Your Health and Wellbeing On this page: Healthy Living Existing health problems Your Mental Health Early Symptoms or Problems Pregnancy related conditions Healthy Living Your health during pregnancy is important for you and your baby. The NHS website provides lots of advice on a healthy diet and some foods to avoid. Smoking and drinking alcohol can harm your baby; visit the NHS pages on quitting smoking and alcohol. You can also find advice and support through Gloucestershire Healthy Lifestyles Service (HLS). Visit their website here for more information. Exercise in pregnancy There are lots of reasons why exercise during pregnancy can be good for both you and your baby including reducing problems you may experience in later pregnancy and helping you to cope with labour. Keep up your normal daily physical activity or exercise (sport, running, yoga, dancing, or even walking to the shops and back) for as long as you feel comfortable. Find out more via the NHS website here or keep reading for local information on classes you can sign up for. Aqua natal exercise class Aqua natal is a gentle and safe way to exercise in pregnancy, and enhances maternal wellbeing. Exercising to music in water is fun, sociable and effective. Women enjoy a variety of exercises supported by the water and finish the class by practising floating relaxation techniques complemented by the buoyancy created in the pool. Classes are run weekly by qualified midwives and are open to all pregnant women who are well from 16 weeks of pregnancy right up until the baby’s due date. When: Fridays 2pm Term Time only Where: GL1 Leisure Centre (FREE for members) How to book: Please talk to your midwife about a referral to your local Aqua natal class. Vaccinations Some vaccinations are recommended during pregnancy, to protect both mother and unborn baby. Read more about them below. There are some vaccinations which are not recommended when pregnant. Read about them here. Flu Developing flu while pregnant could be bad for you and your baby. The vaccination is safe to have at any point during your pregnancy. Read more about it here. Speak to your GP or midwife about booking your flu jab. Whooping Cough Being vaccinated against whooping cough during pregnancy is the best way to protect your baby through the first few weeks of their life. The vaccine is generally offered from 16 to 32 weeks. Find out more. Existing Health Conditions If you have an existing health condition you may be nervous about what it means for your pregnancy and baby. Some exisiting health conditions include asthma, mental health problems, Diabetes and Epilepsy. It is important that if you have an existing health condition you try to go to all your antenatal appointments so your pregnancy team can monitor the health of you and your baby. Asthma If you have asthma, it’s hard to predict whether your asthma symptoms will be any different in pregnancy. Some women’s symptoms will improve, others may not see any change and some will find they get worse. If you find out you are pregnant do not stop taking your asthma medicine. Do see a GP, asthma nurse or specialist as soon as you know you’re pregnant for advice on how to manage your asthma. Your midwife will support you throughout your pregnancy, but your GP, asthma nurse or specialist will continue to manage your asthma care. The NHS website has lots of information about asthma and pregnancy here. Depression & anxiety If you have had depression and anxiety in the past, or have it now, you’re more likely to become ill during pregnancy or in the year after giving birth than at other times in your life. Even if you have depression that’s under control, the hormonal changes your body goes through during pregnancy can lead to a relapse. If you are taking medication for depression, anxiety or other mental illness you should speak to your GP as soon as you know you are pregnant. It is important that you don’t stop your medication suddenly, unless told to by your doctor. Stopping treatment suddenly can cause people to become ill again more quickly. It can also cause side effects. It may be best for you to continue your medication during your pregnancy and when breastfeeding. In Gloucestershire, the perinatal mental health team supports women with mental illness throughout their pregnancy and after the birth of their baby. Find out more about the team, including links to further resources via our specialist services page. Find out more about mental health in pregnancy here. Diabetes The information on this page is for women who were diagnosed with type 1 or type 2 diabetes before they got pregnant. Most pregnant women with diabetes will go on to have a healthy baby, but there are some possible complications you may be at higher risk of. The best way to reduce the risks to you and your baby is to ensure your diabetes is well controlled before you become pregnant. Women with diabetes should take a higher dose of 5 milligrams (mg) of folic acid each day while trying to get pregnant and until they are 12 weeks pregnant. Your doctor will have to prescribe this, as 5mg tablets are not available over the counter. It’s very important to let your midwife or GP know as soon as you find out you are pregnant. Make sure that you attend any appointments made for you so that your care team can monitor your condition and react to any changes that could affect your or your baby’s health. There is lots of information about Type 1 or Type 2 diabetes and pregnancy on the NHS website here. Epilepsy It’s difficult to predict how pregnancy will affect epilepsy. For some women their epilepsy is unaffected, while others may see an improvement in their condition. Before you become pregnant, or as early in your pregnancy as possible, you’ll be referred to an obstetrician, who will discuss and plan your care during pregnancy. Most women with epilepsy will have a healthy pregnancy and go on to have a healthy baby. But there is a slightly higher risk of having a baby with a birth defect or developmental problem, so it’s important to get the right support. If you find out you’re pregnant, don’t stop taking your anti-epilepsy medicine until you’ve spoken with your doctor or specialist. Find out more about epilepsy and pregnancy on the NHS choices website here. HIV & pregnancy You’ll be offered a confidential HIV (human immunodeficiency virus) test as part of your routine antenatal care. Your midwife or doctor will discuss the test with you, and counselling will be available if the result is positive. Current evidence suggests an HIV-positive mother in good health and without symptoms of the infection is unlikely to be adversely affected by pregnancy. However, HIV can be passed from a pregnant woman to her baby during pregnancy, birth or breastfeeding. If you’re diagnosed with HIV, you and your doctor will need to discuss the management of your pregnancy and birth to reduce the risk of infection for your baby. Treatment in pregnancy greatly reduces the risk of passing on HIV to the baby – from 1 in 4 to fewer than 1 in 100. Your baby will be tested for HIV at birth and at regular intervals for up to 2 years. You’ll be advised not to breastfeed, as HIV can be transmitted to your baby in this way. If you’re HIV positive, talk to your doctor or midwife about your own health and the options open to you. You can also contact organisations such as Positively UK or the Terrence Higgins Trust for information and support. The British HIV Association has more information on HIV and pregnancy. Your mental health It is not unusual for women to suffer with mental ill health for the first time in pregnancy. Women may feel more vulnerable and anxious, and some may develop depression. If you have had severe mental illness in the past, or have it now, you’re more likely to become ill during pregnancy or in the year after giving birth than at other times in your life. Severe mental illness includes bipolar affective disorder, severe depression and psychosis. Some women with a history of severe mental illness remain well during pregnancy – everyone is different, with triggers for becoming unwell. It’s useful to plan for all situations. Whatever your situation, talk to your midwife or doctor – there is help, support and treatment available. You can also self-refer to the Let’s Talk service, who offer talking therapies to adults in Gloucestershire who are experiencing mild to moderate anxiety and/or depression. Contact them on 0800 073 2200 or use the online referral form. If you are receiving treatment for an existing mental illness, see here for information about managing your medication. Early Symptoms or Problems Your body has a great deal to do during pregnancy and it can come with a number of symptoms which may cause irritation or discomfort, from constipation and needing to pee a lot to itching or bleeding gums. There’s rarely any need for alarm, but if you are worried it’s important to speak to your midwife or GP. On this page we cover just a couple of potential problems that may be worrying you, but the NHS website has lots of information about common health problems during pregnancy, and advice about things you can do to prevent or relieve your symptoms. Bleeding Vaginal bleeding during the first trimester (first three months) is common. It is not always a sign of a problem and may settle on its own. Most women who experience bleeding or pain do not need to stay in hospital but it is important that they see a specialist to rule out some of the worrying causes. If you have vaginal bleeding contact your GP or midwife. Most GPs can refer you to the early pregnancy unit at your local hospital straight away if necessary. Read more about vaginal bleeding while pregnant here. Severe Nausea and Vomiting 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 (HG). 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. In Gloucestershire, most patients with HG can be treated as day cases, with no need to stay overnight. Find out more here. Worried about miscarriage? A miscarriage is the loss of a pregnancy during the first 23 weeks. Sadly, the majority of miscarriages can’t be prevented. However, there are some things you can do to reduce the risk of a miscarriage. Avoid smoking, drinking alcohol and using drugs while pregnant. Being a healthy weight before getting pregnant, eating a healthy diet and reducing your risk of infection can also help. For more information about miscarriage see our specialist services page here or the NHS website here. Pregnancy related conditions Some women may experience conditions as a direct result of pregnancy. If you are worried about any symptoms you may be experiencing during pregnancy then please contact your midwife or GP. Anaemia Pregnancy can sometimes lead to a lack of iron and cause iron deficiency anaemia. Symptoms can include: tiredness and lack of energy shortness of breath noticeable heartbeats (heart palpitations) pale skin See your GP or midwife if you have symptoms of iron deficiency anaemia. It can be confirmed with a simple blood test and treated by eating iron rich foods and taking iron tablets prescribed by a doctor. There is lots of information on the NHS website on how you can both avoid anaemia and treat the symptoms here. Bleeding Causes of bleeding in later pregnancy can vary from infection, or changes to the cervix caused by hormones, to more serious conditions needing emergency treatment. If you experience bleeding in later pregnancy, you may need to have a vaginal or pelvic examination, an ultrasound scan or blood tests. If your symptoms are not severe and your baby is not due for a while, you’ll be monitored and, in some cases, kept in hospital for observation. How long you need to stay in hospital depends on the cause of the bleeding and how many weeks pregnant you are. Being in hospital allows staff to keep an eye on you and your baby, so they can act quickly if there are further problems. Deep vein thrombosis Deep vein thrombosis (DVT) is a serious condition where a blood clot forms in a deep vein in the body, usually in the leg. DVT isn’t common in pregnancy. But pregnant women at any stage of pregnancy, and up to 6 weeks after the birth, are more likely to develop DVT than non-pregnant women of the same age. Symptoms of DVT include: pain, swelling and tenderness in one leg, usually at the back of your lower leg (calf) – the pain may be worse when you bend your foot up towards your knee. a heavy ache or warm skin in the affected area red skin, particularly at the back of your leg below the knee These can be signs of deep vein thrombosis. It usually happens in only one leg, but not always. If you experience any of these symptoms, call your GP, midwife or maternity advice line on 03004 225541 immediately. There is a very small risk of developing a blood clot which breaks off into the bloodstream, and can block one of the blood vessels in the lungs. This is called a pulmonary embolism (PE) and needs emergency treatment. Call 999 immediately if you: have sudden difficulty breathing have pain or tightness in your chest or upper back are coughing blood For more information about avoiding and/or managing DVT, see here. Gestational Diabetes If you have one or more risk factors for gestational diabetes you should be offered a screening test. Gestational diabetes is high blood sugar that develops during pregnancy and usually disappears after giving birth. It can occur at any stage of pregnancy, but is more common in the second half. It occurs if your body cannot produce enough insulin – a hormone that helps control blood sugar levels – to meet the extra needs in pregnancy. Most women with gestational diabetes have otherwise normal pregnancies with healthy babies. However, gestational diabetes can cause problems for you and your baby during and after birth. The risk of these problems happening can be reduced if it’s detected and well managed. Read more about gestational diabetes here Group B strep Group B strep is common in pregnant women and rarely causes any problems. It’s not routinely tested for, but may be found during tests carried out for another reason, such as a urine test or vaginal swab. If you have group B strep while you’re pregnant: your baby will usually be healthy there’s a small risk it could spread to your baby during labour and make them ill – this happens in about 1 in 1,750 pregnancies there’s an extremely small risk you could miscarry or lose your baby If it is confirmed that you have Group B strep you may be offered antibiotics whilst in labour, to reduce the risk of passing the bacteria to your baby. It is therefore adviseable to contact your local maternity unit as soon as you go into labour or your waters break. If you’re worried about group B strep, speak to your midwife or GP for advice. You can read more about Group B strep on the NHS website here. Obstetric cholestasis Intrahepatic cholestasis of pregnancy (ICP) is a potentially serious liver disorder that can develop in pregnancy. Normally, bile acids flow from your liver to your gut to help you digest food. In ICP, the bile acids don’t flow properly and build up in your body instead. There’s no cure for ICP, but it should go once you’ve had your baby. Some studies have found that babies whose mothers have ICP have a higher chance of being born prematurely or stillborn. If you are diagnosed with ICP, you will have regular liver function tests so your doctor can monitor your condition. Because of the link with stillbirth, you may be offered induction of labour at around 37 to 38 weeks of pregnancy if you have ICP. If you have ICP, you will probably be advised to give birth on the Delivery suite at Gloucester Royal. For more information about cholestasis of pregnancy click here. Placenta praevia (low lying placenta) Placenta praevia is the term used when the placenta is attached in the lower part of the womb, near to or covering the cervix. Bleeding from a low-lying placenta can be very heavy, and put you and your baby at risk. For pregnant women with placenta praevia, a caesarean section birth will usually be recommended. If you have been told that you have a low lying placenta and experience any bleeding, you should call the maternity advice line immediately on 03004 225541 so that you and your baby can be safely monitored. Read more information on placenta praevia. Pre eclampsia Pre-eclampsia is a condition that affects some pregnant women, usually during the second half of pregnancy (from around 20 weeks) or soon after their baby is delivered. Early signs of pre-eclampsia include having high blood pressure (hypertension) and protein in your urine (proteinuria). It’s unlikely that you’ll notice these signs, but they should be picked up during your routine antenatal appointments. In some cases, further symptoms can develop, including: swelling of the feet, ankles, face and hands caused by fluid retention (oedema) severe headache vision problems pain just below the ribs If you notice any symptoms of pre-eclampsia, seek medical advice immediately by calling your midwife or your maternity advice line on 03004 225541. Although many cases are mild, the condition can lead to serious complications for both mother and baby if it’s not monitored and treated. Read more about the causes, treatment, and complications of pre eclampsia here.