Your pregnancy

Across North West London you do not need to let your GP know and can self-refer to a hospital of your choosing to access maternity care. Ideally this should be by 8 weeks to ensure that you receive all the care you require.

The care that you will receive during your pregnancy is known as antenatal care. Your antenatal appointments will be with the maternity team and may be held at the hospital, children’s centre, GP surgery or your home.

You may want to tell your family and friends immediately, or wait a while until you know how you feel. Or you may want to wait until you have had your first ultrasound scan, when you're around 12 weeks pregnant, before you tell people.

Some of your family or friends may have mixed feelings or react in unexpected ways to your news. You may wish to discuss this with a midwife.

If you’re entitled to paid maternity leave, you must tell your employer you’re pregnant no later than the 15th week before your baby is due.

You must tell them:

• You’re pregnant
• The date of the week your baby is due (your employer can ask to see a medical certificate or 'MAT B1 form' – you get this from your doctor or midwife after you’re 20 weeks pregnant)
• The date you want to start maternity leave

They should give you information about:

• Folic acid supplements
• Nutrition, diet and food hygiene
• Lifestyle factors – such as smoking, drinking and recreational drug use
• Antenatal screening tests - you should be told about the risks, benefits and limits of these tests.

Screening for sickle cell disease and thalassaemia should be offered before 10 weeks. This is so you can find out about all your options and make an informed decision if your baby has a chance of inheriting these conditions.

It's also important to tell your midwife or doctor if:

• There were any complications or infections in a previous pregnancy or delivery, such as pre-eclampsia or premature birth
• You’re being treated for a long-term condition, such as diabetes or high blood pressure
• You or anyone in your family has previously had a baby with a health condition (for example, spina bifida)
• There’s a family history of an inherited condition (for example, sickle cell or cystic fibrosis)
• You know that you're a genetic carrier of an inherited condition such as sickle cell or thalassaemia – you should also tell the midwife if you know the baby's biological father is a genetic carrier of these conditions
• You have had fertility treatment and either a donor egg or donor sperm

If you choose to have your baby at home, the midwifery service will support this. Please discuss further with your midwife.

Your midwife will give you your handheld maternity notes.  You’ll take your maternity notes home and  be asked to bring them to all your antenatal appointments. Take your notes with you wherever you go in case you need medical attention while you’re away from home 

From 8 weeks – This is the first midwife appointment (also called the booking appointment) ideally this will happen before you’re 10 weeks pregnant because you’ll be offered some tests that should be done before 10 weeks. Your midwife will ask questions to help find out what care you need.

11 to 14 weeks dating scan - this is the ultrasound scan to estimate when your baby is due, check the physical development of your baby, and screen for possible conditions, including Down's syndrome.

At 16 weeks pregnant - your midwife or doctor will give you results of tests and information about the ultrasound scan you'll be offered at 18 to 20 weeks. They will also check your blood pressure and test your urine.

18 to 20 weeks - you'll be offered an ultrasound scan to check the physical development of your baby and position of your placenta. This is also known as the 20-week scan or anomaly scan.

25 and 31 weeks pregnant - these check-ups will be offered if this is your first pregnancy to measure the size of your uterus, your blood pressure and test your urine.

28 weeks pregnant - this check-up will be to measure the size of your uterus, your blood pressure and test your urine. You will often be given your MAT-B1 at this appointment.

34 weeks - as well as the same checks you had at 28 weeks, your midwife or doctor should give you information about preparing for labour and birth, including how to recognise active labour, ways of coping with pain in labour, and your birth plan.

36 weeks - as well as the same checks you had at 34 weeks; Your midwife or doctor should also give you information on breastfeeding, caring for your newborn baby, tell you about vitamin K and screening tests for your newborn baby, discuss your own health after your baby is born and advise you about the "baby blues" and postnatal depression

38 weeks -  as well as the same checks you had at 36 weeks; Your midwife or doctor will discuss options and choices about what happens if your pregnancy lasts longer than 41 weeks

40 weeks - as well as the same checks you had at 38 weeks; Your midwife or doctor may offer a membrane sweep and discuss options and choices about what happens if your pregnancy lasts longer than 41 weeks

41 weeks - as well as the same checks you had at 40 weeks; Your midwife or doctor will offer a membrane sweep and discuss the options and choices for induction of labour

If you have not had your baby by 42 weeks and have chosen not to have an induction, you should be offered increased monitoring of the baby.

Additional appointments and scans may be offered by your maternity team based on your individual circumstances.

There are lots of things you can do and avoid to keep you and your baby healthy during your pregnancy. The below is not an exhaustive list but things we hope will help you:

Antenatal Appointments

It’s important to not miss any of your antenatal appointments as tests and checks are done to ensure the health of you and your baby. They are also planned at particular times of your pregnancy to be able to spot any problems or anomalies.

Food

The next section will discuss eating well during your pregnancy but in general maintaining a healthy and varied diet will ensure you and your baby are getting essential nutrients and vitamins.

Alcohol and Smoking

It is not recommended to drink any alcohol or smoke during your pregnancy as it can lead to long-term harm for the baby.

Vitamins

It is recommended that you take folic acid when you’re planning on having a baby and up until the first twelve weeks of your pregnancy. Folic Acid reduces the risk of problems in your baby's development. It is also recommended to take a daily Vitamin D supplement. You can get supplements from pharmacies and supermarkets, or a GP may be able to prescribe them for you. If you’re claiming certain benefits and more than 10 weeks pregnant, you may be eligible for Healthy Start Vitamins.

Medicines

It’s important to remember that not all medicines are safe to take when you’re pregnant. Always check with your doctor, pharmacist or midwife before taking any medication.

Exercise

Light, gentle exercise is recommended during pregnancy. The more active and fit you are during pregnancy, the easier it will be for you to adapt to your changing shape and weight gain. It will also help you to cope with labour and get back into shape after the birth.
As long as you feel comfortable you can continue your regular exercise routine. A daily walk, running and pregnancy yoga are great forms of exercise.

Dental Health

You're entitled to free NHS dental treatment if you're pregnant when you start your treatment and for 12 months after your baby is born. To get free NHS dental treatment, you must have:

• a valid prescription maternity exemption certificate (MatEx) OR
• a MATB1 certificate issued by your midwife or GP

Sleep

Under 20 weeks pregnant you can sleep however you feel comfortable, however from 20 weeks you are recommended to sleep on your sides and not on your back. Get tips on sleeping well in pregnancy

Protect yourself against getting ill

Be aware of the symptoms if you are feeling unwell and how to avoid infections that may harm your baby - NHS Infections that may affect your baby.

You are entitled to receive the following vaccinations for free as you’re pregnant:

• the flu vaccination (offered between September and March)
• the whooping cough vaccination (offered from 20-32 weeks)

You will start to feel your baby’s movements around 16-24 weeks – at first it will feel like a flutter and as your pregnancy progresses you’ll feel the kicks! 

Call your midwife or maternity unit immediately if: 

• your baby is moving less than usual
• you cannot feel your baby moving anymore
• there is a change to your baby's usual pattern of movements

Do not wait until the next day – call immediately, even if it's the middle of the night. They'll need to check your baby's movements and heartbeat. Find out more about movements here.

Your feelings

Even if you feel excited about having your baby, it's also common to feel vulnerable and anxious while pregnant.

If feeling down or anxious is affecting your everyday life, tell a midwife. You will be offered help to deal with worrying thoughts or feelings.

Find out more about mental health in pregnancy.

Your relationship

You may find that you are having arguments with your partner while you’re pregnant. 

Some arguments may have nothing to do with the pregnancy, but others may be caused by feeling worried about the future and how you're going to cope.

It's important to talk with your partner about how you’re feeling. If you are worried about your relationship, talk to a friend, family member or your midwife.

Domestic abuse

If your relationship is abusive or violent, get help. Help and support in Hillingdon is available here.

Find out more about domestic abuse in pregnancy.

Money and housing

If money is an immediate concern, find out more about the maternity and paternity benefits and leave you're entitled to claim. Your local Jobcentre Plus or Citizens Advice service can advise you.

If you have a housing problem, contact your local Citizens Advice or your local housing advice centre.

You might be eligible for a Sure Start Maternity Grant on GOV.UK, or Healthy Start vouchers for free milk, vegetables and vitamins.

If you are working and you’re pregnant it’s important for you to be aware of your rights and what you are entitled to.

Your employer must protect your health and safety, and you should have the right to paid time off for antenatal appointment’s and classes. You're also protected against unfair treatment.

If you have any worries or concerns about your health whilst you are at work, talk to your doctor, midwife or occupational health nurse. Find out more here.

You can travel when you’re pregnant, it is however advisable to be mindful of the necessary precautions, knowing when you can travel, to get travel insurance and be informed about vaccinations. It would also be wise to know what the healthcare facilities are like at your destination in case you need to seek urgent medical attention.

Some airlines will ask for a letter from your GP confirming your due date depending on when you are choosing to fly. It differs depending on the airline so please check before booking. Ferry companies also have their own restrictions so would recommend checking their policy too. Find out more about travelling here.

Maintaining a healthy diet and lifestyle is important at any time in your life, but when you’re pregnant it’s especially vital.

Growing a human is no small job and although that doesn’t mean you have to eat a specific diet, it means being more mindful on what you are eating to ensure you get the right balance of nutrients for you and your baby.

Whilst you may be hungrier or crave certain foods, you should not eat for 2! Starting the day with a healthy breakfast will help you avoid snacking on sugary and salty snacks throughout the day. We don’t recommend cutting out all of your favourite foods but eating a varied diet and possibly introducing new foods will be beneficial. The Eatwell Guide has some useful information on what you should eat and what food groups your food needs to come from.

Eating plenty of fruit and vegetables rich in nutrients, vitamins and fibre helps support better digestion and can prevent constipation. The general guidance is at least 5 pieces of fruit and veg a day - canned, frozen, dried or juiced all count!

Eating carbohydrates such as bread, rice, potatoes, pasta, oats, yam and cornmeal are an important energy source and can help you feel full for longer. Instead of white bread, pasta or rice, try 
wholegrain or higher fibre options, brown bread, brown rice and wholewheat pasta.

After 28 weeks your body needs an extra 200 calories per day, this is one banana or 2 slices of wholemeal toast.

Meat, Fish and Dairy

Eating lean meat with the skin removed is a great source of protein. In pregnancy it is important for all meat and fish to be cooked thoroughly ensuring there are is no pink meat and juices have no blood in it.

Try to eat two portions of fish a week, one of which should be an oily fish. When you’re pregnant or trying to get pregnant it is advisable to avoid eating certain fish – shark, marlin and swordfish. When you’re pregnant avoid eating more than two portions of oily fish including tuna a week because it can contain toxins.

You should also avoid eating some raw, undercooked or runny eggs including in mousse, mayonnaise and soufflé due to the risk of salmonella. The only exception to this are eggs that are produced under the British Lion Code of Practice. These eggs have a red lion logo stamped on their shell and are safe for pregnant women to eat raw or partially cooked (for example, soft boiled eggs), as they come from flocks that have been vaccinated against salmonella. 

Milk, cheese, fromage frais and yoghurt are important in pregnancy as they contain calcium which are nutrients that you and you baby need. Try to opt for a low fat variant, semi skimmed, low sugar, skimmed milk, yoghurt or cheese. If you prefer a dairy free go for unsweetened, calcium-fortified versions. There are some cheeses you should avoid in pregnancy, including unpasteurised cheeses. Find out more about foods to avoid in pregnancy.

Saturated Fats and Sugary Foods

Most foods high in sugar and fat are calorific which can contribute to weight gain, and if sugary can lead to tooth decay. Foods such as crisps, chocolates, cakes, biscuits, ice cream and fizzy drinks should be consumed in moderation so try and have these less often and in small amounts.

If you’re craving sweet things, healthy snacks to enjoy can include dried fruit, low fat yoghurt, fresh fruit, a fruit loaf, hummus with wholegrain pitta. Find out more about healthy food swaps.

There are some vaccinations that are recommended during pregnancy:

Flu Vaccine (Offered between September and March)

During pregnancy, your immune system (the body's natural defence) is weakened to protect the pregnancy. This can mean you're less able to fight off infections. As the baby grows, you may be unable to breathe as deeply, increasing the risk of infections such as pneumonia.

These changes can raise the risk from flu – pregnant women are more likely to get flu complications than women who are not pregnant and are more likely to be admitted to hospital. Having the flu vaccine means you're less likely to get flu.

Whooping cough vaccine (offered from 16 weeks)

Whooping cough is a very serious infection, and young babies are most at risk. Most babies with whooping cough will be admitted to hospital.

When you have the whooping cough vaccination in pregnancy, your body produces antibodies to protect against whooping cough. These antibodies pass to your baby giving them some protection until they're able to have their whooping cough vaccination at 8 weeks old.

Coronavirus (Covid-19 Vaccine)

You can have the coronavirus (COVID-19) vaccine during pregnancy. 

It's preferable for you to have the Pfizer/BioNTech or Moderna vaccine. This is because they've been more widely used during pregnancy in other countries and have not caused any safety issues.

Find out more about vaccination in pregnancy.