First-time Mums

Having a first child can be a daunting time for a new mum, and the experience will be unique for every woman. While no amount of preparation will leave you feeling completely confident as you become a mum for the first time, internet and a range of resources are available to advise and prepare you for what’s to come. Learn about your health during pregnancy and know what to expect during birth and post natal.

Your health in pregnancy

A healthy diet is an important part of a healthy lifestyle at any time, but is especially vital if you’re pregnant or planning a pregnancy. Eating healthily during pregnancy will help your baby to develop and grow. You will probably find that you are hungrier than usual, but you don’t need to ‘eat for two’ – even if you are expecting twins or triplets.

Experts are still unsure exactly how much – if any – alcohol is completely safe for you to have while you’re pregnant, so the safest approach is not to drink at all while you’re expecting. Drinking in pregnancy can lead to long-term harm to the baby, with the more you drink, the greater the risk. Stopping smoking will help both you and your baby immediately. Every cigarette you smoke contains over 4,000 chemicals, so smoking when you are pregnant harms your unborn baby.

 Find your birth options in North Central London >

Before taking any medicine when you’re pregnant, including painkillers. check with your pharmacist, midwife or GP that it’s suitable. Most medicines taken during pregnancy cross the placenta and reach the baby. When you’re pregnant or there’s a chance you might get pregnant, you should take a folic acid supplement. It is recommended that you take 400 micrograms each day from before you’re pregnant until you’re 12 weeks pregnant. Folic acid reduces the risk of problems in the baby’s development in the early weeks of pregnancy.

What to expect

You should see a midwife or GP as soon as you find out you’re pregnant. This is so they can organise your NHS pregnancy care (also called antenatal care). The NHS offers all pregnant women in England:

  • 10 pregnancy appointments (seven if you’ve had a child before) to check the health and development of you and your baby)
  • screening tests to find out the chance of your baby having certain conditions, such as Down’s syndrome
  • blood tests to check for syphilis, HIV and hepatitis B
  • screening for inherited blood disorders (sickle cell and thalassaemia)

Knowing what to expect and what you need to do in each of your pregnancy trimesters is important too.

  • As soon as you know you are pregnant, see your GP or self-refer to the provider of your choice. You should receive your booking appointment before ten weeks.
  • Consider where you want to have your baby – at a midwife-led unit, at home or in hospital.
  • Ask your midwife for a maternity exemption certificate to benefit from free prescriptions and NHS dental treatment.
  • You will be offered routine blood tests and an ultrasound scan at around 12 weeks (also known as the dating scan).
  • There are foods you should avoid when you are pregnant – visit www.nhs.uk for the latest guidance.
  • Always check with your GP, pharmacist or midwife before you take any medicine.
  • Visit www.nhs.uk/start4life for tips on keeping yourself well during pregnancy.
  • Ask your midwife for a MAT B1 certificate (after 20 weeks); this confirms your pregnancy for your employer.
  • Book your antenatal classes – your midwife will give you details.
  • If you are out of work or on a low-income, visit www.gov.uk to see what benefits you are entitled to.
  • You will be offered routine blood tests and an ultrasound scan (around 20 weeks) to check your baby’s growth.
  • You will also have the option to find out the gender of your baby, should you wish to.
  • You will be offered a whooping cough vacination, seasonal flu vacination, oral glucose tolerance test (for women at risk of gestational diabetes) and screening for HIV, syphilis and hepatitis B.
  • Prepare your hospital bag and your birth plan – you will get the information you need from your antenatal classes or midwife.
  • Check out what you will need for feeding your baby and prepare yourself now.
  • You will be offered screening tests for your baby and routine blood tests for you; you may also be offered a scan.
  • Visit www.nhs.uk to get advice on common health problems during pregnancy.

Labour and birth

A birth plan is a record of what you would like to happen during your labour and and after the birth. You don’t have to create a birth plan but, if you would like one, your midwife will be able to help. Discussing a birth plan with your midwife gives you the chance to ask questions and find out more about what happens in labour. Your birth plan is personal to you. It depends on what you want, your medical history, your circumstances, and what is available at your maternity service. You need to be flexible and prepared to do things differently from your birth plan if complications arise with you or your baby, or if facilities such as a birth pool aren’t available. The maternity team will tell you what they advise in your particular circumstances. Don’t hesitate to ask questions if you need to.

There are several signs that labour might be starting, including contractions or tightenings, a ‘show’ (when the plug of mucus from your cervix comes away), backache, an urge to go to the toilet (caused by your baby’s head pressing on your bowel) and/or your waters breaking (rupture of membranes). Call your midwife or maternity unit if your waters break, you’re bleeding, your baby is moving less than usual, or you’re less than 37 weeks pregnant and think you might be in labour. These signs mean you need to see a midwife or doctor.

If it’s your first pregnancy, you may feel unsure about when you should go into hospital or a midwifery unit. The best thing to do is to call your hospital or unit for advice. Depending on your symptoms and signs of labour, you may be asked to go in to be checked or you may be asked to wait. Don’t forget to phone the hospital or unit before leaving home, and remember to take your notes.

During the first stage of labour, contractions make your cervix gradually open up (dilate). This is usually the longest stage of labour.

At the start of labour, the cervix starts to soften so it can open. This is called the latent phase, and you may feel irregular contractions. It can take many hours, or even days, before you’re in established labour.

Established labour is when your cervix has dilated to more than 3cm and regular contractions are opening the cervix.

During the latent phase, it’s a good idea to have something to eat and drink as you’ll need the energy once labour is established.

If your labour starts at night, try to stay comfortable and relaxed. Sleep if you can. If your labour starts during the day, keep upright and gently active. This helps your baby move down into the pelvis and the cervix to dilate.

Breathing exercises, massage and having a warm bath or shower may help ease pain during this early stage of labour.

Shortly after your baby is born, you will be given a personal child health record (PCHB), also known as the red book. This may be in an electronic format that is currently being rolled out across areas of England.

Your baby will be offered Vitamin K and a physical examination at birth, and a more detailed examination within 72 hours; you will also be offered a BCG vaccination for your baby.

You will be seen at home by your midwife, after which a health visitor will visit you at home to help you, your family and your new baby stay health.

Register the birth of your baby within 42 days – visit www.gov.uk for details.

Your baby will be offered a heal prick test, which tests your baby’s blood for nine rare, but serious, health conditions

A hearing screening will also be carried out if you had your baby at home; if you had your baby in a birth centre or hospital, this will be arranged for you after the birth.

If you were due for a cervical screening test while pregnant, this should be rescheduled for at least 12 weeks after the birth.

Pregnancy brings about big changes to your life, especially if this is your first baby. Some people cope with these changes easily, while others find it harder. Everybody is different.

Even if you feel excited about having your baby, it’s common for some women to feel more vulnerable and anxious when they’re pregnant. If feeling down or anxious is affecting your everyday life, mention it to your midwife. You don’t have to have a particular mental health problem to be offered help dealing with worrying thoughts or feelings.

It’s quite common for couples to have arguments every now and then during pregnancy. Some of these may be nothing to do with the pregnancy, but others may be caused by one of you feeling worried about the future and how you’re going to cope. It’s important to realise that during pregnancy there are understandable reasons for the odd difficulty between you, and good reasons for feeling closer and more loving.

This animation explains to you the choices that you can make for a birth setting for you and your baby. Further information for the maternity units in North Central London (NCL) can be found in the hospital links above

Health and Care Innovation (HCI) in collaboration with NHS professionals have created an online library of health videos covering all aspects of your maternity care please click here to view the library.