Welcome to the Countess of Chester NHS Foundation Trust and thank you for choosing us to look after you and your

family for your maternity care.

These pages aim to provide you with useful information regarding how to get in contact with a midwife and with early pregnancy information and education.

Finding out you are pregnant it is an exciting and life changing time for a women and her family. The maternity team at the Countess of Chester NHS Foundation Trust are committed to helping you and your partner feel confident, relaxed and safe throughout your pregnancy, birth and beyond.

Our dedicated staff offer a range of services from both hospital and community settings.

Our aim is to:

• Work in partnership with you and your family throughout your pregnancy, birth and afterwards, offering all of the services you will need

• Support you to make decisions about what you want and need from your maternity care

• Provide you with a named midwife who will care for you during your pregnancy and beyond.

• Offer you a choice of where to give birth. This may depend on yours and your baby’s wellbeing. Your midwife will discuss this with you at you first appointment.

Booking your maternity care with us

We provide care to all women in the Chester and Ellesmere Port area, as well as women who live out of the area who choose to have all their care at the Countess of Chester Hospital

The philosophy of the Maternity Services is to provide each woman with the appropriate care for the well-being of the mother and baby. All women are booked for Midwifery Led Care unless the risk assessment undertaken at the booking appointment indicates Midwife and the Consultant (shared care).

To begin your Midwifery care at the Countess of Chester, call our booking Hotline on:

01244 363487

Leave your name and a contact number.

We will then contact you to make an appointment for you to see a midwife. This will be located within a Children's Centre or GP surgery in your local community.

We aim to arrange this with your named midwife. If you aim to have your baby at a neighbouring trust but live within our

boundary, we can share care and see you for part of your care.

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For regular updates on maternity services visit and ‘like’ our Facebook page:

Countess of Chester Maternity Services

Corona Virus: Covid-19

Important information due to recent government recommendations In line with the new national guidance of social distancing, your booking appointment will be conducted over the telephone by a Community Midwife. The Community Midwives office will arrange for a midwife to contact you – a date and approximate time will be given to you.

Your midwife will contact you and conduct the booking over the telephone.

o Your midwife will request your dating scan and the appointment will be forwarded to you from the hospital.

o If you are aware of your height and are able to weigh yourself at home, please do so prior to the telephone apt.

o You will have your blood pressure, urine, accurate height and weight, and booking bloods taken at the hospital when you attend for your dating scan.

o Carbon monoxide monitoring has been suspended as a precautionary measure.

Your midwife will inform you of any further follow-up arrangements in accordance to your own needs and provide you with her contact details.

Read: Corona Virus Infection and Pregnancy Guidance for up to date information

If you or a family member have a new persistent cough and/or fever (temperature above 37.8) and have an appointment or scan at the hospital, please ring antenatal clinic on 01244 365106 or scan department on 01244 365090. In each of these cases we will give you advice on an individual basis regarding further appointments.

Labour Ward is also available 24 hours a day for advice on 01244 365028

NOTE: For all appointments in the community or at the hospital we will be asking women to attend alone. These measures have been put in place to help to protect the safety of mothers and babies by reducing the chance of the spread of COVID-19.

To help reduce the virus from spreading, we have decided to suspend the following group sessions:

• Parent Education Classes • Confident birth Sessions • Early bird Sessions

However, we are currently reviewing how these can be facilitated virtually.

EARLY BIRD INFORMATION

Booking Appointment

Your booking appointment is the first appointment with your midwife and usually takes place between 6-8 weeks of pregnancy.

The appointment may take place at:

Home Children Centre GP Surgery Hospital

How long does the appointment last?The appointment usually takes around one and a half hours

What your midwife may ask:Your midwife will ask some questions to help find out what care you need, such as:

where you live and who you live with the baby's father any other pregnancies or children smoking, alcohol and drug use your physical and mental health, and any issues or treatment you've had any health issues in your family female genital mutilation (FGM) your job, if you have one whether you have people around to help and support you, for example a

partner or family members

The first appointment is your chance to tell your midwife if you need help or feel worried about anything that might affect your pregnancy.

Topics your midwife will discuss with you

Your antenatal plan of care Birth place decisions Screening tests for you and your baby Folic Acid and Vitamin supplementation Diet in Pregnancy and your BMI Healthy lifestyle Choices Antenatal classes Benefit entitlements: free prescriptions/dental care (FW8) Birth choices

Ask questions if you want to know more or don't understand something.

Will I see the same midwife?

The Countess of Chester Maternity Services strive to provide you with a named midwife that can offer you continuity in your antenatal care as early as possible as these factors have been shown to improve outcomes for women and their babies.

You will be given the work mobile number of your named midwife and that of a buddy community midwife - should you need any advice at a time when your named midwife was not available.

You also have access to the community team within working hours and 24 hour access to a midwife on duty on the labour ward.

Although we aim for you to have continuity of midwife throughout your pregnancy, if you have any particular medical or obstetric needs your care will be shared between your community midwife and the hospital obstetric teams so appropriate plans of care can be arranged.

Personal Maternity Record (PMR)

Your personal maternity record will be given to you by your Midwife on completion of the booking appointment. It will contain a record of your personal, health and obstetric history that you shared with the midwife. The information is also stored in the hospital electronic records.

View a Copy of Maternity Notes (PMR) Pages Here

It is important that you bring your maternity notes (PMR) with you to all of your maternity and health related appointments; this includes GP

appointments and any hospital admissions.

Where can I have my Baby?

This table shows the options available to you around your choices for place of birth.

Home Midwifery Led Unit - Blossom Suite

Obstetric unit

Environment √ √ √

One to one care in labour

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refreshments √ √ √

Monitoring for mum

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Monitoring for baby

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Analgesia √ √ √

Emergency management

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Suturing √ √ √

Home birth or midwifery led units are for women who meet low risk criteria. Midwives are the experts delivering care in labour for low risk women and share care with the obstetricians for women where there may be some additional risk factors.

Screening Tests

Screening tests are offered during pregnancy to try to find any health problems that could affect you or your baby. The tests – ultrasound scans, blood tests and a questionnaire – can help you make choices about care or treatment during pregnancy or after your baby is born.

Screening is your choiceWhether or not to have each test is a personal choice and one which only you can make. You can discuss each test you are offered with your midwife and decide, based on your own circumstances, whether or not it is right for you. You can also change your mind at any stage.

Screening test for you

At your Booking appointment your midwife will ask if they can:

Measure your blood pressure Test your urine Measure your height and weight, and work out your body mass index

(BMI) Take some blood tests

Blood Pressure: Your blood pressure will be checked at every antenatal visit. A rise in blood pressure later in pregnancy could be a sign of pre-eclampsia. It's very common for your blood pressure to be lower in the middle of your pregnancy than at other times. This isn't a problem, but it may make you feel lightheaded if you get up quickly. Talk to your midwife if you're concerned about it.

Find out more about high blood pressure and pregnancy.

Urine: You'll be asked to give a urine sample at your antenatal appointments. Your urine is checked for several things, including protein. If this is found in your urine, it may mean you have an infection that needs to be treated; it may also be a sign of pre-eclampsia.

BMI: You'll be weighed at your booking appointment, but you won't be weighed regularly during your pregnancy. Your height and weight are used to calculate your body mass index (BMI). Women who are overweight for their height are at increased risk of problems during pregnancy.

Find out more about being overweight when you get pregnant.

CO monitoring: Carbon monoxide (CO) is a colourless, odourless and tasteless poisonous gas which can kill people. It is present in exhaust fumes, faulty gas appliances, coal, wood, oil burning appliances and cigarette smoke. It is especially dangerous during pregnancy because it deprives the baby of oxygen, slows its growth and development, and increases the risk of miscarriage, stillbirth and sudden infant death. This is why your midwife will offer you the CO screening at your booking appointment and again at around 36 weeks. Women who continue to smoke through their pregnancy will have CO screening at every appointment.

Blood Tests

Ideally you should read the following screening information before you attend your booking appointment: screening tests for you and your baby

During the booking appointment you will be offered blood tests (usually taken from your

arm) for the following:

• Blood Group and Antibodies• Iron count• Sickle Cell and Thalassaemia• HIV• Hepatitis B• Syphilis

Although it is your choice, the tests are strongly recommended to protect your health through early treatment and care. They greatly reduce any chance of passing an infection onto your baby, partner or other family members.

Rh NegativeIf you are found to have rhesus negative blood group, we can offer you a test during pregnancy to see what blood group your baby is.

Being Rh negative tells us if you need to be offered treatment to minimise a rare condition caused if you and your baby have different rhesus factors; in the unlikely event that you and your baby’s blood mix together.

Diabetes ScreeningYou may be offered a blood test (usually at 28 weeks pregnant) to screen for gestational diabetes based on:

BMI (greater than 30) Ethnicity History of a having a previously large previously First degree relative with a history of diabetes (your mum, dad, sibling or

own child) Polycystic Ovary Syndrome and BMI over 25

Screening for your baby

ScansAt the booking appointment your Midwife will ask if you would like ultrasound scans in your pregnancy. If accepted she will request you a dating scan; this is performed at the Countess of Chester hospital usually between 11 and 13 weeks of pregnancy. The date and time of your scan appointment will be posted to your home address.

Purpose of screeningYour Midwife will ask if you have decided to opt for screening test to find out how likely it is that your baby has Down’s syndrome (also known as Trisomy 21 or T21), Edwards’ syndrome (Trisomy 18/T18) or Patau’s syndrome (Trisomy 13/T13. The screening test for these conditions is called the “combined test” or ‘first trimester screening’ and is available between 10 and 14 weeks of pregnancy.

If you choose to have this test, a blood sample is taken from your arm. At the dating scan the fluid at the back of your baby’s neck is measured (known as the nuchal translucency). The information from these 2 tests is combined to work out the chance of your baby having Down’s syndrome, Edwards’ syndrome or Patau’s syndrome.

Results

If your screening test shows a lower-chance result, you should be told within 2 weeks of the test being taken and the results are posted to you at your home address.

If your screening test shows a higher-chance result, you should be told within 5 working days of the blood test result being available. You will be offered an appointment to discuss the test results and the further options you will have.

Screening tests in pregnancy for sickle cell disease and thalassaemia, Down’s syndrome, Edwards’ syndrome, Patau’s syndrome and the following 20-week scan can lead to very personal decisions. It is important to think carefully about whether or not you want to have these screening tests. Your decisions will be respected and health care professionals will support you.

For more information please read:

Public Health England: Screening Tests for you and your BabyNHS Pregnancy Guide: Screening Tests in Pregnancy

Dietary Advice

You don't need to spend lots of money, or go on a special diet – you just need a balance of the right types of food. These include:

Fruit and vegetables: Aim to eat at least 5 portions of fruit and veg a day. Fresh, frozen, canned, dried or juiced can be part of your daily allowance – try to avoid anything with added salt or sugar. Wash all fresh fruit, vegetables and salads to remove all traces of soil and visible dirt.

NHS Health: What Counts as 5 a dayNHS Health: Healthy Start

Starchy foods (carbohydrates): These types of food are an important source of energy, certain vitamins and fibre. They include bread, potatoes, breakfast cereals, rice, pasta and noodles. Opt for wholemeal instead of refined, starchy (white) versions, when possible.

Protein: Foods in this group include meat (avoid liver), fish, poultry, eggs, beans, pulses and nuts. Protein provides the building blocks for your baby to grow.

Aim to have 2 portions of fish each week. Make one of them an oily fish like salmon, sardines or mackerel. There are some types of fish you should avoid (shark, swordfish and marlin) if you're pregnant, or trying to conceive.

Eggs produced under the British Lion Code of Practice (stamped with the red lion) are considered very low risk for salmonella, and safe for pregnant women to eat raw or partially cooked. If you do not know whether the eggs used are Lion Code or not (for example, in a restaurant or cafe), ask the staff or avoid. Non-hen eggs such as duck, goose and quail eggs should always be cooked thoroughly.

You can eat Peanuts or food containing peanuts, such as peanut butter, during pregnancy, unless you're allergic to them or a health professional advises you not to.

Find out more about storing and handling eggs safely.

Dairy products

Dairy includes milk, cheese and yoghurt. These products contain calcium and other essential nutrients. When possible, choose low-fat varieties, such as semi-skimmed, 1% fat or skimmed milk, low-fat yoghurt and reduced-fat hard cheese. If you prefer dairy alternatives, such as soya drinks and yoghurts, opt for unsweetened, calcium-fortified versions.

There are certain foods that you shouldn't eat while you're pregnant as they can put your baby's health at risk.

Milk and yoghurtDo not drink unpasteurised goats' or sheep's' milk, or eat foods made from them, such as soft goats' cheese.

All types of yoghurt, including bio, live and low fat, are fine. Just check that any homemade yoghurt is made with pasteurised milk; if not, avoid it.

Soft ice creams should be fine to eat, as they are processed products made with pasteurised milk and eggs, so any risk of salmonella food poisoning has been eliminated.

Cheese Soft cheeses with white rinds: Do not eat mould-ripened soft cheese (cheeses with a white rind) such as brie and Camembert. This includes mould-ripened soft goats' cheese, such as chèvre. These cheeses are only safe to eat in pregnancy if they've been cooked thoroughly, until steaming hot all the way through.

Soft blue cheeses: You should also avoid soft blue-veined cheeses such as Danish blue, Gorgonzola and Roquefort. Soft blue cheeses are only safe to eat in pregnancy if they've been cooked thoroughly, until steaming hot all the way through.

Hard cheeses: You can eat hard cheeses, such as cheddar, parmesan and Stilton, even if they're made with unpasteurised milk.Soft cheeses: Other than mould-ripened soft cheeses, all other soft types of cheese are OK to eat, provided they're made from pasteurised milk. These include:

cottage cheese mozzarella feta cream cheese paneer

ricotta halloumi some types of goats' cheese processed cheeses, such as

cheese spreads

Cooked soft cheeses that are safe to eat in pregnancy: Thorough cooking should kill any bacteria in cheese, so it should be safe to eat cooked mould-ripened soft cheese, such as brie, Camembert and chèvre, and cooked soft blue cheese, such as Roquefort or Gorgonzola, or dishes that contain them.

It's important to make sure the cheese is thoroughly cooked until it's steaming hot all the way through.

For further information: Are hard cheeses safe to eat in pregnancy? Are cooked brie and blue cheeses safe to eat in pregnancy? Is it safe to eat goats' cheese in pregnancy?

Caffeine

If you're pregnant, it is advisable to limit the amount of caffeine you have to 200 milligrams (mg) a day. This is about the same as 2 mugs of instant coffee. High levels of caffeine in pregnancy can increase the risk of having a low birthweight baby or cause a miscarriage.

Caffeine is found naturally in:

tea coffee chocolate

It's also added to:

energy drinks cold and flu remedies some soft drinks, such as cola

Reducing your caffeine intake: Try drinking water, fruit juice, or decaffeinated tea or coffee. If you occasionally exceed the recommended caffeine limit, don't worry the risks are quite small.

NHS Pregnancy Guide: Caffeine during Pregnancy

Meats Do not eat raw or undercooked meat, including meat joints and steaks cooked rare, because of the potential risk of toxoplasmosis

Cook all meat and poultry thoroughly so it's steaming hot and there's no trace of pink or blood – especially with poultry, pork, sausages and minced meat, including burgers.

Wash all surfaces and utensils thoroughly after preparing raw meat to avoid the spread of harmful bacteria. Wash and dry your hands after touching or handling raw meat.

Cold cured meats: Many cold meats, such as salami, prosciutto, chorizo and pepperoni, are not cooked; they're just cured and fermented. This means there's a risk of toxoplasmosis. It's best to check the instructions on the packet to see whether the product is ready to eat or needs cooking first.

Pre-packed meat: Pre-packed meats such as ham and corned beef are safe to eat in pregnancy. Some websites based in other countries may suggest that you avoid pre-packed meats when pregnant, but this is not the advice in the UK.

Liver: Do not eat liver or products containing liver, such as liver pâté, liver sausage or haggis, as they may contain a lot of vitamin A. Too much vitamin A can harm your baby.

Pâté: Avoid all types of pâté in pregnancy, including vegetable pâtés, as they can contain listeria. They may also contain a lot of vitamin A; too much vitamin A can harm your baby.

Fish

Fish and shellfish: You can eat most types of fish when you're pregnant. Eating fish is good for your

health and the development of your baby, but you should avoid some types of fish and limit the amount

you eat of some others.

Fish to avoid: When you're pregnant or planning to get pregnant, you should not eat shark, swordfish or marlin.

Vitamin and fish oil supplements: Do not take high-dose multivitamin supplements, fish liver oil supplements, or any supplements containing vitamin A.

Fish to restrict: You should also limit the amount of tuna you eat to:

no more than 2 tuna steaks a week (about 140g cooked, or 170g raw each), or

4 medium-size cans of tuna a week (about 140g when drained)

This is because tuna contains more mercury than other types of fish. The amount of mercury we get from food is not harmful for most people, but could affect your baby's developing nervous system if you take in high levels of mercury when you're pregnant.

You should also avoid having more than 2 portions of oily fish a week, such as salmon, trout, mackerel and herring, as it can contain pollutants such as dioxins and polychlorinated biphenyls (PCBs).

Remember, tuna does not count as oily fish, so you can eat tuna (2 tuna steaks or 4 medium-size cans) on top of the maximum amount of 2 portions of oily fish.

Shellfish: Always choose cooked, rather than raw, shellfish – including mussels, lobster, crab, prawns, scallops and clams, as raw shellfish can contain harmful bacteria and viruses that can cause food poisoning. Cold pre-cooked prawns are fine.

Smoked fish: Smoked fish, which includes smoked salmon and smoked trout, is considered safe to eat in pregnancy.

Sushi: It is fine to eat raw or lightly cooked fish in dishes such as sushi when you're pregnant, as long as any raw wild fish used to make it has been frozen first. Freezing/cooking makes raw fish safe to eat.

Lots of the sushi sold in shops is not made at the shop. This type of sushi should be fine to eat. If a shop or restaurant buys ready-made sushi, the raw fish used to make it will have gone through an appropriate freezing treatment. If you're concerned, ask the staff.

For further reading please refer to:NHS Health: Foods to avoid in pregnancyNHS Start4Life: Healthy Eating in PregnancyNHS Health: Having a Healthy Diet in PregnancyNHS Health: The Eat Well GuideNHS Health: Eating Shellfish in PregnancyNHS Health: Is it safe to eat Sushi in Pregnancy

Folic Acid and Vitamin supplementation

Eating a healthy, varied diet in pregnancy will help you get most of the vitamins and minerals you need. But when you're pregnant, or there's a chance you might get pregnant, you should take a folic acid supplement.

Folic AcidFolic acid is very important for the development of a healthy fetus. It can significantly reduce the chance of neural tube defects (NTDs), such as spina bifida.

How much you should takeIt's recommended that all women who could get pregnant should take a daily supplement of 400 micrograms of folic acid before they're pregnant and during the first 12 weeks of pregnancy, when the baby's spine is developing.

If you did not take folic acid supplements before getting pregnant, you should start taking them as soon as you find out you're pregnant.

You can get them from pharmacies, large supermarkets, health food stores, or on prescription from a GP.

When higher doses of folic acid are neededSome women will be advised to take a higher dose of 5mg of folic acid each day until they're 14 weeks pregnant. Talk to your GP for prescription for the higher dose folic acid if any if the following apply to you:

If you or the baby's biological father have a neural tube defect or family history of neural tube defect

If you previously had a pregnancy affected by a neural tube defect you have diabetes if you're taking anti-epilepsy medicine if you have a BMI 30 or more

For further information please refer to: NHS Pregnancy Guide: Why I need Folic Acid in PregnancyNHS Pregnancy Guide: Vitamins and Supplements in Pregnancy

Healthy Lifestyle Choices

Smoking in pregnancyProtecting your baby from tobacco smoke is one of the best things you can do to give your child a healthy start in life. It can be difficult to stop smoking, but it's never too late to quit. There is specialist midwifery support available to help you quit at the Countess of Chester Hospital

Every cigarette you smoke contains over 4,000 chemicals, so smoking when you are pregnant harms your unborn baby. Cigarettes can restrict the essential oxygen supply to your baby. As a result, their heart must beat harder every time you smoke.

Benefits of stopping smoking in pregnancy: Stopping smoking will help both you and your baby immediately. Harmful gases, such as carbon monoxide, and other damaging chemicals will clear from your body. When you stop smoking:

you reduce the risk of complications in pregnancy and birth you are more likely to have a healthier pregnancy and a healthier baby you will reduce the risk of stillbirth your baby is less likely to be born premature your baby is less likely to be born with a low birth weight you will reduce the risk of sudden infant death syndrome (SIDS) (also

known as "cot death")

Stopping smoking now will also help your baby later in life. Children whose parents smoke are more likely to suffer from asthma and other serious illnesses that may need hospital treatment.

The sooner you stop smoking, the better. But even if you stop in the last few weeks of your pregnancy this will benefit you and your baby.

Secondhand (passive) smoke: If your partner or anyone else who lives with you smokes, their smoke can affect you and your baby before and after their birth. You may also find it more difficult to stop if someone around you smokes. Secondhand smoke can also reduce your baby's birthweight and increase the risk of sudden infant death syndrome (SIDS). Babies whose parents smoke are more likely to be admitted to hospital for bronchitis and pneumonia during their first year.

Further Reading:NHS Health: Stop Smoking in PregnancyNHS quit smoking resource: SmokefreeRoyal College of Obs & Gynae: Smoking and Pregnancy

Alcohol

The Chief Medical Officers for the UK recommend that if you're pregnant or planning to become pregnant, the safest approach is not to drink alcohol at all to keep risks to your baby to a minimum.

Drinking in pregnancy can lead to long-term harm to the baby, with the more you drink, the greater the risk.

Drinking alcohol, especially in the first 3 months of pregnancy:

Increases the risk of miscarriage Increases the risk of premature birth Increase your risk baby having a low

birth weight.

Drinking after the first 3 months of your pregnancy could affect your baby after they're born. The risks are greater the more you drink. The effects include learning difficulties and behavioural problems.

Drinking heavily throughout pregnancy can cause your baby to develop a serious condition called fetal alcohol syndrome (FAS).

Symptoms include: poor growth distinct facial features learning and behavioural problems

Drinking less heavily, and even drinking heavily on single occasions, may be associated with lesser forms of FAS. The risk is likely to be greater the more you drink

NHS Health: Drinking Alcohol in Pregnancy

Exercise and keeping healthy

Keeping active and doing exercise while you're pregnant is great for you and your baby. You can keep up your normal level of daily activity and exercise regime, as long as it still feels comfortable.

Here are some tips for exercising while pregnant:

You should be able to hold a conversation while you exercise.

Always warm up and cool down to keep you from pulling any muscles.

Stay hydrated - drink lots of water.

If you want to do an exercise class, make sure the teacher is properly qualified and let them know you're pregnant.

Swimming is a great exercise in pregnancy, as the water supports your body weight. Ask if your local pool offers aquanatal classes.

Other good activities to try while pregnant include walking, running, yoga, pilates, aerobics and pelvic floor exercises.

Some exercises, like running and weight training, will need to be modified as your belly grows.

The best combination of exercise is aerobic and muscle-strengthening; this helps you breathe properly and allows you to better deal with the increased weight you'll be carrying around.

If you're not already active, try building it into your daily life by taking the stairs, doing housework or gardening.

Further reading:NHS Health: Fit4LifeNHS Health: Exercise in Pregnancy

Vaccines recommended in pregnancy

FluDuring pregnancy, your immune system (the body's natural defense) 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.

Find out more about the flu jab in pregnancy

Whooping coughWhooping 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.

Find out more about the whooping cough vaccination in pregnancy

InfectionsFor infections in pregnancy (including Group B Strep, Cytomegalovirus and Toxoplasmosis) please refer to: Pregnancy Infections

Further reading:NHS Health: Vaccines in Pregnancy

Car Travel in Pregnancy

It's best to avoid long car journeys if you're pregnant. However, if it can't be avoided, make sure you stop regularly and get out of the car to stretch and move around.

You can also do some exercises in the car (when you're not driving), such as flexing and rotating your feet and wiggling your toes – this helps keep the blood flowing through your legs and reduce any stiffness and discomfort. Wearing compression stockings while on long car journeys (more than 4 hours) can also increase the blood flow in your legs and help prevent blood clots.

Fatigue and dizziness are common during pregnancy so it's important on car journeys to drink regularly and eat natural, energy-giving foods, such as fruit and nuts.

Road accidents are among the most common causes of injury in pregnant women. If you have to make a long trip it is advisable not to travel on your own. If you do have a car accident, you should always get checked out – no matter how ok you feel.

How to wear your seat belt while pregnant:

Always wear a three-point seat belt Make sure the shoulder belt goes over the shoulder, collarbone and down

across the chest, between the breasts Make sure the lap belt is worn as low as possible under the abdomen and the

baby Adjust the seat belt to fit as comfortably as possible, and adjust the seat too if

necessary

Wearing a seat belt while pregnant is compulsory unless your doctor says you don’t have to for medical reasons.

If that’s the case, you’ll be given a Certificate of Exemption from Compulsory Seat Beat Wearing that you’ll need to keep in your car (Gov.UK, 2018).

For further information see NHS Health: Travel in Pregnancy

Benefits and Entitlements

The Maternity Exemption Certificate (or FW8)

Entitles you to free prescriptions for yourself until your baby is 12months of age.

Can be used to prove your entitlement to free NHS dental treatment

How to apply for an FW8Speak to your midwife, doctor or health visitor; they can complete the online application for you. You can apply as soon as they confirm that you’re pregnant.

Maternity Certificate (or Mat B1)

A Mat B1 form is a form from the government providing medical evidence of your pregnancy and the baby's due date. It is filled in by your midwife or doctor and issued to you (free of charge) on or soon after 20 weeks of pregnancy; it cannot be issued before 20 week.

The Mat B1 enables a pregnant woman to claim:

Statutory Maternity Pay (SMP) from your employer

Maternity Allowance (MA) from Job Centre Plus

The certificate: verifies the pregnancy confirms the date of the expected week of confinement confirms the actual date of birth when completed after confinement

Health Start Vouchers

If you’re pregnant or have a child under 4, the Healthy Start Scheme can help you buy basic foods like milk or fruit. If you qualify for the scheme you’ll be sent vouchers you can use in over 30,000 shops in the UK.

You can also get coupons to swap for:

pregnancy vitamins breastfeeding vitamins vitamins for children aged 6 months to 5 years old

Sure Start Maternity Grant

You may be entitled to get a one-off payment of £500 to help towards the costs of having a child. You usually qualify for the grant if both of the following apply:

you’re expecting your first child, or you’re expecting a multiple birth (such as twins) and have children already

you or your partner already get certain benefits

You must claim the grant within 11 weeks of the baby’s due date or within 6 months after the baby’s birth. You do not have to pay the grant back and it will not affect your other benefits or tax credits.

Who may provide care for you in your pregnancy?

• MidwifeMidwives are the experts in normal pregnancy, labour and postnatal care. As a midwife, we will be your main carer and will refer you to the Drs if we think this is appropriate. We refer to evidence based policies to guide our practice.

• Obstetrician (if appropriate)Obstetricians are Drs who have specialised in care for women in pregnancy, childbirth and afterwards where there are risk factors or complications. Midwives and Drs work together as part of a team.

• Midwifery support worker (MSW)Midwifery support workers and maternity assistants are part of our team but are not registered practitioners. They are highly trained for their roles.

• SonographerIf you decide to have scans during your pregnancy, the Sonographers are the part of the team who perform the scans

• Infant feeding teamInfant feeding team- are there along with the midwives and support staff to help you. It is entirely up to you how you feed your baby, and we are here to provide all the evidence about your options to ensure you and your baby are successful and well.

• National child birth trustNational child birth trust provides our pre-birthing education.Attending these classes offer information about what to expect in pregnancy, birth and the time after birth; they are also a way to meet other families going through the same as you.

FAQ

NHS Health A-Z: Common Health Questions in PregnancySafer Pregnancy: Straight-talking advice for pregnant women