Pregnancy and birth

Before pregnancy

If you are planning a pregnancy, it helps to come in once before you start, especially if you have a condition such as diabetes or epilepsy, or take regular medicine. Do not stop a prescribed medicine yourself. Talk to your doctor first.

A few things help at this stage:

• Taking folic acid and vitamin D, in the amount your doctor advises
• Checking your rubella vaccination and whether your cervical screening is due
• Stopping smoking, alcohol and drugs
• Reaching a healthy weight, because being very under- or overweight can make pregnancy harder

Visits and tests

As soon as you know you are pregnant, arrange your care. At the first visit you are asked about past pregnancies, health conditions and the date of your last period, and your blood pressure and urine are checked. These are checked again at later visits, because early pre-eclampsia usually has no symptoms you would notice.

The number of visits depends on your situation. In a common schedule there are two main scans:

• Weeks 11 to 14: the age of the pregnancy, the due date and the number of babies, and screening for Down’s syndrome if you choose it
• Weeks 18 to 21: a closer look at how the baby’s body is formed

Screening estimates the chance of a problem. It is not a diagnosis. Having it is your choice, and you should know beforehand what a result would mean.

You may also be tested for gestational diabetes. It usually has no symptoms, and early detection and good control reduce the risks.

Your baby’s movements

Most women first feel movements between weeks 16 and 24, usually later in a first pregnancy. There is no set number of movements and you do not need to count kicks. Get to know your baby’s usual pattern. If movements slow down, stop or change, do not wait until tomorrow.

Birth

Regular contractions, your waters breaking and a sticky pink discharge are signs that labour is starting. Early labour can last hours or sometimes days. You and your doctor decide on the way of giving birth according to your situation and your baby’s, and each way has its own benefits and risks.

Higher-risk pregnancy

Some conditions or events in earlier pregnancies mean more frequent visits, such as high blood pressure, diabetes or a past premature birth. If you have such a history, mention it at the very first visit.

When should I call at once?

Bleeding, severe tummy pain, a baby moving less, a severe headache with blurred vision, or sudden swelling of the face and hands should not wait for an appointment. The full list is under urgent signs.