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Antenatal care and antenatal classes IF YOU’RE GOING TO HAVE YOUR BABY IN HOSPITAL, your GP or midwife will send or give you a letter for the hospital. Antenatal care varies around the country. In some areas, the first (booking) appointment is at the hospital then all or most subsequent appointments are with the GP or community midwife unless the pregnancy is complicated, when all appointments are at the hospital. In other areas, all care is given by the GP and/or midwife unless there is a reason for referral to the hospital antenatal clinic. IF YOU’RE GOING TO HAVE YOUR BABY IN A MIDWIFE UNIT OR AT HOME, then you will probably go to your own community midwife for most of your antenatal care. You may need to visit the hospital for an initial assessment and perhaps for an ultrasound scan or for special tests. Sometimes your midwife may visit you at home. WEIGHT You’ll be weighed. From now on, your weight gain will probably be checked regularly, although this is not done everywhere. Most women put on between 10 and 12.5 kg (22–28 lbs) in pregnancy, most of it after the 20th week. Read pages 8–12 on what to eat in pregnancy, and take regular exercise. Much of the extra weight is due to the baby growing, but your body will also be storing fat ready to make breast milk after the birth. HEIGHT Your height will be recorded on the first visit because it is a rough guide to the size of your pelvis. Some small women have small pelvises, and although they often have small babies, they may need to discuss their baby’s delivery with their doctor or midwife. URINE You will be asked to give a sample of urine each time you visit. This will be checked for a number of things including: • sugar – pregnant women may have sugar in their urine from time to time, but, if it is found repeatedly, you will be checked for diabetes (some women develop a type of diabetes in pregnancy known as ‘gestational diabetes’ which can be controlled during pregnancy usually by a change of diet and, possibly, insulin; the condition usually disappears once the baby is born); • protein, or ‘albumin’, in your urine may show that there is an infection that needs to be treated; it may also be a sign of pregnancy-induced hypertension (see High blood pressure and pre-eclampsia on page 84). 52 GENERAL PHYSICAL EXAMINATION The doctor will check your heart and lungs and make sure your general health is good. BLOOD PRESSURE Your blood pressure will be taken at every antenatal visit. A rise in blood pressure later in pregnancy could be a sign of pre-eclampsia (see page 84).
Antenatal care and antenatal classes BLOOD TESTS You will be offered a blood test to carry out a number of checks. Discuss these with your doctor (see box). The tests are for: • your blood group; • whether your blood is rhesus negative or positive – a few mothers are rhesus negative (usually this is not a worry for the first pregnancy). Some rhesus negative mothers will need an injection after the birth of their first baby to protect their next baby from anaemia; in some units, rhesus negative mothers are given injections called ‘anti- D’ at 28 and 34 weeks as well as after the birth of their baby – this is quite safe and is done to make sure that the blood of future babies is not affected by rhesus disease – see page 110); • whether you are anaemic – if you are, you will probably be given iron and folic acid tablets to take (anaemia makes you tired and less able to cope with losing blood at delivery); • your immunity to rubella (German measles) – if you get rubella in early pregnancy, it can seriously damage your unborn baby. If you show low or no immunity, speak with your midwife or GP about what this means for your pregnancy. For more information about rubella, visit www.immunisation.nhs.uk • syphilis – it is vital to detect and treat any woman who has this sexually transmitted infection as early as possible; left untreated, syphilis during pregnancy can lead to miscarriage and stillbirth. • hepatitis B – this is a virus that can cause liver disease and may infect your baby if you are a carrier of the virus or are infected during pregnancy (see page 18). Your baby can be immunised at birth to prevent infection (see page 101), so you will be offered a test to check if you are carrying the virus. TESTS A number of tests will be offered at your first visit, and some of these will be repeated at later visits. You are under no obligation to have any test, although they are all done to help make your pregnancy safer or to help assess the well-being of your baby. Discuss the reasons for tests with your midwife or doctor so that you can make an informed choice about whether or not to have them. There is also written information available about the tests. Ask to have the results explained to you if you do decide to go ahead.See the leaflet Protecting you and your baby, available from antenatal clinics or the Department of Health, Social Services and Public Safety website on www.dhsspsni.gov.uk/phealth HEPATITIS C This virus can cause liver disease and there is a small risk the virus may be passed to your baby if you are infected. This cannot be prevented at present. Tests for hepatitis C are not usually offered routinely as part of antenatal care. If you think you have been at risk of acquiring this virus (see page 18), and wish to be tested, you should discuss this with your midwife or GP. They can arrange a test. If you are infected, your baby can be tested at an appropriate time after birth. If you have hepatitis C you will need to be referred for specialist assessment and follow-up. 53
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Pre the nancy gbook Your complete g
Page 3 and 4: Pre the nancy gbook Your complete g
Page 5 and 6: 11 LABOUR AND BIRTH Getting ready f
Page 7 and 8: Your pregnancy at a glance 16-20 we
Page 9 and 10: Introduction Every parent is differ
Page 11 and 12: Your health in pregnancy • Eat pl
Page 13 and 14: These are available from pharmacies
Page 15 and 16: Your health in pregnancy S MOKING W
Page 17 and 18: Your health in pregnancy P HYSICAL
Page 19 and 20: Your health in pregnancy Foot exerc
Page 21 and 22: Your health in pregnancy your GP, m
Page 23 and 24: 2 Conception To understand about co
Page 25 and 26: Conception T HE WOMAN’ S MONTHLY
Page 27 and 28: Conception T HE BEST TIME TO GET PR
Page 29 and 30: Conception K NOWING THAT YOU’ RE
Page 31 and 32: How the baby develops WEEKS 4-5 Wee
Page 33 and 34: How the baby develops WEEKS 15-22 T
Page 35 and 36: 4 Deciding where to have your baby
Page 37 and 38: Deciding where to have your baby HO
Page 39 and 40: Deciding where to have your baby B
Page 41 and 42: 5 Feelings and relationships From t
Page 43 and 44: Feelings and relationships WORRYING
Page 45 and 46: Feelings and relationships FAMILIES
Page 47 and 48: Feelings and relationships C OPING
Page 49 and 50: 6 Mainly for men Some pregnancies h
Page 51 and 52: Mainly for men PRACTICAL SUPPORT Yo
Page 53: 7 Antenatal care and antenatal clas
Page 57 and 58: Antenatal care and antenatal classe
Page 69 and 70: The feeding question B REASTFEEDING
Page 71 and 72: The feeding question You can get he
Page 73 and 74: The feeding question HOW OFTEN AND
Page 75 and 76: The feeding question B OTTLE FEEDIN
Page 77 and 78: The feeding question The teat As yo
Page 79 and 80: 9 Problems Your body has a great de
Page 81 and 82: Problems FEELING HOT IN PREGNANCY D
Page 83 and 84: Problems can empty it properly. The
Page 85 and 86: Problems VAGINAL DISCHARGE Almost a
Page 87 and 88: 10 What you need for the baby This
Page 89 and 90: What you need for the baby O UT AND
Page 91 and 92: 11 Labour and birth This chapter de
Page 93 and 94: Labour and birth PAIN RELIEF IN LAB
Page 95 and 96: Labour and birth • your contracti
Page 97 and 98: Labour and birth AT THE HOSPITAL Go
Page 99 and 100: Labour and birth • The heartbeat
Page 101 and 102: Labour and birth You can have your
Page 103 and 104: Labour and birth treatment takes ab
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Labour and birth A vaginal breech d
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When pregnancy goes wrong been due.
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13 The first days with your new bab
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The first days with your new baby c
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The first days with your new baby i
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Babies who need special care I NCUB
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The early weeks: you L OOKING AFTER
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The early weeks: you T HE ‘ BABY
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16 The early weeks: your baby The b
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The early weeks: your baby Sadly, w
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The early weeks: your baby If you
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The early weeks: your baby WASHING
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The early weeks: your baby W HERE T
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Thinking about the next baby? conta
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Rights and benefits How much is it?
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Tax Benefit. You may be able to get
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Rights and benefits You must have n
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Rights and benefits How much is it?
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Rights and benefits For further inf
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Giving notice for Ordinary Maternit
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Rights and benefits OTHER EMPLOYMEN
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• explain how you think the new w
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USEFUL ORGANISATIONS Some of these
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Rape Crisis Federation Aylesbury Va
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INDEX A abnormalities tests to dete
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The Pregnancy Book “It contains e
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