnancy, birth and beyond.</span>
<div data-cat="relatedlinks" class="relatedlinks">

<a href="http://www.tamba.org.uk">Twins Trust</a>

<a type="rcog" href="https://www.rcog.org.uk/en/patients/patient-leaflets/multiple-pregnancy-having-more-than-one-baby/">Further guidance on multiple births</a>

</div>

Having twins or triplets

<h1>Information for partners during pregnancy</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.1.2.jpg" alt="Two adult legs in jeans and trainers with a pair of baby shoes between them" width="650" height="406" class="alignnone size-full wp-image-1002" />

<span style="font-weight: 400;">Finding out you are going to become a parent can be an exciting but daunting time. The closer you are to your pregnant partner, the more you’ll be able to share the experience of pregnancy and birth.</span>
<h2>Early pregnancy</h2>
<span style="font-weight: 400;">Whether the pregnancy was planned, or it is unexpected, it is normal to feel a range of emotions when you discover your partner is pregnant. </span>

<span style="font-weight: 400;">Talk to your partner, friends and family about how you are feeling. Your partner may be irritable about things that seem small to you; this is due to the effect of hormones on her mood, and her own fears and anxieties.</span>

<span style="font-weight: 400;">Be patient and learn to support each other and encourage her to talk to those close to her, or her midwife/doctor. </span>

<span style="font-weight: 400;">Learn about the screening tests and scans offered in pregnancy. These tests can have implications for you, your partner and the pregnancy as it progresses.</span>
<h2>During pregnancy</h2>
<span style="font-weight: 400;">Attend antenatal classes with your partner (most classes are designed for both mum and partner) as these will help you feel prepared for the birth and caring for the new baby when he/she arrives. </span>

<span style="font-weight: 400;">Increase your share of the housework, if possible. If you smoke, now is a great time to stop due to the risks of passive smoking on your partner and your baby after birth. Unborn babies that are exposed to smoke are at a greater risk of complications during pregnancy, such as not growing well or even being stillborn. After birth, even if you smoke outside, there is an increased risk that your baby will be affected by Sudden Infant Death Syndrome. Ask your GP for help to stop smoking.</span>

<span style="font-weight: 400;">Support your partner as much as possible, but also find time for yourself to relax. Take pictures with your partner and her growing pregnancy bump, if she likes, as these make great memories. Try bonding with your baby by talking or singing to him/her during pregnancy.</span>
<div data-cat="video" class="videoplayer">

Best beginnings: Baby Communication

<iframe width="560" height="315" src="https://www.youtube.com/embed/j3vZiDYy3kc?rel=0" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen></iframe>

</div>
<div data-cat="relatedlinks" class="relatedlinks">

<a type="nhs" href="https://www.nhs.uk/conditions/pregnancy-and-baby/dad-to-be-pregnant-partner/">Information for partners</a>

<a href="https://www.dad.info/expecting/pregnancy/the-dad-pregnancy-timeline">Dad info</a>
<a href="https://thedadpad.co.uk/">The DadPad</a>
</div>

Information for partners during pregnancy

<h1>Maternity notes</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.1.7.jpg" alt="Close up of midwife and pregnant woman sharing her maternity notes" width="650" height="406" class="alignnone size-full wp-image-1020" />

<span style="font-weight: 400;">You will be given a set of handheld maternity notes you should keep with you at all times, and bring to all your appointments. Your appointments will normally be documented in here, along with results from your blood tests and scans. </span>

<span style="font-weight: 400;">All maternity units in England are moving toward the use of digital records and these records are stored securely on the maternity unit’s IT system. </span>

<span style="font-weight: 400;">You can ask your maternity care provider to explain anything that has been written in your maternity notes if you’re not sure.</span>

Maternity notes

<h1>Screening tests and ultrasound scans</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.1.8.jpg" alt="Utrasound screen image of baby" width="650" height="406" class="alignnone size-full wp-image-1024" />

<span>During pregnancy you will be offered several screening tests to try and find any health problems that could affect you or your baby. It is your decision whether or not to have any of these tests. Read the "Screening tests for you and your baby" booklet from the link at the end of this page. It is important to look through the booklet before your first meeting with your midwife as it contains important information about your screening choices. The booklet is available in different languages.</span>

<div data-cat="video" class="videoplayer">

Antenatal screening

<iframe width="560" height="315" src="https://www.youtube.com/embed/_afr5olIpTM?rel=0&amp;showinfo=0" frameborder="0" allow="autoplay; encrypted-media" allowfullscreen="allowfullscreen"></iframe>

</div>
<div data-cat="submenu" class="submenu"><a href="https://admin.mumandbaby.uk/2018/08/08/blood-tests/">Blood tests</a>
<a href="https://admin.mumandbaby.uk/2018/08/08/screening-tests-for-chromosome-anomalies/">Screening tests for chromosomal anomalies</a>
<a href="https://admin.mumandbaby.uk/2018/08/08/ultrasound-scans/">Ultrasound scans</a></div>

<div data-cat="relatedlinks" class="relatedlinks">

<a href="https://www.gov.uk/government/publications/screening-tests-for-you-and-your-baby-description-in-brief" type="nhs">Screening tests for you and your baby</a>

<a href="https://www.nhs.uk/conditions/pregnancy-and-baby/screening-tests-abnormality-pregnant/" type="nhs">Information about screening tests</a>

<a href="http://www.arc-uk.org">More about antenatal screening: ARC (Antenatal Results and Choices)</a>

<a href="https://www.gov.uk/government/publications/downs-syndrome-edwards-syndrome-and-pataus-syndrome-options-after-a-higher-chance-screening-result/your-choices-after-a-higher-chance-screening-result">Your choices after a higher-chance screening result</a>
</div>

Screening tests and ultrasound scans

<h1>Your first 12 weeks</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.1.5.jpg" alt="Polaroid photo of first scan and pregnancy test" width="650" height="406" class="alignnone size-full wp-image-1006" />

<span style="font-weight: 400;">Your baby grows faster than at any other time in the first 12 weeks. The fertilised egg implants in the womb and divides rapidly into layers of cells.</span>

<span style="font-weight: 400;">Morning sickness is common at this stage, and may occur at any time of day. You may also experience breast tenderness, tiredness, mood swings and changes in your reaction to certain smells and foods along with a metallic taste in your mouth. </span>

<span style="font-weight: 400;">During this time you may experience some spotting or slight vaginal bleeding, which is nothing to worry about. Some women experience no obvious signs or symptoms of pregnancy – everyone is different. Symptoms can also come and go on a daily basis, and this is perfectly normal.</span>

<span style="font-weight: 400;">You won’t feel your baby moving at this stage, nor will you have an obvious baby bump. The first movements are normally felt between 16 and 24 weeks.</span>

<span style="font-weight: 400;">You will have your first appointment with your midwife by 10 weeks. You will also be offered some blood tests. Your midwife will explain all screening tests to you in full. Your first ultrasound scan should be offered to you between 11 and 13 weeks.</span>
<div data-cat="goto" class="goto">

<a href="https://admin.mumandbaby.uk/2018/08/06/maternity-units/" internal="true">Contact my maternity unit</a>

</div>
<div data-cat="submenu" class="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/08/signs-and-symptoms-to-speak-to-a-health-professional-about/" style="font-size: 1rem;">Signs and symptoms to speak to a health professional about</a>

</div>
<div data-cat="relatedlinks" class="relatedlinks">

<a href="https://www.nhs.uk/conditions/pregnancy-and-baby/pregnancy-weeks-9-10-11-12/#your-babys-development" type="nhs">Early pregnancy development</a>

<a href="https://www.gov.uk/government/publications/screening-tests-for-you-and-your-baby-description-in-brief">Screening tests for you and your baby</a>

</div>

Your first 12 weeks

<h1>Your maternity team</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2021/10/Three-smiling-midwives-300x187.jpg" alt="Three midwives" width="300" height="187" class="alignnone size-medium wp-image-18215" />
<h2>Midwife</h2>
You will meet several midwives throughout your pregnancy, birth and beyond. Midwives are the main caregiver when your pregnancy and birth are straight forward. We are working hard to ensure each woman has a named midwife who is responsible for coordinating your maternity care.
<h2>Obstetrician</h2>
<span>These are doctors who specialise in caring for women during pregnancy, birth and in the period immediately after birth (whilst in the maternity unit). You may see an obstetrician during pregnancy if you have any issues which require review or more specialised management, and they will be involved if you have a caesarean or assisted birth.</span>
<h2>Paediatrician/Neonatalogist (baby doctor)</h2>
<span>Paediatricians or neonatologists are doctors specialising in the care of newborn babies and children. They will be involved in your care if early (premature) delivery is anticipated or if there are likely to be concerns about the health of your baby during or after the birth.</span>
<h2>Sonographer</h2>
<span>These are professionals who undertake your ultrasound scans. They are specially trained to undertake scans during pregnancy.</span>
<h2>Maternity support worker</h2>
<span>You may meet maternity support workers during pregnancy, birth or beyond. They support the maternity team and provide some of your care throughout the journey.</span>
<h2>Student midwife</h2>
<span>Many maternity units in England work closely with local universities to support midwives and doctors in training. These students will work alongside their midwife ‘mentor’ and will ask for your consent before providing you with any care.</span>
<h2>Health visitor</h2>
<span>Health visitors work in teams. They work closely with the other professionals listed above, including GPs and organisations that support families where you live. Most families in England will be offered several review contacts and additional support depending on the individual needs of your family.</span>

<span>The health promoting visit at 28 weeks of pregnancy, is the first time that the health visitor meets parents. A health needs assessment will be agreed, covering physical, mental and emotional health and wellbeing. The health visitor will also discuss a number of issues, including transition to parenthood, how to enhance the parent-child bonding experience and how parents can help their baby's early development.</span>
<h2>Other staff members</h2>
<span>You may meet other members of staff or medical students, depending on your pregnancy needs and where you choose to have your care.</span>
<div data-cat="goto" class="goto">

<a href="https://admin.mumandbaby.uk/2018/08/06/maternity-units/" internal="true">Contact my maternity unit</a>

</div>

Your maternity team

<h1>Antenatal care</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.1.jpg" alt="Little girl kisses her pregnant mother's bump﻿" width="650" height="406" class="alignnone size-full wp-image-1027" />
<div data-cat="submenu" class="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/08/your-maternity-team/">Your maternity team</a>

<a href="https://admin.mumandbaby.uk/2018/08/08/your-first-12-weeks/">Your first 12 weeks</a>

<a href="https://admin.mumandbaby.uk/2018/08/08/antenatal-appointments-schedule/">Antenatal appointments schedule</a>

<a href="https://admin.mumandbaby.uk/2018/08/08/maternity-notes/">Maternity notes</a>

<a href="https://admin.mumandbaby.uk/2018/08/08/screening-tests-and-ultrasound-scans/">Screening tests and ultrasound scans</a>

<a href="https://admin.mumandbaby.uk/2018/08/08/having-twins-or-triplets/">Having twins or triplets</a>
<a href="https://admin.mumandbaby.uk/2018/08/08/emergencies/">Getting help during pregnancy/Emergencies</a>

</div>

Antenatal care

<h1>Information for partners (preparing for birth)</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.3.11.jpg" alt="Pregnant woman washing up at a kitchen sink with a man standing behind her holding her affectionately" width="650" height="406" class="alignnone size-full wp-image-1104" />
<h3>Before labour and birth</h3>
<span>It is important to discuss with your partner your role as birth partner and how you feel about being present at the birth. You can write a birth plan together and support her if it needs to change for any reason.</span>

<span style="font-weight: 400;">You can also:</span>
<ul>
 	<li>make sure you can always be contacted in the final weeks</li>
 	<li>arrange how you’ll go to the maternity unit, if you are planning on having the baby there</li>
 	<li>ensure the car always has fuel and ensure you have tested fitting the car seat. You can keep the car seat in the car</li>
 	<li>do a trial run to test your route to the maternity unit, and ensure you have small change for parking meters</li>
 	<li>help pack the maternity unit bag and make sure you pack the things you need</li>
 	<li>think about preparing/freezing some meals for after the birth so you don’t have to worry about cooking when first at home</li>
	<li>learn about what to expect so you can be as prepared as possible to care for your partner and baby read the sections on:</li>
</ul>
<div data-cat="goto" class="goto"><a href="https://admin.mumandbaby.uk/2018/08/28/labour-and-birth/" internal="true">Labour and birth</a>

<a href="https://admin.mumandbaby.uk/2018/09/04/after-your-baby-is-born/" internal="true">After your baby is born</a>
</div>
<span></span>
<h3>Preparing for after the birth</h3>
<span style="font-weight: 400;">The birth can often feel like such a huge event that not much time or attention is given to fatherhood and parenting. Having a baby changes relationships, carries responsibility and has significant financial impact, whilst also being a time of intense joy and pride. Up to 10% of new dads can suffer from postnatal depression, so if you start to feel changes in your mood, talk to your family, friends and GP (and <a href="https://www.nct.org.uk/parenting/postnatal-depression-dads">see here</a>).</span>

<div data-id="Information for partners">Portal: Information for partners</div>

<div data-cat="goto" class="goto">
<a href="https://admin.mumandbaby.uk/2018/08/22/postnatal-depression-and-anxiety/" internal="true">Postnatal depression and anxiety</a>
</div>

<div data-cat="relatedlinks" class="relatedlinks">

<a href="https://www.nhs.uk/conditions/pregnancy-and-baby/dad-to-be-pregnant-partner" type="nhs">Information for partners</a>

<a href="https://www.nct.org.uk/pregnancy/dads-be-and-partners/new-dad-guide-10-facts-for-third-trimester" type="nct">A dad's view</a>

<a href="https://www.dad.info/expecting/pregnancy/the-dad-pregnancy-timeline">Dad info</a>

<a type="nhs" href="https://www.nhs.uk/conditions/pregnancy-and-baby/dad-to-be-pregnant-partner/#be-prepared-for-the-birth">Prepared for birth and beyond</a>

<a href="https://www.familylives.org.uk/advice/pregnancy-and-baby/becoming-a-dad/advice-for-dads-to-be/">Advice for dads to be</a>

<a href="https://thedadpad.co.uk/">The DadPad</a>
</div>

Information for partners (preparing for birth)

<h1>Common pregnancy complaints</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.2.13.jpg" alt="Close up of woman looking concerned" width="650" height="406" class="alignnone size-full wp-image-1073" />
<div data-cat="submenu" class="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/13/urinary-tract-infections-utis/">Urinary tract infections (UTIs)</a>

<a href="https://admin.mumandbaby.uk/2018/08/13/incontinence/">Incontinence</a>

<a href="https://admin.mumandbaby.uk/2018/08/13/feeling-faint/">Feeling faint</a>

<a href="https://admin.mumandbaby.uk/2018/08/13/headaches/">Headaches</a>

<a href="https://admin.mumandbaby.uk/2018/08/13/indigestion-heartburn/">Indigestion/heartburn</a>

<a href="https://admin.mumandbaby.uk/2018/08/13/swollen-hands-ankles-and-feet/">Swollen hands, ankles and feet</a>

<a href="https://admin.mumandbaby.uk/2018/08/13/constipation/">Constipation</a>

<a href="https://admin.mumandbaby.uk/2018/08/13/pelvic-girdle-pain/">Pelvic girdle pain</a>

<a href="https://admin.mumandbaby.uk/2018/08/13/increased-vaginal-discharge/">Increased vaginal discharge</a>

<a href="https://admin.mumandbaby.uk/2021/09/02/blocked-nose/">Blocked nose</a>

<a href="https://admin.mumandbaby.uk/2020/04/23/healthy-pregnancy-class/">Preventing and managing common complaints during pregnancy</a>

</div>
<div data-cat="relatedlinks" class="relatedlinks">

<a type="tommy's" href="https://www.tommys.org/pregnancy-information/im-pregnant/early-pregnancy/10-common-pregnancy-complaints">10 common pregnancy complaints</a>

</div>

Common pregnancy complaints

<h1>Female Genital Mutilation (FGM)</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2019/05/MB_FGM_image-300x187.jpg" alt="Graphic of four identical female silhouettes with one of them highlighted to stand out from the other three" width="300" height="187" class="alignnone size-medium wp-image-6059" />
<h2>What is FGM?</h2>
<span>FGM is sometimes called female genital cutting or female circumcision. The definition of Female Genital Mutilation is “any cutting or damage to the external female genitalia that was carried out for non-medical reasons”.</span>

<span>It is a form of child abuse and is a cultural practice that is illegal in the UK.</span>

<span>FGM is carried out in many parts of the world including Africa, Asia, the Middle East as well as among certain ethnic groups in Central and South America.
Through migration of peoples it is also found in Europe, USA, Canada, Australia and New Zealand.</span>
<h2>What are the different types of FGM?</h2>
<span>The World Health Organisation (WHO) estimates that 200 million women and girls worldwide have been affected by FGM.</span>
<span>WHO has classified 4 Types of FGM:</span>
<span><b>Type 1:</b> part or all of the clitoris and/or clitoral hood has been removed.</span>
<span><b>Type 2:</b> part or all of the clitoris and/or clitoral hood has been removed, as well as the inner labia (lips that surround and protect the urine hole and vaginal opening).</span>
<span><b>Type 3 (pharaonic circumcision):</b> the labia or inner lips have been removed and the remaining edges are then sewn together or fuse together forming a layer of scar tissue with a small single opening at one end.</span>
<span><b>Type 4:</b> any other harmful practices to a woman’s genitals such as pricking, piercing, stretching or burning.</span>
<h2>Possible health problems resulting from FGM</h2>
<ul>
 	<li>urinary infections</li>
 	<li>vaginal infections</li>
 	<li>painful periods</li>
 	<li>painful sex</li>
 	<li>feeling sad, anxious or depressed</li>
 	<li>problems during childbirth.</li>
</ul>
<h2>FGM and pregnancy</h2>
<span>In pregnancy all women will be asked about FGM. Women with FGM should have a appointment with a specialist midwife or doctor in order to make a personalised plan of care as FGM may have physical and/or psychological consequences that can affect your pregnancy or labour. A safeguarding risk assessment will be carried out to ensure that, if you have a baby girl, she will be protected from FGM.</span>
<h2>FGM and UK law</h2>
In the UK, it is against the law:
<ul>
 	<li>for anyone to carry out FGM</li>
 	<li>to take girls or women who live in the UK to another country to carry out FGM</li>
 	<li>to help someone else carry out FGM (this includes making travel arrangements)</li>
 	<li>to sew women up after childbirth (known as reinfibulation).</li>
</ul>
<h2>Women with FGM</h2>
<span>If you thing you have FGM tell your midwife. She will refer you to a clinic where you will be given support by a FGM specialist midwife.</span>
<h2>How can I protect my daughter/s?</h2>
The following resources are helpful:
<br>
NSPCC/FGM Helpline: <a href="tel://0800 0283550">0800 0283550</a>
Police (emergency): <a href="tel://999">999</a>
Non emergency: <a href="tel://101">101</a>
Foreign and Commonwealth office (if abroad): <a href="tel://00 44 207 0081500">00 44 207 0081500</a>
<div data-cat="relatedlinks" class="relatedlinks"><a type="nhs" href="https://www.nhs.uk/conditions/female-genital-mutilation-fgm/">Female genital mutilation</a>
<a type="rcog" href="https://www.rcog.org.uk/media/fcedxjsm/patient-information-leaflet.pdf">FGM patient information leaflet</a></div>

Female Genital Mutilation (FGM)

<h1>Heart health in pregnancy</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2020/05/heart-66893_650x406.jpg" alt="Graphic of red heart with a jigsaw shaped piece missing" width="650" height="406" class="alignnone size-full wp-image-11636" />

<span>Chest pain in pregnancy and/or afer your baby's birth should never be ignored. Some chest pain can be serious and can lead to a heart attack, heart failure, cardiac arrest or even death. Most women do not suffer from these conditions during or after pregnancy but it is important to recognise the symptoms and, if you have any of them, to seek treatment quickly.</span>

<h2>Pre-existing heart conditions</h2>
<span>If you have a known heart condition, were born with a congenital heart defect or have been diagnosed with heart disease, you should tell your midwife/GP/cardiologist and they will monitor your heart health before, during and after pregnancy and your health.</span>

<h2>Symptoms of health attack can include:</h2>
<ul>
<li>Central chest pain</li>
<li>Arm pain or numbness</li>
<li>Pain in the jaw, back or shoulders</li>
<li>Nausea</li>
<li>Sweating/clamminess</li>
<li>Breathing difficulties</li>
</ul>
<span>Some people experience indigestion-like chest or throat pain that does not respond to indigestion remedies.</span>

<h2>When should I contact the midwife or doctor?</h2>
<span>If you feel unwell, contact your midwife or GP for guidance. If you experience some/all of the above symptoms, dial 999 and ask for an ambulance as your heart health needs to be investigated quickly. An ECG monitor and a troponin blood test should be carried out to find out if you have had a heart attack.</span>

<h2>When am I more likely to have a heart attack?</h2>
<span>You are more likely to have a heart attack if you:</span>
<ul>
<li>have a family history of heart problems</li>
<li>have high blood pressure</li>
<li>have high cholesterol</li>
<li>smoke</li>
<li>drink excessively</li>
<li>are obese</li>
</ul>
<span>Rarely, women with no risk factors or history of heart disease in their family will experience heart attack symptoms.</span>

<span>Heart attack symptoms in pregnancy should never be ignored. Contact your midwife or GP for further advice.</span>

<div data-cat="relatedlinks" class="relatedlinks">

<a href="https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/women/pregnancy-and-heart-disease">Pregnancy and heart conditions</a>

<a href="https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/women/misdiagnosis-of-heart-attacks-in-women">Misdiagnosis of heart attacks in women</a>

<a href="https://www.nhs.uk/conditions/heart-attack/" type="nhs">Heart disease in pregnancy</a>
</div>

Heart health in pregnancy

Group B Streptococcus (GBS)

<h1>Infections and viruses</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.2.10.jpg" alt="Virus particles under a microscope" width="650" height="406" class="alignnone size-full wp-image-1055" />
<div data-cat="submenu" class="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/12/chickenpox/">Chickenpox</a>

<a href="https://admin.mumandbaby.uk/2018/08/12/parvovirus-b19-slapped-cheek-syndrome/">Parvovirus B19 (slapped cheek syndrome)</a>

<a href="https://admin.mumandbaby.uk/2018/08/12/335/">Sexually Transmitted Infections (STIs)</a>

<a href="https://admin.mumandbaby.uk/2018/08/12/toxoplasmosis/">Toxoplasmosis</a>

<a href="https://admin.mumandbaby.uk/2018/08/12/group-b-streptococcus-gbs/">Group B Streptococcus (GBS)</a>

<a href="https://admin.mumandbaby.uk/2018/08/12/cytomegalovirus-cmv/">Cytomegalovirus (CMV)</a>

<a href="https://admin.mumandbaby.uk/2020/06/16/listeriosis/">Listeriosis</a>

</div>

Infections and viruses

Deep vein thrombosis in pregnancy

Gestational diabetes

Placenta praaevia

Pre-eclampsia (PET) during pregnancy

<h1>Less common pregnancy complications</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.2.14.jpg" alt="Heavily pregnant lady in hospital gown supports her bump with her hands" width="650" height="406" class="alignnone size-full wp-image-1079" />

If you have any symptoms of gestational diabetes, pre-eclampsia or intrahepatic cholestasis of pregnancy call your maternity triage/assessment unit straight away.
<div data-cat="submenu" class="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/13/gestational-diabetes/">Gestational diabetes</a>

<a href="https://admin.mumandbaby.uk/2018/08/13/pre-eclampsia/">Pre-eclampsia (PET) during pregnancy</a>

<a href="https://admin.mumandbaby.uk/2018/08/13/intrahepatic-cholestasis-of-pregnancy-oc/">Intrahepatic cholestasis of pregnancy (obstetric cholestasis)</a>

<a href="https://admin.mumandbaby.uk/2020/04/27/spontaneous-coronary-artery-dissection-scad/">Spontaneous Coronary Artery Dissection (SCAD) in pregnancy</a>

<a href="https://admin.mumandbaby.uk/2018/08/13/placenta-praaevia/">Placenta praevia</a>

<a href="https://admin.mumandbaby.uk/2018/08/13/placenta-accreta/">Placenta accreta</a>

<a href="https://admin.mumandbaby.uk/2020/06/18/deep-vein-thrombosis-in-pregnancy/">Deep vein thrombosis in pregnancy</a>

<a href="https://admin.mumandbaby.uk/2021/08/25/fibroids/">Fibroids</a>

<a href="https://admin.mumandbaby.uk/2023/03/24/monitoring-your-babys-growth/">Monitoring your baby’s growth</a>

</div>


Less common pregnancy complications

<h1>Pre-existing conditions and pregnancy</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.2.1.jpg" alt="Healthcare professional in discussion with pregnant woman" width="650" height="406" class="alignnone size-full wp-image-1028" />

<span>It is important to tell your GP, obstetrician and/or midwife about any pre-existing physical or mental health conditions. This also includes any previous surgery (including cosmetic procedures) or any childhood conditions or health problems from which you have now recovered.</span>

<span>This information helps the team assess if anything further is needed to keep you and your baby healthy during the pregnancy. If you are under specialist care for your medical condition, it is important that you speak to them and discuss any impact your condition may have on your pregnancy.</span>

<span>Ask them for a summary and for this to be written in your antenatal notes. Notes don’t automatically move between maternity units and/or departments, so don’t assume that your midwife or doctor knows what your previous carers have said or recommended.</span>

If you would like more information, please use the links below to check the safety of your medication in pregnancy.

<span>Conditions we need to know about early (before 12 weeks) include:</span>

<h2>Chronic hypertension and other medical conditions that may increase the risk of you developing blood pressure concerns in pregnancy</h2>

<span>Women with chronic hypertension and certain medical conditions are at a high risk of developing pre-eclampsia and will be prescribed low dose aspirin from 12 weeks. This includes any one of the following <b>high risk factors</b>:</span>
<ul>
<li>Chronic hypertension (high blood pressure).</li>
<li>Pre-eclampsia during a previous pregnancy.</li>
<li>Chronic kidney disease, diabetes, or an inflammatory disease, eg, Systemic Lupus Erythematosus (SLE).</li>
</ul>
<div data-cat="goto" class="goto">
<a href="https://admin.mumandbaby.uk/2021/06/22/chronic-hypertension-high-blood-pressure-frequently-asked-questions/" internal="true" >Chronic hypertension (high blood pressure): Frequently asked questions</a>
</div>

<span>Or more than one of the following <b>moderate risk factors:</b></span>
<ul>
<li>First pregnancy.</li>
<li>Maternal age over 40.</li>
<li>Last pregnancy was more that 10 years ago.</li>
<li>Body Mass Index (BMI) of 35 or more.</li>
<li>Family history of pre-eclampsia.</li>
<li>Expecting more than one baby in this pregnancy.</li>
</ul>
<h2>Thyroid disease</h2>
<h3>Hypothyroidism (under active thyroid)</h3>
<span>As soon as you are pregnant, it is usually recommended that your Levothyroxine dose is increased by 25-50 mcg daily. You should then also contact your GP to arrange blood tests.</span>

<h3>Hyperthyroidism (overactive thyroid)</h3>
<span>You must discuss your plans for pregnancy with your endocrinologist to assess your disease status and the safety of the medications you are taking.</span>

<h2>Epilepsy</h2>
<span>Pregnancy may affect your seizures or the effect of your medication. If you become pregnant without having had a chance to discuss your medication(s), it is recommended that you see your GP or specialist as soon as possible. Prior to this review, keep taking your anti-epileptic medicines as normal.</span>

<span>Certain medications may need to be stopped and changed to an alternative before you become pregnant, or as soon as possible if you’re already pregnant, due to the risks they pose to your baby. Some other medications need to be increased. Your doctor will prescribe a higher dose of folic acid supplementation (5mg per day).</span>

<div data-cat="goto" class="goto">
<a href="https://admin.mumandbaby.uk/2021/09/06/epilepsy-frequently-asked-questions/" internal="true" >Epilepsy: Frequently asked questions</a>
</div>

<h2>Mental health and wellbeing concerns</h2>
<span>It is understandable to worry about the effects of some medicines used to treat mental health conditions and concerns, but it is important not to stop taking your medications without speaking to your GP or specialist. This may lead to withdrawal symptoms, especially if stopped abruptly, could cause a recurrence of your symptoms or make your condition worse.</span>

<div data-cat="goto" class="goto">
<a href="https://admin.mumandbaby.uk/2021/08/11/mental-health-and-wellbeing-concerns-frequently-asked-questions/" internal="true" >Mental health and wellbeing concerns: Frequently asked questions</a>
</div>

<h2>Diabetes</h2>
<span>Women with Type 1 and 2 Diabetes should aim to have tight control of their diabetes prior to and throughout the pregnancy to reduce the risk of miscarriage, congenital malformation, stillbirth and neonatal death. Pregnancy typically places higher demand for insulin than normal and so close monitoring and control of diabetes is important.</span>

<div data-cat="goto" class="goto">
<a href="https://admin.mumandbaby.uk/2021/09/02/type-1-diabetes-frequently-asked-questions/" internal="true">Type 1 diabetes: Frequently asked questions</a>
</div>

<div data-cat="goto" class="goto">
<a href="https://admin.mumandbaby.uk/2021/09/02/type-2-diabetes-frequently-asked-questions/" internal="true">Type 2 diabetes: Frequently asked questions</a>
</div>

<h2>Crohn's Disease, Ulcerative Colitis and other forms of Inflammatory Bowel Disease (IBD)</h2>
<span>It is important to keep Crohn's or colitis under control during pregnancy and you should not stop taking any of your medications unless your IBD team has advised you to do so. The risk from most medication is lower than the risk of a flare up.</span>

<div data-cat="goto" class="goto">
<a href="https://admin.mumandbaby.uk/2021/09/07/crohns-disease-ulceratulcerative-colitis-and-inflammatory-bowel-disease-ibd-frequently-asked-questions/" internal="true" >Crohn’s Disease, Ulcerative Colitis and Inflammatory Bowel Disease (IBD): Frequently asked questions</a>
</div>

<h2>Pregnancy with a heart condition</h2>
<span>Women with known heart conditions need a referral to the specialist maternity services as soon as possible in early pregnancy and ideally would have had some pre-pregnancy counselling before trying for a pregnancy. This is because some heart conditions can increase the risk of complications in pregnancy and some medications may need to be stopped or adjusted.</span>
<span>Please <b>do not</b> stop, or change, any medications without medical advice. If you would like more information, please use the link below to check the safety of your medication in pregnancy.</span>

<h2>Systemic Lupus Erythematosus (SLE)</h2>

<span>SLE is the most common type of Lupus, a chronic auto-immune disease. Symptoms and the extent of disease determine how care is managed before and throughout pregnancy.</span>

<div data-cat="goto" class="goto">
<a href="https://admin.mumandbaby.uk/2021/09/07/systemic-lupus-erythematosus-sle-frequently-asked-questions/" internal="true" >Systemic Lupus Erythematosus (SLE): Frequently asked questions</a>
</div>

<div data-cat="relatedlinks" class="relatedlinks">

<a href="https://www.nhs.uk/conditions/pregnancy-and-baby/" type="nhs">Pregnancy and baby guide</a>
<a href="https://www.btf-thyroid.org/pregnancy-and-thyroid-disorders-guidance-for-patients">Thyroid disease and pregnancy</a>

<a href="https://www.epilepsysociety.org.uk/pregnancy-and-epilepsy#.XtzeiC2ZPNw">Epilepsy and pregnancy</a>

<a href="https://www.rcog.org.uk/en/patients/patient-leaflets/epilepsy-in-pregnancy/" type="rcog">More on epilepsy and pregnancy</a>

<a href="https://www.tommys.org/pregnancy-information/planning-pregnancy/are-you-ready-conceive/planning-pregnancy-mental-health-condition" type="tommy's">Mental health and wellbeing concerns</a>

<a href="https://www.rcpsych.ac.uk/mental-health/treatments-and-wellbeing/perinatal-care-and-covid-19">Mental health and wellbeing concerns and COVID-19</a>

<a href="https://www.diabetes.org.uk/guide-to-diabetes/life-with-diabetes/pregnancy/during-pregnancy">Diabetes and pregnancy</a>

<a href="https://www.crohnsandcolitis.org.uk/about-crohns-and-colitis/publications/pregnancy-ibd">Crohn's Disease, Ulcerative Colitis and other forms of inflammatory bowel disease</a>

<a href="https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/women/pregnancy-and-heart-disease">Pregnancy and heart disease</a>

<a href="https://www.bhf.org.uk/informationsupport/support/practical-support/pregnancy-with-a-heart-condition">Pregnancy with a heart condition</a>

<a href="https://www.medicinesinpregnancy.org/">Medicine in pregnancy</a>

<a href="https://www.tommys.org/pregnancy-information/pregnancy-complications/type-1-or-type-2-diabetes/hyperglycaemia-and-pregnancy" type="tommy's">Pregnancy complications: Type 1 or type 2 diabetes</a>

</div>

Pre-existing conditions and pregnancy

<h1>Sepsis during pregnancy</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2019/06/sepsis-300x187.jpg" alt="Sepsis infection particles under a microscope" width="300" height="187" class="alignnone size-medium wp-image-6118" />

<span>Infection in pregnancy and/or after your baby’s birth should never be ignored. Some infections can progress to a more serious situation known as sepsis, where the infection spreads to the blood stream and through the whole body. If left untreated sepsis can lead to shock, organ failure and death. Whilst most women do not suffer from infection or sepsis during or after pregnancy, it needs to be recognised and treated quickly if they do.</span>
<h2>Signs of sepsis</h2>
<span>The first signs of sepsis are usually a rise in your temperature, heart rate and breathing. You may also feel unwell, have chills and flu-like symptoms and a worrying pain in your tummy and/or diarrhoea. This can progress very quickly so it is important to seek advice if you are concerned about your health.</span>
<h2>How can infection in pregnancy or after childbirth be prevented?</h2>
<span>Good personal hygiene helps. This can include: daily showers/baths, proper hand washing and drying, perineal hygiene to include keeping the perineal area (between the vagina and back passage) clean, dry and frequent changes of maternity/sanitary pads. It is important to wash your hands before and after going to the toilet and changing maternity/sanitary pads.</span>
<h2>When am I more likely to get an infection or sepsis?</h2>
<span>Sepsis may happen in pregnancy or after your baby is born. The risk of getting an infection is increased in the following circumstances:</span>
<ul>
 	<li>After having a miscarriage or an ERPC (ERPC - evacuation of retained products of conception is a surgical procedure to remove tissue from the womb)</li>
 	<li>Premature rupture of membranes (when your waters break long before your baby is due)</li>
 	<li>If your waters break more than 24 hours before your baby is born</li>
 	<li>If you develop a urine infection (UTI)</li>
 	<li>If your baby was born prematurely/early (before its due date)</li>
 	<li>After you have had your baby – this is the most common time for serious infection to develop; especially if you had your baby by an emergency caesarean section, by forceps or vacuum delivery, or if you had a perineal wound or an episiotomy).</li>
</ul>
<h2>When should I contact the midwife or doctor?</h2>
<span>You should contact your GP or the maternity unit if you are worried, unwell and/or if you notice any of the following:</span>
<ul>
 	<li>Pain/burning on passing urine or struggling to pass urine, this could be a symptom of a urinary tract infection</li>
 	<li>Vaginal discharge which may be foul smelling and/or an unusual colour, this could be a sign of a genital tract infection (vaginal/womb infection)</li>
 	<li>Abdominal pain that does not seem to be getting better with simple analgesia, this could be a sign of womb/wound infection or abscess</li>
 	<li>Chills, flu type symptoms or feeling faint and unwell</li>
	<li>Fast breathing or shortness of breath</li>
 	<li>Fast heart rate</li>
	<li>Persistent cough with or with sputum, shortness of breath or chest pain could be a sign of chest infection or pulmonary embolism (blood clot in the lung)</li>
 	<li>A wound that is not healing well, broken down or is red</li>
	<li>Severe pain in one area of breast</li>
 	<li>Diarrhoea</li>
 	<li>Sudden increase in vaginal bleeding (after your baby is born).</li>
</ul>
<span>Contact the maternity unit where you gave birth, your midwife or GP for urgent advice.</span>
<span>For more information:</span>
<div data-cat="goto" class="goto"><a href="https://sepsistrust.org/about/about-sepsis/faqs/">UK Sepsis Trust</a></div>

Sepsis during pregnancy

<h1>Conditions affecting pregnancy</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2020/07/Complications-of-pregnancy-Your-pregnancy-650x406-300x187.jpg" alt="Close up of pregnant woman holding her bump" width="300" height="187" class="alignnone size-medium wp-image-12846" />
<div data-cat="submenu" class="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/08/pre-existing-conditions-and-pregnancy/">Pre-existing conditions and pregnancy</a>

<a href="https://admin.mumandbaby.uk/2018/09/11/infections-and-viruses/">Infections and viruses</a>

<a href="https://admin.mumandbaby.uk/2020/05/01/heart-health-in-pregnancy/">Heart health in pregnancy</a>

<a href="https://admin.mumandbaby.uk/2019/06/11/sepsis/">Sepsis during pregnancy</a>

<a href="https://admin.mumandbaby.uk/2018/08/12/common-pregnancy-complaints/">Common pregnancy complaints</a>

<a href="https://admin.mumandbaby.uk/2018/08/13/less-common-pregnancy-complications/">Less common pregnancy complications</a>

<a href="https://admin.mumandbaby.uk/2019/05/22/female-genital-mutilation-fgm/">Female Genital Mutilation (FGM)</a>
</div>

Conditions affecting pregnancy

<h1>Domestic abuse</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2019/05/MB_Image-300x187.jpg" alt="Graphic of the words domestic abuse surrounded by words relating to abusive actions and emotions" width="300" height="187" class="alignnone size-medium wp-image-5976" />

<span>Domestic abuse may start or get worse during pregnancy or after giving birth.</span>
<span>Domestic abuse includes a range of behaviours including: emotional, psychological, financial, sexual and physical abuse. A person choses to use this abusive behaviour in order to control their partner, ex-partner or family member(s) and it endangers the woman and her unborn child. The abuse is never the fault of the victim/survivor.</span>
<span>If you feel afraid of your partner, ex-partner or family member(s), or change your behaviour as you are afraid of how they might react, you may be experiencing domestic abuse.</span>

Domestic abuse is not something you need to manage alone. If you want to access support for domestic abuse, some options are:
<ul>
 	<li><b>Contacting your local Independent Domestic Violence Advisor service</b></li>
 	<li><b>Speaking to a domestic abuse helpline:</b></li>
<dd><span>24 hour National Domestic Violence Helpline: <a href="tel://0808 2000 247">0808 2000 247</a></span></dd>

<dd><span>Men’s Advice Line: <a href="tel://0808 801 0327">0808 801 0327</a></span></dd>

<dd><span>National LGBT+ Domestic Abuse Helpline: <a href="tel://0800 999 5428">0800 999 5428</a></span></dd>
 	<li><span><b>Speaking to your Midwife, GP or Health Visitor</b></span></li>
</ul>

<span>In an emergency, you should contact <a href="tel://999">999</a>.</span>

<span>The Silent Solution is a police system used to filter out large numbers of accidental or hoax 999 calls. It also exists to help people who are unable to speak, but who genuinely need police assistance. You will hear an automated police message, which lasts for 20 seconds and begins with ‘you are through to the police’. It will ask you to press 55 to be put through to police call management. The BT operator will remain on the line and listen. If you press 55, tap or make a noise, they will be notified and transfer the call to the police. If you don’t do any of the above, the call will be terminated after 45 seconds.</span>
<span>If you pressed 55, a police call handler will announce that you are through to the police.</span>
<span>If you can’t speak, you will be asked to tap the phone, make a noise or press 55. The police call handler will try a number of ways so that you do not feel under pressure to carry out just one prescribed action.</span>
<span>Only by pressing 55, tapping the phone, coughing, or making noise are you guaranteed a response to your call from a police call handler despite your silence. It is much easier to speak to the operator. But if you must stay silent, a mechanism has been provided that you can use to acquire help regardless.</span>
<span>Pressing 55 will not bring emergency services to your door and does not allow the police to track your location. By choosing to stay on the line, you are informing the police call handler that you might have an emergency that keeps you from talking, and they will do everything they can to determine your location so they can deploy officers to you.</span>
<span>The police call handler will try and engage with you, if you remain silent they will attempt to engage further and ask you to tap the phone if you are unable to speak; for example, yes and no questions can be asked by the call handler and answered using one keypad press for yes and two for no. If the police call handler has concerns about your safety, they will continue to try to communicate through sound.</span>
<span>If you are able to speak without putting yourself in danger, the police call handler will ask just yes and no questions if necessary. In some cases, the conversation is led by the caller, who sometimes tries and speaks to the police call handlers in code, if for example the perpetrator has reappeared.</span>
<span>If you can say only one thing, please say your location. If you call from a mobile, we can pin point an estimate location but this does not narrow down enough to provide data we can locate you on.</span>
<span>Police call handlers can request subscriber checks and can carry out background checks to assist in locating you. This can depend on whether you have contacted the police before. Also, if your phone is registered to you, it could determine whether this will provide a potential location for you.</span>
<span>The police call handlers will deal with calls on a case by case basis, as each call is different, and the style of the call is adapted in line with the circumstance.</span>

<span>If you feel you are perpetrating abuse against your partner, ex-partner or family member(s), you can contact:</span>
<span>Respect Helpline: <a href="tel://0808 802 4040">0808 802 4040</a></span>

<div data-cat="relatedlinks" class="relatedlinks"><a href="https://www.nhs.uk/live-well/healthy-body/getting-help-for-domestic-violence/#signs-of-domestic-violence-and-abuse" type="nhs">Signs of domestic violence and abuse</a>

<a href="https://www.thesurvivorstrust.org/pbpaftercsa">Pregnancy, birth and parenthood after childhood sexual abuse</a>

<a href="https://chat.womensaid.org.uk/">Chat.womensaid.org.uk</a>
</div>



Domestic abuse

<h1>Cervical erosion (ectropion)</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2021/07/Cervical-Ectropion-300x242.jpg" alt="Graphic showing where to cervical canal is located with cross-sections of a healthy cervix and one affected by cervical erosion" width="300" height="242" class="size-medium wp-image-17054" />

<span>Cervical ectropion (cervical erosion) occurs when the soft cells that line the inside of the cervical canal spread to the outer surface of your cervix.</span>

<span>These cells are redder and are more sensitive than the cells typically on the  outside, which is why they may cause symptoms like bleeding and discharge.</span>

<span>Cervial ectropion can be caused by hormonal changes, pregnancy and being on the pill. During pregnancy it usually resolves on its own but since it can sometimes cause bleeding, it is advisable to seek advice from your midwife or maternity triage department to rule out any other cause for the bleeding.</span>

Cervical erosion (ectropion)

<h1>Cervical insufficiency (incompetence)</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2021/07/Cervical-insufficiency-incompetence-300x214.jpg" alt="Short cervix in pregnancy illustration" width="300" height="214" class="size-medium wp-image-17031" />
<span>In some women, the muscles that surround the neck of the womb (cervix) are weaker than usual. This is known as cervical insufficiency, cervical incompetence or short cervix. Previous surgery or investigations to this area can sometimes cause the cervix to open too early, leading to miscarriage or pre-term birth. Cervical insufficiency can also be something you can be born with due to the shape of the uterus.</span>

<span>The mid-trimester ultrasound scan will usually identify a short or weak cervix. Your doctor may want to check your cervix early in pregnancy if you have had several miscarriages or if you have had a baby born before 37 weeks of pregnancy.</span>

Cervical insufficiency (incompetence)

<h2>Early pregnancy symptoms and feelings</h2>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2021/07/Early-pregnancy-symptoms-and-feelings-300x200.jpg" alt="Sleepy dark-skinned woman stretching and yawning" width="300" height="200" class="size-medium wp-image-17042" /> 


<span>Early pregnancy comes with a range of physical symptoms and mixed emotions (feelings), some of which may begin before you have a positive pregnancy test.</span>

<span>These include:</span>
<ul>
 	<li>sore (sensitive), heavy breasts</li>
 	<li>nausea or vomiting</li>
 	<li>tiredness or sleeplessness</li>
 	<li>needing to pass urine more often</li>
 	<li>light spotting or bleeding, sometimes accompanied by mild stomach cramps</li>
 	<li>a feeling of stretching and pulling in the tummy (abdomen) and back and at the tops of your legs</li>
 	<li>backache</li>
 	<li>feeling bloated with excess gas (wind)</li>
 	<li>diarrhoea or constipation</li>
 	<li>headaches</li>
 	<li>dizziness or feeling lightheaded</li>
</ul>
<span>Emotionally you may experience mood swings or feel tearful and become easily irritated. These are all normal responses as your body adapts to increasing levels of pregnancy hormones. These symptoms usually disappear as pregnancy progresses. If they don't it is very important to tell your midwife or doctor.</span>
<div data-cat="goto" class="goto"><a href="https://admin.mumandbaby.uk/2018/08/08/your-emotional-health-and-wellbeing-in-pregnancy/" internal="true">Improving your emotional wellbeing in pregnancy</a></div>


Early pregnancy symptoms and feelings

<h1>Ectopic pregnancy: Frequently asked questions</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2021/09/Ectopic-pregnancy-FAQs-300x226.jpg" alt="Young woman with her hands on her stomach grimacing in pain" width="300" height="226" class="size-medium wp-image-17743" />
<h2>What does this mean for me?</h2>
<span>A healthy pregnancy grows inside the uterus (womb), but an ectopic pregnancy is one where the pregnancy grows outside of the uterus. This occurs in about 1 in 80 pregnancies. Unfortunately, a pregnancy that implants outside of uterus cannot survive. The most common place for an ectopic pregnancy to grow is inside the Fallopian tube (the pair of tubes along which eggs travel from the ovaries to the uterus), although it can occur in other places. It can be dangerous if the pregnancy continues to grow and bursts (ruptures) as this can cause life-threatening internal bleeding.</span>

<h2>Why is this happening to me?</h2>
<span>Many women have no risk factors for developing an ectopic pregnancy. Certain things do increase your risk such as: a previous ectopic pregnancy; a history of pelvic inflammatory disease or endometriosis affecting the Fallopian tubes; smoking; previous pelvic or fallopian tube surgery; use of emergency contraception; age (especially 35-40 years), a history of infertility, or a pregnancy conceived via assisted conception or fertility treatments. Pregnancy is very uncommon with an intrauterine device in situ (such as a copper coil or Mirena), or use of the progesterone-only pill, but if you were to fall pregnant with this type of contraception this can also increase your risk.</span>

<h2>What happens next?</h2>
<span>A diagnosis of ectopic pregnancy is usually made with a combination of an ultrasound scan and regular blood tests to look at your pregnancy hormone levels βHCG (beta human chorionic gonadotropin).</span>

<h2>What worrying signs should I look out for?</h2>
<span><b>Vaginal bleeding:</b> this is often less than a usual period or the amount or colour is different to period. If you were not aware you were pregnant you may even mistake it as a normal period. However, bleeding in pregnancy is common and is not always a sign of something serious, but should always be investigated at your local Early Pregnancy Unit (EPU).</span>
<span><b>Abdominal (tummy) pain:</b> this typically occurs in the lower part of your abdomen often on one side and can develop gradually or suddenly and may be quite intense. The pain may come and go and may sometimes be confused with ‘trapped wind’. Pain should also always be investigated in early pregnancy.</span>

<span><b>Shoulder tip pain:</b> This is pain around the shoulder blades, and you should seek urgent medical help if this happens. It may be linked with internal bleeding in the abdomen and irritation of the nerves in this area leads to shoulder tip pain.</span>
<span><b>Diarrhoea:</b> This may also be linked with internal bleeding like shoulder tip pain, as described above. In such cases there will also be abdominal pain and you should also seek urgent medical help if this happens.</span>
<span><b>Ectopic pregnancy rupture:</b> in addition to the above, any of the following symptoms could be a sign of ectopic rupture and requires urgent A&E attendance: constant, severe abdominal pain; nausea/vomiting; dizziness/feeling faint; looking pale.</span>

<h2>How is it treated?</h2>
<span>There are three treatment options for ectopic pregnancy:</span>
<ul>
<li>Expectant management (waiting to see if the ectopic pregnancy resolves by itself)</li>
<li>Medicine to prevent the ectopic pregnancy from developing further</li>
<li>Surgery to remove the ectopic pregnancy.</li>
</ul>

<span>Treatment options will depend on many different factors including, the size and location of the ectopic pregnancy, your blood results, your symptoms, any previous medical and surgical treatments. A specialist will talk you through your options and together you can choose the most suitable management plan. It is important to highlight your future pregnancy plans in this discussion.</span>

<h2>Expectant management</h2>
<span>If you are suitable for this option and choose to have expectant management, you will be monitored to see if your ectopic pregnancy resolves by itself. This involves regular blood tests to check your pregnancy hormone levels (referred to as βHCG (HCG) until they fall and become negative. This can take up to 6 weeks (or longer in small number of cases). The success of expectant management is variable and ranges from 30-100%. It is more likely to be successful if the pregnancy is small and your starting βHCG levels are low. If it is unsuccessful you may require further treatment with medicine or surgery.</span>

<h2>Medical management</h2>
<span>If you are suitable for this method, you may be offered the option of a medicine called Methotrexate to treat the ectopic pregnancy. This is normally a single injection, however approximately 15 in 100 women require a second injection. In some cases, medical management may be unsuccessful, and 7 in 100 women will go on to require surgery.</span>

<span>As with expectant management you will require regular follow up with blood tests to ensure your pregnancy hormone, βHCG levels fall. If medical treatment is successful it will result in a 15% fall in your βHCG level by 1 week after a single methotrexate injection. It may take up to 6 weeks for the βHCG levels to become negative.</span>

<span>Side effects of the medication are rare but include nausea/ vomiting, feeling fatigued, skin rashes, mouth ulcers, abdominal cramping, diarrhoea, sensitivity to sunlight, temporary hair loss and lung inflammation. The medicine can briefly affect your liver, kidneys, and bone marrow (where important blood cells which help fight infection are made) and therefore you will need additional blood tests along with betaHCG levels during your follow up. You should avoid alcohol and vitamins containing folic acid.</span>

<span>Once your βHCG levels become negative you can drink alcohol and you should restart folic acid to rebuild your folate levels during the 3-month washout period for methotrexate.</span>

<span>It is very important that you do not fall pregnant for at least 3 months after having this medicine, if you were to fall pregnant there is a risk of birth defects to a developing baby; this risk is no longer present after 3 months. You should discuss contraception options with the doctor or nurse in the early pregnancy unit, or with your GP.</span>

<h2>Surgical treatment</h2>
<span>This may be offered as an option or recommended as the best course of treatment for you. This will involve general anaesthesia and the entry into the tummy can be done in two ways:</span>
<ul>
<li>Keyhole surgery (laparoscopy) – this is the standard surgical approach for nearly all cases.</li>
<li>Open surgery (laparotomy) - this may be needed on an individual case basis, unique to your clinical circumstances.</li>
</ul>

<span>Managing the ectopic pregnancy can be done in two ways and this will be influenced by the health of the other fallopian tube, the one without the ectopic pregnancy:</span>
<ul>
<li>Salpingectomy, involves the removal of the entire fallopian tube that contains the ectopic pregnancy. This is recommended if the other tube looks healthy.</li>

<li>Salpingostomy is considered if the other tube (not containing the ectopic pregnancy) does not look healthy or is absent. This involves making an incision on the fallopian tube to remove the ectopic pregnancy. The fallopian tube is not removed in this operation.</li>

<li>Both procedures carry small risks associated with having a surgical procedure and general anaesthetic. This includes risk of damage to other organs inside the abdomen such as the bowel, bladder, ureters (tubes that connect the bladder and the kidneys) and blood vessels. The surgeon and anaesthetist will talk you through the risks involved in more details.</li>

<li>After the operation, if your blood group is Rhesus negative, you should be offered an injection called Anti-D to prevent a condition from Rhesus Isoimmunisation. Rhesus Isoimmunisation is where your body develops antibodies if your baby’s blood group is Rhesus positive in this pregnancy. The Anti-D injection prevents your body developing antibodies which can negatively affect a Rhesus positive baby in future pregnancies and is recommended to remove this risk.</li>
</ul>
<h2>What worrying signs should I look out for after expectant or medical treatment?</h2>

<span>If you opt for expectant or medical management you will be able to return home. It’s important that you seek urgent medical attention and attend the A&E department, at any time of the day or night if you develop new symptoms including severe abdominal pain, shoulder tip pain, feeling unwell, faint or collapse. Inform A&E team of the diagnosis of ectopic pregnancy, who will arrange for an urgent review by gynaecology services. This is because there is still a small risk of the tubal pregnancy rupturing, which can potentially cause life-threatening internal bleeding.</span>

<h2>When can I get pregnant again?</h2>
<span>It is very important that you do not fall pregnant until you have completed your follow up after an ectopic pregnancy and your local Early Pregnancy Unit (EPU) confirm βHCG levels have become negative with blood or urine pregnancy tests.</span>

<span>If you chose to have Methotrexate then you need to wait at least 3 months before trying to conceive again. If Methotrexate was not used and your EPU confirms you are no longer pregnant you should wait for at least one period before trying again to help reset your body clock.</span>

<span>However, you should only try for another pregnancy again when you feel ready as the emotional recovery often takes longer than the physical recovery. In your next pregnancy it is most likely that the pregnancy will be in the correct place inside the uterus. However, 10-18 women per 100 will have another ectopic pregnancy. You should therefore contact your local EPU as soon as you know you are pregnant so you can get booked in for an early scan from 5-6 weeks to confirm the location of the pregnancy.</span>

<div data-cat="relatedlinks" class="relatedlinks">

<a href="https://ectopic.org.uk">The Ectopic Pregnancy Trust</a>

<a href="https://www.rcog.org.uk/en/patients/patient-leaflets/ectopic-pregnancy/" type="rcog" >Ectopic pregnancy</a>

<a href="https://www.tommys.org/baby-loss-support/ectopic-pregnancy-information-support" type="tommy's">Ectopic pregnancy information and support</a>
</div>

Ectopic pregnancy: Frequently asked questions

<h1>Hyperemesis Gravidarum support</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2021/08/Pregnant-woman-feeling-sick-hanging-over-the-loo-300x203.jpg" alt="Woman sitting in the bathroom suffering from sickness in early pregnancy" width="300" height="203" class="size-medium wp-image-17148" />
<span>Having a good support network can really help some of the physical and emotional symptoms of Hyperemesis Gradidarum (HG).</span>

<span>Making sure you have supportive people who can help you at home and help you take care of yourself and other children you may have can relieve a lot of the stress that having HG is likely to cause. It can be hard to ask for help but it is important to remember that HG is a serious illness and, if your friend had it, you would want to help them, so ask for help and let other people help you.</span>

<span>You’re likely to need time off work when suffering with HG and your employer has a duty of care to support you with this. Sick leave for pregnancy conditions must be recorded separately and you cannot lose your job because of pregnancy sickness.</span>

<span>Pregnancy Sickness Support have a confidential forum where you can chat with other people who have suffered with pregnancy sickness or HG. The charity offers a helpline or webchat where you can get more specific information about the medication options, services in your area and self-help strategies.</span>

<span>You can also get peer support from Pregnancy Sickness Support by calling the helpline: <a href="tel://07899245001">07899 245001</a> Mon-Fri 9.00-17.00.</span>
<div data-cat="relatedlinks" class="relatedlinks">
<a href="https://www.pregnancysicknesssupport.org.uk/about/">Pregnancy Sickness Support</a>
<a href="https://pregnancysicknesssupport.org.uk/hg-stories/">Pregnancy Sickness Support stories</a>
<a href="https://www.pregnancysicknesssupport.org.uk/get-help/">Pregancy Sickness Support get help</a>
</div>

Hyperemesis Gravidarum support

<h1>Hyperemesis Gravidarum treatments</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2021/08/Pregnant-woman-feeling-sick-sitting-on-bed-300x200.jpg" alt="Young pregnant woman sitting on the bed covering her mouth feeling nauseous in 1st trimester of pregnancy" width="300" height="200" class="size-medium wp-image-17142" />
<h2>What medication can I take and is it safe?</h2>

<span>There are several effective anti-sickness medications that can be taken in pregnancy, if needed. Hyperemesis Gravidarum (HG) is usually worse in the first trimester and it is important medication is started without delay.</span>

<span>Most effective medications for nausea and vomiting are not licensed in pregnancy. This does not mean the medication is unsafe or can’t be used. Taking medicine in pregnancy is about weighing the possible benefits of the medication with the possible risks of either taking the medication or leaving the person without treatment. It is important to remember that untreated HG can be dangerous for mum and baby so generally, the benefits of taking medication outweigh any possible risks.</span>

<span>Taking more than one type at a time can be more effective. There isn't a cure, but you should know within 48 hours if the medication that you have been prescribed is helping or not. If the medicine isn’t helping enough, then you can go back to your GP to talk about what other medicines you could try.</span>
<div data-cat="relatedlinks" class="relatedlinks">
<a href="https://www.pregnancysicknesssupport.org.uk/get-help/treatments/">Pregnancy sickness support treatments</a>
<a href="https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg69/" type="rcog">Guideline and research services</a>
<a href="https://www.bmj.com/content/363/bmj.k5000">British Medical Journal information</a>
<a href="https://journals.sagepub.com/doi/full/10.1177/1753495X20914967">Ondansetron for nausea and vomiting in pregnancy:re-evaluating the teratogenic risk</a>
</div>

Hyperemesis Gravidarum treatments

<h1>Intrauterine pregnancy of uncertain viability: Frequently asked questions</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2021/09/Intrauterine-pregnancy-of-uncertain-viability-FAQs-300x200.jpg" alt="Woman in pain sitting on bed holding her tummy" width="300" height="200" class="size-medium wp-image-17759" />
<h2>What does this mean for me?</h2>
<span>It means the pregnancy has been seen within the womb (uterus) on ultrasound scan, but a tiny baby (embryo) was not seen, or the tiny baby was seen but no heartbeat.</span>

<h2>Why is this happening to me?</h2>
<span>There are two possible reasons:</span>
<ul>
<li>This can be a completely normal finding in a very early pregnancy. A urine pregnancy test can be positive as early as 5 days before you miss your next period. An Intrauterine pregnancy of uncertain viability (IPUV) is also possible if your periods are irregular, you have recently stopped contraception, or you were recently pregnant.</li>

<li>It may also be that the pregnancy is not going to develop as expected, unfortunately. This is more likely if the size of the pregnancy does not match the number of weeks of your pregnancy. This may also be more likely if you develop bleeding in early pregnancy.</li>
</ul>

<h2>What happens next?</h2>

<span>A repeat ultrasound scan in one to two weeks is offered to confirm if a tiny baby (embryo) with a heartbeat can be seen. We know this will be an anxious period of waiting but this time interval is needed to allow the pregnancy to develop. If the pregnancy does not develop as expected, there is the possibility you may be diagnosed with a miscarriage at rescan. But if we confirm at rescan your baby is developing normally and a heartbeat is seen, you should request further pregnancy (antenatal) care by completing a self-referral form for maternity care or speak to your GP about your pregnancy, if not done already.</span>

<h2>What worrying signs should I look out for?</h2>
<span>Vaginal bleeding in early pregnancy is common. Many women with bleeding go on to have a successful pregnancy without complication. Bleeding does increase your risk of miscarriage and may be one of the first signs of this.</span>

<span>Symptoms of miscarriage include heavy bleeding with clots, as well as lower tummy (abdominal) cramps or contraction like pain. If you are concerned you should call your local early pregnancy unit for advice or attend your local emergency department (A&E).</span>

<span>If the bleeding becomes severe (having to change a pad every hour or passing large clots), severe pain that is not controlled with pain relief, or you have a fever, then you should attend your nearest A&E.</span>

<h2>What should I do if I think I am miscarrying?</h2>

<span>Sadly, miscarriages are common and there is a risk this may happen before the next ultrasound scan. This is unlikely to be related to anything you have done or not done but unfortunately it is not possible to prevent a miscarriage at this stage. You can take pain relief such as paracetamol and codeine to help ease any pain. If you have concerns about miscarrying or managing your emotions at this difficult time of uncertainty, then you should call your local Early Pregnancy Unit (EPU) to seek advice or attend A&E if you feel unwell.</span>

<div data-cat="relatedlinks" class="relatedlinks">

<a href="https://www.rcog.org.uk/en/patients/patient-leaflets/early-miscarriage/" type="rcog" >Early miscarriage </a>

<a href="https://www.miscarriageassociation.org.uk">Miscarriage Association</a>
</div>




Intrauterine pregnancy of uncertain viability: Frequently asked questions

<h1>Molar pregnancy: Frequently asked questions</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2021/09/Molar-pregnancy-FAQ-1-300x200.jpg" alt=" Closeup of pregnant womans stomach bump at 8 weeks gestation" width="300" height="200" class="size-medium wp-image-17780" />

<h2>What does this mean for me?</h2>
<span>A molar pregnancy is also known as a Hydatidiform mole or Gestational Trophoblastic Disease. In a molar pregnancy the placental cells grow abnormally. Molar pregnancies occur sporadically as a result of imbalance in the number of chromosomes. Because of this imbalance it is not possible for a healthy pregnancy to develop. There are two types of molar pregnancy.</span>

<h3>1. Partial mole</h3>
<span>This is where two sperms have fertilised an egg and there are three sets of chromosomes instead of the normal two.</span>

<h3>2. Complete mole</h3>
<span>This is where one sperm (or sometimes two) fertilises an empty egg (containing no genetic material).</span>

<h2>How is it diagnosed?</h2>

<span>The diagnosis of a molar pregnancy is often made after a miscarriage, when the pregnancy tissue has been looked under the microscope by a hospital laboratory. There are specific criteria used by the laboratory to determine if the pregnancy was partial and complete molar pregnancy. Sometimes there may be a suspicion of this diagnosis on an ultrasound scan but it can only be confirmed after a detailed examination under the microscope.</span>

<h2>What happens next?</h2>

<span>When there is a suspicion of a molar pregnancy, an operation to remove the pregnancy tissue from the womb will be required, as this is not a healthy pregnancy. This operation is usually done under general anaesthetic and involves a small suction tube being passed through the vagina and cervix (the neck of your womb) to remove the pregnancy. The pregnancy tissue will be sent to the laboratory for detailed assessment.</span>

<span>If a molar pregnancy is confirmed, you will need serial blood tests to confirm that the pregnancy hormone (βHCG) reduce to negative levels. This is important as there is a small risk that some of the abnormal pregnancy cells could develop into a more severe form of molar pregnancy (see below).</span>

<span>You will be referred to the nearest highly specialist centre near you, which are based in London, Sheffield or Dundee who will be in charge of this follow up over several weeks and months. This follow-up is very important because in some cases the molar pregnancy keeps growing and can occasionally develop into a rare form of cancer called Gestational Trophoblastic Neoplasia. This is not common and if it does occur treatment with chemotherapy is associated with extremely high cure rates (98-100% cure rate).</span>

<span>It is very important that you do not fall pregnant until your follow-up has been complete. Nearly all methods of contraception are safe to use, but an intrauterine device such as a coil is not recommended until your betaHCG becomes negative. We recommend you discuss the most appropriate type of contraception further with your doctor. The risk of molar pregnancy happening again in future pregnancy is low and is around 1 in 100 women.</span>

<div data-cat="relatedlinks" class="relatedlinks">

<a href="https://www.rcog.org.uk/en/patients/patient-leaflets/gestational-trophoblastic-disease-gtd/" type="rcog" >Molar pregnancy and gestational trophoblastic disease</a>

<a href="https://www.miscarriageassociation.org.uk">Miscarriage Association</a>
</div>


Molar pregnancy: Frequently asked questions

<h1>Pregnancy of unknown location: Frequently asked questions</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2021/09/Pregnancy-of-unknown-location-300x200.jpg" alt="Woman sitting alone looking worried" width="300" height="200" class="size-medium wp-image-17795" /> 
<h2>What does this mean for me?</h2>
<span>A Pregnancy of Unknown Location (PUL) is when you have a positive pregnancy test but a pregnancy could not be seen on ultrasound scan. There are three main reasons why this can occur:</span>
<ul>
<li>1. The pregnancy is very early and it is too small to be seen on ultrasound scan.</li>
<li>2. The pregnancy has ended in a miscarriage and cannot be seen on ultrasound scan. It can take up to 3 weeks for the pregnancy hormone levels to drop to non-pregnant levels, which is why a pregnancy test may still be positive. This situation is more likely if you have recently had heavy bleeding.</li>
<li>3. The pregnancy has implanted outside the womb, called an ectopic pregnancy, but is too small to be visualised on ultrasound scan.</li>
</ul>
<h2>What will happen next?</h2>
<span>You will have your pregnancy hormone (βHCG) level test. Some hospitals also take a test to assess the progesterone (ovarian hormone) level. The βHCG levels may then be repeated in 48 hours according to the protocol of your local Early Pregnancy Unit (EPU).</span>

<span>A βHCG level rise of 63% over a 48-hour period (known as the ‘doubling time’) is usually (but not exclusively) associated with a pregnancy developing in the uterus. The pattern of these blood tests will help to guide further management including when to repeat further blood tests, urine pregnancy tests or a repeat ultrasound scan.</span>

<span>This can be a stressful time, and it is natural to feel anxious while the location of your pregnancy is uncertain, particularly if you have had a pregnancy loss before. However, the time needed to get the right diagnosis is important and you will be supported throughout by your specialist team in the EPU. You will be advised to attend for further blood tests and scans to make a correct diagnosis of the pregnancy location and to offer you the right care and support. You will be able to contact the team with any queries or concerns you have during this time.</span>

<h2>What worrying signs should I look out for?</h2>

<span>The risk is that this may be an ectopic pregnancy (a pregnancy implanted outside the womb), which sometimes can cause life threatening internal (abdominal) bleeding. The risk of this happening is very low and your EPU team will guide. However, you should call your local EPU for advice or attend your local Accident and Emergency (A&E) department if you have of the following concerns:</span>
<ul>
<li>Vaginal bleeding: If you have any heavy bleeding with severe abdominal pain, fever, or offensive discharge you should seek urgent medical help. However, bleeding is pregnancy is common and may not actually be heavy. It is not always a sign of something serious but should always be investigated.</li>
<li>Abdominal (tummy) pain: This typically occurs in the lower part of your abdomen, often on one side and can develop gradually or suddenly and may be quite intense. The pain may come and go and may sometimes be confused with ‘trapped wind’. Pain should also always be investigated in early pregnancy.</li>
<li>Shoulder tip pain: This is pain around the shoulder blades, and you should seek urgent medical help if this happens. It may be linked with internal bleeding in the abdomen and irritation of the nerves in this area leads to shoulder tip pain.</li>
<li>Diarrhoea: This may also be linked with internal bleeding like shoulder tip pain, as described above. In such cases there will also be abdominal pain and you should also seek urgent medical help if this happens.</li>
<li>Ectopic pregnancy rupture: In addition to the above, any of the following symptoms could be a sign of ectopic rupture and requires urgent A&E attendance - constant, severe abdominal pain; nausea/ vomiting; dizziness/ feeling faint; looking pale.</li>
</ul>

<div data-cat="relatedlinks" class="relatedlinks">
<a href="https://www.rcog.org.uk/en/patients/patient-leaflets/ectopic-pregnancy/" type="rcog" >Ectopic pregnancy</a>
</div>


Pregnancy of unknown location: Frequently asked questions

<h1>Pregnancy sickness and Hyperemesis Gravidarum</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.2.13.1-300x187.jpg" alt="Woman lies in bed looking sick with hand over her mouth" width="300" height="187" class="alignnone size-medium wp-image-1063" />
<h2>What is pregnancy sickness?</h2>
<span>Normal pregnancy sickness is short spells of nausea and occasional vomiting usually during the early stages of pregnancy. It is common in many pregnancies, normally beginning around 4-6 weeks and eases between 12-20 weeks. It can affect you at any time of the day or night, and some people feel sick all day long. It is usually well managed through diet and lifestyle changes. In general, there are no bad physical or mental side effects as it’s a normal part of pregnancy.</span>
<h2>Coping strategies</h2>
<span>If your sickness isn't too bad, you can try some lifestyle changes:</span>
<ul>
 	<li>Get plenty of rest as tiredness can make nausea worse.</li>
 	<li>Avoid foods or smells that make you feel sick.</li>
 	<li>Eat dry toast or a plain biscuit before you get out of bed.</li>
 	<li>Eat small, frequent meals of plain foods that are high in carbohydrate and low in fat (such as bread, rice, crackers and pasta).</li>
 	<li>Eat cold foods rather than hot ones if the smell of hot meals makes you feel sick.</li>
 	<li>Drink plenty of fluids, such as water (sipping them little and often may help prevent vomiting).</li>
</ul>
<h2>When to seek help</h2>
<ul>
 	<li>When your quality of life is being affected and you’re not able to manage your usual activities</li>
 	<li>If your symptoms are much worse than you were expecting them to be</li>
 	<li>If you are not keeping down any food or drink, or only a very small amount</li>
 	<li>If you’ve lost weight</li>
 	<li>If you have signs of dehydration such as dry mouth, dry lips, headaches or feel dizzy, weak or confused. Changes in urine (wee) being darker, not going as much or only weeing a small amount.</li>
</ul>
<span>Please see the following information about Hyperemesis Gravidarum if you suspect you are suffering with a more severe form of pregnancy sickness.</span>
<h2>What is Hyperemesis Gravidarum?</h2>
<span>Hyperemesis Gravidarum (HG) is severe sickness and nausea in pregnancy where medical treatment and emotional support is needed. It can lead to a lot of weight loss and dehydration. Around 10,000-20,000 pregnancies a year are affected by this condition. It can start very early, even before a positive pregnancy test. Symptoms are usually the worst at 9-13 weeks, and get a bit better around 16-24 weeks, but it can go on all the way through the pregnancy for some people.</span>
<h2>When to seek help</h2>
<span>If you are being sick often and cannot keep food down, tell your midwife or doctor, or contact the hospital as soon as possible. There is a risk you may become dehydrated, and it is important you get the right treatment as soon as possible.</span>
<span>You should always seek help if you suspect you have HG, or severe nausea and vomiting, or if you have any of the following symptoms:</span>
<ul>
 	<li>Prolonged or constant nausea and/or vomiting affecting your day-to-day activities, like being about to go to work, look after your home or other children, or look after yourself.</li>
 	<li>You have signs of dehydration, such as a dry mouth, dry lips, headaches, dizziness, weakness, feeling confused. If your wee changes, for example if it is darker, you are not going as much, passing only a small amount.</li>
 	<li>If you’ve lost weight, this could be an indicator of HG.</li>
 	<li>Your symptoms are affecting your mental health and you are struggling to cope.
If you have had HG before, unfortunately, it's likely you will get it again in another pregnancy. If you decide on another pregnancy, it can help to plan ahead, such as arranging childcare so you can get plenty of rest. Talk to your GP about starting medicine early. Medication can be prescribed before symptoms even begin.</li>
</ul>
<h3>Other symptoms of HG:</h3>
<ul>
 	<li>Sensitive to smells</li>
 	<li>Excessive saliva production</li>
 	<li>Headaches and constipation from dehydration</li>
 	<li>Loss of bladder control</li>
 	<li>Tiredness</li>
 	<li>Acid reflux</li>
 	<li>Sensitive to lights/noise/movement</li>
</ul>
<h2>Coping strategies</h2>
<ul>
 	<li>Rest! There may be times where symptoms have eased and you feel like you can do more, but it’s important to still rest as much as possible.</li>
 	<li>Avoid triggers of nausea as much as possible. If that means avoiding cooking and being as far away from the kitchen as possible while someone else is cooking, then that is what you must do. It’s okay to ask that your family, colleagues or friends avoid certain foods whilst you are around them. Other sensory stimulation such as noises, moving, screens, or bright lights may be triggers too and should be avoided if they make your symptoms worse.</li>
 	<li>Try to avoid getting dehydrated. If drinking triggers vomiting or nausea, then sucking ice cubes made of juice or drinking very slowly through a straw may be the only way to stay hydrated. Bottled water may taste better than tap water. If you can’t keep fluids down, then be prepared for a hospital admission to have fluids through a drip. This is vital for you and your baby’s health and can make you feel much better.</li>
 	<li>Keep a diary. Tracking your food and drink intake will be helpful for the doctor to assess what treatment you need and for you to see if you have any food triggers. Tracking your symptoms may show a pattern and show you when is the best time to eat. It can also help you prepare for when you know your symptoms will be worse.</li>
</ul>
<div data-cat="relatedlinks" class="relatedlinks"><a href="https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/vomiting-and-morning-sickness/" type="nhs">Vomiting and morning sickness</a>
<a href="https://www.webmd.com/baby/guide/morning-sickness-pregnant#1">Morning sickness in pregnancy</a>
<a href="https://www.pregnancysicknesssupport.org.uk/what-is-hyperemesis-gravidarum/">What is Hyperemesis Gravidarum?</a>
<a href="https://www.nhs.uk/pregnancy/related-conditions/complications/severe-vomiting/" type="nhs">Severe vomiting</a>
<a href="https://www.pregnancysicknesssupport.org.uk/get-help/">Pregnancy Sickness Support get help</a>

<a href="https://pregnancysicknesssupport.org.uk/get-help/coping-strategies/">Coping strategies</a>
</div>

Pregnancy sickness and Hyperemesis Gravidarum

<h1>Pregnancy sickness: Frequently asked questions</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2021/08/Pregnant-woman-feeling-sick-with-mug-300x200.jpg" alt="Woman feeling sick in early pregnancy" width="300" height="200" class="size-medium wp-image-17154" /> 
<h2>What does this mean for me?</h2>
<span>Nausea and vomiting are common symptoms of pregnancy and affects 8 in 10 women. It usually starts early in pregnancy and resolves by the end of the first trimester, although in some cases it can last for longer. Some women have more severe symptoms, particularly if:</span>
<ul>
 	<li>they had it before: or</li>
 	<li>are having multiple pregnancy like twins or triplets; or</li>
 	<li>an uncommon condition known as a molar pregnancy.</li>
</ul>
<span>Sometimes the symptoms of nausea and vomiting are due to causes such as infection of your bowel, kidney or appendix, or inflammation of your stomach. It is important that these other causes are excluded particularly if you have unusual symptoms such as fever, blood in your vomit, abdominal pain, or loose stools. It is important to consider these other causes if your symptoms only start after your 11th week of pregnancy.</span>
<h2>What is Hyperemesis Gravidarum (HG)?</h2>
<span>This a severe form of nausea and vomiting in pregnancy, where you become dehydrated, lose a significant amount of weight, and have abnormal blood tests. It may affect 1 to 3 in 100 pregnant women. Women with this condition may need to be attend hospital for rehydration. For many women, HG settles by 20 weeks (5months) but occasionally it can last until the end of pregnancy.</span>

<span>Nausea and vomiting of pregnancy can sometimes affect your mood and all aspects of your normal day and home life. In some women, the symptoms can be so severe that they become depressed and need extra support such as counselling. If you find that you persistently feel down then you should seek help and speak to your GP, midwife or local Early Pregnancy Unit (EPU).</span>

<h2>What treatment do I need?</h2>
<span>Most women with mild symptoms will be able to manage their symptoms themselves. You should eat small amounts often and avoid any foods or smells that trigger symptoms. Some women find eating or drinking ginger products helps. Complementary therapies such as acupressure or acupuncture may also be helpful.</span>

<span>If this does not help, you should see your GP, who will prescribe anti-sickness medication. These are safe to take in pregnancy.</span>

<span>If your symptoms do not settle despite oral anti sickness medication, and you have any of the following symptoms, you should attend your local Accident and Emergency (A&amp;E) department or speak to the EPU at your local hospital:</span>
<ul>
 	<li>You are not able to tolerate any food or water.</li>
 	<li>You feel dehydrated (thirsty, dry mouth, dark urine).</li>
 	<li>You have lost weight (losing 5% or more of your pre-pregnancy weight is a concern).</li>
 	<li>You have fever, blood in your vomit, abdominal pain, or loose stools.</li>
 	<li>You have a medical condition which requires you to take tablets you can no longer take due to vomiting e.g anti-epileptic drugs.</li>
 	<li>You have a medical condition such as a heart or kidney problem or diabetes.</li>
</ul>
<span>In the hospital, you will be offered fluids through a drip as well as anti-sickness medication through a drip or as an injection. If these have not helped after regular use, corticosteroids may be added to your treatment, also through a drip. You may also be given some vitamin replacement drips and a blood thinning injection to reduce your risk of blood clots. You will also have some blood tests done and your urine tested to look for infection and to see how dehydrated you are.</span>

<span>If you feel better with these, you can go home and return the following day for some more fluids and medication. This can be continued on a daily basis and avoid the need for admission. But if you are very unwell with your symptoms, you may be offered admission for closer monitoring and treatment.</span>

<span>You will also be offered a non-urgent early pregnancy scan to check if you have a multiple pregnancy, or a molar pregnancy.</span>

<h2>What will this mean for future pregnancies?</h2>
<span>You are at a higher risk of developing this in future pregnancies, so do seek help early if you find that you are struggling with your symptoms.</span>

<h2>Where can I find out more information about this condition?</h2>
<div data-cat="relatedlinks" class="relatedlinks">
<a href="https://www.pregnancysicknesssupport.org.uk">Pregnancy Sickness Support</a>

<a href="https://www.rcog.org.uk/for-the-public/browse-all-patient-information-leaflets/pregnancy-sickness-nausea-and-vomiting-of-pregnancy-and-hyperemesis-gravidarum/" type="rcog">Royal College of Obstetricians &amp; Gynaecologists: Pregnancy and sickness</a>

<a href="https://www.tommys.org/pregnancy-information/im-pregnant/early-pregnancy/morning-sickness-relief-information-and-support" type="tommy's">Tommy's: Morning sickness relief information and support</a>

<a href="https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/vomiting-and-morning-sickness/" type="nhs">NHS Choices: Vomiting and morning sickness</a>

</div>

Pregnancy sickness: Frequently asked questions

<h1>Early pregnancy concerns</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2021/07/Early-pregnancy-concerns-300x200.jpg" alt="Closeup of pregnant womans stomach bump at 2 months gestation" width="300" height="200" class="size-medium wp-image-17022" />
<div class="submenu" data-cat="submenu">

<a href="https://admin.mumandbaby.uk/2021/07/29/early-pregnancy-symptoms-and-feelings/">Early pregnancy symptoms and feelings</a>

<a href="https://admin.mumandbaby.uk/2021/08/10/pregnancy-sickness-and-hyperemesis-gravidarum/">Pregnancy sickness and Hyperemesis Gravidarum</a>

<a href="https://admin.mumandbaby.uk/2021/08/10/hyperemesis-gravidarum-treatments/">Hyperemesis Gravidarum treatments</a>

<a href="https://admin.mumandbaby.uk/2021/08/10/hyperemesis-gravidarum-support/">Hyperemesis Gravidarum support</a>

<a href="https://admin.mumandbaby.uk/2021/08/10/pregnancy-sickness-and-hyperemesis-gravidarum-frequently-asked-questions/">Pregnancy sickness: Frequently asked questions</a>

<a href="https://admin.mumandbaby.uk/2021/07/29/cervical-erosion-ectropion/">Cervical erosion (ectropion)</a>

<a href="https://admin.mumandbaby.uk/2021/07/29/cervical-insufficiency-incompetence/">Cervical insufficiency (incompetence)</a>

<a href="https://admin.mumandbaby.uk/2021/09/02/ectopic-pregnancy-frequently-asked-questions/">Ectopic pregnancy: Frequently asked questions</a>

<a href="https://admin.mumandbaby.uk/2021/09/02/intrauterine-pregnancy-of-uncertain-viability-frequently-asked-questions/">Intrauterine pregnancy of uncertain viability: Frequently asked questions</a>

<a href="https://admin.mumandbaby.uk/2021/09/02/molar-pregnancy-frequently-asked-questions/">Molar pregnancy: Frequently asked questions</a>

<a href="https://admin.mumandbaby.uk/2021/09/02/pregnancy-of-unknown-location-frequently-asked-questions/">Pregnancy of unknown location: Frequently asked questions</a>

</div>

Early pregnancy concerns

<h1>Getting practical help during pregnancy</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2020/08/Yellow-signposts-650x406-300x187.jpg" alt="Signpost showing a variety of direction options" width="300" height="187" class="alignnone size-medium wp-image-13000" />
<span>Additional resources are available to you to help you with finances, housing, infant feeding, peer support, social activities in your area, and many more.</span>

<span>As this information is gathered for your area, this page will include local links to help you find these resources.</span>

Getting practical help during pregnancy

<h1>Oral health and eye care in pregnancy</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.2.9.jpg" alt="Pregnant woman cleaning her teeth" width="650" height="406" class="alignnone size-full wp-image-1048" />
<h2>Oral health in pregnancy</h2>
<span>During pregnancy and after birth it’s important to have regular dental check-ups.</span>
<span>NHS dental care is free for pregnant women and for one year after the birth or the expected first birthday of your baby. It is recommended that all pregnant women see their dentist during pregnancy. It is especially important to see your dentist if you have persistent sore or bleeding gums.</span>

<span>Hormonal changes in pregnancy may cause bleeding gums. It is important to keep a good level of dental hygiene to prevent tooth decay and gum disease. It is recommended that you brush twice a day with fluoride toothpaste containing at least 1350 ppm fluoride (this is safe to use in pregnancy).</span>

<span>Try to limit the amount of sugary food and drink you eat and then keep them for mealtimes rather than as snacks.</span>

<span>Remember to wait to brush your teeth after eating for at least 1 hour. This will prevent further dental erosion.</span>
<h2>Eye care in pregnancy</h2>
<span>During pregnancy you may experience slight changes in your vision and/or dry eyes. Eye tests are recommended every two years. Eye tests are free if you are on social benefits. Contact your local optician to book an appointment.</span>

Your GP can provide you with a signed form for a maternity exemption certificate. This will entitle you to free NHS prescriptions up to one year after the birth of your baby, and free NHS dental care.
<div data-cat="relatedlinks" class="relatedlinks">

<a type="nhs" href="https://www.nhsbsa.nhs.uk/exemption-certificates/maternity-exemption-certificates">Maternity exemption certificates</a>

<a type="nhs" href="https://www.nhs.uk/conditions/pregnancy-and-baby/teeth-and-gums-pregnant/">How to care for your teeth and gums during pregnancy</a>

</div>

Oral health and eye care in pregnancy

<h1>Disability and pregnancy</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2021/09/Disability-and-pregnancy-300x199.jpg" alt="Pregnant woman in wheelchair shopping in baby store" width="300" height="199" class="size-medium wp-image-17864" />

<span>Parents and parents-to-be with additional needs/disability are often well adapted to their activities at home and at work, in their relationships and in interactions with their surrounding environment. Adapting to pregnancy, birth and parenting may require further adaptations. It is estimated that almost 10% of parents have a long term health condition which may result in disability or adaptation to daily living.</span>

<span>Maternity and other services can work in partnership with parents to facilitate individualised decision-making, equal access and making adjustments for pregnancy/birth and parenting.</span>
<h2>Tips for getting the support you need:</h2>
<ul>
<li>Report your additional needs when completing your pregnancy self-referral form and discuss these needs again when you meet your midwife for the first time.</li>
<li>Ask for a named midwife or to be part of a continuity of care team. Knowing your midwife facilitates partnership working and personalised planning around your own needs.</li>
<li>You are the expert in yourself, so talk to your midwife about what would help you through pregnancy, birth and parenting. Complete the Health and wellbeing in pregnancy personalised care and support plan with your midwife, highlighting the need for adjustments and improved access.</li>
<li>Consider a self-referral for a Health Needs Assessment if you require assessment of your home, care needs or benefits.</li> 
<li>Refer yourself to your local sensory impairment team for advice and adaptive equipment i.e. vibrating mat to alert to baby’s cry if you are hearing impaired.</li>
<li>Ask to see an occupational therapist for further specialised adaptive advice for home and parenting. Contact the local Social Services Occupational Therapy (for adaptive equipment and home adaptations) or Community Therapy teams e.g. neuro-rehabilitation for specific conditions such as Multiple sclerosis, Stroke or Functional Neurological Disorder, or via the community Learning Disability Team. Your GP can assist with making these referrals.</li>
<li>You can request longer appointment times, transport and accessibility to venue for appointments to facilitate your or your supporter’s needs.</li> 
<li>Consider if you need someone with you at appointments, i.e. British Sign Language (BSL) interpreter, advocate or supportive relative. Talk about whom you would need to have with you during your hospital inpatient stay – assistance dog/supporter/interpreting service.
<li>Discuss your preferred mode of communication i.e. small chunks of information, emailed information to support verbal advice to support memory, large print, technical aids i.e. signing app, audio messaging.</li>
<li>Ask about access to antenatal classes. The BSL interpreter can be with you if you are hearing impaired; the information can also be tailored for visually impaired parents. The midwife can allocate time for a personal session to individualise to your needs.</li>
</ul>
<h2>Environment:</h2>
<ul>
<li>It may be useful to ask for a tour of the birth and after birth areas to familiarise and identify where adjustments may be required.</li>
<li>Talk to your midwife about accessibility of the birthing pool, bathrooms, showers, bed heights, adjustable cot height and a single room after the baby is born to facilitate your stay if needed.</li>
<li>Talk to your midwife about lighting, sound or temperature sensitivities or any preferences that make adapting to the environment more manageable.</li>
<li>Discuss birth positions in case modifications are needed.</li>
</ul>
<h2>Thinking about baby care:</h2>
<ul>
<li>Talk to the midwife about your home environment – think about inside the home and outdoors.</li>
<li>Baby sleeping area – would a cot attached to the bed make it easier to reach the baby overnight?</li>
<li>Plan your night and day equipment – safe sleeping in your bedroom and in your living room i.e. Moses basket.</li>
<li>Baby changing stations (e.g. mat and equipment) in day/night area – to support energy conservation.
<li>Carrying the baby – a baby wearing sling may help to enable you to keep your hands free or a light pushchair at home to move the baby from room to room.</li>
<li>Transporting the baby – will you use public transport, car or walk? Consider your needs when choosing a pushchair.  The weight, brake location, ease of access, assembly and storage are things to consider when choosing the pushchair.</li>
<li>Infant feeding – discuss with your midwife.  Consider a supportive infant feeding pillow to support baby’s position for feeding. Consider your own comfort and supported position. Where will you be feeding? Modified feeding positions i.e. for one handed feeding, or equipment to support holding the bottle. Ask your midwife about collecting breast milk during the last part of pregnancy if you feel this could be useful to supplement the baby’s needs in the early days.</li>
<li>If fatigue is a concern, your midwife can work with you to offer tips such as sleeping when the baby sleeps, energy conservation tips such as planning, pacing and prioritising what you need to ‘do, delay, delegate or ditch’ to enable your self-care and meeting the needs of your baby.</li>
<li>Talk to your supporters/family to ascertain how they can help you. Plan during the pregnancy so that you are ready for when the baby arrives. Where there is limited support discuss with your midwife to explore what other services might be available to you.</li>
</ul>

<div data-cat="relatedlinks" class="relatedlinks">

<a href="https://www.disabledparent.org.uk/">Disabled parent</a>
<a href="https://www.womenwithepilepsy.co.uk/">Women wih epilepsy</a>
<a href="https://www.remap.org.uk/">Remap: Custom-made equipment</a>
<a href="https://www.demand.org.uk/">Demand: Design and manufacture for disability</a>
<a href="https://www.buzzsprout.com/961453/8500937-episode-56-pregnancy-and-disability">Pregnancy and disability: The Obs Pod, Episode 56</a>
</div>


Disability and pregnancy

<h1>Exercise in pregnancy</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2020/07/Exercise-in-pregnancy-Your-pregnancy-300x187.jpg" alt="Heavily pregnant woman holding her bump" width="300" height="187" class="alignnone size-medium wp-image-12818" />

<span style="font-weight: 400;">Exercise is an important part of maintaining a healthy lifestyle and is known to be safe in pregnancy. </span>

<span style="font-weight: 400;">Pregnancy is not the time to start a challenging new fitness regime, but it is good to maintain your pre-pregnancy level of activity with some adjustments if needed, or to try something gentle like walking, swimming or pregnancy yoga.</span>

<span style="font-weight: 400;">Some women feel exercise helps them adjust to the physical changes taking place in their body, promoting a sense of wellbeing and reducing feelings of stress, anxiety and depression. Exercise may help prevent some pregnancy complications and can help with swollen ankles/feet: </span>
<ul>
 	<li>Avoid exercise where you could lose your balance and hurt yourself.</li>
 	<li>Ensure you drink plenty of water during exercise.</li>
 	<li>Remember that hormonal changes preparing you for birth can make you more flexible. If you have pain in your back or pelvis during exercise, you should speak with your midwive about a referral to a woman's health physiotherapist.</li>
 	<li>It is important to warm up and cool down when exercising to avoid strain or injury.</li>
 	<li>If you are taking a class, remember to inform the trainer you are pregnant.</li>
	<li>You should avoid exercise that causes significant increases to your body temperature such as hot yoga, a jacuzzi or intense exercise when it is hot.</li>
	<li>It is recommended that you exercise to an intensity where your heart rate and breathing rate increases slightly but you can still talk in sentences and do not become excessively out of breath.</li>
	<li>150 minutes of moderate intensity exercise is recommended a week during pregnancy.</li>
	<li>If you have any factors in your pregnancy that make your pregnancy higher risk, you should consult your midwife or obstetrician before exercising during pregnancy.</li>
	<li>If your body is conditioned to weight lifting or high impact exercise preior to pregnancy it may be ok to continue with modifications, however you should consult your midwife or women's health physiotherapists to guide individual advice.</li>
</ul>
<span style="font-weight: 400;">If you experience anything unusual, you should stop exercising, and contact your midwife or doctor.</span>
<div data-cat="submenu" class="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/12/pelvic-floor-exercises/">Pelvic floor exercises</a>

</div>
<div data-cat="relatedlinks" class="relatedlinks">

<a href="http://www.nhs.uk/conditions/pregnancy-and-baby/pregnancy-exercise/" type="nhs">Exercise during pregnancy</a>

<a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/622335/CMO_physical_activity_pregnant_women_infographic.pdf">Physical activity chart</a>

</div>

Exercise in pregnancy

<h1>Improving your emotional wellbeing in pregnancy</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.2.4.jpg" alt="Pregnant woman smiling and holding her bump" width="650" height="406" class="alignnone size-full wp-image-1038" />

<span style="font-weight: 400;">It may seem like everyone else is happy and coping, but it doesn’t mean they are. Lots of women feel low in pregnancy, but many women who feel down may try and hide it.</span>

<span style="font-weight: 400;">Here are some tips to improve your emotional wellbeing:</span>
<div data-cat="submenu" class="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/09/self-help/">Self-help</a>

<a href="https://admin.mumandbaby.uk/2018/08/09/health-and-wellbeing-in-pregnancy-plan/">Health and wellbeing in pregnancy plan</a>

<a href="https://admin.mumandbaby.uk/2018/08/09/when-to-get-help/">When to get help</a>

<a href="https://admin.mumandbaby.uk/2018/08/09/talking-therapies/">Talking therapies</a>

</div>
<div data-cat="goto" class="goto">

<a href="https://admin.mumandbaby.uk/2018/08/06/maternity-units/" internal="true">Contact my maternity unit</a>

</div>
<div data-cat="relatedlinks" class="relatedlinks">

<a href="http://www.netmums.com/support">Net mums support</a>

<a href="http://www.eatingdisordersandpregnancy.co.uk/">Eating disorders and pregnancy</a>

</div>

Improving your emotional wellbeing in pregnancy

<h1>Lifestyle information</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.2.5.jpg" alt="Close up of pregnant woman holding her bump" width="650" height="406" class="alignnone size-full wp-image-1043" />
<div data-cat="submenu" class="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/09/diet/">Diet</a>

<a href="https://admin.mumandbaby.uk/2023/03/24/weight-management/">Weight management</a>

<a href="https://admin.mumandbaby.uk/2018/08/09/alcohol/">Alcohol</a>

<a href="https://admin.mumandbaby.uk/2018/08/12/smoking/">Smoking</a>

<a href="https://admin.mumandbaby.uk/2018/08/12/recreational-illegal-drug-use/">Recreational/illegal drug use</a>

</div>

Lifestyle information

<h1>Medications</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.2.6.jpg" alt="Open pill bottle spilling contents onto tabletop" width="650" height="406" class="alignnone size-full wp-image-1044" />

<span style="font-weight: 400;">If you are taking medications for any long term conditions, do not stop taking them or change the dose without talking to your GP first. If you’re not sure about the safety of certain medications, talk to your GP or local pharmacist. Many medications are safe when breastfeeding but talk to your GP who can confirm or recommend a safe alternative.</span>
<span>Your GP can provide you with a signed form for a maternity exemption certificate. This will entitle you to free NHS prescriptions up to one year after the birth of your baby.</span>

<div data-cat="submenu" class="submenu">
<a href="https://admin.mumandbaby.uk/2020/05/21/commonly-used-medicines-during-pregnancy/">Commonly used medicines during pregnancy</a>
</div>

<div data-id="Medications related links">Portal: Medications related links</div>
<div data-cat="relatedlinks" class="relatedlinks">
<a href="http://www.medicinesinpregnancy.org/">Information about medications in pregnancy</a>
<a type="nhs" href="https://www.nhsbsa.nhs.uk/exemption-certificates/maternity-exemption-certificates">Maternity Exemption Certificates</a>
</div>

Medications

<h1>Sex in pregnancy</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.2.7.jpg" alt="Two pairs of intwined feet stick out from under a bed sheet" width="650" height="406" class="alignnone size-full wp-image-1045" />

<span style="font-weight: 400;">It is safe to have sex in pregnancy, unless your care provider has advised against it. </span>

<span style="font-weight: 400;">Some couples find sex enjoyable during pregnancy, whereas some find their sex drive changes and they don’t feel like they want to have sex as often or at all. If you don’t feel like having sex, think about other ways you could feel intimate and close with your partner. Talk about your feelings with your partner and make adjustments if you need them. Your breasts may be sore and tender, and as your bump grows certain positions become more difficult. Having sex cannot harm your baby, and he or she will not be aware of what is happening.</span>
<div data-cat="relatedlinks" class="relatedlinks">

<a href="http://www.nhs.uk/conditions/pregnancy-and-baby/sex-in-pregnancy/" type="nhs">Sex in pregnancy</a>

<a href="http://www.nct.org.uk/pregnancy/sex-during-pregnancy-questions-and-concerns" type="nct">Further resources about sex in pregnancy</a>

</div>

Sex in pregnancy

<h1>Travel safety</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.2.12.jpg" alt="Pregnant woman holding small wheely suitcase handle" width="650" height="406" class="alignnone size-full wp-image-1062" />

<span style="font-weight: 400;">Always take your hand held maternity notes with you if travelling away from home. If travelling far from home in the middle/later stages of pregnancy, it may be worthwhile looking up the local maternity unit in case you need any urgent care whilst away.</span>
<div data-cat="submenu" class="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/12/travelling-in-london/">Travelling in London</a>

<a href="https://admin.mumandbaby.uk/2018/08/12/cycling/">Cycling</a>

<a href="https://admin.mumandbaby.uk/2018/08/12/353/">Car journeys</a>

<a href="https://admin.mumandbaby.uk/2018/08/12/flying/">Flying</a>

<a href="https://admin.mumandbaby.uk/2018/08/12/travel-vaccinations/">Travel vaccinations</a>

</div>

Travel safety

<h1>Vaccinations during pregnancy</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.2.11.jpg" alt="Close up of health professional's hand with syringe preparing to vaccinate pregnant woman" width="650" height="406" class="alignnone size-full wp-image-1056" />

<div data-cat="goto" class="goto">
<a href="https://admin.mumandbaby.uk/2020/12/17/covid-19-vaccination-flu-vaccine-and-pregnancy/" internal="true">COVID-19 and flu vaccines during pregnancy</a>
</div>

<span style="font-weight: 400;">It is currently recommended that all pregnant women have flu and whooping cough vaccinations during pregnancy. Ask your midwife or your GP's practice nurse about this early in pregnancy. If you are travelling, please see the information on travel safety.</span>
<h2>Do you have an appointment for a vaccination?</h2>
<h3>Please make sure you keep it.</h3>
<span>Vaccinations protect against serious illnesses now and in the future, so it's really important to keep up to date with jabs for you and your family.</span>
<span>This is particularly important if you are pregnant or have small children.</span>
<span>You should attend your appointments as normal, as long as you don't have symptoms of COVID-19 and you are not self-isolating.</span>
<span>If you are worried or have any questions please call your GP practice.</span>
<h2>Flu vaccine</h2>
<span style="font-weight: 400;">The flu vaccine is available in winter every year and is safe at every stage of pregnancy. The flu vaccine is recommended because catching flu when pregnant can cause serious complications for both you and your baby.</span>

<h2>Whooping cough vaccine</h2>
<span style="font-weight: 400;">The whooping cough vaccine is recommended for all pregnant women and can be given between 16 and 38 weeks of pregnancy. Ideally women should have the vaccination between 16 and 32 weeks of pregnancy as this best ensures the vaccine has sufficient time to provide immunity to your baby. Whooping cough in young babies can cause pneumonia and brain damage, therefore having a booster vaccine during pregnancy will help protect your baby.</span>

<div data-cat="relatedlinks" class="relatedlinks">

<a type="nhs" href="https://www.nhs.uk/conditions/pregnancy-and-baby/vaccinations-pregnant/">Information about vaccinations in pregnancy</a>

<a href="https://www.gov.uk/government/publications/vaccination-against-pertussis-whooping-cough-for-pregnant-women">More on vaccinations during pregnancy</a>

<a type="nhs" href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/624265/WhoopingCough_A5_booklet.pdf">Whooping cough</a>

</div>

Vaccinations during pregnancy

<h1>Vitamins and supplements and over the counter medicines</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.2.2.jpg" alt="Close up of pregnant woman comparing pill bottle label with information on hand-held notes" width="650" height="406" class="alignnone size-full wp-image-1029" />
<span>It is recommended that all women take folic acid and vitamin D supplements during pregnancy. If you have a darker skin, or always cover your skin you may be at higher risk of Vitamin D deficiency. See the related link below for further information. You can buy these over the counter or alternatively ask your GP for a prescription. Folic acid can be stopped when you are 12 weeks pregnant, whereas vitamin D can be taken throughout pregnancy and whilst breastfeeding.</span>

<span>Other vitamins are unlikely to be needed if you have a healthy and balanced diet.</span>

<span>Some women find that their iron levels drop in pregnancy – you will be offered blood tests to see if you need any iron supplements. If you receive certain benefits you may be entitled to free vitamins from Healthy Start.</span>

<span>Sometimes it is necessary to take medication in pregnancy, although this should always be on the specific advice of your midwife or doctor.</span>

<span>In some circumstances, certain types of medications are recommended for over the counter purchase rather than requiring a prescription.</span>

<span>The types of medications that fall into this category are:</span>

<span>Antacids</span>
<span>Laxatives</span>
<span>Vitamins and minerals</span>
<span>Iron supplements</span>
<span>Analgesia (painkillers)</span>
<span>Moisturisers and steroids</span>
<span>Aspirin</span>
<span>Treatment for haemorrhoids (piles), thrush, cold sores, dandruff etc.</span>

<span>If your healthcare professional recommends that you take such medication you will be advised to see your local pharmacist, who will be able offer further advice and information about the recommended products.</span>

<div data-cat="relatedlinks" class="relatedlinks">

<a href="https://www.nhs.uk/conditions/pregnancy-and-baby/vitamins-minerals-supplements-pregnant/" type="nhs">Vitamins and supplements in pregnancy</a>

<a type="nhs" href="http://www.healthystart.nhs.uk/">Healthy start</a>

<a type="rcog" href="https://www.rcog.org.uk/en/patients/patient-leaflets/healthy-eating-and-vitamin-supplements-in-pregnancy/">Further guidance on vitamins and supplements in pregnancy</a>

<a href="https://www.tommys.org/pregnancy-information/im-pregnant/nutrition-in-pregnancy/vitamin-d-pregnancy" type="tommy's">Vitamin D in pregnancy</a>

</div>

Vitamins and supplements and over the counter medicines

<h1>Your emotional health and wellbeing in pregnancy</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.2.3.jpg" alt="" width="650" height="406" class="alignnone size-full wp-image-1033" />

<span>Expecting a baby can be a joyful and exciting time. However, it is also common for pregnant women to experience anxiety, depression or emotional distress. As many as one in four women experience emotional difficulties during pregnancy. This can happen to anyone, explore the pages below to find out more about your emotional health and wellbeing. </span>

<div data-cat="goto" class="goto">

<a href="https://admin.mumandbaby.uk/2018/08/06/maternity-units/" internal="true">Contact my maternity unit</a>

</div>
<div data-cat="submenu" class="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/08/talking-about-your-emotional-health/">Talking about your emotional health</a>

<a href="https://admin.mumandbaby.uk/2018/08/08/during-your-pregnancy/">Your emotional health during your pregnancy</a>

<a href="https://admin.mumandbaby.uk/2018/08/08/anxiety-about-childbirth/">Anxiety about childbirth</a>

<div data-id="Volunteer services in your region">Portal: Volunteer services in your region</div>
</div>
<div data-cat="relatedlinks" class="relatedlinks">

<a href="https://www.anxietyuk.org.uk/blog/health-and-other-forms-of-anxiety-and-coronavirus">Anxiety and coronavirus</a>

<a href="https://www.mind.org.uk/information-support/coronavirus-and-your-wellbeing/#TakeCareOfYourMentalHealthAndWellbeing">Coronavirus and your wellbeing</a>

<a href="https://www.mentalhealth.org.uk/publications/looking-after-your-mental-health-during-coronavirus-outbreak">Looking after your mental health during coronavirus outbreak</a>

<a href="http://www.nhs.uk/conditions/pregnancy-and-baby/mental-health-problems-pregnant/" type="nhs">Mental health problems and pregnancy</a>

<a href="http://perinatalpositivity.org">Emotional preparation for families to be</a>

<a href="http://www.bestbeginnings.org.uk/out-of-the-blue">Best Beginnings: Out of the blue videos</a>

<a href="http://www.eatingdisordersandpregnancy.co.uk/">Eating disorders and pregnancy</a>
<a href="https://www.thesurvivorstrust.org/pbpaftercsa">Pregnancy, birth and parenthood afer childhood sexual abuse</a>
<a href="https://www.birthcompanions.org.uk/">Birth Companions - supporting pregnant and new mums in prison</a>
</div>

Your emotional health and wellbeing in pregnancy

Health and wellbeing in pregnancy

<h1>I am not a UK resident</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2020/08/Immigration-image-resized--300x187.jpg" alt="Woman with suitcase arriving in England" width="300" height="187" class="alignnone size-medium wp-image-13034" />
<span>If you are a non-UK resident visiting from overseas, you will need to provide information in order to receive NHS treatment (including maternity care). This will include proof of <b>all</b> of the following:</span>
<ul>
<li>your identity</li>
<li>your permanent address</li>
<li>permission for you to live/work in the UK.</li>
</ul>
<span>You will be asked to provide this information when you come for your first appointment with the midwife.</span>
<span>If you are unsure about your eligibility, contact your maternity unit.</span>
<span>If you are unwell, or are concerned about your unborn baby's wellbeing, you should attend your closest maternity unit for emergency care.</span>

<div data-cat="relatedlinks" class="relatedlinks">
<a href="https://www.nhs.uk/using-the-nhs/nhs-services/visiting-or-moving-to-england/how-to-access-nhs-services-in-england/">How to access NHS services in England</a>

I am not a UK resident

<h1>What next?</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.1.1.jpg" alt="Woman looks at pregnancy test with man" width="650" height="406" class="alignnone size-full wp-image-1001" />

<span style="font-weight: 400;">Once you know that you’re pregnant, you can complete a self-referral form for maternity care. You can do this without seeing your GP, <b>if</b> your maternity unit is already set up to do this - simply choose your maternity unit in the app and follow the self-referral link. If there is no self-referral link, speak to your GP surgery who will help you start your maternity care.</span>

<span style="font-weight: 400;">It is important to have an appointment with your GP if:</span>
<ul>
 	<li>you have any medical conditions or you are taking any regular medications. Please do not stop or change any prescribed medications without medical advice from your GP</li>
 	<li>your pregnancy wasn’t planned, or you are unsure about carrying it on and what your options might be.</li>
</ul>
<span style="font-weight: 400;">Your pregnancy care (known as antenatal care) will consist of a set of scheduled appointments with a midwife and/or specialised doctor (if needed).</span>

<span style="font-weight: 400;">If you are thinking about a homebirth you will need to book your pregnancy at your closest maternity unit so that local midwives can provide you with care in labour at your home.</span>

<div data-cat="relatedlinks" class="relatedlinks">

<a type="nhs" href="https://www.nhs.uk/common-health-questions/pregnancy/am-i-pregnant/">Finding out you're pregnant</a>

<a type="nhs" href="https://www.nhs.uk/conditions/pregnancy-and-baby/finding-out-pregnant/">Am I pregnant?</a>

<a href="https://sexwise.fpa.org.uk/unplanned-pregnancy/pregnant-and-dont-know-what-do">Pregnant and don't know what to do?</a>

<a type="nhs" href="https://www.nhs.uk/pregnancy/">Pregnancy</a>

<a href="https://www.aims.org.uk/">AIMS: Campaigning for a better birth for all</a>

<a href="https://www.birthrights.org.uk">Your rights in childbirth</a>
</div>

What next?

<h1>Your pregnancy in weeks (gestational age)</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.1.4.jpg" alt="Section of woman shown to illustrate fetal growth during pregnancy in nine stages" width="650" height="406" class="alignnone size-full wp-image-1004" />

<span>You can roughly work out when your baby is due using the date of the first day of your last period (LMP). After your first ultrasound scan your due date may change a little; this is quite common.</span>
<h2>5 weeks:</h2>
<span>By the end of the 5th week after fertilisation or 7 weeks gestational age, the baby is known as an "embryo" and is approximately 12.7 millimetres long. The brain, spinal cord, and nervous system are more developed. The head has increased in size, and the nostrils, lips, and tongue are visible. The limb buds have grown into arms and legs.</span>
<h2>6 weeks:</h2>
<span>By the end of the 6th week after fertilisation or 8 weeks gestational age, the embryo is approximately 22 millimetres long. The head is quite large in comparison to the trunk. External ears form elevations on either side of the head. A skeleton made of cartilage, not real bone, has appeared; and a tail is apparent at the end of the spinal cord. Fingers and toes have formed.</span>
<h2>9 weeks:</h2>
<span>By the end of the 9th week after fertilisation or 11 weeks gestational age, the baby looks more human. It measures almost 5 centimetres in length and weighs approximately 4 grams. Most of the major structures have formed. Development now consists of the growth and maturing of present structures. The scrotum has appeared, as have fingernails, toenails and hair follicles.</span>
<h2>12 weeks:</h2>
<span>By the end of the 3rd lunar month, or 12 weeks gestational age, the baby is over 2.5 inches in length and weighs 7 grams. You may hear the baby being referred to as a "fetus" by healthcare professionals. The face is well developed, with the eyelids present, though fused. The baby can move the muscles of his face to squint, purse his lips, and open his mouth. The arms, hands, fingers, legs, feet, and toes are fully developed. The external genitalia show definite signs of male or female sex. The baby can make a fist and kick with his feet, although you won't be able to feel it yet. The uterus can be felt just above the woman’s pubic bone.</span>
<h2>16 weeks:</h2>
<span>By the end of the 4th lunar month, or 16 weeks gestational age, the baby is almost 12 centimetres long and weighs 100 grams. The essential body systems are now present; most of the remaining changes will be in size. To facilitate this growth, the placenta is also growing rapidly. The baby’s skin is getting thicker and less transparent, and is forming several layers. Eyebrows and eyelashes are evident. The baby may suck his thumb, and he may swallow amniotic fluid and then pass it out as urine. Meconium, the baby’s first bowel movement, is beginning to collect in his intestinal tract.</span>
<span>Some women feel the first faint fluttering movements between their pubic bone and navel. These movements are often initially confused with gas, but the feeling is known as “quickening”, the earliest felt movements of a baby. Usually, quickening is first perceived between the 16th and 18th weeks, although this can vary from person to person.</span>
<h2>24 weeks:</h2>
<span>By the end of the 6th lunar month, or 24 weeks gestational age, the baby is almost 28 centimetres and weighs 500 grams. Vernix caseosa, a cheese-like coating that protects the baby’s skin from its watery environment, has developed. The eyes are open, and the fetus can hear. Fingerprints and footprints have formed. By this time you should be able to feel regular fluttering movements. You should inform your midwife if you have not felt any movements by 24 weeks.</span>
<h2>28 weeks:</h2>
<span>By the end of the 7th lunar month, or 28 weeks gestational age, the baby is close to 33 centimetres long and weighs about 900 grams. The eyes can perceive light, and the baby can hear, smell, taste, and respond to touch. The baby has definite awake and sleep periods.</span>
<h2>32 weeks:</h2>
<span>By the end of the eighth lunar month, or 32 weeks gestational age, the average baby is 38 centimetres long and weighs 1,500 grams or more. The skin is still red but is less wrinkled, and the fingernails are long.</span>
<h2>36 weeks:</h2>
<span>By the end of the 9th lunar month, or 36 weeks gestational age, the baby is almost 43 centimetres long and weighs between 2160 grams and 2,500 grams.</span>
<span>During the last 2 months of gestation, the baby gains about 25 grams of weight a day. This weight gain is important because it provides the baby with a layer of fat under his skin that will help keep his body temperature constant outside the uterus. The skin has become smoother, and the redness has faded to pink. Most of the lanugo has dropped off, remaining only on the arms and shoulders. (Lanugo is the first hair that grows out of your baby's hair follicles while they are still developing in the womb.) The lungs are maturing getting ready for respiration.</span>
<h2>40 weeks:</h2>
<span>By the end of the tenth lunar month, or 40 weeks gestational age, the baby’s brain has greatly increased in number of cells. This growth will continue for the first 5 to 6 months after birth. By now, 96% of all babies are positioned head down. During the final 2 to 4 weeks of gestation, the head or other presenting part settles down into the top of the woman’s pelvis. During his last lunar month, the baby gains around 200 grams per week and, by the fortieth week, is an average of 50 centimetres in length and averaging 3 to 3.5 kilograms in weight. The baby is ready to be born.</span>
<h2>42 weeks:</h2>
<span>By the time the baby reaches 42 weeks gestation they are considered postmature. It means a baby’s skin may be temporarily dry, cracked, peeling, loose, or wrinkled because the protective cheesy vernix was shed weeks ago. He may have longer finger and toenails and longer hair. Provided the placenta is functioning well, the baby will continue to gain weight.</span>

<span>Pregnancy is normally between 37 and 42 weeks in length (from the first day of your last period), which is typically known as around nine months – although it is actually a little more than that. You may hear your pregnancy described in three sections, commonly referred to as trimesters:</span>
<ul>
 	<li style="font-weight: 400;"><span style="font-weight: 400;">1st trimester (1-12 weeks)</span></li>
 	<li style="font-weight: 400;"><span style="font-weight: 400;">2nd trimester (13-28 weeks)</span></li>
 	<li style="font-weight: 400;"><span style="font-weight: 400;">3rd trimester (29 weeks to the birth).</span></li>
</ul>
<span>Once your due date is confirmed, you can enter it on the <b>Home page</b>, or into the <b>About me</b> section in this app.</span>
<div data-cat="goto" class="goto"><a href="https://admin.mumandbaby.uk/2018/08/06/about-me/" internal="true" data-pagetype="Forms">About me</a></div>
<div data-cat="goto" class="goto"><a href="https://admin.mumandbaby.uk/2018/08/07/appointments/" internal="true" data-pagetype="Appointments">Appointments</a></div>
<div data-cat="relatedlinks" class="relatedlinks"><a href="http://www.nhs.uk/conditions/pregnancy-and-baby/due-date-calculator/" type="nhs">Pregnancy calculator</a>
<a href="https://www.nhs.uk/start4life/pregnancy/week-by-week/1st-trimester/week-4/#anchor-tabs">4 weeks pregnant? NHS guide to your pregnancy</a>
</div>

Your pregnancy in weeks (gestational age)

<h1>I'm pregnant ...</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2020/07/Im-pregnant-Your-pregnancy-650x406-300x187.jpg" alt="Close up of woman's pregnancy bump" width="300" height="187" class="alignnone size-medium wp-image-12869" />
<div data-cat="submenu" class="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/07/what-next/">What next?</a>

<a href="https://admin.mumandbaby.uk/2018/08/07/your-pregnancy-explained/">Your pregnancy in weeks (gestational age)</a>

<a href="https://admin.mumandbaby.uk/2020/08/05/i-am-not-a-uk-resident/">I am not a UK resident</a>

</div>


I'm pregnant ...

<h1>Miscarriage and the loss of your baby</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.2.15.jpg" alt="Two pairs of hands on a table top with one pair holding the other pair in a gesture of comfort" width="650" height="406" class="alignnone size-full wp-image-1080" />

<span>A miscarriage is the loss of a pregnancy during the first 24 weeks. An early miscarriage occurs up until 13 weeks of pregnancy.</span>

<span>Symptoms of a miscarriage can include bleeding, abnormal vaginal discharge, lower abdominal pain and loss of pregnancy symptoms.</span>

<span>The first trimester can be an anxious time for many reasons, one of which might be worrying about whether the pregnancy will continue. Sadly, as many as one in five early pregnancies will end in miscarriage.</span>

<span>The loss of a baby at any stage of a pregnancy can be devastating for both parents. It doesn’t matter how far into the pregnancy it happened, or whether or not the pregnancy was planned, the sense of loss can be very strong. It is important to remember that everyone deals with loss differently and it’s ok to grieve for your baby. There are a number of organisations that can provide expert support and information for parents who have suffered a loss.</span>

<span>Whilst there are a number of reasons why a pregnancy might not be successful, the majority of first trimester miscarriages occur because of a problem with the chromosomes which mean that the baby could never have developed, not because of anything the mum has done, or not done. The vast majority of women who suffer the loss of a baby do go on to have successful pregnancies in the future. </span>

<span>A miscarriage can be diagnosed by an ultrasound scan. You may be required to stay in the maternity unit overnight but most women can go home on the same day. You will receive follow up from a doctor, nurse or midwife who specialises in early pregnancy.</span>

<span>It is recommended that you inform your maternity care provider (antenatal clinic) about your miscarriage in case they are not aware. You may wish to delete the Mum &amp; Baby app from your device.</span>

<div data-cat="goto" class="goto">
<a href="https://admin.mumandbaby.uk/2021/08/24/miscarriage-and-the-loss-of-your-baby-frequently-asked-questions/" internal="true" >Miscarriage and the loss of your baby: Frequently asked questions</a>
</div>

<div data-id="Miscarriage and the loss of your baby">Portal: Miscarriage and the loss of your baby</div>

<div data-cat="relatedlinks" class="relatedlinks">

<a href="http://www.miscarriageassociation.org.uk/wp-content/uploads/2016/10/Why-Me.pdf">Why me?</a>

<a href="http://www.miscarriageassociation.org.uk">Miscarriage support</a>

<a type="tommy&#039;s" href="https://www.tommys.org/baby-loss-support/miscarriage-information-and-support" type="tommy's" >More on support for miscarriage</a>

<a type="rcog" href="https://www.rcog.org.uk/en/patients/patient-leaflets/early-miscarriage/">Early miscarriage</a>

<a href="https://www.llli.org/commonly-asked-questions-about-lactation-after-loss/">Commonly asked questions about lactation after loss</a>

</div>

Miscarriage and the loss of your baby

<h1>Antenatal classes</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.3.1.jpg" alt="Mothers-to-be and their birth partners attending a antenatal class" width="650" height="406" class="alignnone size-full wp-image-1083" />

<span style="font-weight: 400;">Antenatal education (also known as birth preparation or parent craft classes) can help you to prepare for your baby’s birth, giving you confidence and information. You can attend these classes with your birthing partner so you can prepare together for the arrival of your baby. </span>

<span style="font-weight: 400;">Antenatal education is also a good way to make friends with other parents who are expecting babies around the same time as you. These friendships can help parents through the first few months with their new baby.</span>

<span style="font-weight: 400;">There are two types of class available to choose from:</span>
<ul>
 	<li><span style="font-weight: 400;"> free NHS antenatal classes available at your local maternity unit or children’s centre. Ask your midwife about these classes</span></li>
 	<li><span style="font-weight: 400;">private/independent antenatal classes.</span></li>
</ul>
<span style="font-weight: 400;">Most antenatal classes can be started when you are around 28-32 weeks pregnant, but they can often get booked up in advance so it’s good to arrange your place early on.</span>

<span style="font-size: 1rem;">There are specialised antenatal classes for women expecting twins/triplets and your midwife or doctor will give you the information you need about these.</span>

<span style="font-weight: 400;">Topics covered by antenatal classes include:</span>
<ul>
 	<li><span style="font-weight: 400;">health in pregnancy, including a healthy diet</span></li>
 	<li><span style="font-weight: 400;"> exercises to keep you fit and active during pregnancy</span></li>
 	<li><span style="font-weight: 400;">what happens during labour and birth</span></li>
 	<li><span style="font-weight: 400;">coping techniques for labour and information about pain relief</span></li>
 	<li><span style="font-weight: 400;">relaxation technique</span></li>
 	<li><span style="font-weight: 400;">information about the different modes of birth (vaginal, assisted with ventouse or forceps, caesarean) </span></li>
 	<li><span style="font-weight: 400;">caring for and feeding your baby</span></li>
 	<li><span style="font-weight: 400;">your health after giving birth</span></li>
 	<li><span style="font-weight: 400;">emotions and feelings during pregnancy, birth and after.</span></li>
</ul>
<span style="font-weight: 400;">Classes can be attended by anyone – it doesn’t matter if it is your first baby or your fifth!</span>

A series of short videos have been created for those unable to attend classes in person:
<div data-cat="goto" class="goto">
<a href="https://admin.mumandbaby.uk/2020/06/29/antenatal-classes-videos/" internal="true">Antenatal classes: Videos</a>
</div>

<div data-id="Antenatal classes">Portal: Antenatal classes</div>

<div data-cat="relatedlinks" class="relatedlinks">

<a type="nhs" href="https://www.nhs.uk/conditions/pregnancy-and-baby/antenatal-classes-pregnant/" style="font-size: 1rem;">Antenatal classes</a>

<a type="nct" href="http://www.nct.org.uk">Find an NCT antenatal course</a>
<a type="nhs" href="https://www.nhs.uk/Service-Search/Antenatal%20classes/LocationSearch/358">Find an independent antenatal class near you</a>

</div>

Antenatal classes

<h1>Antenatal classes: Videos</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2020/07/theBirthPreparationCoursePart1_650x406.jpg" alt="Video screen showing Part 1 of the NHS North West London Maternity Services Birth Preparation Course" width="650" height="406" class="alignnone size-full wp-image-12601" />
<span>These short videos have been designed to help those women and their partners who are unable to attend antenatal classes in person.</span>

<div data-cat="video" class="videoplayer">
The Birth Preparation Course Part 1
<iframe width="560" height="315" src="https://www.youtube.com/embed/6Sj01fbI4Pg?rel=0" frameborder="0" allow="accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture" allowfullscreen></iframe>
</div>

<div data-cat="video" class="videoplayer">
The Birth Preparation Course Part 2
<iframe width="560" height="315" src="https://www.youtube.com/embed/PJRmr1Uc52I?rel=0" frameborder="0" allow="accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture" allowfullscreen></iframe>
</div>

<div data-cat="video" class="videoplayer">
The Birth Preparation Course Part 3
<iframe width="560" height="315" src="https://www.youtube.com/embed/7D49w7BwFrY?rel=0" frameborder="0" allow="accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture" allowfullscreen></iframe>
</div>

<div data-cat="video" class="videoplayer">
Birth Choices
<iframe width="560" height="315" src="https://www.youtube.com/embed/s6qQz-MujuU?rel=0" frameborder="0" allow="accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture" allowfullscreen></iframe>
</div>

<div data-cat="video" class="videoplayer">
Home Birth
<iframe width="560" height="315" src="https://www.youtube.com/embed/py_84DiKrUU?rel=0" frameborder="0" allow="accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture" allowfullscreen></iframe>
</div>

<div data-cat="video" class="videoplayer">
Breathing
<iframe width="560" height="315" src="https://www.youtube.com/embed/ynrHKYD9drs?rel=0" frameborder="0" allow="accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture" allowfullscreen></iframe>
</div>

<div data-cat="video" class="videoplayer">
Early Days Part 1
<iframe width="560" height="315" src="https://www.youtube.com/embed/lejF_cMI2to?rel=0" frameborder="0" allow="accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture" allowfullscreen></iframe>
</div>

Antenatal classes: Videos

<h1>Getting to know your baby during pregnancy</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.3.4.jpg" alt="Pregnant woman smiling and holding a pair of baby shoes" width="650" height="406" class="alignnone size-full wp-image-1086" />

<span style="font-weight: 400;">Taking time as part of your daily routine to think about and bond with your unborn baby is known to release oxytocin, a hormone which can help your baby’s brain to develop.</span>

<span>Babies need adults to nurture and support their development during pregnancy and their speech, language and communication beyond birth. There is lots of helpful information to support you with chatting to your bump during pregnancy and talking, singing, playing and reading with your baby after birth.</span>

<span style="font-weight: 400;">You can try:</span>
<ul>
 	<li><span style="font-weight: 400;">talking, singing, playing and looking at books with your baby, and encouraging your partner/family/other children to do the same</span></li>
 	<li><span style="font-weight: 400;">gently massaging your bump</span></li>
 	<li><span style="font-weight: 400;">having a bath</span></li>
 	<li><span style="font-weight: 400;">trying pregnancy yoga</span></li>
 	<li><span style="font-weight: 400;">practising hypnobirthing</span></li>
 	<li><span style="font-weight: 400;">playing music to your baby</span></li>
 	<li><span style="font-weight: 400;">writing a letter to your baby</span></li>
 	<li><span style="font-weight: 400;">using an app to help you understand how your baby is growing and developing, such as the Baby Buddy App.</span></li>
</ul>
<div data-cat="video" class="videoplayer">

Building a relationship with your baby

<iframe width="468" height="263" src="https://www.youtube.com/embed/UmvY7t6RRUo" frameborder="0" allowfullscreen="allowfullscreen"></iframe>

</div>
<div data-cat="relatedlinks" class="relatedlinks">

<a href="https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/relationship-building-resources/building-a-happy-baby/">UNICEF UK Baby Friendly Initiate, Building a happy baby leaflet</a>

<a href="https://www.bestbeginnings.org.uk/baby-buddy">Baby buddy app</a>

<a href="https://hungrylittleminds.campaign.gov.uk/#0">Talking to your baby (Hungry Little Minds)</a>

<a href="https://ican.org.uk/i-cans-talking-point/parents/">I CAN's Talking Point for parents</a>
</div>


Getting to know your baby during pregnancy

<h1>Introducing a sibling to your new baby</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2019/05/siblingphoto-300x187.jpg" alt="Smiling young boy holds a new born baby" width="300" height="187" class="alignnone size-medium wp-image-5983" />

<span>There are no rules about when you tell an older child that a new baby is on the way, but opinion suggests it is wise to do so when you tell others so they hear it from you directly.  A small child will find it difficult to visualise what this will mean for them so using books or pictures can help, or by reference to other friends who may have had a new brother or sister recently.  Provide whatever information is needed within the child’s level of understanding.</span>

<span>As the pregnancy grows, spending time to “talk” to the baby together enables the older child to make a connection and feel the baby kick (“talk back”). Bringing home a newborn is a little different the second time around.  With your first child, you're focused on figuring out how to care for a baby.  With the second baby, you're likely to wonder how your older child will react to having a new sibling.</span>

<span>The links below offer useful advice on how to handle this transition.</span>
<div data-cat="relatedlinks" class="relatedlinks">

<a href="https://www.familylives.org.uk/advice/early-years-development/behaviour/dealing-with-challenging-behaviour-when-a-new-baby-arrives/">Dealing with challenging behaviour when a new baby arrives</a>

<a href="https://www.nhs.uk/conditions/pregnancy-and-baby/children-and-new-siblings/" type="nhs">Children and new siblings</a>

</div>

Introducing a sibling to your new baby

<h1>Perineal massage</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/10/1.3.8.1.jpg" alt="Diagram demonstarting hand positions when performing perineal massage" width="650" height="406" class="alignnone size-full wp-image-3508" />

<span>Massaging the perineum (the area between the vagina and anus) in the later weeks of pregnancy has been shown to reduce the likelihood of tearing during birth, and of needing stitches or an episiotomy. You can start this from when you are 34 weeks pregnant and practice it daily/every other day until the birth of your baby.</span>

<span>How to massage your perineum:</span>
<ul>
 	<li>wash your hands</li>
 	<li>sit comfortably with your legs bent at the knees so you can reach your perineum easily. Use a mirror if you wish</li>
 	<li>massage oil (preferably vegetable-based) into the skin of the perineum using fingers and thumbs</li>
 	<li>place one or both thumbs inside your vagina and press downwards towards the anus. Move to each side in a U-shaped stretching movement. This may give a tingling/burning sensation</li>
 	<li>aim to massage the area inside the vagina, not necessarily just the skin on the outside</li>
 	<li>aim to apply the massage for five minutes.</li>
</ul>

<div data-cat="relatedlinks" class="relatedlinks">

<a href="https://www.nct.org.uk/pregnancy/perineal-massage" type="nct">Perineal massage</a>

<a href="https://www.cochrane.org/CD005123/PREG_antenatal-perineal-massage-for-reducing-perineal-trauma">Perineal massage for reducing perineal trauma</a>
</div>

Perineal massage

<h1>Safety in NHS services</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2020/07/NHS-logo-1-4-300x187.jpg" alt="NHS logo" width="300" height="187" class="alignnone size-medium wp-image-12934" />
<span>This document outlines some recent NHS initiatives aimed at maximising safety, whilst keeping quality of care at the centre of maternity services. This will help you understand how care is designed and how you can seek more support.</span>

<h2>NHS Long Term Plan (2019) aims to:</h2>
<ul>
<li>Improve access to support for mental health with the same urgency as physical health for birthing people, their partners and families. Look out for local information in the app or speak to your healthcare professional.</li>
<li>Improve safety for baby through the NHS England Saving Babies’ Lives Care Bundle standards, by:</li>
</ul>
<ul>
<li>1. Offering choice and personalised care with respect for autonomy and decisions.</li>
<li>2. Offering support to reduce smoking.</li>
<li>3.  Undertaking risk assessment and appropriate management of babies who might be at risk of growth restriction (slow growth).</li>
<li>4.  Informing pregnant people of the importance of promptly reporting a reduction in baby’s movements.</li>
<li>5.  Undertaking effective monitoring of the baby’s wellbeing during labour and birth.</li>
<li>6.  Reducing the number of preterm births and optimising care when preterm delivery cannot be prevented through:</li>
</ul>
<h3>a) Prediction</h3>
<ul>
<li>Undertake a risk assessment and refer to the low, intermediate or high-risk pathway and develop a personalised care plan for the birthing person.</li>
</ul>

<h3>b) Prevention</h3>
<ul>
<li>Assess if aspirin is required from 12 weeks of pregnancy.</li>
<li>Support to stop smoking.</li>
<li>Offer a urine test at the first antenatal appointment (Booking appointment) to screen for urine infection. If treatment is indicated, a repeat urine test should be taken to ensure infection has cleared up.</li>
</ul>

<h3>c) Preparation</h3>
<ul>
<li>Optimise place of birth to ensure that birth occurs in a maternity unit that has the appropriate neonatal care services to support your baby.</li>
<li>Birthing people are offered corticosteroid injections between 24 and 33+6 weeks, optimally at 48 hours before birth. This is to reduce the risk of your baby having breathing difficulties, gut problems, or bleeding in the brain.</li>
<li>Birthing people who are in established labour, or who are having a planned preterm birth within the following 24 hours, are offered magnesium sulphate infusion between 24+0 and 29+6 weeks of pregnancy (or considered for this infusion between 30+0 and 33+6 weeks of pregnancy) to reduce the risk of cerebral palsy in babies.</li>
<li>Improving general health outcomes for you and your baby. NHS England is funding a 6-8 weeks mother’s health check with your General Practitioner (GP)in addition to the baby check to assess your ongoing health and wellbeing needs.</li>
</ul>

<h2>Ockenden Report (2020)</h2>

<span>This report aims to improve safety for you through pregnancy and post-birth through:</span>
<ul>
<li>Enhanced safety in maternity units by undertaking a risk assessment at each contact with the birthing person to ensure that care is tailored to your needs.</li>
<li>Maternity services must ensure that birthing people, their partners and their families are listened to.</li>
<li>Care in complex pregnancies is managed with appropriate expertise and discussion and referrals made to specialist centres where necessary.</li>
<li>Maternity services follow best practice in monitoring of the baby in labour.</li>
<li>Provide access to accurate information to facilitate informed choice of intended place of birth and type of birth.</li>
<li>Ensure there is access to translation services if communication in English is difficult.</li>
</ul>
<h3>Shared decision making</h3>
<ul>
<li>All professionals should support you to make informed, value-based decisions by:</li>
<dd><span>introducing you to the options available, including their advantages and disadvantages</span></dd>
<dd><span>helping you to explore these in the context of your preferences</span></dd>
<dd><span>empowering you to make decisions - all professionals should support you to make informed, value-based decisions by:</span></dd>
</ul>
<ul>
<li>Ask yourself these three questions:</li>
<dd><span>What are my options?</span></dd>
<dd><span>What are the pros and cons of each option for me?</span></dd>
<dd><span>How do I get support to help me make a decision that is right for me?</span></dd>
</ul>
<div data-cat="relatedlinks" class="relatedlinks">
<a href="https://saferpregnancy.org.uk/questions-and-advice-in-pregnancy">Questions and advice in pregnancy</a>
</div>

Safety in NHS services

<h1>Stopping work/slowing down</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.3.8.2.jpg" alt="Heavily pregnant woman asleep on a sofa" width="650" height="406" class="alignnone size-full wp-image-1094" />

<span>When you choose to stop work is a matter of personal preference, but it is worth considering your commute, your working environment, your proximity to your maternity unit and allowing time to prepare for your baby’s arrival. You can discuss this with your midwife or doctor.</span>

<span>Towards the end of pregnancy you may feel quite tired and uncomfortable, and therefore may need help from friends or family to get things done, particularly if you have other children. It’s important to stay active but to also make time for rest, particularly if you aren’t sleeping too well.</span>

Stopping work/slowing down

<h1>Your baby’s movements</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.3.5.jpg" alt="Pregnant woman with a happy surprised expression looking down at her bump" width="650" height="406" class="alignnone size-full wp-image-1087" />

<span>From 16-24 weeks on you should feel the baby move more and more up until 32 weeks, then stay roughly the same until you give birth.</span>

<span>Take time to become familiar with your baby’s normal pattern of movements. You should continue to feel your baby move regularly right up until you give birth to him or her.</span>

<span>The movements your baby makes offer reassurance that he or she is well, and therefore if you notice these movements change or reduce from what you are used to, it is important to call your midwife or attend the maternity unit urgently.</span>

<div data-cat="video" class="videoplayer">

The importance of monitoring fetal movements

<iframe width="560" height="315" src="https://www.youtube.com/embed/waaZX7mrWDs" title="YouTube video player" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen></iframe>
</div>
<span>This video is available in many languages. Click on this link and scroll down to view the videos in English and other languages:</span>
<a href="https://www.nwlondonccg.nhs.uk/services/your-services/pregnancy-maternity-services">The importance of monitoring fetal movements in 20 languages including sign language</a>

<div data-id="Your baby's movements">Portal: Your baby's movements</div>

<div data-cat="goto" class="goto">

<a href="https://admin.mumandbaby.uk/2018/08/06/maternity-units/" internal="true">Contact my maternity unit</a>

</div>
<div data-cat="relatedlinks" class="relatedlinks">



<a type="tommy's" href="http://www.tommys.org/pregnancy/symptom-checker/baby-fetal-movements">Baby movements in pregnancy</a>

<a href="http://www.rcog.org.uk/en/patients/patient-leaflets/your-babys-movements-in-pregnancy/" type="rcog">Your baby's movements</a>

<a href="http://www.kickscount.org.uk/mums/your-babys-movements/">Why movements matter?</a>

<a href="https://www.tommys.org/pregnancy-information/health-professionals/free-pregnancy-resources/leaflet-and-banner-feeling-your-baby-move-sign-they-are-well" type="tommy's">Feeling your baby move is a sign that they are well</a>

<a href="https://www.mamaacademy.org.uk/pregnancy-birth/babies-movements/">Babies' movements - MAMA Academy</a>

</div>

Your baby's movements

<h1>Pregnancy matters</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2021/07/Pregnancy-matters-300x200.jpg" alt="Three multicultural pregnant ladies holding their bumps" width="300" height="200" class="size-medium wp-image-16965" />

<div data-cat="submenu" class="submenu">
<a href="https://admin.mumandbaby.uk/2018/08/13/antenatal-classes/">Antenatal classes</a>

<a href="https://admin.mumandbaby.uk/2020/06/29/antenatal-classes-videos/">Antenatal classes: Videos</a>

<a href="https://admin.mumandbaby.uk/2018/08/13/getting-to-know-your-baby/">Getting to know your baby during pregnancy</a>

<a href="https://admin.mumandbaby.uk/2018/08/13/you-babys-movements/">Your baby’s movements</a>

<a href="https://admin.mumandbaby.uk/2018/08/13/perineal-massage/">Perineal massage</a>

<a href="https://admin.mumandbaby.uk/2018/08/13/stopping-work/">Stopping work/slowing down</a>

<a href="https://admin.mumandbaby.uk/2019/05/22/introducing-a-sibling-to-your-new-baby/">Introducing a sibling to your new baby</a>
<a href="https://admin.mumandbaby.uk/2018/08/13/work-maternity-paternity-leave-and-money/">Work, maternity/paternity leave and money</a>
<a href="https://admin.mumandbaby.uk/2021/10/18/safety-in-nhs-services/">Safety in NHS services</a>
</div>

Pregnancy matters

<h1>Stillbirth</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.2.16.jpg" alt="Close up of woman's hand being enclosed by the hands of another woman to comfort her" width="650" height="406" class="alignnone size-full wp-image-1081" />

<span>When a baby passes away after 24 weeks of pregnancy, either before or during birth, this is known as a stillbirth. Stillbirth is one of the most devastating things a family can experience, and a range of support is given through a specialist team (including midwives, obstetricians, counsellors and charities) to parents who are affected by it.</span>

<span>This period of time may seem a complete blur, and it may seem like you have no control over the things that are happening to you and around you. You may have received the tragic news of your baby’s death and now been sent home for some time before coming into the hospital to give birth. You can talk to your midwives about what to expect to help you prepare yourself for the coming days, but here are a few things to consider.</span>
<h2>Choices</h2>
<span>You still have choices about many things to do with your birthing experience – these can be discussed with your midwives. If you have made a birth plan and wish to retain elements of it, your midwives will work with you to help you achieve that wherever possible – from water birth, to pain relief, to skin-to-skin, to partner cutting the umbilical cord. You may be offered a tablet to stop your milk coming in – it is your choice whether to accept it. Many mums do want this, some do not. You should be given the chance to discuss options relating to this including the opportunity to express and donate your milk – different things will be right for different parents, and this is still your journey, and you can do what is right for you.</span>
<h2>Memory-making</h2>
<span>Your midwives will help you have the opportunity to make memories with your baby. What memories you may choose to make are entirely your choice. There is no ‘right’ or ‘wrong’ way to go through this experience. You do not have to do everything – or anything – that you’re offered, or you can choose to do everything. You do not have to do everything at once, and you can change your mind. Your midwives will support you in any way they can.</span>

<span>Your hospital should have a “Cuddle Cot” or “cold cot” that can help you be able to spend more time with your baby.</span>

<span>You should be offered a memory box by your midwives. Memory boxes are like a starter kit for memory-making, with items inside that can help you capture these moments. If you choose to have one, you may continue to add to it over time or keep items from your pregnancy such as scan photos and your baby’s hospital band.</span>
<h3>Here are some of the things you may wish to consider:</h3>
<ul>
 	<li>A pair of small teddies. Many parents like their baby to keep one, and the other to come home with them in the memory box. You may wish to give your baby one, and then switch them over before you leave so that you keep that one.</li>
 	<li>Inkless prints – prints of your baby’s hands and feet are often a treasured memory, and one that can be used by parents to get other memories made in the future, such as necklaces, cufflinks, or other jewellery. If you want these, you may want to take part in doing them yourselves, or you may want your midwives to do them for you.</li>
 	<li>Clay imprints – like the inkless prints, clay imprints are another memory that you should have the chance to participate in making if you wish, or you may wish for your midwives to do them for you. These are imprints that many parents like as it means they can trace the shape of their baby’s hands and feet with their finger, or put them in a frame – there may be a kit for this in your memory box.</li>
 	<li>3D casts of hands and feet may also be offered to you. Your midwives can take moulds and then connect with charities or casting companies to enable you to have beautiful casts made from the moulds that you can keep.</li>
 	<li>Photographs – it can often seem strange at the time to want to have photos taken of or with your baby that has died, but many parents are so incredibly grateful to have these photos to look back on later. You may also wish to have photos taken with siblings or other family members who you choose to have meet your baby. Make sure you have a phone charger with you when you go into hospital. There are photography charities offering free services that your midwives may be able to get in touch with for you.</li>
 	<li>A lock of your baby’s hair – your midwives may be able to help you take a lock of your baby’s hair to keep. Your memory box may have a little box in to store this.</li>
 	<li>Reading your baby a story – some memory boxes may have a story book in to read to your baby, but if you have a favourite story that you want to read your baby, bring it with you.</li>
 	<li>Clothing – if you have favourite outfits that you have got for your baby, pack them and bring them with you. If your baby is being born premature and is going to be too small for any clothes you may have, speak to your midwives – there are charities that provide specialist clothing for premature babies.</li>
 	<li>Bathing your baby – if this is something you would like to do, speak to your midwives and get their help.</li>
 	<li>Heart in their Hand keyrings – your memory box may contain one of these keyrings – a keyring with a heart cut out to leave in your baby’s hand so that you will be able to remain connected to them. These hearts can also contribute to beautiful photos with your baby. Ask your midwives for more information.</li>
 	<li>You may wish to remember to bring personal effects for yourself/yourselves while you’re in hospital too, such as toothbrushes and toothpaste, sanitary ware, shampoo, changes of clothes, phone chargers, and snacks.</li>
 	<li>These are just a few things you may wish to consider, but this is absolutely your journey and the decisions are yours.</li>
</ul>
<div data-cat="goto" class="goto"><a href="https://www.sands.org.uk/support-you/coronavirus-covid-19-updates/covid-19-and-changes-impact-bereaved-families">Sands: Coronavirus and impact on bereaved families</a></div>
<div data-cat="relatedlinks" class="relatedlinks">

<a type="nhs" href="http://www.nhs.uk/conditions/stillbirth/">Stillbirth</a>

<a type="tommy's" href="https://www.tommys.org/pregnancy-information/pregnancy-complications/pregnancy-loss/stillbirth-information-and-support">Stillbirth support</a>

<a type="sands" href="https://www.sands.org.uk/">Sands charity</a>

<a type="sands" href="https://www.sands.org.uk/about-sands/sands-bereavement-support-app">Sands Bereavement Support app</a>

<a type="rcog" href="https://www.rcog.org.uk/en/patients/patient-leaflets/when-your-baby-dies-before-birth/">More on stillbirth</a>

<a href="https://petalscharity.org/">Stillbirth counselling service</a>

<a href="https://www.tommys.org/baby-loss-support/stillbirth-information-and-support/pregnancy-after-stillbirth" type="tommy's">Pregnant after a stillbirth</a>

<a href="https://www.tommys.org/baby-loss-support/tfmr-terminating-pregnancy-medical-reasons" type="tommy's">Terminating a pregnancy for medical reasons (TFMR)</a>

<a href="https://www.llli.org/commonly-asked-questions-about-lactation-after-loss/">Commonly asked questions about lactation after loss</a>

<a href="https://www.dadstillstanding.com/">Dad Still Standing: Baby loss support for fathers</a>

<a href="https://www.beyondbea.co.uk/">Beyond Bea Charity</a>

<a href="https://www.lullabytrust.org.uk/bereavement-support/">Bereavement support after the death of a baby or child</a>

</div>

Stillbirth

<h1>Your pregnancy</h1>
<div class="submenu" data-cat="submenu">

<a href="https://admin.mumandbaby.uk/2020/07/08/im-pregnant/">I’m pregnant …</a>

<a href="https://admin.mumandbaby.uk/2018/09/03/antenatal-care/">Antenatal care</a>

<a href="https://admin.mumandbaby.uk/2021/07/29/early-pregnancy-concerns/">Early pregnancy concerns</a>

<a href="https://admin.mumandbaby.uk/2021/07/28/pregnancy-matters/">Pregnancy matters</a>

<a href="https://admin.mumandbaby.uk/2018/09/03/health-and-wellbeing-in-pregnancy-2/">Health and wellbeing in pregnancy</a>

<a href="https://admin.mumandbaby.uk/2020/07/07/conditions-of-pregnancy/">Conditions affecting pregnancy</a>

<a href="https://admin.mumandbaby.uk/2023/03/23/coping-with-covid/">Coping with Covid</a>

<a href="https://admin.mumandbaby.uk/2018/08/08/information-for-dads-and-partners/">Information for partners during pregnancy</a>

<a href="https://admin.mumandbaby.uk/2018/08/13/miscarriage-and-the-loss-of-your-baby/">Miscarriage and the loss of your baby</a>

<a href="https://admin.mumandbaby.uk/2018/08/13/stillbirth/">Stillbirth</a>

<a href="https://admin.mumandbaby.uk/2019/05/22/domestic-abuse/">Domestic abuse</a>

<a href="https://admin.mumandbaby.uk/2020/08/03/getting-practical-help/">Getting practical help in pregnancy</a>

</div>


Your pregnancy

<h1>Choosing place of birth</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.3.6.jpg" alt="Sign post with signs to hospital or home birth" width="650" height="406" class="alignnone size-full wp-image-1090" />

<span style="font-weight: 400;">This is a decision you will make following discussion with your midwife or doctor at around 34-36 weeks of pregnancy, but it is helpful to start thinking about your preferences before this time.</span>

<span style="font-weight: 400;">You can change your mind about where to have your baby at any point. If you choose to have your baby at home or in a midwifery led unit (birth centre), some events or complications before or during labour may mean transfer to the labour ward is advised.</span>
<h2>Home</h2>
<span style="font-weight: 400;">At home - in the comfort of your own home with the support of two midwives and whoever you choose to have with you. You can hire a birthing pool and your midwife can provide gas and  air (entonox) if you want to use it.</span>
<h2>Midwife-led unit (MLU)/birth centre</h2>
<span style="font-weight: 400;">This is a ward within the maternity unit. It is a homely and calm environment that supports normal birth with minimal assistance. Midwives and chosen birth partners are on hand to support you. You will have the choice of a birthing pool, gas and air (entonox), aromatherapy and opiate based pain relief, depending on your maternity unit of choice.</span>
<h2>Obstetric-led unit (OLU)/Labour ward/Delivery suite</h2>
<span style="font-weight: 400;">This is a ward in a maternity unit where your care will be provided by a team of doctors and midwives. Normal birth with minimal intervention is always the goal, if it is safe to do so. Access to more specialised medical facilities and equipment is available for those women who need it.</span>
<div data-cat="video" class="videoplayer">

Options for place of birth
<iframe width="560" height="315" src="https://www.youtube.com/embed/1mcI6SZ7gvc?rel=0&amp;showinfo=0" frameborder="0" allow="autoplay; encrypted-media" allowfullscreen="allowfullscreen"></iframe>

</div>
<div data-cat="submenu" class="submenu">

<a href="https://admin.mumandbaby.uk/2021/07/28/options-for-place-of-birth/">Options for place of birth</a>

<a href="https://admin.mumandbaby.uk/2018/08/13/which-option-is-safest-for-me-and-my-baby/">Which option is safest for me and my baby?</a>

<a href="https://admin.mumandbaby.uk/2018/08/13/would-you-like-to-talk-with-somebody-about-your-options-for-place-of-birth/">Would you like to talk with somebody about your options for place of birth?</a>

</div>
<div data-cat="relatedlinks" class="relatedlinks">

<a href="https://www.nhs.uk/conditions/pregnancy-and-baby/where-can-i-give-birth/" type="nhs">Choosing place of birth</a>

<a href="https://www.which.co.uk/birth-choice">Which? Birth choice</a>

<a href="https://www.nct.org.uk/labour-birth/deciding-where-give-birth/giving-birth-home" type="nct">Homebirth</a>

<a href="https://www.which.co.uk/birth-choice/having-a-home-birth/having-a-home-water-birth">Planning a home water birth</a>

</div>

Choosing place of birth

<h1>Giving birth to your breech baby</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2021/07/Breech-birth-300x200.jpg" alt="The words breech birth composed of wooden letters. Pregnant woman in the background" width="300" height="200" class="size-medium wp-image-17008" />

<span>About one in 25 babies are in a breech position (bottom first or feet first) after 36 weeks of pregnancy. If your baby remains breech, you should be offered the choice of attempting to turn your baby, planning a caesarean birth or planning a vaginal birth. The most likely outcome, no matter what you choose, is that you and your baby will be well. But it’s important for you to consider the benefits and risks of each option for you.</span>

<span>Turning the baby head-down gives you the greatest chance of a vaginal birth, about 80%. The procedure of attempting to turn a breech baby is known as External Cephalic Version (ECV). If baby remains breech, only about 60% of these babies will be born vaginally. Some will require a pre-labour caesarean birth, and some will require a caesarean delivery in labour.</span>

<span>All women with a baby who remains breech are offered the option of a planned caesarean birth at 39 weeks. That is because we can identify a difference in short-term outcomes for breech babies. Following a caesarean birth, the perinatal mortality (death) rate is reduced, at 0.5 in 1,000, compared to 1 in 1,000 following a head-first birth, and 2 in 1,000 following a breech birth. In the short-term, there is also an increased chance your baby could need special care following a vaginal birth. However, by two years of age, the same studies show no difference between planning a caesarean birth and planning a vaginal birth for a breech baby.</span>

<span>The benefits of planning a vaginal birth include a quicker recovery and avoidance of the risks associated with caesarean surgery. These include things like heavy bleeding and infection. A caesarean scar also introduces some additional risks, for mother and baby, in all future pregnancies. The perineal outcomes (remaining intact) are similar or better following vaginal breech births, compared to head-first births, and there are fewer instrumental deliveries. You should have the same choice of pain relief, and freedom to choose your birthing position, as you would in any birth. But some of this may depend on the experience of your team, so you should discuss it with them.</span>

<span>Your doctor or specialist midwife will be able to provide you with more information about some specific clinical situations that make breech births safe or less safe, and whether these apply to you. The most important factor that influences the safety of vaginal breech birth is the training, skill and experience of the professionals attending the birth. If your hospital is unable to provide you with a skilled attendant, and you would like to consider planning a vaginal breech birth, you should be offered a referral to a hospital that can.</span>
<div data-cat="goto" class="goto"><a href="https://admin.mumandbaby.uk/2021/07/29/giving-birth-to-your-breech-baby-frequently-asked-questions/" internal="true">Giving birth to your breech baby: Frequently asked questions</a></div>
<div class="submenu" data-cat="submenu"><a href="https://admin.mumandbaby.uk/2018/08/13/external-cephalic-version/">External cephalic version (ECV)</a></div>
<div data-cat="relatedlinks" class="relatedlinks">

<a href="https://www.rcog.org.uk/en/patients/patient-leaflets/breech-baby-at-the-end-of-pregnancy/" type="rcog">Breech presentation at the end of pregnancy</a>

<a href="https://www.tommys.org/pregnancy-information/giving-birth/labour-and-birth-faqs/what-happens-if-my-baby-breech" type="tommy's">What happens if my baby is breech?</a>

<a href="https://www.buzzsprout.com/961453/6254038-episode-31-bottom-down">Episode 31 Bottom Down - The Obs Pod</a>

</div>

Giving birth to your breech baby

<h1>Packing your maternity unit bag</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.3.10.jpg" alt="Pregnant woman with piles of folded baby clothes" width="650" height="406" class="alignnone size-full wp-image-1103" />

Here is a list of things to consider including in your bag. Even if you are planning a homebirth, it is useful to pack a bag in case your plans change before or during labour:
<div data-cat="submenu" class="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/13/for-you/">For you</a>

<a href="https://admin.mumandbaby.uk/2018/08/13/for-your-birth-partner/">For your birth partner</a>

<a href="https://admin.mumandbaby.uk/2018/08/13/for-your-baby/">For your baby</a>

</div>

Packing your maternity unit bag

<h1>External cephalic version (ECV)</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.3.8.4.jpg" alt="Two cross-section diagrams shows a baby in the womb in breech position and then a baby in the womb in head down position" width="650" height="406" class="alignnone size-full wp-image-1096" />

<span>This is a procedure in which a doctor, or specialist midwife attempts to the turn the baby into the correct position using gentle pressure on your abdomen with their hands.</span>

<span>ECV is successful in about 50% of women and is generally safe. One in every 200 babies will need to be delivered by emergency caesarean after an ECV, and your baby will be monitored before and after the procedure to ensure they remain well.</span>
<h2>Moxibustion for breech babies</h2>
<span>This is a traditional Chinese technique which can be used to turn breech babies. It is done by burning a moxa-stick (a tightly packed tube of dried herbs) between the toes from 34-36 weeks of pregnancy. It has no known negative side effects and evidence suggests it can be successful at turning a breech baby. You can ask your midwife or local acupuncturist for more information.</span>

<div data-cat="video" class="videoplayer">
NHS External Cephalic Version (for Breech Baby)
<iframe width="560" height="315" src="https://www.youtube.com/embed/i66P5malx3E?rel=0&amp;showinfo=0" frameborder="0" allow="?autoplay=0&rel=0 encrypted-media" allowfullscreen="allowfullscreen"></iframe>
</div>
<div data-cat="relatedlinks" class="relatedlinks">

<a href="https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg20a/" type="rcog">External cephalic version</a>

</div>

External cephalic version (ECV)

<h1>Your baby’s position</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.3.8.3.jpg" alt="Cross-section diagram of baby in the womb in the head down position" width="650" height="406" class="alignnone size-full wp-image-1095" />

<span style="font-weight: 400;">From 36 weeks pregnant, your baby should turn to the head down (cephalic) position in preparation for birth. </span>

<span style="font-weight: 400;">A small number of babies will not be in this position, and may be either breech (bottom first) or transverse/oblique (lying sideways across your abdomen). If your midwife suspects that your baby is not in the head down position, you may be offered a scan and appointment with a doctor/specialist midwife to discuss your options. These options can include either attempting to turn your baby (see related links below), vaginal breech birth or planned caesarean birth.</span>

<span style="font-weight: 400;">If your baby isn’t head down, don’t worry – there are many options available to you and your team will help you to make any decisions regarding your care moving forward.</span>

<span>Find out more about vaginal breech birth by reading:</span>
<div data-cat="goto" class="goto">
<a href="https://admin.mumandbaby.uk/2021/07/28/giving-birth-to-your-breech-baby/" internal="true" >Giving birth to your breech baby</a>
</div>

<div data-cat="relatedlinks" class="relatedlinks">

<a type="nhs" href="http://www.nhs.uk/conditions/pregnancy-and-baby/breech-birth/">What happens if your baby is breech?</a>

<a type="rcog" href="http://www.rcog.org.uk/en/patients/patient-leaflets/breech-baby-at-the-end-of-pregnancy/">Breech babies at the end of pregnancy</a>

</div>

Your baby's position

<h1>Preparing for birth</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.3.8.jpg" alt="Preparing for birth" width="650" height="406" class="alignnone size-full wp-image-1316" />

Towards the end of pregnancy, you may feel a variety of different emotions as the birth becomes closer. You may feel excited, anxious or even scared - this is all normal. There are things that you can do to help you prepare for birth.
<div data-cat="submenu" class="submenu"><a href="https://admin.mumandbaby.uk/2018/08/13/your-babys-position/">Your baby’s position</a>
<a href="https://admin.mumandbaby.uk/2018/08/13/external-cephalic-version/">External cephalic version (ECV)</a></div>

Preparing for birth

<h1>Planning contraception after birth</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2020/07/Thinking-about-contraception-Your-pregnancy-300x187.jpg" alt="Close up of laughing couple hugging" width="300" height="187" class="alignnone size-medium wp-image-12771" />
<span>It may seem strange to be thinking about and planning contraception whilst you are pregnant. However, research has shown that many couples start having sex within six weeks of the birth of their baby. Did you know that it is possible to become pregnant when your baby is only 21 days old and before your menstrual period returns?</span>

<span>Effective, safe contraception is available at your maternity unit and can be started as soon as you give birth. This means you don’t need extra appointments at your GP or sexual health clinic to start contraception. This is particularly helpful at a time when you will be busy looking after a newborn baby and yourself.</span>

<span>Take some time to speak to your midwife or doctor about the options available to you, some of which may be available immediately after the birth of your baby.</span>

<span>Planned pregnancies with an interval of at least one to two years are associated with a healthier pregnancy for you and your baby. Pregnancy spacing of greater than one year reduces the risk of pre-term birth, low birth weight and neonatal death. It also reduces the risk of complications in a future pregnancy particularly if you have given birth by caesarean section, because it allows the scar on your womb to fully heal.</span>

<span>Effective contraception puts you in control of deciding when and if you would like to have another baby and can have some beneficial effects on your periods and long term health.</span>

<span>You will be asked about your plans for contraception during antenatal appointments. Take some time to think about the different options and what might be right for you. Talk to your midwife or doctor and ask for any further information you may need. Once you have made a choice it can be entered into your personalised care and support plan and provided to you after birth.</span>

<h2>Which form of contraception is right for me?</h2>

<span>The most effective options for contraception are usually those that last for a few years and you do not need to remember to take every day. These are called Long Acting Reversible Contraception (LARC) and include a progestogen or hormone coil, copper coil or progestogen implant.</span>

<span>Short-term methods (those that you need to remember to take every day) include the contraceptive injection (known as Depo-provera or ‘depo’), progestogen only pills (POP or ‘mini pill’) and combined oral contraceptive pill (COCP).</span>

<span>Permanent family planning methods are sterilisation, where the fallopian tubes (tubes connecting the ovaries to the womb) are clipped or cut and for male partners, vasectomy.</span>

<span>It is important to remember that none of these methods protect against sexually transmitted infections. If you are at risk from infection, for example when having sex with a new partner you should also use a barrier method or condom.</span>

<span>Find out more about all the options available in the link below.  Most can be provided as soon as you have given birth. Just ask and remember to make a note of what you would like in section 16 of your Health and wellbeing in pregnancy personalised care and support plan.</span>

<div data-cat="goto" class="goto">
<a href="https://admin.mumandbaby.uk/2018/08/22/resuming-sex-and-contraception/" internal="true">Resuming sex and contraception</a>
</div>
<div data-cat="relatedlinks" class="relatedlinks">
<a href="https://www.sexwise.org.uk/contraception/which-method-contraception-right-me">Which method of contraception is right for me?</a>
</div>


Planning contraception after birth

<h1>Thinking about feeding your baby</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.3.9.jpg" alt="Close up of baby latched onto the mother's nipple" width="650" height="406" class="alignnone size-full wp-image-1099" />

<span>During pregnancy you will have a chance to discuss caring for and feeding your baby, including information about the value of breastfeeding for you and your baby’s health, and how to get breastfeeding off to a good start. It’s never too early to start thinking about how you’re going to feed your baby, but you don’t have to make up your mind until your baby is born. Talking to your midwife about your thoughts and feelings about feeding your baby can be really helpful. You will be supported whatever way you decide to feed your baby.</span>

<span>To help feeding go well, ask your midwife about antenatal breastfeeding classes at your maternity unit or in your local area. This can help you and your partner/supporter to feel more confident and prepared, and help you to avoid some common feeding problems early on. If you have particular questions or concerns about feeding, ask your midwife for an appointment with an infant feeding specialist during pregnancy.</span>

<span>All women are offered the opportunity to hold their baby in skin-to-skin contact straight after birth, for as long as they want. Discuss the benefits of skin-to-skin contact for both you and your baby with your midwife, and how you feel about it.</span>

<span>A midwife will offer to help you to start breastfeeding, or show you how to bottle feed responsively as soon as your baby shows signs that they are ready to feed, usually within the first hour after birth. Your baby won’t be separated from you unless he or she requires special care. After your baby is born you will be offered support from your maternity team to ensure breastfeeding gets off to a positive start. There will also be support available when you are at home.</span>

<div data-cat="submenu" class="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/13/hand-expressing-colostrum/">Hand expressing colostrum before your baby is born</a>

</div>

<div data-cat="video" class="videoplayer">

Human milk

<iframe width="640" height="360" src="https://player.vimeo.com/video/190696865?title=0&amp;byline=0" frameborder="0" webkitallowfullscreen="webkitallowfullscreen" mozallowfullscreen="mozallowfullscreen" allowfullscreen="allowfullscreen"></iframe>

</div>

<div data-cat="video" class="videoplayer">

Colostrum: Liquid gold

<iframe src="https://player.vimeo.com/video/600100188?h=0ff0a70fd9" width="640" height="360" frameborder="0" allow="autoplay; fullscreen; picture-in-picture" allowfullscreen></iframe>

</div>

<span>Explore this topic and the related links to find out more about infant feeding.</span>
<div data-cat="goto" class="goto">

<a href="https://admin.mumandbaby.uk/2018/08/18/feeding-your-baby/" internal="true">Feeding your baby</a>

</div>
<div data-cat="relatedlinks" class="relatedlinks">

<a type="nhs" href="https://www.nhs.uk/start4life/baby/breastfeeding">Start4life</a>

<a href="https://globalhealthmedia.org/portfolio-items/attaching-your-baby-at-the-breast/?portfolioID=5623">Global Health Media, Attaching your baby at the breast video</a>

<a href="https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/foreign-language-resources/">UNICEF UK Baby Friendly Initiative, Foreign language resources</a>

</div>

Thinking about feeding your baby

<h1>Vaginal birth after caesarean (VBAC)</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2021/09/Vaginal-birth-after-caesarean-VBAC-300x200.jpg" alt="Woman showing a cesarean section scar on her belly" width="300" height="200" class="size-medium wp-image-17875" />

<h2>What is VBAC?</h2>

<span>VBAC stands for ‘vaginal birth after caesarean’. This term is used when women give birth or plan to give birth vaginally after previous caesarean birth. Vaginal birth includes normal delivery and delivery assisted by forceps or vacuum cup (ventouse).</span>

<h2>What choices do you have in managing your pregnancy pathway?</h2>

<span>Women who have had a caesarean birth before will have a consultation during the course of pregnancy with either a consultant obstetrician or consultant midwife or designated deputy to discuss individual risks and options.</span>

<span>Women can choose either VBAC or planned elective caesarean, an operation to deliver the baby after 39 weeks of pregnancy. The plan will be reviewed with you throughout pregnancy. You can change your mind and you should discuss any questions with your midwife or obstetrician. In case of any emergency please call your local maternity unit.</span>

<h2>Are all women suitable for VBAC?</h2>

<span>Not all women are recommended for VBAC. In your first/subsequent pregnancy after an LSCS you may have been given a letter which explains your options. At the consultation the obstetric doctor or specialist midwife will discuss your options with you, and review your previous notes, if available. An individualised plan will be agreed with you that will be reviewed throughout your pregnancy.</span>

<h2>VBAC facts</h2>

<span>More than one in five women in the UK may have experienced birth by LSCS. Around half of these are planned and the other half as an emergency. VBAC is generally only offered to women with a singleton pregnancy with the baby in the head down position, who have had a lower segment caesarean section (LSCS).</span>

<span>Chances of success are approximately 72-75%. A number of factors affect the success rate of VBAC. These include maternal weight, your health, and whether your labour starts spontaneously. Women who have an interval of less than a year from a previous LSCS are not at greater risk of scar rupture, but are more at risk of having a preterm birth. It is generally advised that there should be at least a year between births. Women who have had two or more caesarean births can be offered the opportunity for VBAC after counselling. Success rates are similar (62-75%). If you have had a successful VBAC previously you have an 85-90% chance of successful VBAC the next time.</span>

<h2>What are the risks associated with VBAC?</h2>

<span>There is a 1:200 (0.5%) chance of scar rupture, this increases significantly if you are induced. Induction with amniotomy (artificial rupture of the membranes) or balloon catheter is associated with a lower risk of scar rupture compared to using prostaglandins (medical method). Approximately 25% of women in labour will need an LSCS. An emergency LSCS has more risk than a planned LSCS, and you may have a higher chance of haemorrhage, leading to the need for a blood transfusion in this situation. Your chance of experiencing bladder or bowel injury during an emergency procedure is higher than in a planned procedure. Complications for baby are similar to a woman birthing a baby for the first time. You may require an assisted birth, or experience perineal trauma involving the back passage (anus). Estimated birth weight may be a factor in the risk affecting perineal trauma.</span>

<h2>What are the advantages of a successful VBAC?</h2>

<span>If you have a successful VBAC it is associated with fewer complications than a planned LSCS. Your recovery is likely to be quicker and you should be able to return to normal activities sooner. Your hospital stay is likely to be shorter. Your baby is likely to have less chance of breathing difficulties.</span>

<h2>When is VBAC not advisable?</h2>

<span>Planned VBAC is not recommended if you have experienced a previous uterine rupture or have classical caesarean scar (a vertical scar on the tummy) or if there are other pregnancy or medical/health complications, or previous uterine surgery.</span>

<h2>What happens during labour for women experiencing VBAC?</h2>

<span>You will normally be advised to labour in the hospital’s labour ward. You are advised to call the hospital when you have regular contractions or your waters have broken. Continuous monitoring of the baby’s heart rate is recommended. There are a range of pain relief options, and you will be advised about having an intravenous needle inserted in your hand for fluid management. If you choose not to give birth in hospital then you are normally seen by a specialist midwife or consultant midwife who will create an individualised plan with you.</span>

<h2>What happens when labour does not start spontaneously?</h2>

<span>If you are not in spontaneous labour by 40 weeks you will normally be seen in the antenatal clinic and assessed. You will be given options that include induction (IOL) with prostaglandins (medical method), induction with amniotomy (artificial rupture of the membranes) or balloon catheter, or to wait another week. Delivery by LSCS will be discussed with you on an individualised basis. Any decision relating to induction of labour or LSCS will take into consideration any risks for you and your baby.</span>

<div data-cat="relatedlinks" class="relatedlinks">
<a href="https://www.rcog.org.uk/en/patients/patient-leaflets/birth-after-previous-caesarean/" type="rcog">Birth after previous caesarean</a>
</div>


Vaginal birth after caesarean (VBAC)

<h1>Work, maternity/paternity leave and money</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.3.3.jpg" alt="Woman holding a mobile phone to her ear with one hand and carrying a clip board in her other hand" width="650" height="406" class="alignnone size-full wp-image-1085" />

<span style="font-weight: 400;">After your 20 week ultrasound scan, you can ask your midwife or GP for a MATB1 form.  This form entitles you to statutory maternity pay from your employer or maternity allowance from Jobcentre Plus.</span>

<span style="font-weight: 400;">During pregnancy/after birth you are entitled to:</span>
<ul>
 	<li><span style="font-weight: 400;">paid time off for your antenatal appointments</span></li>
 	<li><span style="font-weight: 400;">maternity pay or maternity allowance</span></li>
 	<li><span style="font-weight: 400;">maternity leave</span></li>
 	<li><span style="font-weight: 400;">protection against unfair treatment, discrimination or dismissal.</span></li>
</ul>
<span style="font-weight: 400;">Working partners are entitled to one or two weeks paternity leave and together you may be able to take shared parental leave. </span>

<span style="font-weight: 400;">If you are not working, or you/your household is on a low income you may be entitled to maternity benefits and allowances.</span>

<span style="font-weight: 400;">If you are employed, you must inform your employer that you are pregnant at least 15 weeks before your baby’s due date.  When you tell your employer they must perform a risk assessment, which ensures any necessary adjustments can be made to your working environment or pattern.  It is worthwhile speaking to your company’s human resource department and accessing the policy on pregnancy and maternity leave.</span>

<span style="font-weight: 400;">More information on maternity/paternity leave, work, child or other benefits and money can be found in these related links:</span>
<div data-cat="relatedlinks" class="relatedlinks">

<a href="http://www.gov.uk/browse/childcare-parenting/pregnancy-birth">Government advice</a>

<a href="http://www.maternityaction.org.uk/">Advice on your maternity rights</a>

<a href="http://www.moneyadviceservice.org.uk/en/categories/having-a-baby">The Money Advice Service</a>

<a href="http://www.tuc.org.uk/resource/pregnancy-breastfeeding-and-health-and-safety">Pregnancy, breastfeeding and health and safety</a>

</div>

Work, maternity/paternity leave and money

<h1>Your birth preferences and plans</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/1.3.7.jpg" alt="Pregnant woman sitting up on a bed with a note book and pen" width="650" height="406" class="alignnone size-full wp-image-1092" />

<span style="font-weight: 400;">Completing a birth preferences plan can help you and your birth partner to think about your choices and preferences during labour and the birth of your baby. During your pregnancy you will have the opportunity to meet with your midwife/doctor and discuss the plan – try and do this around the time of your 34 or 36 week appointment. This will help your team understand the kind of birth you would like.</span>

<span style="font-weight: 400;">Read the in app content about labour and birth, then using the birth preferences plan in the <b>Personal care and support plans</b> section write down your thoughts and preferences. See below for what options to consider.</span>
<div data-cat="goto" class="goto">

<a href="https://admin.mumandbaby.uk/2018/08/07/personalised-birth-preferences/" internal = "true" data-pagetype="Forms">Your birth preferences and plan</a>

</div>
<div data-cat="submenu" class="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/13/451/">Options to consider</a>

</div>

Your birth preferences and plans

<h1>Getting ready for birth</h1>
<div class="submenu" data-cat="submenu"><a href="https://admin.mumandbaby.uk/2018/08/13/choosing-place-of-birth/">Choosing place of birth</a>
<a href="https://admin.mumandbaby.uk/2018/08/13/your-birth-preferences-and-plans/">Your birth preferences and plans</a>
<a href="https://admin.mumandbaby.uk/2018/09/03/preparing-for-birth/">Preparing for birth</a><a href="https://admin.mumandbaby.uk/2021/07/28/giving-birth-to-your-breech-baby/">Giving birth to your breech baby</a>
<a href="https://admin.mumandbaby.uk/2021/09/03/vaginal-birth-after-caesarean-vbac/">Vaginal birth after caesarean (VBAC)</a>
<a href="https://admin.mumandbaby.uk/2018/08/13/thinking-about-feeding-your-baby/">Thinking about feeding your baby</a>
<a href="https://admin.mumandbaby.uk/2018/08/13/packing-your-maternity-unit-bag/">Packing your maternity unit bag</a>
<a href="https://admin.mumandbaby.uk/2020/07/02/thinking-about-contraception/">Planning contraception after birth</a>
<a href="https://admin.mumandbaby.uk/2018/08/13/before-labour-and-birth/">Information for partners (preparing for birth)</a></div>
<div data-cat="relatedlinks" class="relatedlinks"><a href="https://www.buzzsprout.com/961453">The Obs Pod: a series of podcasts by NHS obstetrician Flo Wilcock</a></div>

Getting ready for birth

<h1>Induction of labour</h1>
<img class="alignnone size-full wp-image-1139" src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/2.3.2.jpg" alt="Pregnant woman in hospital room sits on an exercise ball supported by her birth partner and a midwife" width="650" height="406" />

<span style="font-weight: 400;">Inducing labour will always be discussed with you, to ensure you fully understand the risks and benefits and your consent will be gained prior to anything happening.</span>

<div class="submenu" data-cat="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/17/why-i-might-be-offered-an-induction-of-labour/">Why might I be offered an induction of labour?</a>

<a href="https://admin.mumandbaby.uk/2018/08/17/how-is-labour-induced/">How is labour induced?</a>

<a href="https://admin.mumandbaby.uk/2018/08/17/frequently-asked-questions/">Induction of labour: Frequently asked questions</a>

</div>
<div class="relatedlinks" data-cat="relatedlinks">

<a href="https://www.nhs.uk/conditions/pregnancy-and-baby/induction-labour/" type="nhs">Induction of labour</a>

<a href="https://www.tommys.org/pregnancy-information/labour-birth/induction-labour-information-about-having-labour-induced" type="tommy's">Having labour induced</a>

<a href="https://www.nice.org.uk/guidance/ng207">Inducing labour</a>

<a href="https://www.buzzsprout.com/961453/6636310-episode-35-induction">Induction - The Obs Pod, Episode 35</a>

</div>

Induction of labour

<h1>Interventions in labour</h1>
<img class="alignnone size-full wp-image-1145" src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/2.3.3.jpg" alt="Pregnant woman reclines on a hospital bed while a midwife feels her bared bump" width="650" height="406" />

<span style="font-weight: 400;">During labour, sometimes things can slow down or concerns can arise with your or your baby's well-being. If this happens your midwives and/or doctors may recommend certain options  to help you to give birth to your baby safely.</span>
<div class="submenu" data-cat="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/17/breaking-your-waters-amniotomy/">Breaking your waters (amniotomy)</a>

<a href="https://admin.mumandbaby.uk/2018/08/17/606/">Oxytocin (known as synto or syntocinon)</a>

<a href="https://admin.mumandbaby.uk/2018/08/17/610/">Episiotomy</a>

<a href="https://admin.mumandbaby.uk/2018/08/17/ventouse-forceps/">Ventouse or forceps</a>

<a href="https://admin.mumandbaby.uk/2018/08/17/caesarean-birth-2/">Emergency caesarean birth</a>

</div>

Interventions in labour

<h1>When pregnancy goes beyond your due date</h1>
<img class="alignnone size-full wp-image-1135" src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/2.3.1.jpg" alt="Close up of pregnant woman with a pen crossing off days on a wall calendar" width="650" height="406" />

<span style="font-weight: 400;">If you have had a healthy pregnancy without complication and haven’t gone into labour by 41 weeks you will have a routine appointment with your midwife to discuss the next steps.  </span>

<h2>What happens at your 41 week appointment?</h2>

<span style="font-weight: 400;">You will be offered a membrane sweep, which is an internal examination of the cervix. During this examination your midwife will insert the tip of her finger into your cervix and sweep around the bag of membranes that cover your baby’s head. This has been shown to release hormones that may encourage labour to start within 24 hours. Sometimes the cervix isn’t yet open, and a sweep isn’t possible. You may be invited to return for more sweeps.</span>

<span style="font-weight: 400;">
</span><span style="font-weight: 400;">Your midwife will also offer you a date to have your labour induced. This is normally recommended by 41 weeks and three, four or five days (depending on your maternity units guidelines and availability). Some maternity units are able to offer complementary therapy to encourage labour to start naturally. Ask your midwife about this.</span>
<div class="relatedlinks" data-cat="relatedlinks"><a type="nhs" href="https://www.nhs.uk/conditions/pregnancy-and-baby/over-40-weeks-pregnant-overdue/">If your baby is overdue</a></div>

When pregnancy goes beyond your due date

<h1>Assisted birth</h1>
<img class="alignnone size-full wp-image-1146" src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/2.3.jpg" alt="Smiling pregnant woman in hospital bed has her hand held by a midwife" width="650" height="406" />
<span style="font-weight: 400;">Assistance with labour and birth may be recommended either:</span>
<ul>
<li>prior to your due date</li>
<li>for medical reasons</li>
<li>when you go beyond your due date; or</li> 
<li>during labour.</li>
</ul>
<div class="submenu" data-cat="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/23/when-pregnancy-goes-beyond-your-due-date/">When pregnancy goes beyond your due date</a>

<a href="https://admin.mumandbaby.uk/2018/08/17/induction-of-labour/">Induction of labour</a>

<a href="https://admin.mumandbaby.uk/2018/08/17/interventions-in-labour/">Interventions in labour</a>

</div>
<div class="relatedlinks" data-cat="relatedlinks">

<a href="https://www.tommys.org/pregnancy-information/labour-birth/assisted-birth" type="tommy's">Assisted birth</a>

<a href="https://www.which.co.uk/birth-choice/safety-and-interventions/inductions-and-interventions-in-labour" type="which">Induction and interventions</a>

<a href="https://www.birthrights.org.uk/factsheets/consenting-to-treatment/">Consent: the key facts - Birthrights</a>

</div>

Assisted birth

<h1>Early signs of labour</h1>
<img class="alignnone size-full wp-image-1110" src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/2.1.jpg" alt="Close up of a pregnant woman propped up in bed holding her the sides of her bump" width="650" height="406" />

<span style="font-weight: 400;">In the week building up to your labour starting you might experience some of the following:</span>
<ul>
 	<li><span style="font-weight: 400;">increased clear vaginal discharge</span></li>
 	<li><span style="font-weight: 400;">mild upset stomach or diarrhoea</span></li>
 	<li><span style="font-weight: 400;">feeling energetic or restless</span></li>
 	<li><span style="font-weight: 400;">frequent practice contractions, or tightenings of the uterus known as Braxton Hicks, and/or backache.</span></li>
</ul>
<span style="font-weight: 400;">Some women won’t notice any of these signs, and it is nothing to worry about if you don’t feel any different towards the end of pregnancy.</span>

<span style="font-weight: 400;">As your labour starts you may notice some of the following signs which can be explored here.</span>
<div class="submenu" data-cat="submenu"><a href="https://admin.mumandbaby.uk/2018/08/14/the-show/">The show</a>
<a href="https://admin.mumandbaby.uk/2018/08/14/contractions/">Contractions</a>
<a href="https://admin.mumandbaby.uk/2018/08/14/your-waters-breaking/">Your waters breaking</a>
<a href="https://admin.mumandbaby.uk/2018/08/14/514/">When to call your midwife/maternity unit</a></div>
<div data-cat="goto" class="goto">

<a href="https://admin.mumandbaby.uk/2018/08/06/maternity-units/" internal="true">Contact my maternity unit</a>

</div>
<div class="videoplayer" data-cat="video">How will I know I am in labour?
<iframe width="560" height="315" src="https://www.youtube.com/embed/jkL1DhAsr_0?rel=0&amp;showinfo=0" frameborder="0" allowfullscreen="allowfullscreen"></iframe></div>
<div class="relatedlinks" data-cat="relatedlinks"><a href="https://www.nhs.uk/conditions/pregnancy-and-baby/labour-signs-what-happens/" type="nhs">Signs that labour has begun</a>
<a href="https://www.tommys.org/pregnancy-information/labour-birth/how-will-i-know-when-labour-has-started" type="tommy's">More on signs labour has started</a></div>

Early signs of labour

<h1>If your baby is too unwell to survive</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2021/08/If-your-baby-is-too-unwell-to-survive-300x200.jpg" alt="Premature little baby in an incubator" width="300" height="200" class="size-medium wp-image-17551" />
<span>Sometimes babies are born so early or so unwell it is very hard for them to survive despite having intensive care. This will be a very difficult time for you and your family. Your baby will have fought so hard to have met you and spend time with you since their birth.</span>

<span>Whilst your baby is still alive, you may wish to make memories with them such as making prints of their hands and feet, taking photos and videos of you all together, introducing them to siblings and family they may not have met yet, reading them your favourite books and having a ceremony to celebrate their life. The neonatal team helping you to care for your baby will be able to assist you with all these things and any other requests you may have.</span>

<h2>End of life care for your baby</h2>
<span>If the neonatal team has spoken to you about your baby dying, they may start to change the focus of their care from active care to focusing more on maximising their comfort. This may involve doing fewer painful procedures on your baby or starting your baby on some medicines to keep your baby comfortable.</span>

<span>The team will discuss with you, whenever possible, about where you would like to be with your baby when they stop receiving active treatment and transition to receiving comfort-focused care. This is usually in hospital, but may be in a hospice, or even at home. The neonatal staff will support in making these decisions. The neonatal team may also introduce you to the palliative care team, who are experts in caring for babies with life-limiting conditions.</span>

<span>The team will also discuss with you whether you would like your baby to have a postmortem examination to find out more about the problems that have made your baby so ill. There are also some instances where the coroner may make this decision.</span>

<h2>After your baby has died on a neonatal ward</h2>
<span>The neonatal unit staff will support you to be able to provide care for your baby around the time of death. They will issue you with a death certificate and provide you with all the information you need about registering your baby’s death. You will be offered a bereavement appointment to talk about your baby’s care a few weeks after their death. A bereavement nurse will be in regular contact with you too.</span>

<div data-cat="relatedlinks" class="relatedlinks">
<a href="https://www.sands.org.uk/">Sands support</a>
</div>


If your baby is too unwell to survive

<h1>Meeting your baby for the first time</h1>
<img class="alignnone size-full wp-image-1147" src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/2.4.1.jpg" alt="New mother in a birthing pool holds her newborn baby for her birthing partner to hold" width="650" height="406" />

<span style="font-weight: 400;">Meeting your baby for the first time can cause many different emotions in new parents. After months of build up to the birth, you may feel elation and an instant rush of love but don’t be concerned if you initially feel dazed and disconnected, or have concerns over whether the baby is alright. Making an emotional connection with your baby can take time. It is important to remember that there is no right or wrong way to feel about your newborn and that for some parents it can take quite a while to adjust to the fact that labour is over and their new baby has arrived.</span>
<div data-cat="video" class="videoplayer">

Meeting your baby for the first time

<iframe width="560" height="315" src="https://www.youtube.com/embed/0vzW9qPz3So" frameborder="0" allowfullscreen="allowfullscreen"></iframe>

</div>

Meeting your baby for the first time

<h1>You: straight after birth</h1>
<img class="alignnone size-full wp-image-1149" src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/2.4.2.2.jpg" alt="Close up of new mother sitting up in a hospital bed and holding her new born baby" width="650" height="406" />

<span style="font-weight: 400;">After your placenta has been delivered, your midwife or doctor will ask to check and see if you have any tears to the perineum and/or vagina that might require stitches. If you do need stitches, your midwife or doctor will explain this to you.</span>

<span style="font-weight: 400;">Before stitching your midwife or doctor will ensure the area is numbed with local anaesthetic, or if you have an epidural already, this will be topped up. Most tears will be repaired in your birthing room, more significant tears require repair in an operating theatre. Tears are repaired using dissolvable stitches and normally heal within a month of birth.</span>

<span style="font-weight: 400;">All women will lose some blood after giving birth, this happens because the area of the womb where the placenta was attached takes time to heal. Bleeding may be heavy immediately after the birth, but will reduce significantly over the next few days and weeks. Bleeding will normally last between two and six weeks. Your midwife will check on your bleeding regularly straight after birth.</span>

<span>If there is significant bleeding this is called a postpartum haemorrhage (PPH). Your midwife and doctor will take prompt action to stop ongoing blood loss.</span>

<div data-cat="submenu" class="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/21/understanding-perineal-tears/">Understanding perineal tears</a>

</div>


<div class="relatedlinks" data-cat="relatedlinks">

<a href="https://www.nhs.uk/conditions/pregnancy-and-baby/you-after-birth/" type="nhs">You after birth</a>

<a href="https://www.rcog.org.uk/en/patients/patient-leaflets/third--or-fourth-degree-tear-during-childbirth/" type="rcog">Third and fourth degree tears</a>

<a href="https://www.rcog.org.uk/en/patients/patient-leaflets/heavy-bleeding-after-birth-postpartum-haemorrhage/" type="rcog" >Heavy bleeding after birth (postpartum haemorrhage)</a>

<a href="https://www.buzzsprout.com/961453/8348398-episode-53-tears-and-stitches">Perineal tears and stiches - The Obs Pod, Episode 53</a>

</div>

You: straight after birth

<h1>What happens straight after birth</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/2.4.2.jpg" alt="New mother holds her new born baby to her bare chest under a sheet" width="650" height="406" class="alignnone size-full wp-image-1153" />

<span style="font-weight: 400;">Explore what will happen once your baby has arrived.</span>
<div data-cat="video" class="videoplayer">

What will happen after my baby is born?

<iframe width="560" height="315" src="https://www.youtube.com/embed/hao7l1iTFNo?rel=0&amp;showinfo=0" frameborder="0" allow="autoplay; encrypted-media" allowfullscreen="allowfullscreen"></iframe>

</div>
<div class="submenu" data-cat="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/17/626/">Skin-to-skin contact</a>

<a href="https://admin.mumandbaby.uk/2018/08/17/you-straight-after-birth/">You: straight after birth</a>

<a href="https://admin.mumandbaby.uk/2018/08/17/your-baby-straight-after-birth/">Your baby: straight after birth</a>

<a href="https://admin.mumandbaby.uk/2018/08/17/vitamin-k-for-newborn-babies/">Vitamin K for newborn babies</a>

<a href="https://admin.mumandbaby.uk/2018/08/17/identification-for-your-newborn-baby/">Identification for your newborn baby</a>

</div>
<div class="relatedlinks" data-cat="relatedlinks">

<a href="https://www.nhs.uk/conditions/pregnancy-and-baby/what-happens-straight-after-the-birth/" type="nhs">What happens straight after birth</a>

<a href="https://www.nct.org.uk/birth/after-your-baby-born" type="nct">More on after your baby is born</a>

</div>

What happens straight after birth

<h1>Immediately after giving birth</h1>
<img class="alignnone size-full wp-image-1154" src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/2.4.jpg" alt="Mother in hospital bed holds her baby to her chest" width="650" height="406" />
<div class="submenu" data-cat="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/17/meeting-your-baby-for-the-first-time/">Meeting your baby for the first time</a>

<a href="https://admin.mumandbaby.uk/2018/08/17/what-happens-straight-after-birth/">What happens straight after birth</a>

</div>

Immediately after giving birth

<h1>Preterm labour and birth</h1>
<img class="alignnone size-full wp-image-1123" src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/2.2.6.jpg" alt="Preterm baby sleeps inside an incubator" width="650" height="406" />

<span style="font-weight: 400;">A baby that is born before 37 weeks gestation is considered to be ‘premature’ or ‘preterm’. There are different categories of prematurity:</span>
<ul>
 	<li><span style="font-weight: 400;">extremely preterm (less than 28 weeks)</span></li>
 	<li><span style="font-weight: 400;">very preterm (between 28 and 32 weeks)</span></li>
 	<li><span style="font-weight: 400;">moderate to late preterm (between 32 and 37 weeks).</span></li>
</ul>
<span style="font-weight: 400;">In the UK, roughly eight one in every 100 babies will be born prematurely. Extremely preterm birth is less common with less than one in 100 babies being born between 22 and 28 weeks gestation.</span>

<span style="font-weight: 400;">Preterm birth carries risks because babies who are born too soon may not be fully developed, and need specialist help for life outside of the womb. Preterm babies are also at risk of longer term health problems, including learning disabilities and visual and hearing impairment.</span>
<h2>Call your midwife or maternity unit if you are less than 37 weeks pregnant and you have:</h2>
<ul>
 	<li><span style="font-weight: 400;">regular period type pains or contractions</span></li>
 	<li><span style="font-weight: 400;">constant abdominal pain</span></li>
 	<li><span style="font-weight: 400;">a "show" – the mucus plug that sits inside the cervix during pregnancy. This can be clear or blood stained</span></li>
 	<li><span style="font-weight: 400;">fresh red bleeding from the vagina (take a photograph to show the midwife)</span></li>
 	<li><span style="font-weight: 400;">a gush or trickle of fluid from your vagina – this could be your waters breaking (place a sanitary towel (pad) inside your underwear to show your midwife)</span></li>
 	<li><span style="font-weight: 400;">backache that is not usual for you, or pressure in the vagina or rectum.</span></li>
</ul>
<span>In most cases of preterm birth contractions and labour start spontaneously. Sometimes preterm birth happens when obstetricians or fetal medicine specialists intervene because of concerns about your health or the health of your baby.</span>

<span>You may find this range of videos about premature birth from Best Beginnings helpful:</span>
<div data-cat="goto" class="goto"><a href="https://www.bestbeginnings.org.uk/watch-small-wonders-online">Premature birth videos</a></div>
<div data-cat="goto" class="goto">

<a href="https://admin.mumandbaby.uk/2018/08/06/maternity-units/" internal="true">Contact my maternity unit</a>

</div>
<div class="submenu" data-cat="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/14/causes-of-preterm-birth/">Causes of preterm birth</a>

<a href="https://admin.mumandbaby.uk/2018/08/14/what-happens-if-i-go-into-preterm-labour/">What happens if I go into preterm labour?</a>

<a href="https://admin.mumandbaby.uk/2018/08/14/what-happens-if-my-baby-is-born-prematurely/">What happens if my baby is born prematurely?</a>

</div>
<div class="relatedlinks" data-cat="relatedlinks">

<a href="https://www.nhs.uk/conditions/pregnancy-and-baby/premature-early-labour/" type="nhs">Premature labour and birth</a>

<a href="http://www.bliss.org.uk">Bliss: for babies born prematurely or sick</a>

<a href="https://www.tommys.org/pregnancy-information/premature-birth/organisations-support-around-premature-birth" type="tommy's">Preterm birth</a>

<a href="https://www.tommys.org/pregnancy-information/premature-birth/my-prem-baby-app" type="tommy's">My prem baby app</a>

</div>

Preterm labour and birth

<h1>Tips for birth partners</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2021/08/Tips-for-birth-partners-300x200.jpg" alt="Man massaging his partner's belly during labour at an unassisted home birth" width="300" height="200" class="size-medium wp-image-17586" />

<span>Supporting your partner during labour and birth can be a rewarding and bonding experience for both of you. Use the Personalised Birth Preferences plan in the app to help you think about both of your needs and choices for labour and birth.</span>

<span>Staying well-hydrated and nourished during the labour will help you to stay alert, so come prepared with non-perishable snacks and drinks. It is also okay to take a break occasionally, especially if labour is long. Chat about this with your partner before labour so everyone's expectations can be met.</span>

<span>If you have helped to pack the hospital bag, you will know where to find a hat and nappy for your newborn baby, as these are the first things the midwife will ask you for.</span>

<span>Depending on hospital policy it may be possible to have more than one birth partner during labour. It is wise to check with your midwife ahead of time.</span>

<div data-cat="relatedlinks" class="relatedlinks">

<a href="https://www.nhs.uk/pregnancy/labour-and-birth/what-happens/tips-for-your-birth-partner/" type="nhs" >Tips for your birth partner</a>

<a href="https://www.nct.org.uk/labour-birth/dads-and-partners/ten-tips-for-birth-partners" type="nct" >Ten tips for birth partners</a>
<div>


Tips for birth partners

<h1>Antibiotics in labour</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2021/09/Antibiotics-300x200.jpg" alt="Cannula in back of hand" width="300" height="200" class="size-medium wp-image-17890" />
<span>There are two reasons why you might be given antibiotics during labour:</span>

<h2>1)	Known risk of an infection</h2>
<span>Antibiotics in labour will be recommended if there is an increased risk of infection to the baby by bacterium called Group B Streptococcus (GBS). This could be indicated in labour if:</span>
<ul>
<li>a) results in your current or previous pregnancy have detected GBS in vaginal or urine testing; or</li>
<li>b) labour starts prior to 37 weeks and is associated with rupture of membranes prior to the onset of labour.</li>
</ul>
<span>The team will check your allergies and available results to determine which antibiotics to give you until your baby is born. When antibiotics are administered for this indication only, you will be able to walk around in labour.</span>

<h2>2)	Signs of a possible infection</h2>
<span>Infection in labour may be suspected based on symptoms like fever, or signs like a higher than expected heart rate in you or baby in the womb.</span>

<span>Infection can occur in any part of your body. If we can’t identify where the infection is, we work on the assumption that it could be in the womb, and this may be difficult to confirm until at least a few days later.</span>

<span>Untreated infection can sometimes spread to the blood and if not treated it may have serious consequences. Given the risk that an infection may pose, the medical team will undertake a detailed assessment of you and your baby. They will conduct a range of tests on you to help establish the type of infection. This will include blood tests, urine tests and vaginal swabs. The tests include full blood count, C-reactive protein (CRP), blood/urinary/vaginal culture and sensitivity. The team will recommend starting antibiotics through a cannula (a very fine, flexible plastic tube) directly into your vein.</span>

<span>You will need to be monitored closely and this will involve continuous monitoring of you and the baby, which may limit you from walking around in labour. We will continue to support your birth preferences as best as possible and discuss all options and recommendations so that you can make informed choices about your care. We will help you adopt positions that are comfortable for you and that are known to support vaginal births.</span>

<span>Some of the blood results will be available within a few hours and some tests (microbiological cultures and sensitivity) may take up to 3 days.</span>

<span>Your team will continue to monitor you and your baby closely through your labour and will keep you informed of their findings and recommendations. You are encouraged to ask any questions or share concerns you may have.</span>

<h2>What will happen after the birth?</h2>

<h3>1)	Known risk of an infection</h3>
<span>If you received antibiotics in labour only because of the known risk of GBS infection, this will be stopped at the time of the birth. For 12-24 hours after the birth, your team will monitor you and the baby for anything concerning, including signs of infection. The monitoring aims to identify early warning symptoms and signs. For the baby, this will include overall assessment and regular measurement of heart rate, respiratory rate, colour, temperature and feeding. The baby will stay with their mothers on the postnatal ward.</span>

<h3>2)	Signs of a possible infection</h3>

<span>Your antibiotics will be continued through the cannula until your temperature has been normal for at least 24 hours after the birth, you feel well and the infection results indicate an improvement.</span>

<span>Based on your recovery and test results, you may need to continue the antibiotic course as tablets. The total duration of antibiotics can vary but they will be safe to take if you are breastfeeding.</span>

<span>If you have a urinary infection, you will need to repeat a urine test (culture and sensitivity) a week after you complete your antibiotics course to make sure the infection has been treated fully.</span>

Antibiotics in labour

<h1>Birth with twins or more</h1>
<img class="alignnone size-full wp-image-1119" src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/2.2.5.jpg" alt="Close up of new born twins lying together" width="650" height="406" />

<span style="font-weight: 400;">During pregnancy you will have an appointment to discuss your options for the birth of your twins. More than 40% of twins are born vaginally with the remainder being born by either planned or emergency caesarean. </span>

<span>The most common way for twins to lie is both with their heads down. It is common for one or both babies to be feet or bottom down (breech). Some babies lie across your womb (transverse lie) and if this is the case with the first twin to be born, you’ll need a caesarean section. If you’ve had a vaginal birth for the first twin but the second is lying across your womb, they may need help to turn so they can be born.</span>

<span style="font-weight: 400;">In some cases a planned caesarean will be recommended, for example, if your babies share one placenta, or the first baby is in the breech (bottom first) position. </span>

<span style="font-weight: 400;">During labour, it is recommended that your babies have continuous electronic fetal monitoring, as the risk of complications during labour is higher for twins. It may also be recommended that you have an epidural, in case you require an emergency caesarean birth quickly. There will be more people at the birth of twins, often two midwives, two obstetricians and two neonatal doctors.</span>

<span style="font-weight: 400;">If you have triplets or more, planned caesarean birth would be recommended for you as the safest way to deliver your babies.</span>
<div class="relatedlinks" data-cat="relatedlinks">

<a href="https://www.nhs.uk/conditions/pregnancy-and-baby/giving-birth-to-twins/" type="nhs">Giving birth to twins</a>
</div>

Birth with twins

<h1>Coping strategies and pain relief in labour</h1>
<img class="alignnone size-full wp-image-1132" src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/2.2.7.jpg" alt="Close up of heavily pregnant woman leaning forwards with her birth partner standing behind her and touching her waist" width="650" height="406" />

As labour progresses, there are plenty of options available to help you manage the sensation of the contractions as they get stronger and more intense.
<div class="submenu" data-cat="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/14/coping-in-early-labour/">Coping in early labour</a>

<a href="https://admin.mumandbaby.uk/2018/08/14/self-hypnosis-deep-relaxation-techniques/">Self-hypnosis/Deep relaxation techniques</a>

<a href="https://admin.mumandbaby.uk/2018/08/14/complementary-therapies/">Complementary therapies</a>

<a href="https://admin.mumandbaby.uk/2018/08/14/tens-transcutaneous-electrical-nerve-stimulation/">TENS (transcutaneous electrical nerve stimulation)</a>

<a href="https://admin.mumandbaby.uk/2018/08/14/gas-and-air-entonox/">Gas and air (Entonox)</a>

<a href="https://admin.mumandbaby.uk/2018/08/14/water/">Water</a>

<a href="https://admin.mumandbaby.uk/2018/08/14/opioids/">Opioids (pethidine/diamorphine/meptid)</a>

<a href="https://admin.mumandbaby.uk/2018/08/14/epidural/">Epidural</a>

</div>
<div class="relatedlinks" data-cat="relatedlinks">

<a href="https://www.nhs.uk/conditions/pregnancy-and-baby/pain-relief-labour/" type="nhs">Pain relief in labour</a>

<a href="https://www.labourpains.org">Pain relief information in English and other languages</a>

</div>

Coping strategies and pain relief in labour

<h1>Emergencies</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/10/1.1.10.jpg" alt="Woman looking concerned while making a mobile phone call" width="650" height="406" class="alignnone size-full wp-image-2893" />
<div data-cat="submenu" class="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/08/before-18-20-weeks-gestation/">Before 18-20 weeks gestation</a>

<a href="https://admin.mumandbaby.uk/2018/08/08/after-18-20-weeks-gestation/">After 18-20 weeks gestation</a>

<a href="https://admin.mumandbaby.uk/2018/08/08/after-37-weeks-gestation-when-expecting-labour/">After 37 weeks gestation/when expecting labour</a>

</div>
<div data-cat="goto" class="goto">

<a href="https://admin.mumandbaby.uk/2018/08/06/maternity-units/" internal="true">Contact my maternity unit</a>

</div>

<h1>Monitoring your baby</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2020/05/Monitoring-baby-650x406.jpg" alt="Heavily pregnant woman lies on her side while a fetal monitor is attached to her abdomen" width="650" height="406" class="alignnone size-full wp-image-11861" />

<span style="font-weight: 400;">During labour, your midwife will listen to your baby’s heartbeat to check his/her wellbeing, and to ensure he/she is coping well with labour. </span>

<span style="font-weight: 400;">There are three different ways your midwife can check this, by using either:</span>
<ul>
 	<li style="font-weight: 400;"><span style="font-weight: 400;">a hand-held machine</span></li>
 	<li style="font-weight: 400;"><span style="font-weight: 400;">a Pinard stethoscope; or </span></li>
 	<li style="font-weight: 400;"><span style="font-weight: 400;">continuous electronic fetal monitoring.</span></li>
</ul>
<span style="font-weight: 400;">If you have had a normal and healthy pregnancy, and your labour started naturally after 37 weeks, you will normally be offered monitoring using a small-hand held machine which produces the sound of your baby’s heartbeat. This is the same machine that your midwife/doctor used to listen to your baby’s heartbeat during pregnancy. </span>

<span style="font-weight: 400;">Your midwife will listen to your baby’s heartbeat intermittently and regularly throughout labour. Your midwife may offer to listen to your baby's heartbeat with a Pinard stethoscope. Like a traditional stethoscope you will not be able to hear the heartbeat but the midwife will hear it clearly. </span>

<span style="font-weight: 400;">Continuous electronic fetal monitoring (sometimes called a CTG) is a machine which is used to record your baby’s heartbeat and the contractions of your womb constantly throughout labour. It may be recommended that you have this type of monitoring if you’ve had any complications during pregnancy or labour and if you are using an epidural for pain relief. Midwives and/or doctors will look at this recording regularly throughout labour. You will need to wear two belts around your abdomen to keep the monitors in place. In some units a wireless machine may be available (this is known as telemetry), which means you may be able to move around more freely. </span>

<span>It is helpful to discuss the benefits of the different methods of monitoring prior to going into labour.  The method recommended by the midwife or doctor will depend on the health of you and your baby at the onset of labour.</span>

<span style="font-weight: 400;">Additional monitoring may be recommended if your midwives or doctors are concerned about your baby’s heartbeat during labour, this could be either: </span>
<ul>
 	<li style="font-weight: 400;"><span style="font-weight: 400;">a fetal scalp electrode (FSE) which is attached directly to your baby’s head</span></li>
 	<li style="font-weight: 400;"><span style="font-weight: 400;">a fetal blood sample (FBS). This test involves taking a very small sample of blood from your baby’s head to check how they are coping.</span></li>
</ul>
<div class="relatedlinks" data-cat="relatedlinks">

<a href="https://www.nhs.uk/conditions/pregnancy-and-baby/what-happens-during-labour-and-birth/" type="nhs">What happens during labour</a>

<a href="https://www.tommys.org/pregnancy-information/labour-birth/monitoring-your-baby-labour" type="tommy's">Monitoring your baby in labour</a>

</div>

Monitoring your baby

<h1>My team for labour and birth</h1>
<img class="alignnone size-full wp-image-1133" src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/2.2.8.jpg" alt="Midwife touches the control of a monitoring machine" width="650" height="406" />
<h2>Midwives</h2>
<span style="font-weight: 400;">Midwives are your main carers in labour, whether you choose to have your baby at home, in a midwifery-led birth centre or on an obstetric labour ward. Women in established labour will normally receive one-to-one care in labour from a named midwife. Your midwife will support you during labour, ensuring you and your baby are well and safe.  </span>
<h2>Obstetricians</h2>
<span style="font-weight: 400;">An obstetrician will be involved in your care if any complications or more complex needs arise during labour and/or birth. If an induction of labour is recommended for you, or if your labour and/or birth slow down it is likely that you will be seen by an obstetrician. If there are concerns with your health,  the health of your baby or if an assisted or caesarean birth is recommended you will also be seen by and cared for by an obstetrician who will work in partnership with your midwife. </span>
<h2>Maternity support workers</h2>
<span style="font-weight: 400;">These may work under the direct supervision of your midwife to provide you with support during labour.  They may also help you with feeding your baby immediately after birth.</span>
<h2>Anaesthetist</h2>
<span style="font-weight: 400;">If you have an epidural during labour, this will be put in by an anaesthetist. If you require a caesarean birth, you will also be cared for in theatre by an anaesthetist, in partnership with an obstetrician and your midwife. Anaesthetists may also become involved in your care if you have any complications or need a higher level of care due to medical conditions.</span>
<h2>Theatre team</h2>
<span style="font-weight: 400;">If you have a planned or emergency caesarean birth, there will be staff in the theatre to assist the anaesthetist, obstetrician and midwife who are caring for you. You may also be in theatre if an assisted birth is recommended, or if you have any complications after the birth that require more intensive care. </span>
<h2>Student midwives/doctors</h2>
<span style="font-weight: 400;">During labour and birth, there may be a student midwife or doctor working with your named midwife. Student midwives or doctors may provide you with care and support under direct or indirect supervision of the midwife, depending on their stage of training. Care will only be provided with your consent, and your midwife will discuss this with you.  </span>
<h2>Admin/clerical</h2>
<span style="font-weight: 400;">The team of midwives and doctors in birth centres and labour wards are supported by a team of reception, clerical and administrative staff that you may meet. Please ensure you inform the clerical team if you have any changes to your contact number, address or GP to ensure that information is recorded correctly on key documentation.</span>
<div data-cat="relatedlinks" class="relatedlinks">

<a href="https://www.nhs.uk/conditions/pregnancy-and-baby/antenatal-team-midwife-obstetrician-pregnant/" type="nhs">Your team for labour and birth</a>

<a href="https://www.nct.org.uk/pregnancy/your-care-through-pregnancy-labour-and-birth" type="nct">Midwife-led care in labour</a>

</div>

My team for birth and labour

<h1>Planned (elective) caesarean birth</h1>
<img class="alignnone size-full wp-image-1118" src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/2.2.4.jpg" alt="Baby delivered by caesarean birth in an operating theatre being held while the umbilical cord is clamped" width="650" height="406" />
<span style="font-weight: 400;">
Just over one in ten women will have a planned caesarean birth. This is due to a variety of factors, and the decision will be made together with your obstetric and midwifery team.</span>

<span>Some people start labour or break their waters before the planned caesarean date.  If this happens, you should contact your maternity unit straight away.</span>

<span style="font-weight: 400;">
The day before your caesarean you will be asked to take some medications. These should be taken the night before and also on the morning of your operation, as directed. You should not eat any food after midnight but may drink water until 6am on the morning of your operation.
</span>
<span style="font-weight: 400;">
On the day of your caesarean you will normally arrive at your maternity unit early in the morning. Sometimes if the labour ward is busy, you may have to wait for a period of time before your operation can start. In the operating theatre, your chosen birth partner can normally accompany you and can stay by your side throughout the surgery, unless, for medical reasons, you require a general anaesthetic.
</span>
<span style="font-weight: 400;">
The majority of women have a spinal anaesthetic or combined spinal epidural which causes the body to go numb from the abdomen to the feet. A catheter will be inserted into your bladder, and this will normally be removed the following day. Once the operation starts, the baby is normally born within 10 minutes, and all being well you can have skin-to-skin contact with your baby in the operating theatre while the operation is completed. If your waters have broken, a gentle vaginal cleansing solution will be used to reduce the risk of infection.</span>

<span style="font-weight: 400;">After the surgery you will spend a few hours in a recovery area, and a nurse or midwife will check your observations regularly. You can start bonding with and feeding your baby during this time. Your anaesthetic will wear off after a few hours.</span>

<span style="font-weight: 400;">You will normally stay on a postnatal ward for one to three nights, depending on your recovery. You will be given regular painkillers. You will be helped to become mobile once the anaesthetic wears off. Early
mobilisation and pressure stockings are recommended for all women to reduce the risk of developing blood clots after surgery. Some women are offered blood thinning injections.</span>
<div class="relatedlinks" data-cat="relatedlinks">

<a href="https://www.nhs.uk/conditions/caesarean-section/what-happens/" type="nhs">Caesarean birth: what happens</a>
<a href="https://www.nct.org.uk/labour-birth/different-types-birth/caesarean-birth/having-caesarean-what-expect" type="nct">More on caesarean birth</a>

<a type="rcog" href="https://www.rcog.org.uk/for-the-public/browse-all-patient-information-leaflets/considering-a-caesarean-birth-patient-information-leaflet/">Considering a caesarean birth patient informaton leaflet</a>

<a href="https://www.birthrights.org.uk/factsheets/right-to-a-c-section/">Your right to a caesarean birth</a>

<a href="https://www.birthrights.org.uk/factsheets/consenting-to-treatment/">Consent: the key facts - Birthrights</a>

</div>

Planned caesarean birth

<h1>Positions for labour and birth</h1>
<img class="alignnone size-full wp-image-1117" src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/2.2.3.jpg" alt="Heavily pregnant woman stands bent forward at right angles with her elbows resting on the back of a sofa" width="650" height="406" />

<span>During labour, it is good to stay as active as possible, and to try different positions. By doing this you will encourage your baby through the birth canal in the best position for birth, whilst also helping your own comfort and coping ability. Staying active and upright is also known to shorten the length of labour.</span>

<span>You can try:</span>
<ul>
 	<li>walking</li>
 	<li>standing with support from your birth partner</li>
 	<li>going up and down stairs</li>
 	<li>rocking/swaying</li>
 	<li>using a birthing ball</li>
 	<li>sitting upright or squatting</li>
 	<li>all fours position (on your hands and knees) or kneeling</li>
 	<li>lying on your side, supported by pillows (when you want to rest).</li>
</ul>
<span>During birth, your midwife will support you to try different positions. It is important to listen to your body, and try whatever feels right for you. The positions you can adopt may depend on whether you’ve chosen to have a water birth, or if you have an epidural.</span>

<div class="videoplayer" data-cat="video">Positions for birth
<iframe src="https://www.youtube.com/embed/gDZ3PfCD7Go?rel=0&amp;showinfo=0" width="560" height="315" frameborder="0" allowfullscreen="allowfullscreen"></iframe></div>

<div class="relatedlinks" data-cat="relatedlinks">

<a href="https://www.babycentre.co.uk/l25025610/16-birthing-positions-for-labour-images">Birthing positions for labour</a>

<a href="https://www.buzzsprout.com/961453/8528365-episode-57-upright-birth">Upright birth - Episode 57, The Obs Pod</a>
</div>

Positions for labour and birth

<h1>Stages of labour</h1>
<img class="alignnone size-full wp-image-1115" src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/2.2.1.jpg" alt="Heavily pregnant woman sits on a exercise ball in her hospital room and is held from behind by her birth partner" width="650" height="406" />

<span>Labour is divided into four stages:</span>
	
<div data-cat="submenu" class="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/14/early-labour-latent-phase/">Early labour/latent phase</a>

<a href="https://admin.mumandbaby.uk/2018/08/14/first-stage/">First stage</a>

<a href="https://admin.mumandbaby.uk/2018/08/14/second-stage/">Second stage</a>

<a href="https://admin.mumandbaby.uk/2018/08/14/third-stage/">Third stage</a>

</div>





Stages of labour

What to expect in labour and birth

<h1>Labour and birth</h1>
<div class="submenu" data-cat="submenu"><a href="https://admin.mumandbaby.uk/2018/08/14/early-signs-of-labour/">Early signs of labour</a>
<a href="https://admin.mumandbaby.uk/2018/08/29/what-to-expect-in-labour-birth/">What to expect in labour and birth</a>
<a href="https://admin.mumandbaby.uk/2018/08/17/assisted-birth/">Assisted birth</a>

<a href="https://admin.mumandbaby.uk/2018/08/14/preterm-labour-and-birth/">Preterm labour and birth</a>

<a href="https://admin.mumandbaby.uk/2018/09/03/immediately-after-giving-birth/">Immediately after giving birth</a>

<a href="https://admin.mumandbaby.uk/2021/08/31/tips-for-birth-partners/">Tips for birth partners</a>

<a href="https://admin.mumandbaby.uk/2020/06/10/what-if-my-baby-needs-additional-support/">What if my baby needs additional support?</a>

<a href="https://admin.mumandbaby.uk/2021/08/27/if-your-baby-is-too-unwell-to-survive/">If your baby is too unwell to survive</a>
</div>

Labour and birth

<h1>Air travel with your baby</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/3.3.6.6.jpg" alt="Mother in airline seat with baby facing her in baby airline seat" width="650" height="406" class="alignnone size-full wp-image-1206" />
<h2>Some things to consider before you plan to fly with your new baby: </h2>
<h2>Immunisations: </h2>
<span style="font-weight: 400;">Whilst airlines may accept babies older than seven days old for travel, be aware that newborn babies are still developing their immune system and so are at risk of picking up infectious diseases.  If possible consider having your baby's first immunisations administered before you travel.</span>
<h2>In-flight cabin pressure changes and babies' ears:</h2>

<span style="font-weight: 400;">During take-offs and landings, changes in cabin pressure can briefly affect the middle ear pressure and trigger severe ear pain.  To reduce the chances of your baby getting pain, encourage your baby to feed, or suck on a pacifier during take-offs and landings.</span>

<h2>Before booking:</h2>
<span style="font-weight: 400;">If you are traveling abroad, you will need a passport/visa for your baby.  Check individual airline websites for specifications on travelling with an infant. </span>

<div data-cat="relatedlinks" class="relatedlinks">

<a href="https://www.nhs.uk/chq/Pages/933.aspx?CategoryID=62&amp;SubCategoryID=63" type="nhs">Can I take my baby on an aeroplane?</a>

</div>

Air travel with your baby

<h1>Baby car seats and slings</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2020/05/Car-seats-and-baby-slings-650x406.jpg" alt="Man straps baby into car seat" width="650" height="406" class="alignnone size-full wp-image-11871" />
<span>When travelling by car it is essential to place your baby in a suitable baby car seat. You will need the car seat to take your newborn baby home from hospital, so it is worth taking the time to find a suitable car seat during pregnancy.</span>

<span>Many parents also choose to carry their baby in a sling. The guidance in the link below shows how to do this safely.</span>

<div data-cat="relatedlinks" class="relatedlinks">

<a href="https://www.nhs.uk/conditions/pregnancy-and-baby/child-car-seats-and-child-car-safety/" type="nhs">Child car seats and child car safety</a>

<a href="http://babyslingsafety.co.uk/">Baby sling safety</a>
</div>

Baby car seats and slings

<h1>Baby's oral health</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2020/05/brushing-teeth-787630_1280_650x406.jpg" alt="Older baby holds baby toothbrush in their mouth" width="650" height="406" class="alignnone size-full wp-image-12010" />
<h2>Brushing</h2>
<ul>
<li>Start brushing your baby's teeth as soon as they come through the gum - usually at around 6 months old.</li>

<li>Use a baby toothbrush and a tiny smear of family or baby toothpaste, containing at least 1000ppm fluoride.</li>

<li>Don't rinse your baby's mouth after brushing.</li>

<li>Brush your baby's teeth twice a day - once at night and once during the day, usually in the morning.</li>
</ul>

<div data-cat="video" class="videoplayer">
NHS Oral health guidance for babies
<iframe width="560" height="315" src="https://www.youtube.com/embed/-wJ_vMydc8g" frameborder="0" allow="autoplay; encrypted-media" allowfullscreen="allowfullscreen"></iframe>
</div>

<div data-cat="video" class="videoplayer">
Brushing for 0 to 3 year olds with Dr Ranj
<iframe width="560" height="315" src="https://www.youtube.com/embed/owbp5F0K45c" frameborder="0" allow="autoplay; encrypted-media" allowfullscreen="allowfullscreen"></iframe>
</div>
<h2>Sugar</h2>
<ul>
<li>Too much sugar can harm your baby's new teeth.</li>

<li>Only give water or milk to your baby to drink. Fresh fruit and vegetables provide your baby with all the sugar they need.</li>

<li>Try not to give any food containing extra sugar - if you do, makde sure it is with a meal and not as a snack.</li>

<li>Fresh fruit and vegetables are tooth-friendly snacks just like cheese, rice cakes, breadsticks and plain yogurt.</li>
</ul>
<div data-cat="goto" class="goto">
<a href="https://www.nhs.uk/start4life/weaning/">Baby food advice from NHS Start4life</a>
</div>

<h2>Dentist</h2>
<span>National guidance advises that all babies should visit the dentist for the first time by their first birthday.</span>

<div data-cat="relatedlinks" class="relatedlinks">
<a href="https://dentalcheckbyone.co.uk">Baby dental check by first birthday</a>

Baby's oral health

<h1>Birth registration</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/3.3.6.5.jpg" alt="Mother holds baby while sitting in a hospital chair" width="650" height="406" class="alignnone size-full wp-image-1205" />

<span style="font-weight: 400;">Following the arrival of your baby, the birth needs to be registered within 42 days (six weeks) at your local registry office. It is through this process that you will obtain a birth certificate. </span>

<span style="font-weight: 400;">The registration should be done in the borough you gave birth in. You may register the birth in a different area if this is more convenient, however your details will need to be sent to the borough in which you gave birth in order for them to generate a valid birth certificate.</span>

<span style="font-weight: 400;">The service is normally provided by appointment only, but this may vary from one area to the next. Please take the Personal Child Health Record (red book) and your baby’s NHS number with you, as the registrar may ask to see it.</span>

<div data-id="Birth registration for your region">Portal: Birth registration for your region</div>

Birth registration

<h1>Child benefit</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2019/05/childbenefit-300x187.jpg" alt="Child benefit form" width="300" height="187" class="alignnone size-medium wp-image-6053" />

<span>Child benefit is a tax-free payment that is aimed at helping parents cope with the cost of bringing up children. You get Child Benefit if you’re responsible for one or more children under 16 (or under 20 if they stay in approved education or training). There’s no limit to how many children you can claim for.</span>

Find out more and how to claim:
<div data-cat="goto" class="goto"><a href="https://www.gov.uk/child-benefit">Child benefit</a></div>
<div data-cat="goto" class="goto"><a href="http://www.gov.uk/government/publications/child-benefit-claim-form-ch2">Child benefit claim form</a></div>

Child benefit

<h1>Baby and other practicalities</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/3.3.6.jpg" alt="Close up of baby clipped into a baby car seat" width="650" height="406" class="alignnone size-full wp-image-1207" />
<div data-cat="submenu" class="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/20/vaccinations/">Vaccinations</a>

<a href="https://admin.mumandbaby.uk/2020/05/21/babys-oral-health/">Baby’s oral health</a>

<a href="https://admin.mumandbaby.uk/2018/08/20/778/">The Personal Child Health Record Book (the red book)</a>

<a href="https://admin.mumandbaby.uk/2020/06/05/your-babys-development/">Your baby’s development</a>

<a href="https://admin.mumandbaby.uk/2018/08/20/781/">Birth registration</a>

<a href="https://admin.mumandbaby.uk/2019/05/30/child-benefit/">Child benefit</a>

<a href="https://admin.mumandbaby.uk/2020/08/03/getting-practical-help-2/">Getting practical help after birth</a>

<a href="https://admin.mumandbaby.uk/2018/08/20/784/">Air travel with your baby</a>

<a href="https://admin.mumandbaby.uk/2020/05/19/baby-car-seats-and-slings/">Baby car seats and slings</a>

</div>

Baby and other practicalities

<h1>After your baby is born</h1>
<div data-cat="submenu" class="submenu">

<a href="https://admin.mumandbaby.uk/2018/09/13/postnatal-care-explained/">Postnatal care explained</a>

<a href="https://admin.mumandbaby.uk/2018/08/18/feeding-your-baby/">Feeding your baby</a>

<a href="https://admin.mumandbaby.uk/2018/09/13/caring-for-your-baby/">Caring for your baby</a>

<a href="https://admin.mumandbaby.uk/2018/09/13/your-physical-health-and-wellbeing-after-birth/">Your physical health and wellbeing after birth</a>

<a href="https://admin.mumandbaby.uk/2018/09/13/your-emotional-health-and-wellbeing-after-birth/">Your emotional health and wellbeing after birth</a>

<a href="https://admin.mumandbaby.uk/2018/09/13/relationships/">Relationships after birth</a>

<a href="https://admin.mumandbaby.uk/2018/09/13/baby-practicalities/">Baby and other practicalities</a>

</div>


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