Congratulations on the birth of your baby!
This section aims to cover some information that you and your partner may find useful as you get ready to take your baby home from hospital. We understand it can feel like a lot to take in. If you have any questions, please don’t be afraid to ask, or look at the further information available on the site.
Following the birth of your baby, the midwives and doctors will talk to you about your recovery and help decide the best time for you to go home. This can vary depending on how well you and your baby are.
You will find lots of useful information for new mothers on this site or you can ask your midwife any questions at your appointments.
Before you leave, make sure our staff have the right address and phone number for you so we can arrange your next appointment.
When you go home, you’ll be under the care of the community midwifery team. Your appointment may take place over the phone, in a community hub or at your home.
If you need further support, you can contact your midwife or the postnatal ward if it is outside of routine working hours on the phone numbers provided.
Your health visitor will contact you in the first two weeks to arrange an appointment. The health visiting team can support you and your family until your child reaches school age.
For babies born prematurely or with extra health needs you may also have follow- up appointments with the neonatal community service.
Click here for more information about your appointments and postnatal care
The physical recovery from pregnancy and birth is different for everyone. During the six weeks after birth, your body will slowly begin the process of getting back to its pre-pregnancy state. It’s important to remember that this happens at a different pace for everyone, and some women take longer to recover than others.
Click here for more information if you have concerns about your postnatal health
After birth you will experience vaginal bleeding, similar to that of a heavy period. You may have one or two quite large clots (the size of a tomato or satsuma) or several smaller ones (about the size of a grape) during the first two to three days. Over the following days and weeks your blood loss should reduce in quantity, it may even completely stop but then restart a few days later. This is normal, it is just your body getting itself ready to begin its menstrual cycle again.
If you are breastfeeding, you may find your blood loss is initially slightly heavier just after feeding your baby. You may also find that when your postnatal bleeding stops completely, your period may not return for many months.
If you have any worries please click here for further information.
You may experience pain, similar to mild labour pains after the birth. After pains following birth are normal and not a cause for concern. You may notice these are worse if you have had more than one child. Some women notice afterpains while breastfeeding. You should expect after pains to improve day by day as your womb (uterus) returns to its normal size. Taking regular paracetamol (1g every 4-6 hours - not exceeding 4g in 24hrs) and ibuprofen (200–400 mg 3–4 times a day) will help with the discomfort. Please avoid taking medication that contains codeine if breastfeeding.
If you have concerns about your afterpains please click here
For more information about pain relief and medications following birth please click here
After birth, some women need stitches to their perineum which is the area between your vagina and bottom. The length of time it takes for these to heal is very individual and depends on the type of tear. Keeping your perineal area as clean and dry as possible, changing maternity pads frequently and washing your hands before and after going to the toilet will help to reduce the risk of infection.
If you experience an increase in pain from your stitches, notice an unpleasant smell or discharge then please let your midwife or GP know, so they can check them for you.
If you have had a 3rd or 4th degree tear, a follow-up appointment will be made for you so we can be sure it is healing well.
For more information please click here
For information about recovery after your caesarean section please click here
Your pelvic floor muscles are the group of muscles you would use to stop yourself passing wind or for holding in a wee. The pelvic floor are weakened by pregnancy and birth so we advise doing exercises to help strengthen them again to prevent future problems. Generally these exercises are tricky immediately following birth, but get easier in the coming weeks. Try and make them a part of your daily routine.
You may like to download the squeezy app for information and reminders. For more information, Click here
Some women are advised by their midwife to wear special stockings after the birth to reduce the risk of blood clots in the legs. This advice will depend on the type of birth and any additional risk factors. You are at your highest risk of developing a blood clot just after having your baby so tell your midwife or another health professional if you experience pain in your lower leg, or redness, swelling or pain in your groin.
There are some signs that we ask you to look out for and report to a health professional. These include:
If you feel unwell or experience pain after your baby is born please look at the information here, call your midwife or the postnatal ward if it is out of hours. In an emergency, call 999.
Pregnancy and birth can cause many strong emotions. It is important to talk about how you feel with your midwife and other health professionals and also with your partner, family and friends.
It is very normal to become very teary and emotional around day three – you may have heard of this period described as the ‘baby blues’. Your hormone levels are high, you’re likely to be very tired and the adjustment to new family life can feel overwhelming for many women. These are very normal feelings and they may fluctuate over the first 7-10 days.
If after two weeks you feel that you are still feeling down, depressed or hopeless and have little interest in doing things then please speak to your health visitor or see your GP. Your GP can give you ongoing emotional support and signpost you to other health professionals if needed.
Please listen to your family and friends if they have any concerns regarding your emotional wellbeing as it is often loved ones who notice you may need extra support.
Click here for more information
There are no rules about when to start having sex again after you have given birth, but it is important that you are aware that you are fertile and could conceive again from approximately 21 days following birth.
Exclusively breastfeeding is not a reliable form of contraception and other methods such as condoms, pills, injections, implants or the coil are recommended to avoid becoming pregnant again too soon. Many of these can be started immediately after birth. If you are breastfeeding and you would like to use a hormonal contraception then you will be advised to have a progesterone-only option.
Click here for more information
If you, or your partner are a smoker and would like help with quitting please let your midwife or GP know. They will be more than happy to help with this, or you can self refer to your local quit smoking service. There is a range of free help available including nicotine replacement therapies. Smoking around your baby increases the risk of Sudden Infant Death Syndrome also known as SIDS or cot death. If you plan to continue then please smoke outside, away from your baby then wash your hands and change your clothes (where possible) before going near your baby.
If you have a background medical condition or a new medical condition diagnosed in pregnancy your healthcare team will outline the future plan with you before you go home. It may be important for you to see your GP for on-going tests and further treatments.
You may have delayed your screening for cervical cancer while you were pregnant, please remember to re book this once your baby is over 12 weeks old.
As a new Dad or partner you will feel excited, but you may also feel left out, unsure or overwhelmed. The regional “Dad Pad” is a resource available to ALL partners to give you the knowledge and practical skills that you need.
Click here for more information
Your midwife or maternity support worker will offer to weigh your baby at intervals once you are at home. It is normal for most babies to lose some weight in the first few days but the staff will check that this is in the normal range and will offer support with feeding if needed.
Click here to learn more about your postnatal care and appointments
Your midwife or maternity support worker will offer to weigh your baby at intervals once you are at home. It is normal for most babies to lose some weight in the first few days but the staff will check that this is in the normal range and will offer support with feeding if needed.
Click here to learn more about your postnatal care and appointments
Your baby’s umbilical cord will dry and eventually fall off between 3-10 days old. Please keep the cord area clean by wiping around it with cotton wool and water daily. You do not need to wait until the cord and clamp have fallen off before bathing your baby but make sure its dry before dressing your baby.
You can fold over the top of your baby’s nappy to expose the cord to air to encourage drying sooner if you prefer. If you notice the cord area is bleeding, oozing or developing a nasty smell then please let your midwife know. Once the cord and clamp have fallen off carry on cleaning the umbilical area until it has healed.
All babies have a strong desire to be close to their parents as this helps them feel more secure and loved. Having your baby close to you will help you to learn their cues that they are hungry or need a cuddle.
Breastmilk is tailor made for your baby to provide all the nutrients, comfort and protection that they need. You may find that in the early days of establishing breastfeeding, it may take a while to feel confident. The most common challenges can be resolved quickly and easily with the right support. There is lots of help in your local area so please reach out if you have any questions or concerns. Babies cannot be overfed at the breast so you can use breastfeeding to soothe your baby as well as a way to spend time together or having a rest when you both want to.
If you are using a bottle to feed your baby, please ensure you follow the guidance to make up and give the milk as safely as possible. Enjoy holding your baby close during the feeds with lots of eye contact. Learn how to do paced bottle feeding to notice their cues of when they want to be fed and when they have had enough.
Click here for more information on feeding your baby
Click here for information if you have breastfeeding concerns
Babies who are drinking well will be regularly passing urine, stools and waking frequently on their own to feed. You can keep a close eye on their nappies and behaviour to know if they are feeding well.
Click here of more information
Around half of newborn babies will develop a condition called neonatal jaundice. This is where their skin appears yellow.Jaundice doesn’t usually cause your baby any problems however if you notice your baby’s skin, eyes or gums are yellow or if your baby becomes reluctant to feed, sleepy and difficult to wake call your midwife as your baby will need to be checked over by a health professional that day. Regular feeding will help to naturally reduce the bilirubin levels causing your baby’s skin to look yellow.
Click here if you are concerned your baby has neonatal jaundice
The amount a baby cries varies hugely. A baby’s cry is designed to get your attention and it is OK to find that frustrating when you don’t know what it is that your baby wants.
From the age of two weeks infant crying generally increases, reaching a peak at around 6-8 weeks, before starting to reduce.
There are various things you can try in order to soothe your baby. Holding them, gently rocking, walking them around, taking them for a walk in the pram or sling are all methods you may find useful.
It is never OK to shake your baby but it is OK to leave your baby in a safe place and walk away momentarily. Providing your baby is in a safe place give yourself a chance to regroup for a few minutes then return to the baby when you feel calmer.
Remember it is very normal for babies to cry sometimes. It is normal to find it hard at times and its worth having the support of family and friends. If you are ever concerned about the level of your baby’s crying please read the further information here or seek advice from a health professional.
From birth, all breastfed babies should be given a daily supplement of vitamin D (8.5 to 10mcg). But if your baby is having more than 500ml (about a pint) of first infant formula a day, they do not need a supplement because formula is already fortified with vitamin D. Breastfeeding mothers are also encouraged to take a supplement of 10 micrograms a day.
Ensuring your baby is safely settled for sleep is important to help prevent Sudden Infant Death also known as (SIDS) or cot death.You can reduce the risk of SIDS by adopting some safe sleeping advice. The key points to remember are:
•Co-sleeping (sleeping in the same bed as your baby) can be dangerous if either you or your partner smoke, have been drinking, or taken any drugs (including medication that can make you feel drowsy), or if your baby was born at a low birth weight or prematurely.
It is important to keep pillows, sheets and blankets away from the baby.
If you have any questions about safe sleeping, you can speak to your midwife or health visitor or read more information here
Legally you must register your baby within 42 days of their birth. You can use the www.gov.uk/register-offices website to find your closest registry office, and follow the links to their website for contact details and how to book an appointment. If you are married or in a civil partnership then only one parent needs to attend. If you are unmarried and want both parents to be on the birth certificate you will need to attend together.
Your GP would like to see you once your baby is 6-8weeks old. This is for a final postnatal check on you, and a repeat of the newborn and infant examination- that your baby would have had soon after they were born. Some GP practices prefer you to register your baby at the surgery before the appointment and this can be done once you have registered your baby’s birth and have a birth certificate.
Babies should travel in the right car seat for their age and weight, facing backwards, ideally secured by Isofix or the car seatbelt on the rear seats.
If you travel with your baby on the front seat of your car, make sure that the passenger air bag has been switched off and the baby is rear facing in the car seat. It is unsafe for your baby to wear coats and snowsuits whilst in their car seat travelling in a car, so tuck a blanket around them if it is cold. If it is too warm in your car to wear a coat yourself then your baby is likely to get too warm in a coat. Try not to let your baby spend too long in a car seat. There is no published evidence of how long a baby should stay in a car seat but car seat manufacturers recommend that this is for no longer than 2 hours. Taking your baby out and laying them flat at regular intervals is advised.
Click here for more information.
Pets may find it unsettling once you arrive home with your new baby. Give your pet time to get used to the new smells and noises and don’t force them if they want to hide temporarily. We recommend not leaving your pet alone with a baby or toddler and keeping toys separate.
You baby’s skin has never seen any sun and is very sensitive. It’s a good idea to keep your baby out of direct sunlight and cool in the shade, wearing suncream (higher than 30SPF) when needed. It can be dangerous to place a muslin or cover over your baby’s pram for shade as this increase the temperature around your baby and can lead to over heating.
Please give us your feedback on your care and help us improve the service we offer by completing the friends and family questionnaire. You can do this via your Badger notes.
You may feel the need to talk to a midwife about your birth experience if you have specific questions you would like answered, things you can’t remember or are unsure of. Your midwife can give you details about the service within your hospital to support you with this.
If you would like to be part of a group to help improve maternity services, you can get in touch with your local Maternity Voices Partnership via Facebook.
Now, please download the Healthier Together Urgent Care app which will be there for you if you are worried your baby is unwell and assist you with accessing help.
Please don’t forget there is loads of information held on the Healthier Together website to support you with your new baby. This includes the following sections:
And much more.
Please look here to help understand what's normal and what's not for a new born baby.
If you are concerned your baby is unwell find more information here
Please download the Healthier Together Urgent Care app which will be there for you if you are worried your baby is unwell and assist you with accessing help.
Before pregnancy
A woman’s chance of becoming pregnant decreases with age, particularly after the age of 35 because both the number and quality of eggs get lower. A man’s ability to have a baby also declines with age, though not as much as women’s. If the male partner is over 40, this can make it harder for the woman to get pregnant, especially if she is also over 40. However more than 8 in 10 of couples will conceive within a year if the woman is under 40 years of age, and they have regular sex (every 2 to 3 days) without using contraception.
Top tips
- At any age, it is a good idea to be as healthy as possible before you get pregnant.
- See your GP if you haven’t conceived after a year of trying or within six months of trying to conceive if you are over 36.
During pregnancy
While most women have healthy pregnancies and babies, the chance of complications in pregnancy increases with age. Such complications include miscarriage, pre-eclampsia (high blood pressure and protein in the urine) or having a baby with a chromosomal abnormality, for instance Downs syndrome. All women, regardless of their age, have a chance of having a baby with a chromosomal abnormality, however this chance increases with maternal age.
All women are offered antenatal screening to detect baby’s that have a high chance of conditions such as Downs syndrome.
Top tips
- It is important that you attend all your antenatal care appointments so problems can be spotted as early as possible.
Before pregnancy
Fertility begins to improve quickly when you and your partner go smokefree. After 12 months of trying, women who are smokefree are twice as likely to be pregnant than women who smoke tobacco. Even smoking a small number of cigarettes a day can make getting pregnant more difficult. Second-hand smoke (breathing in tobacco smoke from others) is also likely to reduce your chances of conceiving. Smoking has been shown to reduce the quality of both the egg and sperm.
During pregnancy
Smoking in pregnancy is damaging to the health of you and your baby in many ways. Smoking in pregnancy is the biggest risk factor for stillbirth and infant death. Carbon monoxide (CO) monitoring is used by midwives for all women during pregnancy to detect harmful level of carbon monoxide. This may be due to smoking, exposure to secondhand smoke or to unsafe levels of carbon monoxide from other sources, including faulty cooking and heating appliances. To learn more about smoking in pregnancy, including about e-cigarettes and how to get support to quit, visit our stop smoking page by clicking here.
Top tips
- Ideally, it is best for both you and your partner to stop smoking before you try to become pregnant. However, if you are pregnant, it is still important to stop smoking. The earlier you stop smoking the healthier you and your baby will be.
- If you are pregnant, let your midwife know that you or our partner smokes as they can help you to get the right support to stay smokefree. You may also want to encourage others whose secondhand smoke you are exposed to e.g. family members or friends, to get support.
Before pregnancy
Drinking a lot of alcohol, or drinking alcohol frequently, can affect fertility in both men and women. The UK Chief Medical Officers recommend that if you are pregnant or planning to become pregnant, the safest approach is not to drink alcohol at all to keep risks to your baby to a minimum.
If having treatment to assist fertility, studies have also shown that even light drinking can reduce the chances of success. Drinking excessively can damage the egg and sperm.
During pregnancy
There is no known safe level of alcohol to drink during pregnancy. The UK Chief Medical Officers guideline suggest the risk of harm to the baby is likely to be low if a woman has drunk only small amounts of alcohol before she knew she was pregnant or during pregnancy. Drinking heavily during pregnancy can cause a baby to develop fetal alcohol syndrome (FAS) which is a serious condition (read more about it by clicking here).
Top tips
- If you are planning to become pregnant and would like support to reduce or stop drinking alcohol, including if you are worried that you might be dependent on alcohol, speak to your GP or the specialist alcohol treatment service in your area (using the link above).
- Once you stop contraception it is best to avoid alcohol as you may get pregnant straight away.
- If you are pregnant, let your midwife know how much alcohol you drink including if you are worried that you might be dependent on alcohol as they can discuss this with you and help you to access support if it might help.
Before pregnancy
Using drugs, such as cannabis, cocaine, and new psychoactive substances (also known as ‘legal highs’) can affect fertility in both men and women.
Cannabis is the most commonly used recreational drug. In women, heavy cannabis use can cause hormones to be unbalanced so women who use it are more likely to find it difficult to get pregnant.
Some prescription drugs can also lead to dependence and are not suitable to take during pregnancy.
During pregnancy
Illegal drugs may cause serious problems in pregnancy and affect your baby’s growth and development. Some prescription drugs can also lead to dependence and are not be suitable to take during pregnancy.
Top tips
- Once you stop contraception it is advised to avoid taking illegal drugs (and new psychoactive substances) as you may become pregnant at any point.
- If you would like support to quit, including if you are worried that you might be dependent on drugs, speak to your GP or the specialist drug treatment service in your area. If you are pregnant, let your midwife know what drugs you are taking and how, as they can help you to access support.
- The FRANK website is also a good source of information, both about the different types of drugs, and the local help available if you are concerned about your drug use.
- If you are concerned that you are dependent on a prescription medication, speak to your midwife or a doctor so they can help you get the right support.
Before pregnancy
If you’re planning to get pregnant, eating a healthy, balanced diet will help you stay well throughout pregnancy and be good for your baby’s health. The best foods for getting pregnant are the same as those for general well-being. For both men and women, being overweight or underweight can affect fertility, cause health problems during pregnancy and during birth, as well as affect the future health of a child. Men can also improve the chances of a pregnancy with a healthy, balanced diet because sperm quality can be affected.
If you are trying to get pregnant eating a healthy, varied diet will help you to get most of the vitamins and minerals you need. All women need to take folic acid tablets (see section on folic acid below for further information) before getting pregnant to offer protection against neural tube defects such as spina bifida in the early stages of pregnancy. It is almost impossible to get enough folic acid through your diet to give the most protection.
During pregnancy
When pregnant, guidelines recommend you and your baby will benefit from a healthy diet in which you get five portions of fruit or vegetables each day (with at least 3 portions of vegetables). A healthy balanced diet will give you most of the vitamins and minerals you need for your developing baby and help keep you and baby healthy and strong ahead of birth. Some foods should be avoided during pregnancy to minimize the risk of food poisoning which can be harmful to you and your baby (see link below for more information on specific foods). A poor diet can also damage your teeth. Hormonal changes during pregnancy can make gums more vulnerable to plaque, leading to inflammation and bleeding. The best way to prevent or deal with gum problems is to practice good oral hygiene. Pregnant women, or women who have had a baby in the past 12 months are entitled to free NHS dental care (you'll need a Maternity Exemption Certificate from you midwife or doctor).
Top Tips
Before and during pregnancy
- There is lots of information on having a healthy diet, foods to avoid, and vegetarian and vegan diets during pregnancy on our staying healthy during pregnancy page under the 'eat well during pregnancy' section - to access it, click here.
- Aim to eat a variety of healthy foods every day. Making some improvements to your diet will have a positive effect, do as much as you can. Talk to your midwife for advice if needed.
- Most women should take 400mcg of folic acid every day for two months before trying for a baby and until 12 weeks pregnant. You will need a higher dose of folic acid tablets if you have some health conditions such as diabetes, epilepsy or have a BMI (Body Mass Index) over 30. See the section on folic acid below for further information.
- Do not eat for two - during the last three months of pregnancy you may need an additional 200 calories a day.
- Weight gain during pregnancy varies greatly. For more information on what to expect see the 'weight gain in pregnancy' section by clicking here.
- Practice good oral hygiene during pregnancy (ask your midwife how to apply for a Maternity Exemption Certificate).
Before pregnancy
Being a healthy weight is helpful if you are planning to have a baby. Your BMI (Body Mass Index) is a measure that uses your height and weight to work out if your weight is in a healthy range (a BMI calculator is available here).
Having an unhealthy (overweight or underweight) BMI can affect your fertility, cause health problems during pregnancy and during birth, as well as affect the future health of a child.
High BMI
Having a high BMI can reduce your chances of getting pregnant. The ideal BMI for getting pregnant is between 18.5 and 24.9. This is known as the healthy range. If you have a high BMI, bringing it closer to the healthy range before trying for a baby will help you get pregnant as well as improving the health of your future pregnancy and child. If you have a high BMI bringing it down, even by 1 or 2 points, can make a positive difference.
A high BMI in a man can also affect the quality and quantity of their sperm, which can contribute to difficulty conceiving.
Low BMI
Having a BMI below 18.5 is classed as underweight, which can make it harder to get pregnant.
Having a low BMI can also cause periods to become irregular or stop. This can be a sign that ovulation is not happening (releasing an egg from your ovary each month), which is needed to get pregnant. If you are not having periods, putting on weight to get to a healthy BMI may help this.
Top Tips
- Everyone regardless of BMI should aim to eat a healthy, balanced diet as well as being physically active (see nutrition and physical activity sections below for further information). Before pregnancy, if you have a high BMI, bringing your BMI down 1 or 2 points towards the healthy range will reduce your risks and increase your chances of conceiving.
- If you are finding it difficult to achieve a healthy weight before pregnancy:
Speak to your GP who may be able to help you access weight management or other specialist support around increasing/losing weight. Some services accept self-referrals which you may be able to find details of on the Internet for a service in your area.
- See section below for information explaining more about folic acid. For women who have a BMI over 30, a higher daily dose of folic acid is needed (5mg daily). Ask your pharmacist or GP if you are unsure what dose may be suitable for you. The GP will need to write a prescription for you.
- If you are unsure what your BMI is, you may find this calculator helpful - to access it, click here.
Before pregnancy
Exercise/being active can boost your chances of becoming pregnant. Women who do regular, moderate exercise typically get pregnant more quickly than women who don’t exercise regularly. Any activity which raises your heart rate, makes you breathe faster and makes you feel warmer counts.
Being active by doing regular moderate exercise before you get pregnant can reduce your risk of having problems in pregnancy, such as gestational diabetes or pre-eclampsia (high blood pressure and protein in the urine) that might harm you or your baby.
Feeling low or anxious can be common if you are trying to become pregnant. Staying active can help to boost your mood and lessen stress. If feeling low or anxious persists, visiting a GP can help to get the right support.
During pregnancy
Being active during pregnancy is safe and healthy for mother and baby, however if you play a sport where there is contact/risk of contact or potential risk of falling (especially in later stages when balance/centre of gravity alters due to larger baby bump) you should avoid these and opt for a non-contact sport or activity. As your bump gets bigger you may find that you feel light headed or dizzy lying on your back. This is because the weight of your bump presses on the main blood vessel bringing blood back to your heart and this can make you feel faint. It is best to avoid lying on your back if you experience light headedness.
Being active by doing regular moderate exercise during pregnancy can help lead to a healthy pregnancy and birth. It can reduce risk of having problems in pregnancy, such as gestational diabetes or pre-eclampsia.
Feeling low or anxious can be common during pregnancy. Staying active can help to boost your mood and lessen stress. If feeling low or anxious persists, speaking to your midwife or visiting a GP can help to get the right support.
Top Tips
Before pregnancy
- If you have always been moderately active, continuing to exercise at the same level before pregnancy is safe and healthy.
- If you have not been active before, start to build up your level of activity now. Start by finding ways to build small amounts of physical activity into your daily routine, for instance by walking to work.
- Before pregnancy, the Chief Medical Officer suggests to aim for at least 150 minutes or moderate intensity activity per week or at least 75 minutes of vigorous intensity activity per week, or a combination of both. Also aim to minimise time spent being inactive. This infographic may be helpful.
During pregnancy
- Exercise during pregnancy is very beneficial to both yours and your baby’s health.
- Practicing pelvic floor exercises regularly may help prevent leaking urine accidentally when you cough or strain, both during your pregnancy and after your baby is born.
- Find out more information here.
Before and during pregnancy
Folic acid (a vitamin) is important as it reduces the risk of birth defects known as neural tube defects, including spina bifida (a serious spinal problem).
While folic acid is contained within certain foods, even a healthy diet does not contain enough folic acid for pregnancy. Taking folic acid tablets is therefore very important.
Every woman of reproductive age needs enough folic acid every day to help make new cells, whether planning to get pregnant or not.
It is advised that all women take folic acid tablets before getting pregnant to offer protection against neural tube defects such as spina bifida in the early stages of pregnancy.
Some women, including those with diabetes, epilepsy, rheumatoid arthritis, or who have a BMI over 30, need to take a higher dose of 5mg of folic acid (instead of 400mcg). This is available free of charge through your doctor.
All women are offered an ultrasound scan and to look for conditions such as spina bifida.
Top Tips
- Two to three months before you plan to stop contraception start taking a daily folic acid tablet of 400mcg and continue taking up to week 12 of pregnancy. This can be bought from a supermarket or high street pharmacy.
If you are eligible for Healthy Start vitamins, they contain 400mcg folic acid. Find out more here.
- For women who have a BMI over 30 or who have long term conditions such as epilepsy, rheumatoid arthritis, or are taking certain medications, a higher daily dose of folic acid is needed (5mg daily). Ask your pharmacist or GP if you are unsure what dose may be suitable for you. The GP will need to write a prescription for you.
- Find more information about screening for physical abnormalities in pregnancy here (this information is available in multiple languages).
Before pregnancy
Vitamin D helps us to absorb the right amount of calcium and phosphate which are needed to keep bones, teeth and muscles healthy.
We get vitamin D from sunlight and it is also found in some foods. Most of us don’t get enough vitamin D from our diet and we rely on the summer sunlight on our skin to make enough vitamin D for the winter months.
During pregnancy
Vitamin D is especially important in pregnancy as it helps your baby’s bones, teeth, kidneys, heart and nervous system to develop. All pregnant women are advised to take a 10 microgram supplement of vitamin D each day to give your baby enough vitamin D for the first few months of life.
Without it, there is a risk that your child will have soft bones, which can lead to rickets (a disease that affects bone development in children).
Some women are more likely to need vitamin D than others. You may have an even higher risk of vitamin D deficiency if you; always cover your skin, use high-factor sun block, have dark skin, spend very little time outside, have a BMI above 30.
During pregnancy, do not take vitamin A supplements or any supplements containing vitamin A (retinol), as too much could harm your baby.
Action
If you are pregnant, discuss with your GP or midwife if you are not sure what dose of vitamin D is right for you and consider buying a pregnancy appropriate 10 microgram supplement.
If you are buying a multivitamin supplement, ensure the supplement is specific to pregnancy.
- If you are eligible for Healthy Start vitamins, they contain vitamin D. Find out more click here.
Before and during pregnancy
High levels of caffeine before and during pregnancy can result in babies having a low birth weight. Too much caffeine can also increase the risk of miscarriage. Advice is to limit caffeine intake to 200mg a day.
Top Tips
Reduce caffeine intake to under 200mg a day. Decaffeinated drinks may be a helpful alternative. Be aware that chocolate, energy drinks and cola, as well as tea and coffee contain caffeine.
These are common sources of caffeine:
- Mug of instant coffee = 100mg
- Mug of filter coffee = 140mg
- Mug of tea = 75mg
- Can of cola = 40mg
- Can (250ml) of energy drink: up to 80mg
- Bar (50g) of plain chocolate = less than 25mg
- Bar (50g) of milk chocolate = less than 10mg
This caffeine calculator may be useful to estimate how much caffeine you are consuming.
Before pregnancy
Planning for a baby can be a big change in someone's life. It can also lead to worries about money, family relationships, as well as a range of other things. Being anxious from time to time is normal, but if it does not go away then it is important to talk to someone about it.
Those who experience difficulty in becoming pregnant may experience an impact on their emotional health and wellbeing too. Partners may become anxious which can increase risk of sexual dysfunction. The process of treatment to assist conception too can be a source of stress, anxiety and depression.
For individuals with an existing mental health condition, sometimes becoming pregnancy can trigger this condition to become worse, in other cases there will be no change - everyone is different. Mental health conditions are often managed with medications. Doctors and specialists can help with decisions about how mental health conditions can be managed during pregnancy. This may include ensuring that conditions are as stable as possible before pregnancy and checking suitability of medications for mother and baby. It may be helpful for mental health conditions to be monitored closely during pregnancy.
During pregnancy
For information on mental health during pregnancy, click here.
Top Tips
- Take care of your emotional health as you try to become pregnant, including through being active, eating well, finding ways to relax and avoiding drugs and alcohol.
- Take notice of your emotional health. Try to talk to someone you trust if you are feeling stressed, anxious or are experiencing symptoms of your mental health condition, whether that be your partner, a friend or family member or your doctor who may be able to help you access support. Remember that changes to emotional wellbeing at this time are not unusual.
- For individuals who are taking medication for mental health conditions and who are planning to become pregnant, talk to a doctor or specialist letting them know your plans, ideally before stopping contraception.
- Do not stop taking medication before speaking to a doctor or specialist as it could be dangerous. They will work with you to find the most suitable medication for managing your mental health condition in pregnancy.
- Meet other expectant and new parents by downloading the MUSH app.
- Remember, pregnant women, or women who have had a baby in the past 12 months are entitled to free prescriptions (you'll need a Maternity Exemption Certificate).
Before pregnancy
Close management of diabetes (type 1 or type 2 diabetes) before pregnancy can help reduce risks of pregnancy loss or birth defects. Suitability of some medications which are part of diabetes management may need to be reviewed ahead of pregnancy and therefore it is important to speak to your doctor before trying to become pregnant.
During pregnancy
Individuals who have diabetes (either type 1 or type 2) can experience diabetes related complications unlinked to pregnancy (known as microvascular and macrovascular complications). However, the combination of diabetes and pregnancy can increase the risk of developing these problems, or making existing problems worse.
Due to hormonal changes, pregnancy can sometimes cause rapid progression of diabetic retinopathy (a microvascular complication), which affects the small blood vessels in the retina of the eye. Checks to identify diabetic retinopathy therefore need to be undertaken more frequently during pregnancy.
In addition, women who have not previously had diabetes can experience gestational diabetes, a condition characterised by high blood sugar during pregnancy. Gestational diabetes resolves after pregnancy, but increases a woman’s chance of developing Type 2 diabetes subsequently.
Top Tips
- It is important to speak to your diabetes specialist as soon as you start thinking about stopping your contraception. The earlier the better, 6–12 months before thinking about having a baby is ideal. There are important steps which your specialist can help with to make sure you are ready before you conceive. This includes reviewing how your blood glucose levels are controlled, reviewing suitability of medication for pregnancy, and prescribing a higher dose of folic acid (5mg daily) to take while you are trying to get pregnant.
- Aim to keep good control of your diabetes and blood pressure during pregnancy, as well as not smoking, as this will reduce the chance of complications associated with diabetes developing or progressing.
- Ensure you know how frequently to attend diabetic eye screening during pregnancy. This is usually every 3 months, starting within the first 6 weeks of pregnancy.
- Find more information about diabetic retinopathy screening in pregnancy by clicking here (this information is available in multiple languages).
Before pregnancy
Many people take medications prescribed by their GP Suitability of some medications may need to be reviewed for use during pregnancy. For other medications, the health condition may need to be carefully monitored. This will depend on the specific health condition and therefore it is important to talk about plans for pregnancy with your doctor, only taking your medications with their advice. Over the counter medicines, complementary medicines or other supplements also need to be considered, talk to your pharmacist for more information.
Depending on the health condition, sometimes a higher dose of folic acid may need to be prescribed (5mg daily rather than 400mcg) to take while trying to get pregnant and for during pregnancy, according to your doctor's advice.
Find more information on some pre existing medical conditions here.
During pregnancy
Management of health conditions can change during pregnancy. You may be regularly reviewed during pregnancy so that your condition can be closely monitored.
Top Tips
- Speak to a doctor or pharmacist? about plans to try for a baby so that your treatment can be checked for safety in pregnancy.
- Your doctor will talk to you about:
Prescribing a higher dose of folic acid (5mg daily) to take while you are trying to get pregnant
Any medications you are taking so their suitability can be reviewed
How your condition may affect pregnancy and vice versa
How you will be cared for during pregnancy.
- Remember, pregnant women, or women who have had a baby in the past 12 months are entitled to free prescriptions (you'll need a Maternity Exemption Certificate).
Before pregnancy
Sexually transmitted infections (STIs) are conditions that are passed from one person to another through sexual contact. Many STIs have no or only mild symptoms. This means that there is a group of people who are living with STIs that they do not know they have, increasing their risk of passing their infection on to other sexual partners.
Many STIs can affect chances of getting pregnant. For instance, chlamydia and gonorrhoea are two of the most common STIs. Either can lead to infertility in men and women if not treated.
Syphilis, another STI, can be treated but if a woman becomes pregnant when she already has syphilis, (or becomes infected while pregnant), it can be very dangerous for the baby. Click here for more information about syphilis.
HIV and Hepatitis B can also be passed on by sexual contact (as well as by other routes of transmission). For those living with HIV or Hepatitis B, it is important to talk to your specialist doctor or nurse. They can advise about conceiving safely, minimising the risk of passing the infection on to the baby and planning specialist care which may be needed during pregnancy and birth. Click here for more information about HIV and Hepatitis B.
Most STIs can be treated with antibiotics, special creams or shampoos. But some treatments are not suitable if you are pregnant and therefore it’s a good idea to get checked before trying for a baby.
During pregnancy
For more information on how sexually transmitted infections may affect your pregnancy. click here.
You will be screened for HIV, Hepatitis B and syphilis as part of the Infectious Diseases in Pregnancy Screening programme. This is part of routine antenatal screening and is offered, and recommended, for all pregnant women in England in every pregnancy.
Top Tips
- Before trying for a baby, if you have any reason to believe you or your partner may have an STI, contact your local Sexual Health service about getting a sexual health screen. For many services, you will be able to access a sexual health screening test that will be posted to your home. In some areas you may need to go to your local sexual health clinic for a check-up.
- For people living with HIV or Hepatitis B, talk to your specialist doctor or nurse as they can advise about conceiving safely and it will be necessary to plan specialist care needed during pregnancy and birth.
- Find more information about infectious disease screening in pregnancy here (this information is available in multiple languages).
Before pregnancy
If you're planning a pregnancy, it’s a good idea to check if you are up to date with your cervical screening and if necessary, have the test before getting pregnant. Cervical screening aims to identify abnormal cells which can sometimes lead to cervical cancer. Having this test before becoming pregnant means that any further tests or treatment can be arranged around pregnancy.
All women aged 25 to 49 who are registered with a GP get a letter inviting them for cervical screening every three years. If you’re planning a pregnancy there’s no need to wait for a letter.
During pregnancy
Cervical screening is not advised during pregnancy as it makes the results of the test harder to interpret.
Top Tips
- Contact your GP practice to find out if your cervical screening test is due, telling them about your pregnancy plans. If you have not had a cervical screening test in the last three years (if you are between 25 and 49 years) make an appointment before you begin trying to get pregnant.
Before pregnancy
Rubella (also known as German measles) is rare but it can be dangerous to the unborn baby if you catch it while you’re pregnant. It can cause hearing loss, eye conditions, heart defects, brain damage or pregnancy loss. This can be prevented by making sure you have had two doses of the MMR vaccination, which includes rubella, before you start trying for a baby. Click here for more information about Rubella and the MMR vaccination.
There has also been a significant rise in measles in the UK in the past few years. By ensuring that you have had two doses of the MMR vaccine before you become pregnant, you will reduce the chance of you baby caching measles in the 1st year of their life (before they are given the MMR vaccine at a year of age). Although extremely rare, measles in early childhood can result in a progressive brain condition called SSPE. Watch this mother's story of SSPE in her daughter following measles as a baby.
During pregnancy
The MMR vaccine is a live vaccine (it contains a weak form of the virus to make your body develop immunity) and therefore it is not given during pregnancy.
Top Tips
- If you have not had two MMR vaccinations, or you have no way of being certain that you were vaccinated, ask your GP for these doses one month apart and with the second dose at least a month before pregnancy.
Before pregnancy
Sickle cell disease and thalassaemia affect haemoglobin, a part of the blood that carries oxygen around the body. Individuals living with sickle cell disease or thalassaemia need specialist care throughout their lives.
For women living with thalassaemia who are having regular blood transfusions and iron chelation it may take several years for women to become physically fit enough to have a successful pregnancy.
Suitability of some medications which are part of thalassaemia and sickle cell disease management and those used for pain relief during sickle cell crises (painful episodes) may need to be reviewed before pregnancy and therefore it is important to speak to your specialist doctor before trying to become pregnant.
It may also be possible to be referred for specialist genetic counselling before pregnancy to understand the chances of genetic conditions being passed on.
During pregnancy
Sickle cell disease in pregnancy affects each woman differently but woman may experience more frequent painful episodes.
Sickle cell disease can make some pregnancy related complications more common, including pregnancy loss, blood clots and high blood pressure. Thalassaemia can also increase the risk of blood clots during pregnancy.
Top Tips
Before pregnancy:
-If you or your baby’s father have someone in your family with sickle cell disease or thalassaemia talk to your specialist or GP about the chance of passing the condition onto your baby and treatment during pregnancy.
Your doctor will talk to you about:
Any medications you are taking so their suitability can be reviewed
How your condition may affect pregnancy
How you will be cared for during pregnancy
During pregnancy:
- All pregnant women in England are offered a blood test to find out if they carry a gene for thalassaemia.
-Those at high risk of being a sickle cell carrier are offered a test for sickle cell. If the mother is found to be a carrier, screening is also offered to the father. Both parents need to carry a gene for these conditions for it to be passed on to the baby. If one parent carries a gene, the baby may also be a carrier of the condition.
-If the result shows your baby has sickle cell disease or thalassaemia, you'll be offered an appointment with a health professional to understand more about it and to talk through choices.
- Find more information about sickle cell and thalassemia screening in pregnancy here (this information is available in multiple languages).