Your journey to parenthood On this page: Early Days Mid to Late Pregnancy Preparing for Birth Going Overdue Early Days When you find out you’re pregnant, you may feel happy and excited, or shocked, confused and upset. Everybody is different, and don’t worry if you’re not feeling as happy as you expected. Even if you’ve been trying to get pregnant, your feelings may take you by surprise. Some of this may be caused by changes in your hormone levels, which can make you feel more emotional. Even if you feel anxious and uncertain now, your feelings may change. Talk to your midwife or GP – they will help you to adjust, or give you advice if you don’t want to continue with your pregnancy. Men may also have mixed feelings when they find out their partner is pregnant. They may find it hard to talk about these feelings because they don’t want to upset her. Both partners should encourage each other to talk about their feelings and any worries or concerns they may have. Take a look at the ‘you and your partner’ section of this website for more information and advice. What happens now? As soon as you know you are pregnant, you can book an appointment directly with a community midwife. Your GP surgery will be able to put you in touch. It’s best to do this as soon as possible, so that your antenatal care can begin. Your pregnancy will be treated confidentially, even if you are under 16. If you have special health needs, your midwife, GP or other doctors may take shared responsibility for your maternity care. You can find information on the NHS website week by week as your baby develops as well as suggestions for things you should be considering at each stage. You can also sign up for Start4Life’s weekly emails for expert advice, videos and tips on pregnancy, birth and beyond. Meeting your midwife The first appointment with your midwife is sometimes known as the ‘booking appointment’, which should usually happen when you are between 8 to 12 weeks pregnant. Find out more via the your care section of the site here. Dating scan The first scan, sometimes called the dating scan, takes place between 8 and 14 weeks. Based on your baby’s measurements, the estimated due date will be calculated. Find out more about the ultrasound scans you will be offered throughout your pregnancy here. Until your scan, if you know when the first day of your last period was, you can work out an approximate due date by using this NHS pregnancy calculator. A healthy start A healthy diet is important during pregnancy, but it is also recommended that you take some supplements such as folic acid. The NHS website here provides an overview of what supplements you should and should not take when pregnant. If you need it, support is available to help you quit smoking. Gloucestershire’s Healthy Lifestyles Service is there to help. Find out more via their website, call 0800 122 3788 or email firstname.lastname@example.org. It is important that you do not stop taking a medicine that has been prescribed to keep you healthy without first checking with your doctor. Stopping taking your medicine could be harmful to both you and your baby. Talk to your doctor immediately if you take regular medicine, ideally before you start trying for a baby or as soon as you find out you’re pregnant. Read more about managing your medication in pregnancy here. Early symptoms Find out more about symptoms you may experience early in your pregnancy via the health and wellbeing section here. If you experience symptoms such as bleeding or pain in early pregnancy, you may be referred to the Early Pregnancy Assessment Unit (EPAU). Find out more via the specialist services section of our website here. Twins (or more) In recent years, fertility treatments and the fact that women are having babies later has made multiple births more common. It’s usually possible to find out if you’re having twins through your dating scan. Because there are increased risks with a twins or triplet pregnancy, especially if your babies share a single placenta, good antenatal care is essential. The NHS website has lots of information about the different types of twins, your check-ups and scans as well as extra care you may need. Tamba (Twins And Multiple Births Association) is the UK’s leading twins and triplets charity. Their website contains lots of tips and information about what to expect while you are pregnant. Mid to Late Pregnancy There is lots to think about during the mid to late stages of your pregnancy. Follow the development of your baby via the NHS website week by week guide here. '20 week' Scan You will be invited for a mid-pregnancy or anomalies scan, often known as the ’20 week’ scan between 18 to 21 weeks and 6 days. Find out more about this scan via the NHS website or in our tests and choices section here. Antenatal groups Antenatal groups are aimed at pregnant women and their birth partners from around 28 weeks. They consist of four, two hour sessions which take place at locations across Gloucestershire including Gloucestershire Royal Hospital, Cheltenham General Hospital, Stroud Maternity Unit, Cirencester Hospital, The Vale Community Hospital in Dursley and various locations across the Forest of Dean. Each session focuses on a different stage of your journey: Session 1 – Labour Session 2 – Birth Session 3 – Feeding Session 4 – Life with Your Baby The sessions are interactive and have been developed with women and partners. Each session is facilitated by a midwife, with support at some of the sessions from maternity support workers, breast feeding peer supporters and health visitors. Hypnobirthing Hypnobirthing involves using a mixture of visualisation, relaxation and deep breathing techniques which can give you and your birth partner the tools and techniques you need to cope with labour and birth. Courses are offered as an addition to standard antenatal groups. Courses are available to anyone from approximately 28 weeks pregnant and include: Understanding the process of labour and how to work with your body Exploring the relationship between pain and labour Practicing positions for birth Learning techniques of deep relaxation and breathing techniques Understanding the impact of hormones on labour and birth Giving birth partners the confidence and knowledge to work with you in labour, using breathing and relaxation techniques Helping birth partners to understand the importance of the birth environment and creating a calm birth room In Gloucestershire, hypnobirthing courses are offered by Gloucestershire Hospitals NHS Foundation Trust at a cost of £125* per couple. This includes 10 hours of teaching across four weeks on evenings and weekends in Gloucester, Cheltenham and Stroud. To book, please contact email@example.com with your name and due date. *concessionary places are available, please get in touch with the team for further information. Where to give birth The decision about where to have your baby is an important one. You do have choices, you are not limited to the closest location (e.g. you can live in Stroud but choose to give birth in Cheltenham), but these do depend on your individual needs. Your midwife will discuss your options with you. Head on over to our services pages for more information about your options for where to have your baby. Your birth plan A birth plan is a record of what you would like to happen during your labour and after the birth. You don’t have to create a birth plan but, if you would like one, your midwife will be able to help. Find out more via our Labour and Birth page, or visit the Gloucestershire Hospitals NHS Foundation Trust site. The NHS website also has a template you can use. Work and benefits You need to tell your employer when you wish to start your maternity leave 15 weeks before your due date. Find out more about your rights and benefits in ‘you and your partner’ here or via the NHS website here. Sleeping Positions Research has shown that in the third trimester (after 28 weeks of pregnancy) going to sleep on your back increases your risk of stillbirth. It is therefore adviseable to sleep on your side in the third trimester because it is safer for your baby. This advice relates to any episode of sleep, including: going to sleep at night returning to sleep after any night wakenings day time naps. We don’t want you to become anxious about this. If your pregnancy is uncomplicated your risk of stillbirth is low (1 in 200 babies are stillborn). Going to sleep on your side will make it even lower. To read more about your sleeping position in pregnancy click here Your Baby's Movements You may feel your baby move as early as 16 weeks of pregnancy, but most women usually feel something between 18 and 24 weeks. If this is your first pregnancy, you may not notice your baby’s movements until you are more than 20 weeks pregnant. This can feel like anything from a flutter, kick, swish or roll. There is no set number of normal movements you should be feeling. Get to know your baby’s normal pattern of movements. Feeling your baby move is a sign they are well. If your baby moves less or if you notice a change in the pattern of movements this can sometimes be an important warning sign that a baby is unwell. If you get the right treatment and care as soon as you can this could save your baby’s life. Contact your midwife or maternity unit immediately if you think your baby’s movements have slowed down, stopped or changed. Call the maternity advice line 0300 422 5541. The Tommy’s website has more advice on your baby’s movements in pregnancy here. Hearing Your Baby's Heartbeat Your midwife may offer to listen to your baby’s heartbeat from 16 weeks onwards. It can be a lovely experience for you and your partner and even your children to hear your baby. However, it is important that only midwives and trained health professionals use the equipment, known as a doppler, to listen in. When using a hand held doppler it is possible for there to be some confusion with the mother’s own heartbeat and pulsing of the placenta which can be doubled to sound like the baby’s heartbeat. This means that when you listen in, you may not be hearing the baby’s heartbeat at all and can be falsely reassured. It is also very difficult to listen to the baby’s heartbeat before about 14-16 weeks, so if you are unable to hear it, this may cause lots of unnecessary panic and anxiety. It is important to remember that the presence of a heartbeat should never be relied upon as a sign that all is ok. If you notice a change in your baby’s regular pattern of movement, they could be unwell. Do not be tempted to use a home doppler to check on the health of your baby at home. If you have any concerns about your baby’s movements, whether they have slowed down or changed pattern, you should contact your maternity unit immediately on 0300 422 5541 to be monitored properly. Measuring Your Bump It is important that you attend all your antenatal appointments in order for your midwife to monitor your baby’s growth. Once you reach 25 weeks, your midwife will use a tape measure to measure the size of your uterus at each appointment. All measurements are plotted on a chart and this enables us to assess your baby’s growth in comparison to the average growth of babies at the same stage in pregnancy, as well as to make sure that your baby is growing at a normal rate. If your midwife feels that this needs to be checked more accurately, you will be referred for a growth scan. Travel Most women can travel safely well into their pregnancy. Wherever you go, it is a good idea to take your maternity medical records (sometimes called handheld notes) with you so you can give doctors the relevant information if necessary. Wherever you go, find out what healthcare facilities are at your destination in case you need urgent medical attention. Read more about the proper precautions, when to travel, vaccinations and travel insurance, here. Preparing for Birth It is important for you to know the signs of labour and to be prepared. Knowing all about the stages of labour and what to expect will also help put your mind at rest. Find out more via the Labour and Birth page here. As you get closer to your due date, there are lots of things to think about in preparation. We take you through some of these below: Your birth plan Your birth plan is a record of what you would like to happen during your labour and after the birth. It’s important to be flexible, and be prepared to do things differently from the plan, should complications arise for either you or your baby, or if facilities such as birthing pools aren’t available. You don’t have to create a birth plan but, if you would like one, your midwife can help you. Discussing your plan with your midwife will also give you the chance to ask questions and find out more about what happens during labour. You can change your mind about your wishes for labour and birth at any time. You can read more about creating a birth plan via the Gloucestershire Hospitals NHS Foundation Trust website. The NHS website also has a template you can use. Braxton Hicks Braxton Hicks is the name given to the action when the womb contracts and tightens with your bump becoming hard to touch; it then relaxes again, becoming soft. They usually start in the second half of the pregnancy but can happen earlier. Many women don’t have them at all. They are often called ‘practice contractions’ but they are NOT contractions. Sometimes you may feel one or two tightenings in an hour or in a day, but they are usually short, lasting about 20-30 seconds each, irregular and do not continue for a long period of time. Most of the time, women find them to be painless but sometimes they can be uncomfortable. Read more about braxton hicks, here. Your hospital bag Whether you’re planning to have your baby at home, in hospital or one of our midwifery led units, you should get a few things ready at around 4 weeks before your due date. If you are attending one of our local antenatal classes, the midwives will give you some suggestions of what you’ll need to pack, or check the NHS website here. Your birth partner If you are planning to have your baby in the hospital or one of our midwifery led units, you can have a maximum of two birth partners to support you through your labour and birth. Your birth partner(s) may be the baby’s father, a close friend, partner, or a relative – and there are quite a few practical things they can do to help you. Read more about how your birth partner can support you here. Waters breaking before labour starts It’s normal for waters to break before labour starts in up to 1 in 5 pregnancies. When your waters break, you should call the maternity advice line/triage as soon as possible on 0300 422 5541. Read the leaflet from Gloucestershire Hospitals NHS Foundation Trust here for more information about what happens when your waters break and the options you may have. Anxious about labour and birth? If you’re anxious about giving birth, you could be offered the chance to discuss your anxiety with a healthcare professional who can offer support during your pregnancy and labour. Please speak to your midwife for further information about this service. Going Overdue Pregnancy normally lasts about 40 weeks – that’s around 280 days from the first day of your last period. Most women go into labour a week either side of this date, but some women go overdue. To help you with the choices available to you should you go overdue please see this leaflet. Bringing on labour There are no proven ways of starting your labour yourself at home. You may have heard that certain things can trigger labour, such as herbal supplements and having sex, but there’s no evidence that these work. Other methods that aren’t supported by scientific evidence include acupuncture, homeopathy, hot baths, castor oil, and enemas. Having sex won’t cause harm, but you should avoid having sex if your waters have broken as there’s an increased risk of infection. Stretch and sweeps Before inducing labour, you’ll be offered a “membrane sweep”, also known as a “cervical sweep”, to bring on labour. To carry out a membrane sweep, your midwife or doctor sweeps their finger around your cervix during an internal examination. This action should separate the membranes of the amniotic sac surrounding your baby from your cervix. This separation releases hormones (prostaglandins), which may kick-start your labour. Having a membrane sweep doesn’t hurt, but expect some discomfort or slight bleeding afterwards. Being induced Most women go into labour naturally (spontaneously) by the time they’re 42 weeks pregnant. Sometimes labour can be induced if your baby is overdue or there’s any sort of risk to you or your baby’s health. An induced labour is one that’s started artificially. Induction of labour is fairly common. It’s your choice whether to have your labour induced or not. Read more about induction of labour here or watch the short film below.