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Antenatal Care

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As soon as you think you are pregnant contact your GP who will confirm it and refer you to the community midwives.

The booking appointment will take place around 8 -12 weeks and this is where you will meet your named community midwife who will provide your antenatal and postnatal care.

During this appointment you will be given your handheld green notes which you need to bring to all your appointments. The midwife will discuss your medical history, previous pregnancies and obstetric history, in addition to advising on folic acid, nutrition, diet and lifestyle.

Screening tests will be discussed and arranged, bloods will be taken enabling us to recommend the best plan of care for your pregnancy.

Your booking appointment is an opportunity to discuss with your midwife if you feel you are in a vulnerable position or need extra support because of domestic violence, sexual abuse, substance misuse or female genital mutilation. If you are disabled and require special requirements let our midwife know and she can arrange what you need.

If English is not your first language and you need an interpreter please let your midwife know and she can make arrangements.

Where to have your baby

If you have had a good pregnancy with no maternal or fetal factors that place the pregnancy at increased risk you can choose to have your baby in our low risk room (Lavender) or on labour ward. It is important that you make an informed decision about where you would like to give birth, you can change your mind after you have decided.

Lavender Room

  • Frequently Used Abbreviations

    • You may hear about these abbreviations either during your pregnancy or on the ward:
      • AC - Abdominal Circumference
      • AF - Artificial Feeding
      • APH - Antepartum Haemorrhage
      • ARM - Artificial Rupture of Membranes
      • BF - Breastfeeding
      • BMI - Body Mass Index
      • BP - Blood Pressure
      • BPM - Beats Per Minute
      • EFM - Electronic Fetal Monitoring
      • Ceph - Cephalic (head)
      • CVS - Chorionic Villus Sampling
      • CRP - C/Reactive Protein
      • DVT - Deep Vein Thrombosis
      • ECV - External Cephalic Version
      • ERPC - Evacuation of Retained Products    of Conception
      • FBC - Full Blood Count
      • FBS - Fetal Blood Sample
      • FH - Fetal Heart
      • FM - Fetal Movements  FSE - Fetal Scalp Electrode
      • GA - General Anaesthetic
      • GBS - Group B Strep
      • GDM - Gestational Diabetes
      • GTT - Glucose Tolerance Test
      • Hb - Haemoglobin
      • Hep B - Hepatitis B
      • HVS - High Vaginal Swab
      • IOL - Induction of Labour
      • MSU - Midstream Specimen of Urine
      • PET - Pre-eclampsia
      • PIH - Pregnancy Induced Hypertension
      • PPH - Postpartum Haemorrhage
      • SBR - Serum Bilirubin (jaundice)
      • TENS - Transcutaneous Electrical Nerve Stimulation
      • USS - Ultrasound Scan
      • VBAC - Vaginal Birth after Caesarean
      • VE - Vaginal Examination
  • Schedule of Antenatal Appointments

    • Schedule of antenatal appointments
  • Healthy Diet

    • Following a healthy diet and lifestyle will help to keep you well during your pregnancy, giving your baby the best possible start in life.
    • Food
    • You don't need to follow a special diet, just make sure that you get a balance of nutrients that are important for you and your baby.
    • Fruit and vegetables
    • Fruit and vegetables - Make sure you eat at least five portions of fruit and vegetables each day ensuring you wash them carefully. Fruit and vegetables also provide fibre, which helps with digestion and prevents constipation.
    • Potatoes
    • Potatoes, bread, rice, pasta and other starchy carbohydrates - Carbohydrates are an important source of vitamins and fibre, whilst making you feel full and not containing too many calories. They should form the main part of every meal wholemeal varieties will add extra fibre to your diet. These include bread, potatoes, cereals, pasta, rice, oats, noodles, maize and sweet potatoes.
    • Salt and sugar
    • Foods high in fat, salt and sugars - Food and drinks high in fat and sugar are not needed in your diet and should only be consumed in small amounts, try to avoid foods which are high in fat, salt and sugar.
    • Fats
    • Fats - Some fat in your diet is essential but we eat too much saturated fats so they need to reduce the amount or change to unsaturated fats. Unsaturated fats are healthier as they are usually from plants and in liquid form e.g. vegetable oil, rapeseed oil and olive oil. Choosing lower fat spreads, as opposed to butter, will reduce your saturated fat intake and reduce cholesterol in the blood. 
    • Dairy
    • Dairy and alternatives - Milk and dairy foods like cheese, fromage frais, soya drinks and yogurts are important in your diet because they contain protein, calcium and other nutrients. Try to eat two or three portions a day using low-fat varieties.
    • Keep hydrated by drinking at least 6 - 8 glasses of fluid a day.
    • Beans, pulses, fish, eggs, meat - These foods are good sources of essential vitamins and minerals. Make sure you only eat in moderate amounts each day. Try to eat two portions of fish a week, one of which should be oily fish.
    • Here is a useful video to watch about food and pregnancy
  • Foods to avoid

    • There are some foods that you should not eat when you are pregnant because they may make you ill or harm your baby.
    • You should avoid:
    • Soft cheeses with white rinds - Do not eat mold-ripened soft cheese, such as Brie and Camembert as well as mold-ripened soft goats' cheese, such as chèvre due to the risk of a bacterial infection, listeria. Cheese
    • Soft Blue Cheeses - avoid soft veined cheeses such as Danish blue, Gorgonzola and Roquefort.
    • These cheeses may contain listeria, a bacterium that can harm your baby, leading to miscarriage, stillbirth and severe illness in the newborn baby.
    • Hard cheeses such as cheddar, parmesan and processed cheeses made from pasteurised milk such as cottage cheese, mozzarella and cheese spreads are safe to eat during your pregnancy.
    • Soft cheeses contain more moisture and are less acidic. This means they are an ideal environment for harmful bacteria, such as listeria, to grow in. Even a mild form of listeria can lead to severe pregnancy complications and serious illness in a newborn baby.
    • Raw or undercooked meat -Make sure when you're cooking meat it is cooked all the way through with juices running clear. You can still eat steak but it should be well done and not rare.
    • Liver products - 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 which can be harmful your baby.
    • Pâté - Avoid all types of pâté, including vegetable pâtés as they can contain listeria.
    • Fish- You should avoid shark, marlin and swordfish and limit the amount of tuna you eat to no more than two tuna steaks a week (about 140g cooked or 170g raw each) or four medium-sized cans of tuna a week (about 140g when drained). These types of fish contain high levels of mercury, which can damage your baby's developing nervous system.
    • Fish
    • Don't eat more than two portions of oily fish per week. Oily fish includes salmon, mackerel, sardines and trout.
    • Shellfish - Make sure all shellfish is cooked as raw shellfish can contain harmful bacteria and viruses that can cause food poisoning. Cold pre-cooked prawns are fine.
    • Peanuts-Peanuts or food containing peanuts can be eaten as part of a healthy balanced diet unless you are allergic to them or your health professional advises you not to.
    • Here is a helpful video to tell you more about foods you should avoid during pregnancy
  • Vitamins and Minerals

    • Eating a healthy, varied diet will help you to get the vitamins and minerals you need while you are pregnant. However, there are some that are especially important.
    • Here is a useful video on vitamins and minerals which are good for you to have during pregnancy
    • Folic acid -Folic acid is very important for the development of a healthy baby as it can reduce the risk of neural tube defects such as spina bifida and anencephaly in your unborn child. It is recommended to take a daily supplement of 400 microgram of folic acid until you are 12 weeks pregnant. Folic acid is found in foods such as green leafy vegetables, brown rice, granary bread and breakfast cereals fortified with folic acid.
    • Vitamin D
    • Vitamin D -Vitamin D regulates the amount of calcium and phosphate in the body, which are needed to keep bones, teeth and muscles healthy. Our bodies make vitamin D when our skin is exposed to summer sunlight. Pregnant and breastfeeding women are recommended to take 10 micrograms (10mcg) of vitamin D a day. Vitamin D can be found in oily fish (sardines, mackerel and herring), eggs and red meat.
    • Iron
    • Iron - If you are short of iron, you may feel very tired and suffer from anemia. If your iron levels are low then will be advised to taken iron supplements. Lean meat, green leafy vegetables, dried fruit and nuts contain iron.
    • Vitamin C - Vitamin C protects cells keeping them healthy. Vitamin C is found in oranges, red and green peppers, strawberries, broccoli, Brussel sprouts and potatoes.
    • Vegan
    • Vegetarian and special diets - A varied and balanced vegetarian diet should give you all the nutrients that you need for your pregnancy. It can be difficult to get enough iron and vitamin B12. If you have any concerns then talk to your Midwife or GP. If you are vegan or follow a restricted diet because of food intolerance e.g. a gluten-free diet for coeliac disease or for religious reasons, talk to your midwife or GP who can refer you to a dietician for advice on how to make sure you are getting all the nutrients you need for you and your baby.
    • Coffee beans
    • Caffeine - High levels of caffeine can result in babies having a low birth weight which can increase the risk of health problems in later life. Too much can also cause miscarriage.
    • Caffeine is found naturally in lots of foods such as coffee, tea and chocolate and is added to some soft drinks and energy drinks. It can also be found in certain cold and flu remedies.
    • You should have to no more than 200mg a day or try decaffeinated tea and coffee, fruit juice or water and limit the amount of 'energy' drinks, which may be high in caffeine.
    • Caffeine content of food and drink:
      • 1 mug of instant coffee: 100mg
      • 1 mug of filter coffee: 140mg
      • 1 mug of tea: 75mg
      • 1 can of cola: 40mg
      • 1 can of 'energy' drink: up to 80mg
      • 1 x 50g bar of plain chocolate: up to 50mg
      • 1 x 50g bar of milk chocolate: up to 25mg
  • Lifestyle

    • Alcohol in pregnancy - Experts are still unsure exactly how much alcohol, if any, is safe to have whilst you're pregnant.  The Chief Medical Officer for the UK recommends the safest approach is not to drink any alcohol.
    • Avoid drinking alcohol if there is any chance you may be pregnant and if you have any concerns about your alcohol intake you should consult with a health professional.
    • Drinking in pregnancy and binge drinking can lead to early miscarriage as well as increasing the risk of long-term damage to your baby's physical and mental development.
    • Alcohol is a toxic substance and takes approximately 11/2 hours to break down 1 unit of alcohol. The alcohol passes into the mum's blood stream and then crosses the placenta into the baby's blood stream. The placenta does not act as a filter and the baby's liver is not developed to process the alcohol. This can lead to a condition like Fetal Alcohol Syndrome and Fetal Alcohol Spectrum Disorder.
    • Fetal Alcohol syndrome (FAS) - Children born with FAS can have growth problems, facial defects, and lifelong learning and behaviour problems.
    • Fetal Alcohol Spectrum Disorder (FASD)- A range of less obvious effects that can be mild to severe and can relate to one or more of the following:
      • Low birth weight.
      • Eating and sleeping problems.
      • Problems seeing and hearing.
      • Difficulty following directions and learning to do simple things.
      • Trouble paying attention and learning in school.
      • Trouble getting along with others and controlling their behaviour.
    • Children born with FASD may need medical care all their lives, and/or need special educational support.
    • FAS and FASD are 100% preventable by not drinking alcohol during your pregnancy.
    • Flying
    • Flying while pregnant -. Most airlines will not let you fly after week 37 of pregnancy or week 32 if you're pregnant with twins.
    • Long distance flying (over five hours) has an increased risk of thrombosis (blood clots). Make sure that you drink plenty of water to keep hydrated. You can buy compression stockings from the chemist will reduce your risk of blood clots and fluid being retained in your legs (oedema). You can buy these over the counter in a pharmacy.
    • Safety in the car - Car accidents are the most common injuries to pregnant women. To protect yourself wear your seatbelt with the diagonal strap across your body between your breasts and the lap strap over your upper thighs. The straps should lie above and below your bump.
    • Smoking - Protecting your baby from tobacco smoke is one of the best things you can do for your baby to give them a healthy start in life. Cigarettes contain over 4000 chemicals and restrict the essential oxygen supply to your baby making their tiny heart beat harder every time you smoke. Babies born to mothers who smoke are on average 200g lighter than other babies. This can lead to problems during and after delivery and are more prone to making babies more likely to develop an infection. Stopping smoking will benefit you and your baby immediately, allowing your oxygen levels to return to normal, reduce the risk of stillbirth, and decrease the chances of having a premature baby with additional health problems.
    • E Cigarettes - The devices currently on the market do not meet the appropriate standards of safety and quality. The level of risk associated with their use is not known.
    • If you smoke and want help to give up then talk to your midwife or contact Guernsey Quit line www.gsyquitline.com
    • Medicines- Talk to your doctor if you take regular medication - ideally before you start trying for a baby or as soon as you find out you are pregnant, to make sure it is suitable whilst pregnant.  Make sure that you inform all health professionals that you are pregnant before they prescribe you anything or give you treatment.
    • Illegal drugs - Illegal drugs like cannabis, ecstasy, cocaine and heroin can harm your baby. If you use illegal drugs, it is important to talk to your midwife so they can refer you for additional support. Some dependent drug users initially need drug treatment to stabilise or come off drugs to keep the baby safe.
    • Medicinal Cannabis (CBD oil) -Medicinal cannabiscan be used to helps relieve chronic pain and even lowers the symptoms of anxiety and stress without the high. There is very limited evidence available to medicinal cannabis use in pregnancy and most health professionals advise against its use in pregnancy.
    • Yoga
    • Exercise and keeping active - The more active and fit you are during pregnancy, the easier it will be for you to adapt to your changing shape and cope with labour. Keep up your normal daily physical activity or exercise (sport, dancing or just walking to the shops and back) for as long as you feel comfortable. Don't exhaust yourself, and remember that you may need to slow down as your pregnancy progresses or if advised to. As a general rule, you should be able to hold a conversation as you exercise. If you become breathless as you talk, then you are probably exercising too strenuously.
    • Swimming
    • If you were inactive before you were pregnant, don't suddenly take up strenuous exercise. Begin exercising gradually with 10 minute bouts of moderate intensity continuous exercise building up to a total of 150 minutes across the week.
    • Make sure that you warm up and cool down. Try to keep active on a daily basis half an hour of walking each day can be enough. If you cannot manage that, any amount is better than nothing. Avoid any strenuous exercise especially in hot weather and take plenty of water and other fluids. Swimming is a good activity whilst pregnant as the water will support your increased weight. Some local swimming pools provide aqua natal classes with qualified instructors.
    • Kings Health Club - Pre and postnatal exercise classes-Body BalanceYogaBody Pump and Aquafit. \
    • Yoga Elements- Prenatal Yoga
    • Nurturing Birth and Beyond - Pregnancy Yoga, Mother and Baby Yoga
  • Antenatal tests

    • During your pregnancy you will be offered a range of tests designed to check and assess the development and wellbeing of you and your baby. They will include blood tests and ultrasound scans.
    • It is important that you understand the reason for the tests so as to be able to make an informed decision about whether to have them.
    • Urine sample - At each antenatal appointment you will be asked to provide a urine sample which will check for several things, including protein and infections.
    • Height and weight -You will be weighed during your booking appointment and along with your weight we will work out your BMI. Women who have a raised BMI >30 are at increased risk of problems in their pregnancy.
    • Blood pressure - Your blood pressure will be checked at each antenatal appointment. A rise in blood pressure later in pregnancy could be a sign of pre-eclampsia. It is common for your blood pressure to be lower in the middle of your pregnancy. This is not a problem but can make you feel lightheaded if you get up too fast.
    • Blood tests -You will be offered several blood tests during your pregnancy, some will be recommended if you are at particular risk of a condition or infection. You will be offered a test for three infectious diseases HIV, Hepatitis B and Syphilis. These tests are advised to protect your health through early treatment as well as reducing the risk of passing on the infection. These can be declined. You will be tested to check your blood group and to see whether you are rhesus negative or positive. Women who are rhesus positive have a substance known as D antigen on the surface of their red blood cells. Rhesus negative women do not. A woman who is rhesus negative can carry a baby who is rhesus positive if the baby's father is rhesus positive. During pregnancy or birth, small amounts of the baby's blood can enter the mother's bloodstream. This can cause the mother to produce antibodies. This usually doesn't affect the existing pregnancy, but the woman becomes 'sensitised'.
    • This means that if she gets pregnant with another rhesus positive baby, the immune response will be quicker and much greater. The antibodies produced by the mother can cross the placenta and attach to the D antigen on her baby's red blood cells. This can be harmful to the baby as it may result in a condition called haemolytic disease of the newborn, which can lead to anaemia and jaundice.
    • Anti-D injections prevent rhesus negative women producing antibodies against the baby and reduce the risk of a rhesus negative woman becoming sensitised. Rhesus negative mothers who are not sensitised are offered an anti-D injection at around 28 weeks as well as after the birth of their baby. This is safe for both the mother and her baby.
    • Rh Status - https://youtu.be/pwKqwcVNuMY
    • You will have your iron levels checked to see if you have anaemia. Anaemia can make you tired and less able to cope with any loss of blood when you give birth. If tests show you are anaemic you will be given iron tablets.
    • Ultrasound Scans
    • Ultrasound
    • You will routinely be offered two scans, the dating scan at 8-12 weeks which will determine the baby's due date and the anomaly scan at about 20 weeks.
    • Ultrasound scans use sound waves to build a picture of the baby in the uterus. The scans are painless, have no side effects on mother and baby and can be carried out at any stage of pregnancy.
    • At the dating scan, the sonographer will check your baby's measurements and be able to give you your baby's estimated date of delivery (EDD). It will confirm a single baby or if you are carrying twins as well as the position of the placenta.
    • You will be asked to have a full bladder, this pushes your uterus up and gives a better picture of baby. Scans are medical procedures but many women see them as the highlight of the pregnancy. It's very exciting to "see" your baby in the uterus often moving their hands and feet. Ask for a copy of the picture, there will be a small charge.
    • The anomaly scan checks the physical development of your baby, although it can't pick up every condition. It will look in detail at the baby's bones, heart, brain, spinal cord, face, kidneys and abdomen, checking for 11 rare conditions. It only looks for these conditions and cannot find everything that might be wrong.
  • Screening

    • Here is a useful video about screening
    • Testing for Downs syndrome, Patau and Edwards syndrome - Between 10 and 14 weeks you can have "the combined test".  You will be offered a blood test and at the dating ultrasound scan the fluid at the back of your baby's neck will be 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.
    • Baby
    • If you are further along in your pregnancy you will be offered a blood test called the "quadruple test" usually between 14 and 20 weeks of pregnancy. The quadruple test is not quite as accurate as the combined test.
    • The results of the test cannot tell you if your baby definitely has Down's syndrome, Edwards' syndrome or Patau's syndrome, it will give you a low or high risk.
    • You can choose to have the screening test for all three conditions, or just for Down's syndrome, just for Edwards and Patau's syndrome or decline them all.
    • You will get two results, one for Down's syndrome and a joint one for Edwards' syndrome and Patau's syndrome.
    • If the test shows the risk of the baby having Down's syndrome, Edwards or Patau's syndrome is lower than the recommended national cut-off, this is known as having a 'low-risk' result, but it does not mean there is no risk.
    • If you have a high risk result, you will be offered a diagnostic test to find out for certain whether or not your baby has Down's syndrome, Edwards' syndrome or Patau's syndrome.
    • Diagnostic tests for Down's syndrome will also look at chromosomes 18 and 13, so will also tell you whether or not your baby has Edwards' syndrome or Patau's syndrome. Similarly, diagnostic tests for Edwards' syndrome and Patau's syndrome will also look at chromosome 21 for Down's syndrome.
    • Video Screening tests for you and your baby: https://youtu.be/_afr5olIpTM
    • Baby 2
    • In a small portion of women who elect to have the diagnostic test approx. 1 out of 200 women (0.5%) will miscarry as a result of the test. It is up to you whether or not to have the further test.
    • There are two types of diagnostic tests:
    • Chorionic villus sampling - Chorionic villus sampling (CVS) is usually done from 11 to 14 weeks of pregnancy. A fine needle, usually put through the mother's abdomen, is used to take a tiny sample of tissue from the placenta. The cells from the tissue are then tested for Down's syndrome, Edwards' syndrome and Patau's syndrome.
    • Amniocentesis - Amniocentesis is usually done after 15 weeks of pregnancy. A fine needle is passed through the mother's abdomen into the uterus to collect a small sample of the fluid surrounding the baby. The fluid contains cells from the baby, which are tested for Down's syndrome, Edwards' syndrome and Patau's syndrome.
    • After finding out the results of the diagnostic testing a small number of women who have the diagnostic test will find out their baby has one of the conditions.
    • If your results show your baby has Down's syndrome, Edwards' syndrome or Patau's syndrome, there are two options, continue with the pregnancy and prepare for their child with the condition; or you can decide not to continue with the pregnancy and have a termination.
    • You will be supported with the decision making.
    • Here for you
    • Fetal movements -You will usually start feeling some flutters or movements between 16 and 22 weeks. Later in pregnancy your baby will develop its own pattern of movements - which you will soon get to know and feel every day.
    • At each antenatal appointment, your midwife will talk to you about baby's movements, try to familiarise yourself with the daily pattern.
    • Any change, especially a reduction in movements, may be a warning sign that your baby may need further monitoring. If you have any concerns please contact Loveridge Ward straight away: 01481224377
  • Infections

    • Influenza (Flu) - While flu is a mild illness for most people, it can be very serious for pregnant women. Pregnant women are more likely to develop serious complications as a result of flu, and rarely even death, compared to women who are not pregnant. There are also risks for the baby, including miscarriage and premature labour.
    • Receiving the flu vaccine during pregnancy is the best way to protect you and your unborn baby from getting serious complications of flu, including death. The flu vaccine is licensed for use by the European Medicines Agency and is regularly used for pregnant women across the United Kingdom, Ireland and other countries.
    • The flu vaccine is available every year from late September onwards, the start of the winter flu season, contact Loveridge ward to make your appointment.  The vaccine can be given at any stage in your pregnancy but ideally as early in the season as possible in order to receive the best protection for you and your baby. Even if you received the flu vaccine in the past, you still need to get the vaccine as flu protection only lasts for one flu season.
    • Pregnant women can suffer the same minor side effects as anyone else, including soreness where the vaccine was injected and, less often, a slight temperature and aching muscles for a couple of days after being vaccinated. Other reactions are very rare. Flu vaccine does not contain live virus and so it cannot give you flu. It will only protect you against flu.
    • Whooping Cough - Whooping cough (pertussis) is an infection which can affect people of all ages but is particularly serious in babies. Most babies who get it will have to be admitted to hospital, some will end up in intensive care and it can even result in death.
    • Very young babies (under three months) are at most risk of serious disease. All babies are vaccinated against whooping cough at two, three and four months of age. This means they can be vulnerable to the infection in the first two to three months of life before they get their vaccines.
    • The best way to protect babies is to give the mother the vaccine during pregnancy, at any stage after 16 weeks. She will make antibodies that will be passed onto the unborn baby, which then protect the baby after it is born and get their own vaccine.
    • All pregnant women are offered the whooping cough vaccine between 16 and 32 weeks of pregnancy. This is the recommended time so the unborn baby receives the highest level of protection. Studies have shown that giving the vaccine to pregnant women is very safe for both baby and mum.
    • Vaccine
    • Group B streptococcus - Group B strep or GBS is a bacterium, which can be found in the intestine and vagina. Approximately 28% of women carry GBS without any symptoms and approximately 20% of pregnant women are colonised with GBS. In a very small number it infects the baby, usually just before or during labour and can lead to serious illness or death.
    • You will be offered antibiotics in labour if you have previously had a baby with invasive GBS infection, GBS has been found in your urine in your current pregnancy, GBS has been found on swabs from your vagina which have been taken for another reason during this pregnancy, you have a high temperature during labour, you have an infection of the membranes around the baby (Chorioamnionitis).
    • Group B Strep Support is the UK charity working to stop group B Strep (GBS) infection in babies. Leaflet available
    • www.gbss.org.uk/wp-content/uploads/2019/12/2017-Joint-RCOG-GBSS-PIL_final.pdf
    • Sexually Transmitted Infections (STI) - STI's are on the increase, with chlamydia being the most common.
    • Up to 70% of women and 50% of men show no symptoms of a STI. However, many STI's can affect your baby's health during pregnancy and after birth.
    • If you have any reason to believe that you or your partner have should get checked out with your GP or the Orchard Centre
    • Leaflet available: www.gov.gg/CHttpHandler.ashx?id=118932&p=0
    • Rash in pregnancy - Itching is common in pregnancy. It can be caused by raised levels of certain chemicals in the blood, such as hormones. As your bump grows, the skin of your tummy (abdomen) is stretched and this may also feel itchy.
    • If you develop a rash or illness at any time in your pregnancy then contact your midwife or GP as you will probably need extra investigations.
  • Problems in pregnancy

    • During pregnancy, your body goes through a lot of changes. Sometimes these changes can cause discomfort and make you worried about what is happening. It is important that you talk to your midwife and/or GP if you have any symptoms.
  • Minor problems

    • Backache - During pregnancy your ligaments become softer, stretching to prepare you for labour. This can put strain on the joints in your back and pelvis.
    • Back pain
    • To reduce the risk of backache:
      • Avoid lifting heavy objects
      • Keep your back straight when lifting
      • Wear flat shoes to allow your weight to be evenly distributed,
      • When sitting, sit with your back straight and well supported.
    • If you continue to suffer with backache ask your midwife to refer you to the physio.
    • Constipation -You may become constipated in early pregnancy because of the hormonal changes taking place in your body.
    • How to avoid constipation:
      • Eat foods that are high in fibre, like wholemeal breads, wholegrain cereals, fruit and vegetables, and pulses such as beans and lentils
      • Exercise regularly
      • Drink plenty of water
      • Try to avoid iron supplements
    • Cramp - It is a sudden sharp pain usually in the calf muscles or feet generally occurring at night.  What causes it is not yet understood.
    • Ways to avoid cramp:
      • Regular, gentle exercise in pregnancy, particularly ankle and leg movements, will improve your circulation and thus stop cramp.
    • Feeling faint - You may often feel faint due to the hormonal changes in your body and your brain not getting enough oxygenated blood.
    • If your oxygen levels are too low you may actually faint. This can happen if you stand up too quickly or stand still for too long or even when lying on your back.
    • To avoid feeling faint:
      • Get up slowly from sitting or lying down.
      • If you feel faint when standing still, sit down quickly until the feeling passes or lie on your side.
      • It is not advisable to lie flat on your back later on in pregnancy or during labour.
    • Headaches - Some women suffer from headaches and migraines during pregnancy. It is important that you try to get regular rest and relaxation
    • The recommended dose of paracetamol is safe to take in pregnancy.
    • If the headache is severe or accompanied with blurred vision, swelling or heartburn then contact Loveridge Ward immediately.
    • Incontinence - Incontinence is a common problem which can affect you during and after your pregnancy. Sometimes are unable to stop a small leak of urine when you cough, sneeze or laugh. This is because your pelvic floor muscles relax slightly in preparation for labour and delivery.
    • In some cases, it can become a problem and you will be referred to urology for review.
    • Indigestion and heartburn -Indigestion is caused by hormonal changes in late pregnancy and due to the growing uterus pressing on your stomach.
    • Heartburn is more than indigestion, it is a strong burning sensation in the chest. It is caused by stomach acid passing from your stomach back into the tube leading to your stomach because of the valve relaxing.
    • Indigestion
    • How to avoid indigestion:
      • Eat little and often
      • When eating sit up straight to take the pressure off your stomach
      • Avoid fried and spicy foods
    • How to avoid heartburn:
      • Sleep well propped up with plenty of pillows
      • Avoid eating and drinking a few hours before going to bed
      • Drinking a glass of milk can help
    • Carpel tunnel syndrome - Carpal tunnel syndrome is a condition that occurs as a result of swelling around the nerves of the wrist causing numbness, tingling or pain in one or both wrists. Pregnant women are prone to the disorder, with about 40% of women experiencing some symptoms during pregnancy.
    • The intensity of symptoms can vary from mild irritation, to occasional soreness, to serious pain. Symptoms may stop you from sleeping or make it difficult to perform regular tasks such as working, getting dressed, cooking or caring for your baby.
    • Symptoms can be worsened by:
      • repeating the same hand movements frequently
      • keeping your hands in the same position for an extended time
      • putting weight on straightened arms
    • The treatment will depend on the severity and the stage of your pregnancy.
    • The pain can be reduced by simple self help
      • elevating your hands when you're resting or not using them
      • keeping your wrists in a neutral position (not bent forwards or backwards) during the day, and as much as possible while you're sleeping
      • maintaining good posture in your arms and wrists while working at a desk
      • taking breaks every 20 minutes while working at a desk
      • avoiding activities that strain your wrist
      • Applying an ice pack on your inner wrist or by placing your hand in cold water for between 30 seconds and 2 minutes can help
      • Referral can be made to a physio where you may be given splints to wear on your wrists.   
    • Leaking nipples - Leaking nipples are normal and usually nothing to worry about. The leaking milk is colostrum, which is the first milk your breasts make to feed your baby.
    • Anaemia -Anaemia is having low blood count. You may be unaware that your levels are low but if you feel tired, are pale, suffer from shortness of breath or dizzy then it is worth mentioning to your midwife. Women with anaemia during pregnancy are at higher risk of low birth weight babies and of needing a blood transfusion. Having anaemia can make caring for yourself and your baby more difficult.2
    • You will have a blood test for anaemia at your booking appointment. Ensure you have a varied diet that contain good sources of iron like red meat, chicken and fish. If you are vegetarian then you need to make sure you are getting enough iron from other foods such as tofu, beans, lentils, peas and dried fruits.
    • Your GP may give you a prescription for iron tablets. When taking it is best to take on an empty stomach with foods rich with vitamin C e.g. orange juice which will ensure your body absorbs as much iron as possible. Tea, coffee, dairy products and antacids can all reduce the amount of iron you absorb, so avoid these for about two hours before taking your iron tablets. Iron tablets can make you constipated so make sure you drink plenty of fluids and have lots of fibre in your diet.
    • Nausea and Morning Sickness - Nausea is very common in the early weeks of pregnancy, some women feel sick and some are sick. It can happen at any time of day - or even all day long.
    • Hormonal changes in the first three months are probably one cause and the nausea usually disappear around the 12th to 14th week.
    • How to avoid nausea and morning sickness -
      • If you feel sick first thing in the morning, get up slowly and if possible eat something like a plain biscuit or dry toast before you get up.
      • Try to get plenty of rest and sleep whenever you can. Feeling tired can make the sickness worse.
      • Eat little and often - don't stop eating.  Eat bland, non-greasy foods, such as baked potatoes, pasta and milk puddings, which are simple to prepare.
      • Drink plenty of fluids.
      • Try to distract yourself as much as you can as nausea can get worse if you think about it.
      • Try to avoid foods and smells that make you feel worse.
      • Wear loose clothes without tight waist bands.
    • Some women continue to feel nauseous and are unable to keep anything down leading to dehydration and weight loss. If you suffer from hyperemesis then you may need admission to hospital to help with rehydration via a drip and anti sickness medication.  Vomiting may last up to 20 weeks or until the end of your pregnancy
    • Hyperemesis -  About Hyperemesis Gravidarum (HG) - HER Foundation
    • Pelvic Girdle Pain (PGP) - Pelvic girdle pain (PGP) is the general term for all pelvic pain. It includes pubic pain - previously called symphysis pubis dysfunction (SPD). PGP includes pain anywhere from the lower back down to the thigh, either at the front or back
    • The pain may range from a mild ache to severe pain that limits your daily activities.
    • Getting referred and diagnosed early can reduce ongoing discomfort and minimise pain with early referral to the physios
    • Skin and hair changes - Hormonal changes in your pregnancy will make your nipples and the area around them to go darker. Birthmarks, freckles and moles may also darken.
    • Some women develop a dark line down from their belly button to the pubic hair which gradually fades once your baby has been born.
    • If you go out in the sun whilst pregnant make sure you apply a good high factor sunscreen as you will tan more easily and don't stay out in it for too long.
    • Sleep - Later in your pregnancy you might find getting a good night's sleep difficult. Lying down can be uncomfortable and when you get comfortable you need to go to the toilet. Lying on your side with a pillow between your legs and under your tummy may help.
    • Stretch Marks - These are pink or purple lines which usually occur on your abdomen or sometimes on your upper thighs or breasts. Not all women get them, it depends on your skin type.
    • Some women's skin is more elastic. You are more likely to get stretch marks if your weight gain is more than average.
    • After your baby is born, the marks should gradually pale and become less noticeable.
    • Swollen Hands and Feet - Ankles, feet and fingers often swell in pregnancy because your body is holding more water than usual. Towards the end of the day especially if the weather is hot or if you have been standing a lot, the extra water tends to gather in the lower parts of your body.
    • Try to avoid standing for long periods, rest with your feet up higher than your heart as much as you can and wear comfortable shoes.
    • Tiredness -In the early part of your pregnancy you may feel tired or even exhausted. Try to make time to rest with your feet up as well as accepting help from friends and family.
    • At the end of your pregnancy you may feel tired because of the extra weight you are carrying. Make sure that you get plenty of rest.
    • Vaginal Discharge -Most women will have increased vaginal discharge during pregnancy. Normal discharge should be clear and white and not smell.
    • If the discharge is coloured or smells unpleasant or if you are experiencing itchy or soreness then you may have a vaginal infection. The most common infection is thrush and you need to speak to your midwife or GP for some medication.
  • Major Problems

    • High Blood Pressure and Pre-eclampsia -Your midwife will check your blood pressure and urine at every antenatal appointment. This is because a rise in blood pressure and protein in your urine can indicate pre-eclampsia (PET).
    • Some of the symptoms of pre-eclampsia are:
      • Raised blood pressure
      • Headaches
      • Proteinuria
      • Visual disturbances
      • Epigastric pain
    • It is a life threatening condition which if left untreated can cause fits and can affect your baby's growth.
    • Pre-eclampsia usually occurs after 20 weeks but can occur earlier and can also develop after the birth.
    • Some women may need admission to hospital for monitoring and medication to lower the high blood pressure. Pre-eclampsia can be a reason to deliver the baby early either by induction of labour or by caesarean section.
    • Placenta Praevia - Placenta praevia (or a low-lying placenta) is when the placenta is attached in the lower part of the uterus near to or covering the cervix.
    • The position of your placenta is recorded at your 20 week scan and if low you will be offered an extra scan at about 34 weeks to recheck the position. At this stage the placenta in 90% of women has moved away from the cervix.
    • If the placenta is still low at 34 weeks there is a chance that you could have some vaginal bleeding. This bleeding can be heavy and potentially put your baby at risk. If this is the case you will be admitted to Loveridge Ward for monitoring and if the placenta is near or covering the cervix you will be offered a caesarean section.
    • Itching -Mild itching is normal in pregnancy because of the increased blood supply to the skin. In late pregnancy the skin of the abdomen is stretched and this may also cause itchiness.
    • Severe Itching and Obstetric Cholestasis - Severe itching can be an indication of obstetric cholestasis. This is a potentially dangerous liver disorder that can run in families.
    • The main symptom is severe generalised itching without a rash on the hands and feet, most commonly in the last four months of pregnancy.
    • Obstetric cholestasis can lead to premature birth, stillbirth or serious health problems for your baby. It can also increase the risk of maternal haemorrhage after the delivery.
    • If you develop severe itching especially to your hands and feet or you develop jaundice (yellowing to the whites of the eyes and skin) you should contact your midwife.
    • Vaginal Bleeding - Bleeding from the vagina at any time is concerning. It is important to find the cause quickly as some types of bleeding are more serious than others.
    • Bleeding after sex - The cells on the surface of the cervix often change in pregnancy and make it more likely to bleed - particularly after sex. This is called a cervical erosion.
    • Bleeding in late pregnancy - The most common bleeding in late pregnancy is the small amount of blood mixed with mucus that is known as a 'show'. This is a sign that the cervix is changing and becoming ready for labour to start. It may happen a few days before contractions start or during labour itself.
    • Deep Vein Thrombosis (DVT) -DVT is a serious condition where blood clots develop and can be fatal if the clot travels from the legs to the lungs. The risk may increase if you are on a long-haul flight (over five hours), where you sit still for a long time.
    • Pregnancy increases the risk of having a blood clot during pregnancy and for about six weeks.
    • There are two kinds:
      • Deep-vein thrombosis (DVT)
      • Pulmonary embolism (PE)
    • A DVT is a blood clot that forms in a deep vein, most commonly in the leg or pelvis. It usually presents with pain or discomfort and swelling to your lower legs sometimes with red, purple, blue or white discolouration.
    • A PE occurs when part or all of the blood clot breaks free and reaches your lungs.
    • It usually is accompanied by coughing sometimes with blood-stained spit, chest pain and shortness of breath.
  • Overdue

    • Your pregnancy usually lasts for 40 weeks, with most women going into labour within a week either side of her due date.
    • Overdue
    • At your 40 week appointment you will be offered a membrane sweep which involves having a vaginal examination where your midwife will sweep her finger around your cervix aiming to separate the membranes from your cervix. This separation releases hormones (prostaglandins), which may kick-start your labour.
    • The examination isn't painful but can be uncomfortable.

 

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