Pregnant people are entitled to paid time off work to attend antenatal care. For more information please visit the Gov.uk website about Pregnant employees' rights. This also gives information about maternity benefits and leave entitlement.

Maternity Action is the UK’s maternity rights charity dedicated to promoting, protecting and enhancing the rights of all pregnant women, new mothers and their families to employment, social security and health care. https://maternityaction.org.uk/

Early Pregnancy Video

The video below will provide you with the information you need prior to your booking appointment.

Your first appointment

At the start of your pregnancy, during your first visit your Midwife will make an assessment based on your previous and current medical history and pregnancy history, as well as any social and mental health needs. 

Dependent on the outcome of your assessment, you will be allocated to either high risk or low risk care. Your care will be planned ensuring that you receive any additional scans or appointments with an Obstetrician if required. The Antenatal Pathways below show additional care you may require depending on your medical or pregnancy needs.

Throughout your pregnancy you will be offered regular appointments with your Midwife. Your care will be designed around your individual needs, although there are a minimum number of times it is recommended that you are seen. These appointments check that you and your baby are healthy and that any problems can be picked up as early as possible. Information about your appointments and what will be discussed can be found in the NICE Schedule of antenatal appointments.

For further information about your antenatal care visit: NHS Choices, Your antenatal care.

We understand that on some occasions you may wish to request a different Midwife to care for you. This can be accommodated by speaking to one of the Community Midwife Managers. Please e-mail community.midwives@mcht.nhs.uk with your contact details, asking to speak to a Manager. 

It is important that your baby’s growth is monitored accurately during pregnancy. Your Midwife will assess your risk of having a small or growth restricted baby, and will arrange regular ultrasound scans if you have any risk factors.

If you have no risk factors, your baby’s growth is assessed by measuring your abdomen. These measurements will begin to be plotted at you first appointment after 26 weeks.

All measurements are plotted onto an electronic customised growth chart. The chart is calculated using your height, weight, ethnic origin and details about any previous babies you may have had. The system will calculate your baby’s expected growth rate and indicate if further investigation or actions are required.

GROW 2.0 Leaflet [Perinatal Institute]

Preventing a Urine Infection in Pregnancy

General advice helping to prevent urine infections

Consistent good hygiene practice is essential to reduce and prevent infection and exposure to antibiotics.

  • As you touch people, surfaces and objects throughout the day, you accumulate germs on your hands. It is advisable to wash your hands before going to the toilet as well as afterwards
  • Always wipe from front to back whenever you go to the toilet. This prevents unwanted bacteria transferring from the anus to the vagina.
  • Try to fully empty your bladder when using the toilet.
  • Drink plenty of fluids.
  • Empty your bladder as soon as possible after intercourse.
  • Fresh underwear daily, loose cotton underwear preferably.
  • Shower/bathe daily. Avoid excessive washing, or using harsh perfumed soaps which may strip away the natural protective barrier, leaving you more vulnerable to infection.

Bacteria can be present in the urine without any symptoms

Harmful bacteria may be present in your urine sample without any symptoms resulting in a urine infection. At the beginning of pregnancy we ask all women at the booking appointment to be checked for urine infection regardless of symptoms. We will continue to test your urine throughout pregnancy using a dipstick and laboratory testing when needed.

During pregnancy there are hormonal, metabolic and mechanical factors that provide conditions which are more favourable for microbial growth in urine and cause a greater incidence of bacterial urine infection sometimes without symptoms.

What is a midstream urine sample?

At the beginning of your pregnancy journey your Midwife will ask you to provide a midstream urine sample to check for urinary tract infection (UTI).

A midstream urine sample means you don't collect the first or last part of urine that comes out. This reduces the risk of the sample being contaminated with bacteria from:

  • Your hands. 
  • The skin around the urethra, the tube that carries urine out of the body.

How to collect a midstream urine sample

  • Wash your hands. 
  • Start to urinate and collect a sample of urine "midstream" in a clean container provided.
  • Follow the Monovette user guide to collect the sample in the tube.
  • Discard the remaining urine.
  • Wash your hands thoroughly.

What urine samples are used for?

Your Midwife or Doctor may ask for a urine sample to help them diagnose or rule out certain pregnancy related conditions.

Urine tests during pregnancy are most commonly done to check for infections – such as a UTI. UTIs are common in pregnancy, and left untreated can lead to complications.

E. Coli

E. Coli bacteria are a common cause of cystitis, an infection of the bladder that occurs when there is a spread of the bacteria from the gut to the urinary system. Women are more susceptible to urinary tract infection by E. Coli because of the close proximity of the urethra and the anus.

E. Coli infections can be serious so preventing infections is important. The bacteria are usually spread through faecal matter reaching the mouth, or on wiping excrement wiped to the vagina.

Common symptoms of UTI

  • Burning sensation during urination.
  • Needing to urinate more frequently (although as a single symptom this is a common harmless effect if pregnancy).
  • Sensation of needing to pass large volumes of water when only a small amount is expelled.
  • Lower abdominal pain.
  • Cloudy, dark or blood stained urine.
  • Unpleasant offensive smell to urine.

If you experience any of the symptoms above see your GP.

Test of Cure - repeating your urine sample

Why have I been given another sample pot?

As you know the last sample of your urine that was sent off to the laboratory showed that you had a urine infection. You have now picked up your antibiotics to hopefully clear this infection, but we want to be sure that these clear your infection completely.  

We request that you provide another urine sample to be sent to the laboratory to make sure your infection is completely cleared.

When should I send my repeat urine sample?

Once your antibiotics are complete, please collect a midstream urine sample. This can be taken to either:

  • Your GP Surgery Reception
  • Antenatal Clinic Reception

This should be done as soon as possible after completing your antibiotics. Drop off a freshly taken sample Monday- Friday (these services are usually closed Saturday and Sunday).

Please do not wait until your next planned appointment to provide this repeat sample unless it is within 2-3 days of completing your antibiotics.

How do I complete the sample?

Please see ‘How to collect a mid stream urine sample’  information above and ‘Urine Monovett User Guide’. Then place patient sticker (top left of request form) onto the green topped bottle, put the bottle into the bag included and attach the request form to it. If you are struggling to do this don’t worry, the reception staff can help.

Is it important to repeat this test?

Yes. Hopefully your antibiotics have cleared your infection but if harmful bacteria remain in your urinary system (bladder, kidneys, or connecting tubes), it could cause complications to you or your pregnancy. 

Will I hear back about this repeat test?

The hospital will not contact you if the results are normal, but you can confirm these results at your next planned appointment. If you need further follow up or treatment after this sample the hospital will contact you.

*Please also remember to bring a fresh mid-stream urine sample to your next planned appointment*

Monovette.PNG

 

Personalised care planning

During your pregnancy we will continuously assess you and your baby to ensure that we provide the appropriate care. Your Midwife will discuss an individual plan of care with you and together you will agree the pattern of your appointments. If at booking or during your pregnancy, any risk factors are identified, you will be referred to an Obstetrician to further plan your care.

For women with health and pregnancy related conditions additional appointments are required. These are outlined in our antenatal care pathways.

Terms you may hear

During your pregnancy you may hear terms and not know what they mean, we have listed some below with an explanation to help.

Antenatal  Time before birth while being pregnant
Intrapartum Time during labour and birth
Postnatal Time immediately after birth
Perinatal Covers antenatal, intrapartum and postnatal period
ANDAU Antenatal Day Assessment Unit

Cardiotograph (CTG)

 Electronic monitoring of your baby's heart rate
Obstetrician A Doctor specialising in care during pregnancy and the early postnatal period.
Screening tests Investigations and tests for you and your baby to assess for potential medical conditions or problems

Choose the right service within Maternity

Our Midwives are always here to answer any concerns you may have, however we would like you to contact the professional or department most appropriate for the concern you have.

Choosing the right service
I want to rearrange my appointment / scan

Antenatal Clinic (ANC): 01270 273127
(Mon-Fri, 8:30am-4:30pm, excluding Bank Holidays)
I cannot contact my Community Midwife

E-mail: community.midwives@mcht.nhs.uk
Community Midwives Office: 01270 612177
Your call or e-mail will be responded to within 72 hours
I would like to reserve a birthing pool for a homebirth Midwifery Led Unit: 01270 278063
I have symptoms of a chest / ear / throat infection / diarrhoea / illness not associated with pregnancy

NHS 111 via telephone or online https://111.nhs.uk/

GP or out of hours service
I need a repeat prescription

Prescriptions given by Triage, Maternity Ward or ANC contact ANC: 01270 612171, (Mon–Fri, 8.30am – 4.30pm excluding bank holidays)
Prescriptions given by your GP, contact your GP surgery
Diabetes medication, contact the Diabetes Specialist Nurses

I have one of the following concerns:

  • Bleeding
  • Falls/accident
  • My waters have broken (with or without contractions)
  • Abdominal pain / injury
  • A reduction in my baby’s movements or a change in the pattern of movements
  • A urine infection not getting better with treatment by my GP
  • I think I am in labour (less than 37 weeks)
  • Headaches and visual disturbances
  • Itching all the time, particularly on my hands and feet
  • An immediate concerns relating to my pregnancy
  • Unusual calf pain

Triage can advise on pregnancy related concerns from 16 weeks gestation, 24 hours a day, 7 days a week (similar to an Emergency Department). Triage: 01270 273116

We prefer if you telephone first so we can plan your care and advise you appropriately. However, you are welcome to come to Triage without ringing first if you would feel more comfortable to do so.
I have unusual chest pain Attend the Emergency Department immediately
I have had my baby and have concerns about myself and/or my baby

For urgent concerns dial 999.
Immediate concerns, Ward 23: 01270 612287 (24 hours a day)
Non immediate concerns/rearranging a postnatal visit,
e-mail: community.midwives@mcht.nhs.uk

I am in labour (37 weeks+)

Depending where you are planning to have your baby, contact:
Maternity Triage: 01270 273116
Midwife Led Unit: 01270 278063
I have concerns about my baby's feeding For any concerns regarding your baby's feeding, contact Maternity Triage: 01270 273116

 

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