Weight management
Weight management
Disability and pregnancy
Disability and pregnancy
Parents and parents-to-be with additional needs/disability are often well adapted to their activities at home and at work, in their relationships and in interactions with their surrounding environment. Adapting to pregnancy, birth and parenting may require further adaptations. It is estimated that almost 10% of parents have a long term health condition which may result in disability or adaptation to daily living.
Maternity and other services can work in partnership with parents to facilitate individualised decision-making, equal access and making adjustments for pregnancy/birth and parenting.
Tips for getting the support you need:
- Report your additional needs when completing your pregnancy self-referral form and discuss these needs again when you meet your midwife for the first time.
- Ask for a named midwife or to be part of a continuity of care team. Knowing your midwife facilitates partnership working and personalised planning around your own needs.
- You are the expert in yourself, so talk to your midwife about what would help you through pregnancy, birth and parenting. Complete the Health and wellbeing in pregnancy personalised care and support plan with your midwife, highlighting the need for adjustments and improved access.
- Consider a self-referral for a Health Needs Assessment if you require assessment of your home, care needs or benefits.
- Refer yourself to your local sensory impairment team for advice and adaptive equipment i.e. vibrating mat to alert to baby’s cry if you are hearing impaired.
- Ask to see an occupational therapist for further specialised adaptive advice for home and parenting. Contact the local Social Services Occupational Therapy (for adaptive equipment and home adaptations) or Community Therapy teams e.g. neuro-rehabilitation for specific conditions such as Multiple sclerosis, Stroke or Functional Neurological Disorder, or via the community Learning Disability Team. Your GP can assist with making these referrals.
- You can request longer appointment times, transport and accessibility to venue for appointments to facilitate your or your supporter’s needs.
- Consider if you need someone with you at appointments, i.e. British Sign Language (BSL) interpreter, advocate or supportive relative. Talk about whom you would need to have with you during your hospital inpatient stay – assistance dog/supporter/interpreting service.
- Discuss your preferred mode of communication i.e. small chunks of information, emailed information to support verbal advice to support memory, large print, technical aids i.e. signing app, audio messaging.
- Ask about access to antenatal classes. The BSL interpreter can be with you if you are hearing impaired; the information can also be tailored for visually impaired parents. The midwife can allocate time for a personal session to individualise to your needs.
Environment:
- It may be useful to ask for a tour of the birth and after birth areas to familiarise and identify where adjustments may be required.
- Talk to your midwife about accessibility of the birthing pool, bathrooms, showers, bed heights, adjustable cot height and a single room after the baby is born to facilitate your stay if needed.
- Talk to your midwife about lighting, sound or temperature sensitivities or any preferences that make adapting to the environment more manageable.
- Discuss birth positions in case modifications are needed.
Thinking about baby care:
- Talk to the midwife about your home environment – think about inside the home and outdoors.
- Baby sleeping area – would a cot attached to the bed make it easier to reach the baby overnight?
- Plan your night and day equipment – safe sleeping in your bedroom and in your living room i.e. Moses basket.
- Baby changing stations (e.g. mat and equipment) in day/night area – to support energy conservation.
- Carrying the baby – a baby wearing sling may help to enable you to keep your hands free or a light pushchair at home to move the baby from room to room.
- Transporting the baby – will you use public transport, car or walk? Consider your needs when choosing a pushchair. The weight, brake location, ease of access, assembly and storage are things to consider when choosing the pushchair.
- Infant feeding – discuss with your midwife. Consider a supportive infant feeding pillow to support baby’s position for feeding. Consider your own comfort and supported position. Where will you be feeding? Modified feeding positions i.e. for one handed feeding, or equipment to support holding the bottle. Ask your midwife about collecting breast milk during the last part of pregnancy if you feel this could be useful to supplement the baby’s needs in the early days.
- If fatigue is a concern, your midwife can work with you to offer tips such as sleeping when the baby sleeps, energy conservation tips such as planning, pacing and prioritising what you need to ‘do, delay, delegate or ditch’ to enable your self-care and meeting the needs of your baby.
- Talk to your supporters/family to ascertain how they can help you. Plan during the pregnancy so that you are ready for when the baby arrives. Where there is limited support discuss with your midwife to explore what other services might be available to you.
COVID-19 and flu vaccines during pregnancy
COVID-19 and flu vaccines during pregnancy
COVID-19 and flu vaccines are recommended in pregnancy. Pregnant women and birthing people are strongly advised to take the COVID-19 and flu vaccines. COVID-19 and flu vaccines can be given at any stage in pregnancy. Vaccination is the best way to protect against the known serious risks of COVID-19 including protection against admission to intensive care and premature birth of the baby. Most maternity units offer vaccination, you can also book via the national vaccination booking system or ask your GP. For more information and most recent data around vaccination in pregnancy and while breastfeeding please visit: The Royal College of Obstetricians and Gynaecologists advice on vaccination in pregnancy and while breastfeeding Key information on COVID-19 in pregnancy Read this link for further information about the COVID-19 vaccine:COVID-19 Gov.UK vaccination of women of childbearing age, currently pregnant, planning a pregnancy or breastfeeding
Book or manage your coronavirus (COVID-19) vaccination
Commonly used medicines during pregnancy
Commonly used medicines during pregnancy
1. Analgesics (pain killers)
a) Paracetamol (500mg tablets)
What is it used for? Paracetamol is a commonly used pain killer in pregnancy. Paracetamol works by relieving pain and lowering high temperature. It can provide effective relief from mild to moderate pain, including headache, toothache, sore throat, symptomatic relief of rheumatic aches and pains, influenza symptoms and fever. How do I take it? Paracetamol can be taken regularly or when required for pain. Dosage: Adults and young persons aged 12 and over: take 2 tablets up to 4 times per day, as required. The tablets should be taken with water. Take only as much as you need to relieve symptom and leave at least 4 hours between each dose. Do not take more than 8 tablets in 23 hours. What are the side effects? Paracetamol is generally well-tolerated in most people. Is it safe to use during pregnancy? Paracetamol is commonly used during pregnancy.b) Co-dydramol
What is it used for? Co-dydramol (10/500 10mg dihydrocodeine and 500mg paracetamol) is a combination of paracetamol and dihydrocodeine. Dihydrocodeine is stronger than paracetamol and is used for the relief of mild to moderate pain. How do I take it? Dosage: Co-dydramol 1 to 2 tablets every 6 hours when required up to a maximum of 4 times per day. Do not take more than 8 tablets in 24 hours. We recommend that you step down pain relief and substitute these tablets for paracetamol as soon as possible which is usually after 3-4 days. Since these tablets contain paracetamol you should not take any other paracetamol tablets at the same time. Do not drink alcohol whilst taking co-dydramol. What are the side effects? The most common side effects of dihydrocodeine are drowsiness, constipation, feeling sick or dry mouth. You may be advised to take a gentle laxative if you experience constipation whilst taking co-dydramol. Is it safe to use during pregnancy? Use of dihydrocodeine during pregnancy as a pain killer can be justified where paracetamol has not been effective. Use the minimum effective does for the least amount of time. If you would like any further information regarding the use of dihydrocodeine in pregnancy, please discuss it with your midwife/doctor.2. Ferrous Sulphate (Iron supplements)
What is it used for? Iron supplements are used to treat iron deficiency anaemia. When the body does not get enough iron, it cannot produce the number of normal red blood cells needed to keep you in good health. It is common for women who are pregnant or who have just given birth to have this condition. These medicines work by replacing body iron. Iron is a mineral that the body needs to produce red blood cells. How should I take it? Swallow the tablets who with water. Although iron preparations are best absorbed on an empty stomach, they may be taken after food to reduce the effects on the stomach. Iron supplements should not be taken within one hour before or two hours after eating or drinking the following products: tea, coffee, milk, eggs and wholegrains. These products can reduce the absorption of iron. Dosage: Ferrous sulphate 200 mg tablets Treatment of iron deficiency anaemia: 1 tablet 2-3 times a day. Prevention of iron deficiency anaemia: 1 tablet per day. What are the side effects? Like all medicines, ferrous sulphate tablets may cause side effects, the most common of which are constipation, diarrhoea, stomach pain, feeling sick and blackened stools (faeces). Is it safe to use during pregnancy? Ferrous sulphate tablets are commonly used safely in pregnancy. Ensure that you do not take more than the recommended dose. If you cannot tolerate ferrous sulphate tablets, an alternative is available called ferrous fumarate. This is available as a liquid or tablets. The same side effect and safety information applies as above for ferrous sulphate.3. Laxatives
What are they used for? Laxatives are used to treat constipation. Pregnant women may experience constipation, which can be very uncomfortable. This is because the whole digestive system is influenced by hormonal changes during pregnancy. It is important for pregnancy women to look after their diet and maintain regular bowel habits to avoid unnecessary discomfort. What else can I do to prevent becoming constipated? The following hints are helpful in maintaining regular bowel habits:- Eat fibre-containing foods, e.g. wholegrain bread, fruit and vegetables.
- Drink sufficient liquid, preferably water.
- Take regular exercise.
a) Lactulose
Lactulose is a liquid laxative used to treat and prevent constipation. Lactulose can take 2-3 days to have an effect; it is generally considered to be a gentle laxative. Dosage: Usually 10 mls twice daily. It must be taken regularly to have an effect.b) Fybogel (Ispaghula husk)
Fybogel is a high fibre drink that works to increase the fibre in your diet. Increased fibre in the diet helps to gently relieve constipation. Fybogel is considered to be a gentle laxative. It is important to maintain an adequate intake of fluid whilst using Fybogel. Dosage: The usual dose is one sachet mixed with a glass of water, up to twice daily. Is it safe to use Lactulose or Fybogel during pregnancy? Lactulose and Fybogel are not absorbed into the blood and only have a local effect on the gut. Both drugs are generally considered safe to use in pregnancy and for breastfeeding, under the advice of a midwife or doctor.4. Blood clot prevention
Enoxaparin (also known as Clexane) is used to prevent blood clots. Blood clots usually present as deep vein thrombosis (DVT) usually in a leg vein, or pulmonary embolism (PE), a blood clot in the lung. Blood clots are more common during pregnancy and some women will be more at risk of blood clots than others. Your risk factors for developing a blood clot will be assessed at your booking appointment and if you are admitted to the hospital. As well as prevention, enoxaparin is also used at higher doses for treatment of DVT and PE. How is enoxaparin used during pregnancy? During the antenatal period, your midwife or obstetrician will assess your risk of developing a DVT/PE. They will look at your previous history and other risk factors that may exist. Your obstetrician will then decide if you require enoxaparin during pregnancy, and the dose you are to have. Is it safe to use during pregnancy? Enoxaparin is given as an injection just beneath the skin (subcutaneous). It is usually injected into a skin fold in your abdomen (stomach) or the upper part of your thigh. If this is not suitable, you may be advised to inject into an alternative site. It should not be injected into your muscles. It may be given either once or twice daily. You should administer the dose at the time recommended by your doctor. How to inject Enoxaparin (Clexane) You will be able to inject enoxaparin once you have been shown how to do so by your doctor or midwife, or by following the instruction leaflet that will be given to you upon discharge. It is a simple process and one that you can do at home. Follow these steps:- Wash and dry your hands.
- Clean the injection site. If someone else is doing it for you it is advisable that they wear gloves.
- Choose the injection site either on the outer aspect of your left or right thigh or your stomach if advised to do so. It is important that you change the site each time. If there is any oozing of blood at the injection site, apply gentle pressure. Do not rub as this may cause bruising.
- Dispose of the syringe in the yellow sharps box provided. This box should be kept out of the reach of other people.
Lifestyle information
Lifestyle information
Health and wellbeing in pregnancy
Health and wellbeing in pregnancy
Pre-eclampsia (PET) during pregnancy
Pre-eclampsia (PET) during pregnancy
This is a rare but serious condition of pregnancy, usually occurring after 20 weeks. It is defined by the combination of raised blood pressure and protein in the urine. Often there are no symptoms and pre-eclampsia is usually detected through regular antenatal checks, and can sometimes develop quickly.
Symptoms include:
- severe headaches
- sudden increase in swelling – particularly in the face, hands, feet or ankles
- problems with your vision such as blurring or bright spots before your eyes
- severe pain just below your ribs
- feeling very unwell.
Gestational diabetes
Gestational diabetes
Gestational diabetes is high blood sugar that develops during pregnancy and usually disappears after the birth. It occurs when the body cannot produce enough insulin (a hormone responsible for controlling blood sugar levels) to meet the increased demands of pregnancy. Symptoms aren’t common, but many women are screened for this condition during pregnancy, particularly if they have certain risk factors. Ask your midwife if you are at risk of developing gestational diabetes and if you need to be tested.
Gestational Diabetes Part 1
Gestational Diabetes Part 2
Gestational Diabetes Part 3
Portal: Gestational diabetes (Related link)
Travel vaccinations
Travel vaccinations
If you are travelling to countries that require specific vaccinations please speak to your practice nurse. Some vaccines that use live bacteria or viruses are not recommended during pregnancy because of concerns they could harm the baby in the womb. Inactivated vaccines are safe in pregnancy.
Flying
Flying
Flying is not harmful to you or your baby, but it is important to discuss your pregnancy with your midwife or doctor before travelling by plane.
The likelihood of going into labour is higher after 37 weeks and some airlines will not let you fly towards the end of pregnancy. Check with the airline directly about this. After week 28 of pregnancy, the airline may ask for a letter from your GP confirming your due date, and that you aren’t at risk of complications.
Long-distance travel carries a small risk of blood clots (known as deep vein thrombosis or DVT). Discuss any long-haul travel with your doctor as you may require DVT preventative medication, particularly if you have other risk factors.
When in the air, drink plenty of water and move around the cabin regularly. You can buy a pair of compression stockings from a pharmacy, which will help reduce the risk of DVT.
