THE PREGNANCY

I. INTRODUCTION

Having a baby is one of the most exciting things that can happen to you. But you might be
feeling nervous as well. If it’s your first baby, it’s hard to know what to expect. Your mum,
colleagues, friends and relations might all be giving you advice. And then there is all the
information on the internet as well as in magazines and books. At times it can feel
overwhelming and it’s hard to know who is right when people say different things. This paper
brings together everything you need to know to have a healthy and happy pregnancy, and to
make sure you get the care that is right for you. The guidance about pregnancy and babies does
change. So it’s important to get up-to-date, trusted advice so that you can make the right
decisions and choices.

II. YOUR PREGNANCY AT A GLANCE

II. 1 Before Pregnant
Think about the lifestyle factors that might affect your ability to get pregnant and have
a healthy pregnancy. This applies to men too. You are more likely to get pregnant if
you are both in good health. If you or your partner take any medication, talk to your
doctor about whether it will affect your pregnancy. Take 400 micrograms of folic acid
a day. You should continue to take this until you are 12 weeks pregnant. If you have a
health condition, for example mental health problems, diabetes or a family history of
any inherited diseases, talk to your GP or a specialist before you try to get pregnant.
Talk to your GP or a healthcare professional if you have any concerns or need support.

II. 2 0-8 Weeks

• You can take a pregnancy test from the first day that you miss your period
• As soon as you know you are pregnant, get in touch with a midwife or your GP to
organise your antenatal care (see Finding out that you are pregnant on page 16 and
Antenatal care on page 40). Begin to think about where you want your baby to be
born (see Choosing where to have your baby on page 70). Some pregnant women
start to feel sick or tired or have other minor physical problems for a few weeks.
 • Take 10 micrograms of vitamin D per day, which is in Healthy Start vitamin
supplements or other supplements recommended by your midwife. You should
continue to take vitamin D throughout your pregnancy and while you are
breastfeeding.

II. 3 8–12 WEEKS

You will usually attend your first appointment by 10 weeks and your booking
appointment by 12 weeks. At the booking appointment, your weight, height and body mass
index will be measured. You will be asked about your health and family history as well as
about your baby’s father’s family history. This is to find out if you are at risk of certain
inherited conditions. Your hand-held notes and plan of care will be completed. • Your
midwife will discuss various tests you will be offered during your pregnancy, one of which
is an ultrasound scan to check for abnormalities in your baby. You will be offered
information about what to expect during pregnancy and how to have a healthy pregnancy.
Ask if you are unsure about anything.

You can ask your midwife about your rights at work and the benefits available.
You will usually be offered an ultrasound scan between eight and 14 weeks. This will check
the baby’s measurements and give an accurate due date. The scan can also detect
abnormalities and check if you are carrying more than one baby. Your partner can come
along to the scan. If you get Income Support, income-based Jobseeker’s Allowance or
incomerelated Employment and Support Allowance or are on a low income and receive
Child Tax Credit, you should complete a Healthy Start application form. This is to claim
vouchers to spend on milk, fruit and vegetables. Healthy Start vitamin supplements
(containing vitamin D) are free without prescription for any pregnant woman, new mother
or child who gets Healthy Start vouchers. Make a dental appointment. NHS dental care is
free during pregnancy and for a year after the birth of your baby. Just 12 weeks after
conception, your baby is fully formed. It has all its organs, muscles, limbs and bones, and
its sex organs are well developed. Your baby is already moving about but you cannot feel
the movements yet.

II. 4 12–16 WEEKS

 Start to think about how you want to feed your baby. Make sure you are wearing a
supportive bra. Your breasts will probably increase in size during pregnancy so you need
to make sure you are wearing the right sized bra. If you have been feeling sick and tired,
you will probably start to feel better around this time. At 14 weeks, your baby‘s heartbeat
is strong and can be heard using an ultrasound detector. Your pregnancy may just be
beginning to show. This varies a lot from woman to woman.

II. 5 16–20 WEEKS

You may start to feel your baby move (see How your baby develops on page 18).
Your tummy will begin to get bigger and you will need looser clothes. You may feel a
surge of energy. Try to do your pregnancy exercises regularly. Your midwife or doctor
should: review, discuss and record the results of any screening tests; measure your blood
pressure and test your urine for protein; consider an iron supplement if you are anaemic.
Your midwife or doctor should give you information about the anomaly scan you will be
offered at 18–20 weeks and answer any questions you have. Your baby is now growing
quickly. Their face becomes much more defined and their hair, eyebrows and eyelashes
are beginning to grow. Ask your doctor or midwife to let you hear your baby’s heartbeat.

II. 6 20–25 WEEKS

Your uterus will begin to get bigger more quickly and you will really begin to look
pregnant.You may feel hungrier than before. Stick to a sensible balanced diet. Ask your
midwife about antenatal education. You will begin to feel your baby move.

II. 7 25 WEEKS

Your baby is now moving around vigorously and responds to touch and sound. If
this is your first baby, your midwife or doctor should: – check the size of your uterus –
measure your blood pressure and test your urine for protein. If you are taking maternity
leave, inform your employer in writing 15 weeks before the week your baby is due. You
can claim for Statutory Maternity Pay (SMP) and the Health in Pregnancy Grant at the same
time (see Rights and benefits on page 156). If you are entitled to Maternity Allowance, you
can claim from when you are 26 weeks pregnant. If your partner plans to take paternity
leave, they will need to inform their employer

II. 8 28 WEEKS

Your baby will be perfectly formed by now, but still quite small. You may find that
you are getting more tired. Your midwife or doctor should: – use a tape to measure the size
of your uterus – measure your blood pressure and test your urine for protein – offer more
blood screening tests – offer your first anti-D treatment if your blood type is rhesus
negative. If you are claiming Statutory Maternity Pay (SMP), you must inform your
employer at least 28 days before you stop work (see Rights and benefits on page 156). You
can claim a lump sum Sure Start Maternity Grant to help buy things for your new baby if
you get one of the following: – Income Support – income-based Jobseeker’s Allowance –
income-related Employment and Support Allowance – Pension Credit – Working Tax
Credit where the disability or severe disability element is included in the award Child Tax
Credit paya Think about what you need for the baby (see What you need for your baby on
page 127). If you have young children, it’s good to talk to them about the new baby. Make
sure your shoes are comfortable. If you get tired, try to rest with your feet up.ble at a rate
higher than the family element.

II. 9 31 WEEKS

If this is your first baby, your midwife or doctor should: – review, discuss and record
the results of any screening tests from the last appointment – measure the size of your uterus
and check which way up the baby is – measure your blood pressure and test your urine for
protein.

II. 10 34 WEEKS

Your midwife or doctor will give you information about preparing for labour and
birth, including how to recognise active labour, ways of coping with pain in labour and
developing your birth plan. They should also: – review, discuss and record the results of
any screening tests from the last appointment – measure the size of your uterus – measure
your blood pressure and test your urine for protein – offer your second anti-D treatment if
your blood type is rhesus negative. Make arrangements for the birth. You can give birth at
home, in a midwifery unit or in hospital. If you have children already, you may want to
make childcare arrangements for when you go into labour. You may want to ask about
whether tours of maternity facilities for birth are available.

Think about who you would like to have with you during labour. Get your bag
ready if you are planning to give birth in hospital or in a midwifery unit. You will probably
be attending antenatal classes now. You may be more aware of your uterus tightening from
time to time. These are mild contractions known as Braxton Hicks contractions. You may
feel quite tired. Make sure you get plenty of rest.

II. 11 36 WEEKS
Make sure you have all your important telephone numbers handy in case labour
starts. Your midwife or doctor should give you information about: – feeding your baby –
caring for your newborn baby – vitamin K and screening tests for your newborn baby –
the ‘baby blues’ and postnatal depression. Your midwife or doctor should: – measure the
size of your uterus – check the position of your baby – measure your blood pressure and
test your urine for protein. Sleeping may be increasingly difficult.

II. 12 38 WEEKS

Most women will go into labour spontaneously between 38 and 42 weeks. Your
midwife or doctor should give you information about your options if your pregnancy lasts
longer than 41 weeks. Your midwife or doctor should: – measure the size of your uterus –
measure your blood pressure and test your urine for protein. Call your hospital or midwife
at any time if you have any worries about your baby or about labour and birth.

II. 13 40 WEEKS

Your midwife or doctor should give you more information about what happens
if your pregnancy lasts longer than 41 weeks. Your midwife or doctor should: – measure
the size of your uterus – measure your blood pressure and test your urine for protein.
II. 14 41 WEEKS

If your pregnancy lasts longer than 41 weeks, you may be induced. Your
midwife or doctor will explain what this means and what the risks are. Your midwife or
doctor should: – measure the size of your uterus – measure your blood pressure and test
your urine for protein – offer a membrane sweep. Discuss options and choices for induction
of labour. Call your hospital or midwife if you have any worries about your baby or about
labour and birth.