Booking your first appointment

Congratulations on your pregnancy

The first step is to book an appointment with the Midwife at your GP surgery, ideally this appointment should be when you are between 6 to 10 weeks pregnant, and this will ensure screening tests and your first scan can be arranged in a timely manner. If you cannot get an appointment before you are 10 weeks pregnant ask to speak to the Midwife or contact the Community Midwives Office:

Coventry Community Midwives: 02476 967424
Rugby Community Midwives: 01788 663184

Pregnancies are dated in weeks starting from the first day of a woman’s Last Menstrual Period (LMP), not from the conception date.

This appointment will take approximately one hour, your partner or a friend are welcome. During this appointment the midwife will take a detailed family and medical history, as well as details of previous births if any, discuss your screening options with regards to your scans and routine bloods.

During your pregnancy, you'll be offered a range of tests, including blood tests and ultrasound baby scans.

These are designed to:

  • Help make your pregnancy safer
  • Check and assess the development and wellbeing of you and your baby
  • Screen for particular conditions

You don't have to have any of the tests – it's your choice. However, it's important to understand the purpose of all tests so you can make an informed decision about whether to have them. You can discuss these with the midwife at your first appointment.

 

It would be useful to read the booklet ‘Screening Tests for You and Your Baby’ which will give you more information prior to your appointment. This is available online in multiple languages:

https://www.gov.uk/government/publications/screening-tests-for-you-and-your-baby-description-in-brief

 

 

Health and Wellbeing

A healthy diet is an important part of a healthy lifestyle at any time, but is especially vital if you're pregnant or planning a pregnancy. Eating healthily during pregnancy will help your baby to develop and grow.

You don't need to go on a special diet, but it's important to eat a variety of different foods every day to get the right balance of nutrients that you and your baby need.

It's best to get vitamins and minerals from the foods you eat, but when you're pregnant you need to take a folic acid supplement as well, to make sure you get everything you need.

Read our "Eat Well in Pregnancy" leaflet.

Read the RCOG leaflet "Healthy eating and vitamin supplements during pregnancy.

No need to "eat for two"

You will probably find that you are hungrier than usual, but you don't need to "eat for two" – even if you are expecting twins or triplets.

Try to have a healthy breakfast every day, because this can help you to avoid snacking on foods that are high in fat and sugar.

Eating healthily often means just changing the amounts of different foods you eat so that your diet is varied, rather than cutting out all your favourites. You don't need to achieve this balance with every meal, but try to get the balance right over a week.

Folic acid before and during pregnancy

You should take a 400 micrograms folic acid tablet every day while you are trying to get pregnant and until you are 13th week of pregnancy.

Folic acid is important for pregnancy, as it can help to prevent birth defects known as neural tube defects, including spina bifida. If you didn't take folic acid before you conceived, you should start as soon as you find out that you are pregnant.

You should also eat foods that contain folate (the natural form of folic acid), such as green leafy vegetables. Some breakfast cereals and some fat spreads such as margarine may have folic acid added to them.

It's difficult to get the amount of folate recommended for pregnancy from food alone, which is why it is important to take a folic acid supplement.

Higher dose folic acid

Some women have an increased risk of having a pregnancy affected by a neural tube defect, and are advised to take a higher dose of 5 milligrams (mg) of folic acid each day until they are 12 weeks pregnant. Women have an increased risk if:

  • they or their partner have a neural tube defect
  • they have had a previous pregnancy affected by a neural tube defect
  • they or their partner have a family history of neural tube defects
  • they have diabetes
  • If your BMI is 30 or above

This is a higher dose than the usual pregnancy dose, so you’ll need a prescription from your doctor. Ideally, this should be taken a month before you get pregnant and until you reach your 12th week of pregnancy. If you didn’t take it before you got pregnant don’t worry, just start taking it now until you are 12 weeks.

In addition, women who are taking anti-epileptic medication should consult their GP for advice, as they may also need to take a higher dose of folic acid.

Vomiting and morning sickness in pregnancy

Nausea and vomiting in pregnancy, often known as morning sickness, is very common in early pregnancy.

It can affect you at any time of the day or night, and some women feel sick all day long.

Morning sickness is unpleasant, and for some women it can significantly affect their day-to-day life. But it doesn't put your baby at any increased risk, and usually clears up by weeks 16 to 20 of your pregnancy.

Some women develop a severe form of pregnancy sickness called hyperemesis gravidarum. This can be serious, and there's a chance you may not get enough fluids in your body (dehydration) or not get enough nutrients from your diet (malnourishment). You may need specialist treatment, sometimes in hospital.

Sometimes urinary tract infections (UTIs) can also cause nausea and vomiting. A UTI usually affects the bladder, but can spread to the kidneys.

Call your midwife or GP immediately if you’re vomiting and:

  • have very dark-coloured urine or have not had a pee in more than 8 hours
  • are unable to keep food or fluids down for 24 hours
  • feel severely weak, dizzy or faint when standing up
  • have tummy (abdominal) pain
  • have pain or blood when you pee
  • have lost weight

These can be signs of dehydration or a urine infection.

Read our leaflet on pregnancy sickness.

Read the RCOG leaflet on pregnancy sickness.

Bleeding and severe abdominal pain in early pregnancy

Bleeding during pregnancy is relatively common and doesn't always mean there's a problem – but it can be a dangerous sign.

If you experience bleeding in early pregnancy or severe abdominal pain please contact the Early Pregnancy Assessment Unit (EPAU) at UHCW, this is an emergency service which is open 7 days a week and 24 hours a day

EPAU: 02476967000

Read the RCOG leaflet on beeding and/or pain in early pregnancy.

Antenatal urine tests

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.

Pre-eclampsia affects 5% of pregnancies and can lead to a variety of problems, including fits (seizures). If left untreated, it can be life-threatening. Pre-eclampsia can also affect the growth and health of the baby.

Blood pressure tests in pregnancy

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.

Screening for HIV, syphilis and hepatitis B

You'll be offered a blood test for three infectious diseases:

  • HIV
  • Hepatitis B
  • Syphilis

This is usually offered at an appointment with a midwife when you are around 8 to 12 weeks pregnant.

The tests are recommended to protect your health through early treatment and care, and reduce any risk of passing on an infection to your baby, partner or other family members.

Blood group and rhesus status

It's useful to know your blood group in case you need to be given blood – for example, if you have heavy bleeding (haemorrhage) during pregnancy or birth.

The test tells you whether you are blood group rhesus negative or rhesus positive. Women who are rhesus negative may need extra care to reduce the risk of rhesus disease.

Rhesus disease can happen if a pregnant woman who is rhesus negative develops antibodies that attack the baby's blood cells. This can lead to anaemia and jaundice in the baby.

If you're rhesus negative, you may be offered injections during pregnancy to prevent you from producing these antibodies. This is safe for both mother and baby.

Gestational diabetes

You may be at higher risk of developing diabetes in pregnancy (gestational diabetes) if you:

  • Have a body mass index more than 30
  • Age 35 and above
  • have had diabetes in pregnancy before
  • have had a baby weighing 4.5kg (9.9lb) or above the 90th centile
  • have a close relative with diabetes (parents or siblings)
  • Polycystic Ovary Syndrome (PCOS)
  • are of southeast Asian, black Caribbean or Middle Eastern origin

If you're considered to be at high risk for gestational diabetes, you may be offered a test called the OGTT (oral glucose tolerance test). This involves drinking a sugary drink and having blood tests.

The OGTT is done when you're between 24 and 28 weeks pregnant. If you've had gestational diabetes before, you'll be offered: An OGTT earlier in pregnancy, soon after your booking visit, and another at 24 to 28 weeks if the first test is normal.

Read our leaflet on the Glucose Tolerance Test