Antenatal care

Antenatal care is the care you get from health professionals during your pregnancy. It's sometimes called pregnancy care or maternity care.

You will mainly be under the care of a midwifery team and should have a named midwife who will oversee your care. If your pregnancy is more complex or you have pre-existing health conditions you might also see a doctor who specialises in pregnancy and birth (an obstetrician).

You should start your antenatal care as soon as possible once you know you're pregnant.

Tell us you're pregnant: complete a maternity self-referral

 

During an appointment the midwife/doctor will check the health of you and your baby, give you information and answer any questions.

Your schedule of appointments will vary depending on your circumstances.

This will be discussed with you, with your midwife, at your initial appointment. If you’re pregnant with your first baby, you’ll have more appointments than those already with children. 

We follow the Perinatal Institute Gap and Grow Growth Assessment Protocol, this will be discussed with you on an individual basis.

Non-pregnancy related care will still be provided by your GP or specialist team.

The Health Visiting team will also be in contact with you towards the end of your pregnancy and once your baby is born to continue your community care.

Pregnancies requiring additional care

Multiple pregnancies

In the UK about one in every 63 pregnancies results in a multiple birth, with an upward trend over the last 20 years. Expecting twins or triplets can be an exciting yet worrying time for parents.

We run a specific clinic for parents expecting twins or triplets. You will have an extended first appointment with a specialist multiple pregnancy midwife who will continue to see you throughout your pregnancy. They work closely with the consultants who will develop a plan of care with you, including additional scans and appointments.

More information about multiple pregnancies is available from the Twins Trust and Bliss, as well as the Royal College of Obstetricians and Gynaecologists.

Gestational diabetes

Whether you have type 1 or type 2 diabetes at the start of your pregnancy you will be under the care of the Diabetes team involving a consultant, nurse, midwife, dietitian and an endocrinologist (diabetes specialist). Your care will be tailored to your needs, and your diabetes nurse or GP will help you manage your diabetes before you see your midwife.

More information about managing diabetes during your pregnancy is available from Diabetes UK.

Gestational diabetes

Gestational diabetes is the development of diabetes in pregnancy and detected by a blood test, usually done at 28 weeks of pregnancy. The hormones produced during pregnancy can make it difficult for your body to process starchy and sugary foods, resulting in gestational diabetes.

If you are diagnosed with gestational diabetes, you will be invited to a group education session to discuss your ongoing care.

 

Breech

Most babies who are in a bottom down (breech) position will turn to the normal head down position (cephalic) by 37 weeks. After 37 weeks they are much less likely to turn by themselves.

It is often possible to manually turn a baby head down by applying gentle pressure on the mother’s abdomen, improving the chances of having a vaginal birth. This is known as an external cephalic version or ECV.

If your baby is breech your midwife or doctor will discuss the possibility of an ECV with you, including the risks and benefits. If an ECV is agreed you will be given an appointment and information about coming in to hospital for the procedure.

We also offer moxibustion as an alternative option for trying to turn your baby. This is a traditional Chinese technique using ‘moxa sticks’ (made from a herb) as a gentle heat source applied to acupuncture points on your feet. Some scientific studies suggest it can be effective, but it hasn’t been researched well enough for us to be sure. Please speak to your midwife or consultant.

Birth after caesarean

Most women who have had one previous caesarean section can choose to give birth vaginally next time.

We aim to support you with having a vaginal birth, sometimes called VBAC (vaginal birth after caesarean). Your options should be discussed with you in a specialist midwifery clinic after your 20 week scan.

You will also be seen by an obstetrician by 32 weeks to discuss your birth preferences. The Royal College of Obstetricians and Gynaecologists have information on birth after previous caesarean.

Support for complex social issues

Your midwife will be able to support you with any concerns you may have. For additional support, you may find these websites and support groups useful:

  • Change Grow Live provides local support and treatment services for those living in west Kent (Dartford, Gravesham and Swanley, Maidstone, Sevenoaks, Tunbridge Wells, and Tonbridge and Malling)
  • AA provides support groups and online forums for individuals struggling with alcoholism.
  • The Domestic Abuse Support in Kent provides advice and information on services for victims, friends and family, and perpetrators of domestic abuse.