Recovery from vaginal or assisted birth
Recovery after vaginal or assisted birth
Weight management
Weight management
Weight gain in pregnancy
Normal weight gain in pregnancy is between 10-12.5kg (22-28lb). Calculate your BMI (Body Mass Index) with the BMI calculator below, using your pre-pregnancy weight. If you start your pregnancy with a high BMI (more than 35) or low BMI (18 or less) your midwife or GP may give you special dietary advice about weight gain or loss.Your body’s journey during pregnancy and birth
Monitoring your baby’s growth
Monitoring your baby’s growth
During pregnancy your midwife or doctor will be checking to ensure that your baby is growing well. This is done at defined stages in the pregnancy, either by measuring your bump with a tape measure or by routine ultrasound scans. If there is a concern about the growth of your bump you may be referred for a growth scan. Your baby’s progress is plotted on a chart by the person taking the measurement (midwife, doctor or sonographer).
If your baby is found to be growing smaller than expected you may require additional ultrasound scans and antenatal appointments to monitor your baby’s wellbeing.
Coping with Covid
Coping with Covid
What should I do if get COVID-19 whilst pregnant?
If you test positive for COVID-19 outside of a hospital setting, you should contact your community midwife or maternity team to make them aware of your diagnosis. If you have no symptoms or mild symptoms, you will be advised to recover at home. If you have more severe symptoms, you might be treated in hospital. In most cases Covid during pregnancy is a mild viral illness. It is advisable to keep well hydrated and to monitor your temperature. Low temperature (less than 36 degrees) or high temperature (above 37.5 degrees) should be notified to your maternity team. If you feel your symptoms are worsening or if you are not getting better, you should contact your maternity care team, your GP, or use the NHS 111 online service/NHS 24 for further information and advice. In an emergency, call 999. If you develop more severe symptoms or your recovery is delayed, this may be a sign that you are developing a more significant chest infection that requires specialised care. This advice is important for all pregnant women/birthing people, but particularly if you are at higher risk of becoming seriously unwell and being admitted to hospital. This includes women who are in their third trimester, from a Black, Asian or minority ethnic background, over the age of 35, overweight or obese, or have a pre-existing medical problem, such as high blood pressure or diabetes. If you have concerns about the well-being of yourself or your unborn baby during your illness, contact your community midwife or, if out-of-hours, your maternity team. They will provide further advice, including whether you need to attend hospital.Recovery from vaginal or assisted birth
Recovery from vaginal or assisted birth
Once you are admitted to the postnatal ward or discharged home from hospital to the care of the community midwife, you can expect that your body will need some time to recover from the birth. Midwives, maternity support workers or nurses may be involved in your care and will carry out routine checks to ensure that you are well. This will include a regular top to toe physical check, including inspection of sutures (stitches).
If you have had a vaginal birth you will be offered pain relief. Read “Commonly used medicines” to find out what painkillers are routinely offered. Read “After pains” and “Perineal after-care” which explains how you can help yourself if you are experiencing after pains or if you have had an episiotomy (cut) or a perineal tear. If you have had an assisted delivery you may need to have a urinary catheter for a few hours. Read “Passing urine” for more information.
It is important to eat well and drink plenty of fluids to promote health and wellbeing after any type of birth.
I am not a UK resident
I am not a UK resident
If you are a non-UK resident visiting from overseas, you will need to provide information in order to receive NHS treatment (including maternity care). This will include proof of all the following:
- your identity
- your permanent address
- permission for you to live/work in the UK.
Portal: I am not a UK resident
Group B Streptococcus (GBS): Frequently asked questions
Group B Streptococcus (GBS): Frequently asked questions
How is the diagnosis made?
Group B streptococcus (GBS) is a bacterium that lives in the body and causes no harm to you; it can cause a serious infection in a baby around the time of birth. GBS is carried in the vagina or rectum of up to 40% of women. It can be found on a vaginal or rectal swab or a urine test. In the UK there is no current screening programme for the carriage of GBS.What does this mean?
For me:
If you are found to carry GBS in your current pregnancy you will be recommended to receive intravenous antibiotics during labour, to minimise the chance of your baby developing a GBS infection. If GBS is found in your urine during pregnancy, you should receive antibiotic treatment.For my baby:
Most babies that come into contact with GBS during birth are well and do not develop GBS infection. If a baby does show signs of GBS infection, with prompt treatment most babies will recover completely. Rarely, GBS infection can be the cause of a neonatal death or longer term disability.What will the medical team recommend?
Intravenous antibiotic prophylaxis (IAP) for you during labour. If there are any concerns about your baby after birth, the neonatal team may recommend they receive antibiotics as well.What are the ‘red flag’ symptoms/concerns, which mean that they should be reported immediately?
If you are known to carry GBS, you should inform your maternity unit straight away when your waters break, or if you are having regular labour pains.Timing of birth
If your pregnancy progresses to term (after 37+0 weeks) IAP should be commenced as soon as labour starts or when your waters break, if they do so before labour. If your waters break before labour, induction of labour will be recommended to reduce the time your baby is exposed to the GBS bacteria.How may this impact my birth choices?
IAP is not available at home, or in some midwifery led units, so if you agree with the recommendation to receive IAP you may need to plan labour and birth in an obstetric unit.How may this affect care after the birth?
Depending on how long your receive IAP for before your baby is born, your baby may need some additional observation in hospital before you are able to go home.What will this mean for future pregnancies? How can I reduce my risk of this happening again?
In a future pregnancy you will be offered IAP again in labour, or testing for GBS carriage 3-5 weeks before birth is expected.Where can I find out more information about this condition?
Royal College of Obstetricians & Gynaecologists: GBS in pregnancy and newborn babiesFeedback on your Trusts’ websites
Feedback on your Trusts’ websites
Our maternity website in North Central London where you can give us your feedback is: www.nclmaternity.nhs.uk
You can give feedback on the website by using the “Contact us” tab at the purple menu bar near the top of the page.
We also have links to the local service user groups, called Maternity Voices Partnership of which there are four in NCL – the link can be found in the link below.
If you are a maternity service user and would like to get involved in shaping local maternity services, please visit our page: NCL Maternity Voice Partnership. Safety in NHS services
Safety in NHS services
This document outlines some recent NHS initiatives aimed at maximising safety, whilst keeping quality of care at the centre of maternity services. This will help you understand how care is designed and how you can seek more support.
NHS Long Term Plan (2019) aims to:
- Improve access to support for mental health with the same urgency as physical health for birthing people, their partners and families. Look out for local information in the app or speak to your healthcare professional.
- Improve safety for baby through the NHS England Saving Babies’ Lives Care Bundle standards, by:
- 1. Offering choice and personalised care with respect for autonomy and decisions.
- 2. Offering support to reduce smoking.
- 3. Undertaking risk assessment and appropriate management of babies who might be at risk of growth restriction (slow growth).
- 4. Informing pregnant people of the importance of promptly reporting a reduction in baby’s movements.
- 5. Undertaking effective monitoring of the baby’s wellbeing during labour and birth.
- 6. Reducing the number of preterm births and optimising care when preterm delivery cannot be prevented through:
a) Prediction
- Undertake a risk assessment and refer to the low, intermediate or high-risk pathway and develop a personalised care plan for the birthing person.
b) Prevention
- Assess if aspirin is required from 12 weeks of pregnancy.
- Support to stop smoking.
- Offer a urine test at the first antenatal appointment (Booking appointment) to screen for urine infection. If treatment is indicated, a repeat urine test should be taken to ensure infection has cleared up.
c) Preparation
- Optimise place of birth to ensure that birth occurs in a maternity unit that has the appropriate neonatal care services to support your baby.
- Birthing people are offered corticosteroid injections between 24 and 33+6 weeks, optimally at 48 hours before birth. This is to reduce the risk of your baby having breathing difficulties, gut problems, or bleeding in the brain.
- Birthing people who are in established labour, or who are having a planned preterm birth within the following 24 hours, are offered magnesium sulphate infusion between 24+0 and 29+6 weeks of pregnancy (or considered for this infusion between 30+0 and 33+6 weeks of pregnancy) to reduce the risk of cerebral palsy in babies.
- Improving general health outcomes for you and your baby. NHS England is funding a 6-8 weeks mother’s health check with your General Practitioner (GP)in addition to the baby check to assess your ongoing health and wellbeing needs.
Ockenden Report (2020)
This report aims to improve safety for you through pregnancy and post-birth through:- Enhanced safety in maternity units by undertaking a risk assessment at each contact with the birthing person to ensure that care is tailored to your needs.
- Maternity services must ensure that birthing people, their partners and their families are listened to.
- Care in complex pregnancies is managed with appropriate expertise and discussion and referrals made to specialist centres where necessary.
- Maternity services follow best practice in monitoring of the baby in labour.
- Provide access to accurate information to facilitate informed choice of intended place of birth and type of birth.
- Ensure there is access to translation services if communication in English is difficult.
Shared decision making
- All professionals should support you to make informed, value-based decisions by:
- introducing you to the options available, including their advantages and disadvantages
- helping you to explore these in the context of your preferences
- empowering you to make decisions – all professionals should support you to make informed, value-based decisions by:
- Ask yourself these three questions:
- What are my options?
- What are the pros and cons of each option for me?
- How do I get support to help me make a decision that is right for me?
