Maternity Care at Whitchurch Surgery
Maternity care is shared between the woman’s own GP and the midwife. The North Hampshire NHS Trust provides the Midwifery service and our Midwife is Angela Howard-Higgins. When women discover they are pregnant, they are asked to make an appointment with the midwife or GP to discuss their general health and to ascertain any problems with previous pregnancies. Advice is given on screening, healthy eating and help if needed with smoking cessation. A screening leaflet is available from reception, explaining the tests available so that options can be discussed prior to the booking appointment.
Choosing where to give birth
Women have the choice between delivering in hospital or at home. A home birth has been shown by research to be as safe as a hospital birth for women who have uncomplicated pregnancies. Women are attended by two midwives on a 24-hour on-call rota and transfer to hospital by ambulance is undertaken if the midwife has any worries.
For those who prefer a hospital birth, the two local hospitals used are the Basingstoke & North Hampshire Hospital (BNHH)at Basingstoke and the Royal Hampshire County Hospital (RHCH) at Winchester. Women also have the choice of delivering in the Andover Birth Centre (ABC), a midwife-led centre, although this is currently closed for deliveries but available for post natal care.
The Booking Appointment
The booking appointment should optimally take place before 10 weeks gestation and will take approximately one hour to one hour fifteen minutes. During this time a detailed history of previous pregnancies, current health concerns and screening for Down’s Syndrome is discussed as well as your past and present health and social issues. you may wish to attend this appointment alone or with someone you feel comfortable discussing such matters with.
Blood tests, urine sampling and measurement of blood pressure will be taken. A measurement of height and weight is recorded. A plan is then made for the pregnancy, incorporating the woman’s wishes. This plan is reviewed at every follow-up appointment.
Now that you are pregnant, some early advice
- Take Folic Acid tablets, 400mcgs once a day until 12 weeks of pregnancy. If you have seen the GP, they may have already prescribed these for you.
- If you need to take painkillers, Paracetamol is safe to take in pregnancy, but avoid Ibuprofen.
- Avoid all other medication unless advised by your GP, Midwife or Pharmacist.
- Avoid cigarettes and alcohol.
- It is reommended that you do not eat liver during pregnancy due to the high content of
Vitamin A. - Food made from un-pasteurised or UHT milk eg soft cheeses such as camembert, brie,
blue-veined cheese etc and shellfish should be avoided. - Ensure eggs are hard boiled and avoid foods with raw egg (such as home-made mayonnaise, mousse, egg custard. You can, however, have store-bought mayonnaise if made with powdered milk.
- Ensure that your meat is cooked thoroughly and that you was your fruit and vegetables even if they are pre-packed.
- it is possible to catch an infection called toxoplasmosis from cats and lambs. This is very dangerous in pregnancy, therefore avoid handling cat-litter trays and ensure your hands are washed thoroughly after touching cats or lambs as well as following any gardening.
Follow-up Appointments
Follow-up appointments are much shorter, approximately 20 minutes. A urine sample and blood pressure are taken. The growing uterus is palpated and the baby’s heart listened to. Clinics for follow-up appointments are Tuesdays
Screening for Down’s Syndrome
Screening is offered to all women. The risk of having a baby with Down’s Syndrome is increased with maternal age. There are various national screening tests:
Nuchal Fold Scan – this is the most popular and is non-invasive and carries no known risk to either the mother or baby. Carried out between 11-13 weeks of pregnancy, a blood test for hormone levels will be taken at the same time to optimise the result. This scan is currently undertaken on the NHS if booked for a home birth or birth at NHH or RHCH.
Triple Test – this is a blood test only, taken at 16 weeks gestation if too late for the Nuchal Fold Scan, and measures the level of certain hormones. It is also a non-invasive test and carries no risk to the baby or mother.
Amniocentesis – It is offered to women who's Nuchal Fold screening is high risk. The test is invasive and carries with it a risk of miscarriage (1:100), but it is a diagnostic test rather than a screening test. This means it will tell you if the baby you are carrying is an affected infant rather than giving a calculated risk or probability.
Scans
A dating scan is only offered if you do not wish to have Nuchal fold screening and is at approximately 12 weeks as well as a scan at approximately 20 weeks gestation. They are offered at all hospitals and used to check the baby’s internal organ growth and to look for any abnormality. No further scans should be necessary as long as the pregnancy progresses normally. The midwife or GP will refer for extra scans should they have any concerns.
Parentcraft Classes
These classes are offered from 30 weeks and are held in various locations, days and times. Please discuss with the Midwife.
Hand Held Notes
A full record of the pregnancy will be given to women to carry with them. It is advised to carry these at all times in case of emergency, and can be presented whenever consultation is sought with any medical problem.
After the birth
Postnatal visits are routinely arranged for the first day home (even weekends and bank holidays), day 3 and 5 post delivery, and again at around 10 days. Extra visits may be arranged for various reasons. These may be in the home, at the surgery or post natal clinics in the hospitals, and could be between 0800 and 1800. Your care will be handed to the Health Visiting Team from day 10 to 14 post natally. Your Health Visitor will make contact with you ante natally around 36 weeks to introduce the team and her role in care for 0 - 5 years.
Post Natal checks
You will need to book a check-up with your doctor for 6 weeks after the birth of your baby.
A separate appointment will be sent to you for your baby's 6 week check.