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First steps in pregnancy

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If you are pregnant, you may wonder what's ahead. There will be appointments and your antenatal care to consider, as well as how you might feel. You may also be curious about ways that you can take care of your health, and your baby.

If you have any questions, please speak to a doctor or midwife caring for you.

Coronavirus: maternity services update

Due to the ongoing coronavirus (COVID-19) pandemic we understand that you might be worried about the situation and the impact it will have on your pregnancy and care. We have created a list of frequently asked questions to reassure you in this difficult time. You should also read about the changes we have made to our community midwifery services and specific advice about feeding your baby.


 

On this page

Arranging and understanding your care

Your emotional and physical wellbeing

Taking vitamins, minerals and supplements

Food and drink in pregnancy

Exercise and staying active

Lifestyle changes

Useful resources

Organisations offering support and advice

 

Arranging and understanding your care

Choosing Guy's and St Thomas' for your antenatal care

For the best care for you and your baby, we encourage you to self-refer as soon as possible so that you can see a midwife and have your early screening tests.

You can have your antenatal care (this is the care during your pregnancy), your delivery, or both, with us. If you would like us to care for you when you are having your baby, you can complete our online referral form.

Please contact the antenatal booking team on 020 7188 8002 for more information, or if you need help with completing the form.

If you are unsure if you want to continue with your pregnancy, you should talk to your GP or contact your local Sexual and Reproductive Health Clinic.

We've also listed some helplines of organisations that can support you with a range of issues. The staff you talk to will respect your decision, whatever it might be.

Your first midwife appointment

Your first appointment will be with your midwife. This is called the booking appointment and ideally this should take place before 12 weeks, either at your local hospital or at a local health clinic.

At this appointment the midwife will ask you about your medical history, previous pregnancies, take blood samples, give you advice for the pregnancy and plan your care throughout the pregnancy.

You should also be given information about taking folic acid and vitamin D supplements, food hygiene and aspects of your life that may affect your or your baby’s health (such as smoking, recreational drug use and alcohol). This is a good time to discuss any concerns or worries you may have. The appointment will probably last about 1 hour. 

More information about your first midwife appointment.

Your 12-week scan

You will be offered an ultrasound scan around 11 to 14 weeks. This is called a nuchal scan (often referred to as the 12-week scan) and will estimate when your baby is due and check the physical development of your baby.

You may want to tell your family and friends immediately that you’re pregnant, or wait a while until you have sorted out how you feel. It's common to wait until the 12-week scan before telling people. This is due to the higher chance of miscarriage in the first 12 weeks of pregnancy.

At this scan you will also be offered screening for Down’s syndrome. The test combines information from the scan of the baby and a blood test from the mother. It's important to know that it's your choice whether to have this screening or not. Your midwife or GP will discuss the test with you to help you decide if you want to have it.

Prescriptions and NHS dental treatment

Prescriptions and NHS dental treatment are free while you are pregnant and for 12 months after you have given birth. To claim free prescriptions, ask your doctor or midwife for form FW8 and send it to your health authority. 

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Your emotional and physical wellbeing

Pregnancy (and all the changes that come with it) can differ hugely from person to person. It's likely that you'll feel differently at different stages in your pregnancy. However you feel, it's that you feel able to get support and advice, should you need it. 

  • Physical changes

     

    Feeling tired: It is common to feel very tired, or even exhausted, during pregnancy, especially during the first 12 weeks or so. 

    Nausea and vomiting: You may feel and/or be sick. If you are being sick all the time and can’t keep anything down, contact your GP or the Early Pregnancy and Acute Gynaecology Uni (EPAGU)

    Changes in your breasts: Your breasts may become larger and feel tender, just as they might do before your period. The veins may be more visible, and the nipples may darken and stand out.

    Peeing more often: You may feel the need to pass urine more often than usual, including during the night.

    Increased vaginal discharge: Please see your GP if you have any vaginal soreness or irritation, or if the discharge has an offensive or bad smell, as you may have a vaginal infection or thrush. 

    Constipation: This is common during pregnancy. Try eating more high fibre foods such as fruit, vegetables and whole-grain cereals and breads. You should drink enough water - about 1.2 litres of clear fluids of water or well-diluted squash every day (about 6 to 8 glasses). If this does not help, see your GP for further advice. 

    Tastes and smells: You may have a more sensitive sense of smell than usual. It's also normal to stop enjoying certain foods or drinks. You may also start to crave different foods due to the hormonal changes. 

    If you are worried because you are having stomach pains or bleeding you can talk to your GP or contact our EPAGU.

    More about early signs and symptoms of pregnancy on the NHS website.

  • Emotional changes

     

    Hormonal changes, and big changes to your life, may cause you to feel a range of strong emotions - both good, bad, and somewhere in between. This is completely normal when you are pregnant. However, it's also important to recognise when you might need more support. 

    The NCT website has more about managing emotions during pregnancy.

Mental health during pregnancy

Your antenatal team should ask you about your mental health. This will give you the opportunity to talk about any concerns, and to get help if necessary. This is important if you feel more vulnerable and anxious while you are pregnant.

When you have your first appointment you should be asked if you have ever had problems with your mental health in the past. You should also be asked about this again following the birth of your baby. This is to allow your care team to understand your needs and plan appropriate care for you.

Talk to your GP, midwife or health visitor if you have any concerns about your mental health during or after your pregnancy.

More about mental health and pregnancy on the NHS website. 

If you are at risk of abuse or violence

It is estimated that 1 in 4 women experience domestic abuse or domestic violence at some point in their lives. This may be physical, sexual, emotional or psychological abuse. Almost a third of this abuse starts in pregnancy, and existing abuse may get worse during pregnancy or after giving birth.

Domestic abuse during pregnancy puts you and your unborn child in danger. If you are being hurt or threatened, or are feeling unsafe or afraid of your partner (ex-partner or anyone else) you can talk in confidence to your GP, midwife, doctor, health visitor or social worker.

Alternatively, you can contact Mozaic or the National Domestic Violence Helpline. If you are in immediate danger, call 999.

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Taking vitamins, minerals and supplements

Eating a healthy and varied diet will help you get most of the things you need. However, there are some supplements you should take in addition. 

Taking folic acid

Folic acid is very important to take as it can help prevent neural tube defects, such as spina bifida. You should take 400 micrograms of folic acid every day while you are trying to get pregnant and until you are 12 weeks pregnant. 

If you didn’t take folic acid before you became pregnant, you should start as soon as you find out that you are pregnant. 

Some couples are at higher risk of having a child with a neural tube defect (NTD). This includes those who have an NTD themselves, those with a family history of NTDs, and those taking certain epilepsy medicines. If your doctor thinks you are at high-risk then they will prescribe you a high dose of folic acid (5 milligrams daily).

More about folic acid and pregnancy on the NHS website.

Taking vitamin D

It's also advised that you take vitamin D as a supplement. You need vitamin D to keep your bones healthy and to provide your baby with enough vitamin D for the first few months of its life. You should take 10 micrograms of vitamin D each day.

You can get folic acid and vitamin D supplements from your local pharmacy and supermarket. Your GP may also be able to prescribe them for you. 

You may be able to get free vitamins through the Healthy Start scheme.

Supplements containing vitamin A

Do not take vitamin A supplements, or any supplements containing vitamin A, as too much could harm your baby. If you are unsure about any medication you are taking, please speak to your midwife, doctor or GP immediately.

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Food and drink in pregnancy

Eating healthily during your pregnancy will help your baby to develop and grow, and will keep you fit and well.

Eating well and healthily

It’s important to eat a range of different foods every day to get the right balance of nutrients that you and your baby need. This means plenty of fresh fruit and vegetables, carbohydrates, some protein and dairy, and cutting down on foods high in saturated fat and sugar. 

The NHS website has guidance about a healthy diet in pregnancy. 

Food and drink to avoid

Some foods you should avoid or be careful with. This is because some foods contain bacteria or toxins that can make you unwell, or can be harmful to your baby. 

This includes avoiding foods such as mould-ripened cheese (camembert, blue cheese and brie), uncooked meat and shellfish, and certain types of fish (swordfish). There are others that should be limited, such as tuna and caffeine. 

The NHS website has a comprehensive list of food to avoid.

You should also be mindful of toxoplasmosis, a common infection that you are more vulnerable to while pregnant. You can pick it up from undercooked meat, contaminated soil or water, or from the poo of cats. 

More about toxoplasmosis on the NHS website.

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Exercise and staying active

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.

Keep up your normal daily physical activity or exercise for as long as you feel comfortable.

Some vigorous or very demanding sports, such as contact sports or racquet games, carry extra risks such as falling or putting too much strain on your joints. You should avoid scuba diving while you are pregnant because this can cause problems in the developing baby. Your midwife will be able to advise you further about exercise.

  • Gaining weight and support

     

    You are likely to gain between 8kg to 14kg (17.5lb to 30lb) while you are pregnant, putting most of the weight on after week 20. However, this will vary. You can talk to your GP or midwife for more advice. 

    More about putting on weight during pregnancy on the NHS website

    Although putting on weight is a normal part of being pregnant, these changes in your body might trigger difficult feelings around eating, particularly if you have had or are living with an eating disorder.

    If this is the case, the idea of gaining weight might be very difficult to accept. It's important that you tell your midwife and GP so that they can offer you extra support. You could also contact organisations like Beat and Mind as they may able to help you with this. 

 

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Lifestyle changes

Making changes to your habits and daily life might feel fine when you are pregnant, or it may feel frustrating.

If you want to make changes but are struggling to adapt, it's important to know that there are always places to turn to for support. Your GP and midwife are there to help you, and we've also listed some organisations you might find helpful

Medication

Some medicines are safe to take during pregnancy, but others may harm your baby. If you take any regular medication, talk to your doctor as soon as you know you are pregnant. Ideally you should ask them for advice before trying for a baby.

  • Always check with your doctor, pharmacist or midwife before taking any medicine during pregnancy.
  • Make sure your doctor, dentist, pharmacist, or any other healthcare professional treating you or offering advice on medicines knows that you are pregnant. 
  • Use as few over-the-counter medicines as possible.

Caffeine

High levels of caffeine increases the risk of miscarriage and can lead to a small birth-weight baby. You don’t need to cut caffeine out completely, but you should not have more that 200mg a day.

Be aware that some fizzy drinks (in particular, energy drinks and cola) can be high in caffeine and some medicines also contain caffeine. Please check the ingredients or ask your pharmacist if you are unsure.

More about limiting caffeine during pregnancy on the NHS website.

Smoking

Smoking increases the risk of your baby being underweight or being born too early. You will reduce these risks if you can give up smoking, or at least smoke less, while you are pregnant.

You can get help to stop smoking from your midwife, GP or the NHS Smoking Helpline. You may also be able to get help and support from our Stop smoking service.

Alcohol

If you are pregnant, or planning to become pregnant, you should try to avoid alcohol completely in the first 3 months of pregnancy because there may be an increased risk of miscarriage. If you choose to drink, protect your baby by not drinking more than 1 or 2 units of alcohol once or twice a week. 

More information about alcohol and pregnancy on the NHS website.

Illegal drugs

Using illegal drugs during pregnancy (including cannabis, ecstasy, cocaine and heroin) can have a serious harmful effect on your unborn baby. However, people who regularly use drugs daily should not stop using them abruptly without first seeking medical advice.

Drug withdrawal treatment can benefit you and your unborn baby by helping you to overcome your addiction. You can get help from your midwife, GP, or you can contact FRANK.

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Contact us

If you have any questions or concerns please call our Maternity Helpline on 020 7188 8760 (Monday to Friday, 10am to 6pm).

Out of hours, call the Maternity Assessment Unit 020 7188 1722 or 020 7188 1723.

Help and advice in early pregnancy

The Early Pregnancy and Acute Gynaecology Unit (EPAGU) is available for help and advice if you have a problem in early pregnancy (up to 18 weeks), such as pain, bleeding or severe vomiting.

If you are up to 18 weeks pregnant then you do not need to make an appointment and can just walk in to be seen by a specialist nurse (8th floor, North Wing, St Thomas’ Hospital, Westminster Bridge Road, London SE1 7EH).

For advice, call the EPAGU on 020 7188 0864 and ask to speak to a nurse (Monday to Friday, 8.30am to 6.30pm, or Saturday and Sunday, 9.30am to 3.15pm).

If you need to speak with someone urgently

If you need to speak to someone urgently and you are less than 18 weeks’ pregnant please call the EPAGU on 020 7188 0864.

If you need to speak to someone urgently and you are 18 weeks’ pregnant or more, call the Maternity Assessment Unit on 020 7188 1722 or 020 7188 1723.

In an emergency

In an emergency attend the Emergency Department (A&E) at St Thomas’ Hospital (ground floor, Lambeth wing, open 24 hours a day).

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Useful resources

NHS - Pregnancy and coronavirus

NHS - Quit smoking

NHS - Sex in pregnancy 

NHS - Travelling in pregnancy

NHS - Your pregnancy and baby guide

GOV.UK - Healthy start scheme

GOV.UK - Flu vaccination when pregnant

GOV.UK - Maternity pay and leave 

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Organisations offering support and advice

Alcoholics Anonymous (AA)

Offers support and advice if you need help with a drinking problem, or if your drinking has reached the point where it worries you.

Call 0800 9177 650 or email help@aamail.org

Brook

Brook has a network of centres across the UK offering free and confidential sexual health advice and contraception to young people under the age of 25.

Citizens Advice Bureau (CAB) 

Helps people to resolve their legal, money and other problems by providing free, independent and confidential advice, and by influencing policymakers.

Family Planning Association Helpline

Help, advice and information for all ages on all areas of sexual health, including contraception, sexually transmitted infections, pregnancy choices, abortion and planning a pregnancy.

Call the Sexual Health line free on 0300 123 7123

FRANK

Friendly, confidential drug advice.

Call 0300 123 6600 or text 82111 

Marie Stopes

Offers support and advice for sexual healthcare services, including abortion. 

Call 0345 300 8090

Miscarriage Association

Support and information for anyone affected by miscarriage, ectopic pregnancy or molar pregnancy.

Call 01924 200 799 or email info@miscarriageassociation.org.uk

Mozaic

Free, confidential and independent support, advice and information for women experiencing domestic violence, based at St Thomas’ Hospital.

Call 020 7188 7710 or email mozaicreferrals2@gstt.nhs.uk

National Childbirth Trust (NCT)

Information and support on pregnancy, birth and early parenthood. 

National Domestic Abuse Helpline

For women experiencing domestic abuse and their families, friends, colleagues and others calling on their behalf. 

Call 0808 2000 247 (24-hours)

Royal College of Obstetricians and Gynaecologists

Information and advice about your pregnancy, including leaflets on air travel during pregnancy and alcohol during pregnancy. 

 

 

Resource number: 3751/VER2

Last reviewed: October 2017 | Next review: October 2020

A list of sources is available on request.

 


Where next?

 Contact us

If you have any questions or concerns please call the Maternity Helpline, Monday to Friday, 10am to 6pm.

Phone 020 7188 8760 

Out of hours, please contact the Maternity Assessment Unit.

Phone 020 7188 1722

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