Make sure you're booked into antenatal classes if you want to attend (see pages 64–5). You will probably now attend antenatal classes (see Antenatal care and antenatal classes, page 51).
T HE B ALANCE OF G OOD H EALTH
This chapter describes some of the things you need to think about to make sure you and your baby stay healthy during pregnancy. You don't need to follow a special diet, but make sure you eat a variety of different foods each day so you get the right balance of nutrients you and your baby need.
V ITAMIN
F OLIC ACID
In addition to eating a wide variety of foods, there are some precautions you should take to protect your baby's well-being as well as your own. This will help to avoid infection with Toxoplasma, which can cause toxoplasmosis and can harm your baby (see page 18).
V EGETARIAN , VEGAN AND
Avoid eating peanuts and foods containing peanut products (eg peanut butter, unrefined peanut oil, certain foods, etc.) if you or your baby's father or a previous child has a history of hay fever, asthma , eczema or other allergies. Avoid eating shark, marlin and swordfish, as these types of fish contain high levels of mercury that can harm your child's developing nervous system.
S MOKING
There is no evidence that light or occasional drinking during pregnancy will harm your baby. It is important to speak to your doctor or midwife immediately so they can refer you to a maintenance reduction programme.
H ERBAL AND
If you're feeling tense after a hard day at work, physical activity is a great way to relax and help you sleep soundly. If you take exercise classes, make sure your teacher is properly trained and knows that you are pregnant and how far along your pregnancy is.
R UBELLA
Avoid oral sex if you or your partner have cold sores or active genital herpes. If you think you may have been at risk, discuss the matter with your GP, midwife or obstetrician.
H EPATITIS B
If you have never had chicken pox or are not sure and have come into contact with a child or adult who has chicken pox, contact your GP, midwife or obstetrician immediately. This infection can harm your baby if you get it during pregnancy, so be careful (see page 19).
OR HEPATITIS B
Tell your doctor or midwife if you or your partner get recurrent herpes or develop the symptoms described above. If you are HIV positive, talk to your doctor about your health and the options available to you, or contact the organizations listed on page 143 for advice and counselling.
HEPATITIS B
Chickenpox infection during pregnancy can be dangerous for both mother and baby, so seek advice as soon as possible. The risk of passing HIV to your baby can be significantly reduced during pregnancy and after birth (see box on page 54).
P ARVOVIRUS B19 (S LAPPED
VDU S
During the week after fertilisation, the fertilised egg, or embryo, moves
Nausea – you may feel sick, or even be sick, not necessarily in the morning, but at any time. Need to pass water more often. You may find that you have to get up at night to do it.
W EEK 3
You can breastfeed your baby or give your baby a pacifier if you wish. If the room is too warm for you, keep your baby's clothes or bedding light;
C LEAN AIR
You should clean your baby's bottom carefully every time you change a diaper to help prevent soreness. Wash your baby's bottom and genitals with cotton wool and warm water and dry them well.
P UTTING ON
4 Wash the rest of your baby's face and neck with damp cotton wool and gently pat dry. 5 Remove the diaper and wash the baby's genitals, again with cotton wool and warm water.
B ATHING
If you can't get to your GP straight away, call 999 for an ambulance or take your baby to the emergency department of your nearest hospital as soon as possible. If your baby develops jaundice (looks yellow) when he or she is over a week old, or has jaundice which continues for over two weeks after birth (see page 113).
T HE ‘G LASS T EST ’
If you have seen your GP and your baby is not getting better or seems to be getting worse, tell your GP again the same day. You will meet other mothers when you start taking your baby to the Child Health Clinic.
D IFFICULTY
Addictive medications affect your ability to become pregnant, and if you do become pregnant, it is likely to harm your baby's health. If you have access to the internet, you can claim online via the Child Benefit e-service: esd.dwp.gov.uk/dwp/index.jsp.
T AX C REDITS
If you are 16-17 years old and facing serious problems, you may be able to claim it before your child is born. You can also get income support if you are single and pregnant and you are not healthy enough to work.
C OUNCIL T AX B ENEFIT
You can also get help if you receive a tax credit or pension credit. If you are entitled to one of the above-mentioned benefits, you can claim during your visit to the hospital upon presentation of proof that you are receiving the benefit.
M ATERNITY A LLOWANCE (MA)
If you are not sure whether you are eligible or not, apply and your local Jobcentre Plus/Disability Benefit branch will find out if you can get the benefit. The rules are complicated, so if you're not sure if you're eligible, file a claim.
I NCAPACITY B ENEFIT (IB)
In this case, your employer can start your maternity leave even if you are only absent for one day. In this case, your employer can start your maternity leave even if you are only sick for one day.
You can take AML if you have worked for the same employer for at least 26 weeks before the 15th week before the expected week of birth. If you are made redundant while on maternity leave, your employer must offer you any suitable alternative work available.
During the entire maternity leave, you are still entitled to your statutory rights (ie rights that apply by law to all employees in this country). You must ask your employer to confirm this agreement in writing and confirm that you will have the right to return to the same job.
If you can't come back because you're sick, you can take sick leave as long as you count yours. If you later decide not to return, you can cancel in the normal way.
O THER EMPLOYMENT RIGHTS
If this is not possible or will not avoid the risk, your employer must offer you a suitable one. If you are dismissed while you are pregnant or on maternity leave, your employer must give you a written statement of the reasons.
O THER TYPES OF LEAVE
If this is not possible, your employer must suspend you from full pay for as long as is necessary to avoid the risks. You must give your employer 21 days notice of the dates you wish to take your leave.
R ETURN TO WORK ON C HILD -F RIENDLY
You have the right to appeal within 14 days of receiving your employer's rejection notice. Your employer must hold the appeal meeting within 14 days of receiving your notice of appeal.
Sussex TN40 1JA www.child.org.uk Self-help organization offering information and support to people experiencing infertility and childlessness. Windsor House Windsor Lane Cardiff CF10 3GE www.eoc.org.uk Information and advice on discrimination and equal opportunities issues.*.
USEFUL ORGANISATIONS
Child Safe Wales Llandough Hospital Penlan Road Penarth CF64 2XX www.capic.org.uk Get more information or details. RELATE (National Marriage Guidance) (Severni Wales) 8 Rivieres Avenue Colwyn Bay LL29 7DP www.relate.org.uk (Srednji in Zahodni Wales).
INDEX
This revised edition published by the Office of The Chief Medical Officer, Welsh Assembly Government, based on the original version produced by The Department of Health, 2004. Crown copyright January 2005 Public Health Strategy Division, Office of The Chief Medical Officer, Welsh Assembly Government , Cathays Park,.
USEFUL NUMBERS
Royal College of Obstetricians and Gynecologists Royal College of Paediatrics and Child Health St John Ambulance. This publication has been produced by the Welsh Assembly Government as part of its response to Health Challenge Wales.
W EEKS 4-5
W EEKS 6-7
W EEKS 8-9
W EEKS 10-14
W EEKS 15-22
W EEKS 23–30
W EEKS 31-40
They want you to feel as comfortable as possible with all aspects of the care you receive, both during your pregnancy and during delivery. The choice you have about where to have your baby and how you are cared for depends to some extent on where you live.
I N HOSPITAL
A T HOME
Would you like your partner or supervisor to be present if you have a caesarean section or a forceps delivery, for example? I think that's always in the back of your mind: you don't know if it's right.
L ONE P ARENT H ELPLINE
If you have housing problems, contact your local CAB or your local Housing Advice Centre. If you are short of money, you may be able to get funeral expenses paid out from the Social Fund.
D OMESTIC
If you were married and your husband worked, you may be entitled to widower's allowance, based on his national insurance contributions. If you were not married, you are not considered a widow and you are therefore dependent on your private schemes or income support or the tax credit for working families if you work.
VIOLENCE
B EREAVEMENT
D OMESTIC V IOLENCE
You may be worried that your home is not in order, or that you will feel obligated to stay in a job you don't like. Your partner may feel insecure about her changing body and may be very hurt if she thinks you don't like it either.
A FATHER )
The closer you can get to her, the more you will be able to share this experience. Most men stay with their partners during childbirth, but it is important that both are comfortable with this.
F EELING LOW
You may have to tell someone all about the birth before you can rest, but then sleep if you can. You also need to recover from the birth and, when the baby comes home (if the birth took place in a hospital), you can expect broken nights for some time.
The midwife or doctor will want to know the date of the first day of your last period in order to calculate when the baby is due. This is a good option and it often helps if you can write down what you want to say beforehand as it's easy to forget once you're there.
Q UESTIONS
It is important to find out what you want to know and to express your own feelings and preferences. You should allow plenty of time as you will likely see a midwife and a doctor, and may be offered an ultrasound scan.
W EIGHT
H EIGHT
U RINE
B LOOD TESTS
T ESTS
This test uses sound waves to build up a picture of the baby in the womb. It should always be performed with the help of ultrasound to check the position of the baby and placenta.
CVS)
When deciding whether or not to proceed with this test, try to balance the risk of He will be able to support you in discussing any concerns or finding out what you want to know.
If you have your baby at a GP or midwifery unit or at home, your GP may be involved in your baby's birth. If your baby should have problems, you will be able to talk to the pediatrician about this.
R ESEARCH
The pediatrician can check your baby after birth to make sure all is well and will be there when your baby is born if you had a difficult birth. If your baby is born at home or your stay in hospital is short, you may not be able to see a pediatrician at all.
S TUDENTS
The health visitor will contact you to arrange a home visit when your baby is ten days old to offer help and support. You should start making inquiries early in pregnancy so that you can be sure of getting a place in the class you choose.
It's never too early to start thinking about how you're going to feed your baby. However, you may need a little extra help learning to position your baby (see page 70).
Slide one of your fingers into your baby's mouth, gently break the suction and try again. If your nipples are sore during feeding, your baby's position may need to be adjusted.
W IND
If you are worried, your midwife or health visitor will advise you on how much milk your baby is likely to need. If you put on more makeup than your child wants, throw away what's left at the end of the feed.
B ACKACHE
You may become constipated very early in pregnancy due to the hormonal changes that occur in your body.
C RAMP
F AINTNESS
This is due to hormonal changes and an increase in blood supply to the skin.
H EADACHES
I TCHING
If you feel sick first thing in the morning, give yourself time to get up slowly. If you find you have to get up at night, try cutting out drinks late at night, but make sure you keep drinking plenty throughout the day.
P ILES
You are uncomfortable lying down, or just when you start to feel comfortable, you have to get up to go to the bathroom. You are more likely to get stretch marks if your weight gain is more than average.
I F YOU AREN ’ T
In the last weeks of pregnancy, you may also be asked to keep track of your baby's movements. If you notice that your baby's movements are becoming less frequent or slower, or if they stop, contact your midwife or doctor immediately.
D EEP V EIN T HROMBOSIS (DVT)
If you use a washing machine, do not use enzyme (bio) powders, as this can irritate your baby's skin. When you have your baby at home, your midwife will give you a list of things to have ready.
I MPORTANT
For yourself, prepare loose clothes that are easy to wear, baby clothes (including a cover), some diapers and a scarf or blanket to wrap the baby in.
S TOCKING UP
T RANSPORT
I F LABOUR
But if you don't have anyone, don't worry - your midwife will give you the support you need. This method allows you to be free to move around in labor if you want.
The obstetrician places the forceps around the baby's head and with a gentle firm pull the baby can be born. In vacuum delivery, a shallow rubber or metal cap is placed on the baby's head using suction.
I NDUCTION
an elective caesarean section may be recommended if labor is considered dangerous for you or the baby. A general anesthetic is sometimes used, especially when the baby needs to be delivered very quickly or if there are technical problems, but this increases the risks for you and the baby.
N EXT T IME
An epidural is usually recommended and forceps are often used to position the baby's head (see page 101). The baby is turned into the usual head-down (cephalic) position by pressing on the woman's abdomen.
T WINS
If your abortion is very late, you may be able to see and hold your baby, if you wish, and take a picture. After a miscarriage, you may have a 'D and C' (ie, dilation and curettage) to empty the uterus.
A FTERWARDS
If you want to organize a funeral or cremation and your baby was lost before 24 weeks, you will need a certificate from the hospital. If you are breastfeeding, it will help to feed your baby as often as he or she needs (see page 69).
S TITCHES
Sometimes it's easier to pee while sitting in a bowl of water or a warm bath. This should mean that when you open your bowels, you will pass a bowel movement more easily.
B LEEDING
Y OUR SHAPE
If your blood type is Rh negative and your partner's blood type is Rh positive, blood samples will be taken after the birth to determine whether your baby is Rh positive and whether you need an injection to protect the next baby from anaemia.
Y OUR BABY
T HE NAVEL
V ITAMIN K
The marks on the nape of the neck may last much longer, but they will be covered with hair. But if you also notice a change in your baby's behaviour, for example if your baby is not feeding properly or is very sleepy or very irritable, you should tell your doctor or midwife straight away.
J AUNDICE
As you begin to closely observe your baby, you will likely find a variety of small marks and spots, mainly on the head and face, but sometimes larger marks as well. Even if you can't be with your baby all the time, you can express the milk given by the nurses when you are away.
But it's important to make sure everything is fine if your baby is still jaundiced after two weeks. If your baby is disabled in some way, you will be dealing with a jumble of different emotions – love mixed with fear, pity mixed with anger.
W ORRIES AND
It may be possible for your baby to receive phototherapy at your bedside so you don't have to separate. The more you can share your baby's care, the more you will both enjoy your baby.
R EST
F OOD
S EX AND
CONTRACEPTION
You can go to your GP or be asked to return to hospital. You may want to make a list of questions to take with you so you don't forget what you want to ask.
