This antenatal guide is aimed at providing you with information regarding local services for antenatal and postnatal care. Antenatal care is provided by all doctors at this practice in conjunction with local hospitals.
When you suspect you are pregnant please make an appointment with your doctor. The first appointment will be to discuss the arrangements for your care, including choice of hospital and general health issues designed to promote a healthy pregnancy.
If you wish to have your “first choice” it is necessary to book early, so please do not delay your first appointment with the doctor. The four hospitals are Kingston, Chelsea and Westminster, Queen Charlottes Unit at Hammersmith, and West Middlesex. They are all large maternity units within general hospitals and all offer a similar standard of care. Queen Charlotte’s has an intensive care unit for babies and receives referrals from other hospitals when indicated. Information about facilities e.g. birth pools, can be found on the hospital websites.
Following delivery, it is normal for the community midwife to attend to you for the 7-10 days and then the Health Visitor will take over with full GP cover throughout.
Supplementation with folic acid is one of the most significant interventions available. 400 mcg/day for all women has been shown to reduce the incidence of neural tube defects (NTD), such as spina bifida, by 72%.
Early pregnancy testing
The first appointment will initially be for a scan at 11-13 weeks.
Most hospitals now offer screening for chromosome problems (e.g. Down’s syndrome) in early pregnancy. This may be as part of an ultrasound scan at about 11 & 13 weeks and a blood test. The scan is offered routinely to all patients at Kingston, West Middlesex, Chelsea and Westminster and Queen Charlotte’s.
Booking appointment with the midwife at 14-16 weeks.
Second (detailed) scan at 20-22 weeks.
Whooping Cough Vaccine
The best time to get vaccinated to protect your baby is ideally at 20 weeks, after the foetal scan, up to 32 weeks of pregnancy. This maximises the chance that your baby will be protected from birth, through the transfer of your antibodies before he or she is born. If any reason you miss having the vaccine, you can still have it up until you go into labour. However, this is not ideal, as your baby is less likely to get protection from you. At this stage of pregnancy, having the vaccination may not directly protect your baby, but would help protect you from whooping cough and from passing it on to your baby.
If you are considering a home birth or Domino delivery (in which your care is home based but the midwife goes with you to hospital for delivery and then accompanies you home) this may be arranged with the Community Midwives at Kingston Hospital. Please phone 8546 7711 ex 3863 and a midwife will arrange to discuss this with you. We are not directly involved with home deliveries but are happy to assist with antenatal and postnatal care.
MAT B1 Form
Although your midwife should automatically give you a MAT B1 form at the antenatal appointment after your 20 week scan, you may need to request it. It is available from either your midwife of your GP.
You will need to sign it then at some stage before you are 25 weeks pregnant, you will need to give it to your employer.
Free Prescriptions and Dental Care
All prescriptions and NHS dental treatment are free while you are pregnant and for 12 months after your baby's due date. Children also get free prescriptions until they are 16. To claim free prescriptions, ask your doctor or midwife for form FW8 and send it to your health authority.
You will be sent a maternity exemption certificate (MATEX) that lasts for 12 months after your due date. You must have a valid exemption certificate to claim free prescriptions and dental care.
Most of the links in this list take you to the GOV.UK website, where you'll find the most up-to-date information about rights and benefits, including those for pregnant women and parents.
Most airlines ask for a medical confirmation of fitness to fly once a pregnancy has reached 28 weeks. They ask for this to be completed by either a doctor or a midwife.
If you require a fit to fly letter from us, you need to see your GP one week before you plan to fly.
In healthy women on a normal diet, advice on eating 5 portions of fruit and vegetables per day and drinking plenty of milk to raise stores of vitamins, iron and calcium is reasonable. Because of the dangers of toxoplasmosis and listeriosis, women should avoid:
Uncooked meat, fish and eggs
Milk that has not been pasteurised
All unwashed fruit and vegetables (they should be washed)
Vegetarians, and especially vegans, are at risk of various nutritional deficiencies and may need to be referred to a dietitian. Asian women are at special risk of vitamin D deficiency and may benefit from a supplement. Women should be cautioned to avoid many herbal preparations and teas; their use and safety in pregnancy has not been studied.
Women who exercise regularly should be advised to continue to do so. Those who are inactive should start a gentle program of regular exercise. Moderate exercise has not been shown to cause any harm, but patient should be warned of the dangers of highly energetic and contact sports that would risk damage to the abdomen, falls or excessive joint stress. Strenuous exercise in the first 3 months of pregnancy is inadvisable, because of the possible risks to the fetus of overheating. Similarly, saunas and hot tubs should be avoided. Scuba diving should be avoided as it can cause fetal birth defects and fetal decompression disease.
For more information please click on the link
There is no clear safe level of consumption. The safest approach may be to avoid any alcohol intake during pregnancy, although there is no evidence that one or two drinks, once or twice a week is likely to harm the fetus.
Smoking in pregnancy is associated with a large number of adverse effects in pregnancy including7:
If you need help or advice about smoking cessation, please ask to see one of our nursing team as soon as possible.
Advise on maternity rights and benefits and reassure patient on how safe it is to continue working in pregnancy. Check occupation for exposure to harmful agents.
If you're pregnant, your employer must protect your health and safety, and you may have the right to paid time off for antenatal care. You are also protected against unfair treatment.
If you enjoy your work and like the people you work with, you may have mixed feelings when you go on maternity leave. Try to make the most of these few weeks before your baby is born. It's also a good opportunity to make some new friends. You may meet other pregnant women you want to keep in touch with at antenatal classes, or you may get to know more people living close by.
Find out about your employee rights when you're on maternity, adoption or parental leave please click on the link
If you are a father-to-be or a pregnant woman's partner – including same-sex partner – you could have the right to paternity leave. You may have the right to up to 26 weeks' Additional Paternity Leave. Find out more about paternity leave please click on the link