Maternity Medical Services

Maternity Medical Services - First 12 weeks

In the early stages of pregnancy women will normally arrange a routine appointment with their own GP.  At this stage, the pregnancy is confirmed by a pregnancy test, if this has not already been done.  From details of the woman’s last menstrual period an expected date of delivery (EDD) is estimated.

Simple lifestyle advice on smoking, alcohol and drug taking is offered.  We always check that women are taking folic acid (400 mcg) during the first 12 weeks of their pregnancy to help prevent neural tube defects and Downs’ Syndrome.

A full ante-natal booking is arranged before 12 weeks.  At this 2nd consultation, details of all previous pregnancies are recorded and an examination undertaken including blood pressure, urine and a cardio-respiratory examination.

Routine blood tests are taken for blood count, blood group, antibodies, rubella, HIV and glucose.  Urine is tested for protein and an attempt is made to detect the baby’s heart using a sonic aid.

A routine scan for dating purposes and neural tube defect screening is arranged and an anomaly scan is undertaken at 20 weeks.

The Midwife will either call at the patient’s home, or the patient may come to the Midwife’s clinic to complete all of the details on the maternity booking form.

Maternity Medical Services - From 12 weeks to Delivery

A blood test is taken at 15 weeks to assess the risk of carrying a baby with Downs’ Syndrome or neural tube defects.  In early 2005 this is expected to change to serum screening with a 12 week scan, which will be 90% accurate.

In early pregnancy you should see your GP or Midwife every 4 weeks.  At each consultation you should bring with you your pregnancy notes and a sample of urine.  Your blood pressure will be checked and the size of your womb measured.  Your baby’s heart rate will be recorded.

At 28 weeks further blood tests will be taken to test for anaemia and red cell antibodies and glucose.

From 32 weeks you should have an appointment every two weeks.

From 38 weeks you could have weekly appointments.  Appointments are made as necessary according to each woman’s needs.

Choice of place desired for delivery can be made and discussed at any time in your pregnancy and a home birth is an option available to any woman who has an uncomplicated pregnancy.

Eight weeks after the birth of your baby you should attend an appointment with your GP to check that all is well with both yourself and your baby.

Role of Hospital Clinics in the Provision of Ante-Natal and Post-Natal Care

Your GP and Midwife may decide after consultation with you that they can care for you exclusively throughout your pregnancy and the delivery of your baby, particularly if it is not your first baby and your first delivery was uncomplicated.

However, in the following circumstances they may choose to refer you to the Hospital for an assessment by a specialist:

If it is your first pregnancy (very rarely)
You have had previous complicated pregnancies
You have other problems that may complicate the pregnancy
You are expecting twins
You develop complications in pregnancy, e.g. bleeding or raised blood pressure.

In these situations your GP and Midwife will offer some of the ante-natal care in conjunction with the Specialist.  However, responsibility for the delivery will rest with the Specialist’s Team at the Hospital.