Patient Information
INFORMATION FOR PARENTS
ABOUT PREGNANCY AND BIRTH
Derriford Hospital
Derriford Road
Plymouth
PL6 8DH
0845155 8155
www.plymouthhospitals.nhs.uk
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Contents
1. Making choices during pregnancy and
where to have your baby ................................. 1
2. The professionals you may meet during
your pregnancy ............................................... 4
3. Pattern of antenatal care ................................. 6
4. 12 Week dating scan ....................................... 8
5. General advice during pregnancy .................. 10
6. MRSA screening in pregnancy ....................... 16
7. Managing common problems in pregnancy.... 19
8. When to call the midwife, GP or hospital ........ 20
9. How will I deliver my baby? ........................... 22
10. Choices for pain relief in labour ................... 28
11. Useful advice for when you come into
Hospital .......................................................... 32
12. Vitamin K and your newborn baby ............... 36
13. Choosing how to feed your baby ................ 39
14. Birth Afterthoughts service .......................... 43
15. Supervisors of Midwives .............................. 44
16. Patient involvement in Maternity services .... 45
17. Children’s centres......................................... 46
18. Antenatal classes ......................................... 48
19.Smoking cessation ........................................ 49
20. Domestic abuse............................................ 52
21. How to find advice and support if you have
any concerns .................................................. 52
22. Research in the Maternity Unit ..................... 54
Useful contacts …………………..………….. 55
Useful websites ……………………………… 56
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1. Making choices during pregnancy & where to
have your baby
Congratulations on your news. Now that you are pregnant
there are some things you might like to know.
When your community midwife sees you, she will talk to
you about your pregnancy, medical and family history.
She will also talk to you about the plans for your care.
This will include who cares for you in your pregnancy and
during labour.
It is important that you choose what happens to you during
your pregnancy and the birth of your baby. These choices
should be based on the information you are given by your
health care professionals.
Choices in care
Midwife led care: This option is available to women who
have no medical problems either with themselves or their
pregnancy. Your community midwife coordinates your care
and will look after you throughout your pregnancy together
with your GP. During labour a midwife at the Maternity
Unit will provide care for you when you arrive at the
hospital.
If you choose to have a home birth you will be cared for by
the same team of midwives (The Jubilee Midwives)
throughout your pregnancy and they will attend your home
when you are in labour.
The Jubilee midwives also provide a service for women
who may particularly benefit from having a small group of
midwives looking after them. This allows the women and
the midwives to get to know one another well. The Jubilee
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midwives will continue to look after you even if you choose
to have your baby in hospital. One of the team will come
into hospital when you are in labour and provide all your
care.
Consultant led care: If you have had any health problems
or problems with previous pregnancies, your midwife or
GP will help you to decide which is the best option for you.
If you are referred for consultant led care, your consultant
obstetrician together with your GP and community midwife
will look after you. Your consultant obstetrician will
coordinate your care throughout pregnancy. During labour
a midwife at the Maternity Unit will provide care for you.
Your consultant’s team of doctors will provide any medical
care.
Where can I have my baby?
You may choose to have your baby at home or in the
hospital. It is important that you discuss these options with
your midwife and GP as well as your family and friends.
At home
Some women choose to have their baby at home as they
feel more relaxed and want to be in a familiar environment.
A home birth is suitable for low risk pregnancies where
there are no anticipated complications.
Advantages to having your baby at home
 Women feel more relaxed in their own home and as a
result require less pain relief.
 Young children do not have to be left with friends or
family.
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 You are more likely to know the midwife.
Disadvantages to having a home birth
 You can choose to use any method of pain relief
except for an epidural.
 If a complication arises during your labour you will be
advised to transfer to the hospital.
Possible reasons for transfer to hospital
 Labour is not progressing.
 You want an epidural.
 Your midwife is worried about the health of your baby.
 Occasionally following delivery you or your baby may
require medical care.
If you choose to have your baby at home your Jubilee
team of midwives and GP will provide your antenatal care.
We aim to have two community midwives in attendance for
the birth of your baby. They have direct access to the
Maternity Unit for help or advice, if necessary.
In hospital
If you have any health problems or problems with your
pregnancy it is advised that you give birth in hospital.
In the Maternity Unit at Derriford Hospital we try our utmost
to make the environment as comfortable as possible for
you and your family. During your stay you will receive care
from hospital-based midwives.
Advantages of having your baby in hospital
 You can choose the type of pain relief you want
including an epidural.
 If there is a problem with you or your baby a doctor
can attend to you immediately.
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Disadvantages of having your baby in hospital
 You will be in an unfamiliar environment.
 You are unlikely to know the midwife caring for you in
labour.
When to choose?
You may change your choice of care or place of delivery at
any time during your pregnancy if another option becomes
more suitable to you.
2. The professionals you may meet during your
pregnancy
Community midwife
Your named community midwife will provide you with
antenatal and postnatal care. If you choose to have a
homebirth it will be a Jubilee midwife who provides care in
labour as well.
GP
Your family doctor provides you with medical care and
forms part of the team that delivers your pregnancy care.
Hospital midwife
Hospital midwives will provide your care throughout the
time you are in hospital and during visits to the Day
Assessment Unit and the consultant antenatal clinic.
Consultant
Consultants provide hospital care in the case of
complicated or high-risk pregnancy and labour. They do so
together with the medical team, which includes the
registrar and doctors training in obstetric care.
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Maternity care assistants
Maternity care assistants work within the hospital and
community setting. They provide care for you and your
baby under the direction of the midwife.
Health visitor
The midwife will hand your care and ongoing support over
to a Health Visitor between the 10th – 28th day after your
baby’s birth. The Health Visitor’s role extends up to school
age and includes routine health checks for your baby. The
health visitor assistant provides care for you and your
baby under the direction of the health visitor.
Social worker
The Children’s Social Care service is available for families
with additional needs. Their team also includes Family
Support Workers who can help provide assistance to
these families.
Sonographer
The sonographer is the person who will performs the 12week dating scan and the 18-20 week anomaly scan of
your baby. A midwife who has had extra training in order
to do this may perform the 12-week dating scan.
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WEEKS
PREGNANT
Confirmation
of pregnancy
6 - 9 weeks
10 weeks
TYPE OF APPOINTMENT
LOCATION
PROFESSIONAL
Collect information booklet
Surgery or
Children’s centre
Surgery or
Children’s Centre
Midwife
Initial BOOKING appointment
includes initiation of notes,
discussion of blood test,
screening for Down’s and
healthy options for pregnancy.
Booking may take place over
2 visits. However, it is usually
completed by 13 weeks.
Screening bloods
12 weeks
SCAN dating / nuchal
Hospital
15 – 16
weeks
Routine antenatal check-up
Surgery /
Midwife / GP
community setting
19 – 20
weeks
Anomaly Scan &
appointment with hospital
doctor if under Consultant
Led Care
Routine antenatal check-up
25 weeks *
26 – 28
weeks
28 – 30
weeks
31 weeks *
Sonographer
Sonographer
Hospital
Surgery /
Midwife / GP
community setting
Routine antenatal and bloods Surgery /
Midwife / GP
for AB’s, Hb & random sugar community setting
Prophylactic Anti D
Hospital
Midwife
if Rh negative
Routine antenatal
appointment
Routine antenatal
appointment
Surgery /
Midwife / GP
community setting
Surgery /
Midwife / GP
community setting
Discuss birth plan options &
BF. Check presentation.
Further bloods if required
Routine antenatal
appointment
Surgery /
Community Midwife
community setting
40 weeks
Routine antenatal
appointment
Surgery /
Midwife / GP
community setting
41 weeks
Discuss and book date for
induction of labour
Surgery /
Midwife / GP
community setting
34weeks
36 weeks
38 weeks
Surgery /
Midwife / GP
community setting
3. Pattern of antenatal care
* - for first time mums only
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Should you require an additional appointment for medical
reasons the midwife or doctor will advise you. Should you
feel unwell or be in need of reassurance between booked
appointments you should make an appointment with either
your doctor or community midwife. In addition, there are
community clinics at various locations, please phone the
Plymouth Advice line (01752) 439875 between 9 – 10
am for more information.
Cornwall Advice line (01579) 335645 between 9:30 –
10:30 am for more information.
Please remember to bring your pregnancy notes with
you to every appointment.
At each appointment you need to provide a specimen of
urine, which will be checked for sugar and protein. Your
blood pressure will be checked at every appointment.
Please make an immediate appointment if you get a
severe headache, visual disturbances or sudden onset of
severe swelling. Do not wait until your next antenatal
appointment.
After 14 weeks the well being of your baby will be checked
by monitoring the heartbeat and after 20 weeks the growth
will be checked by measurement of your abdomen from
the pubic bone to the top of your bump.
You can monitor the well being of your baby by observing
the movements from 26 weeks onwards. Please note that
babies DO NOT slow down coming up to delivery. If your
baby is moving less than it normally would please contact
the midwife, doctor or hospital.
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Your Partner is welcome to attend appointments with
you.
4. 12 Week dating scan
Why do I need a scan?
You will be offered a short ultrasound scan to see how far
the pregnancy is and if you are expecting more than one
baby. (Please note this scan does not identify the sex
of the baby)
Will an ultrasound scan harm my baby or me?
As far as we are aware there are no harmful effects from
ultrasound but to ensure this we only scan when
appropriate. Later in your pregnancy if you need lots of
scans it will be because your baby requires close
monitoring. Research suggests that the risk of ultrasound
is very small compared with the potential benefit in
monitoring babies who are small for their age or are
carried by mothers who are diabetic, for example.
Do I need to prepare for my scan?
For this scan you should attend with a fairly full bladder to
help get a clear view of the baby.
Will I get a picture?
It will be possible for you to buy a printed scan image of
your baby at this stage, for £4.00. Please buy your token
in the Day Assessment Ward before your scan. You will
need to bring with you 4 x £1 coins as no change is
available in ANC / DAW. If you do not have the correct
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change it may be obtained from the Cashier’s office;
opening hours Mon – Thurs 09:30 – 4:30pm, Friday 09:30
– 4:00pm.
It will be possible for you to buy a printed scan image of
When attending:
Please bring your notes with you, allow ample time for
parking, and only bring one other person to accompany
you.
Nuchal scan
A nuchal scan is performed as a screening test for Down’s
syndrome. You should have received a booklet, which
covers screening for yourself in pregnancy and screening
for your baby. You can also speak to your Midwife or GP
about screening for Down’s syndrome.
If you choose to have screening your midwife will arrange
for you to have a blood test done just after 10th week of
pregnancy, which will be used in combination with the
nuchal scan to calculate the risk of your baby having
Down’s syndrome.
Your dating / nuchal scan appointment will be sent to
your home address through the post.
For more detailed information, contact the Screening
Coordinators, Ruth Rice or Sharon Lister on 01752
763627
What if there is something wrong with my baby?
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The dating scan may pick up some abnormalities or the
nuchal scan together with the blood test may show a ‘highrisk’ result. If the signs suggest a problem you will be
offered counseling and the opportunity to have other tests,
as appropriate to the abnormality identified, before
deciding whether to continue the pregnancy.
5. General advice during pregnancy
Exercise
 Continue with your normal routine, walking, swimming
etc, but take care not to overheat, over exert or over
stretch yourself.
 If attending an exercise class ensure the instructor
knows that you are pregnant.
 Some sports activities are not advisable due to risk of
trauma – please speak to your midwife or GP
If you are used to exercising, continue this but you might
have to slow down and do less strenuous activities.
Drink water before, during and after exercise to avoid
dehydration.
Listen to your body and pace yourself. Find an exercise
class that suits pregnancy.
Walking, swimming or static cycling is good in pregnancy,
being mild or moderate exercise.
Stop exercising if you become breathless or too hot.
Avoid high impact activities e.g. jumping, running and
contact sports in late pregnancy.
Do not exercise if you feel unwell, tired or
uncomfortable or have pain.
Caring for your back
During pregnancy, the increased weight of your baby puts
more strain on your lower back. Ligaments provide
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support but soften with the hormonal changes of
pregnancy. Joints become less stable, causing poor
posture, often when you are tired. Discomfort can be felt in
the upper and lower back, into the pelvic area and at times
down your legs.
To prevent backache keep good posture:
 When standing or walking, be upright and
avoid slouching.
 Alter your posture regularly.
 In late pregnancy, rest when you need.
 When sitting, support your back comfortably.
Deep abdominal hold to increase support for your back
and pelvis with your muscles. Rest in any position, breathe
in gently and as you breathe out draw in your tummy and
hold it in for ten seconds. Keep breathing. Try to do this
five times or as many as you can.
Pelvic tilt to correct your posture
Draw in your tummy as above and flatten the hollow of
your back to tilt your pelvis. Hold this position for five
seconds. Let go. Repeat five times or as many times as
you can. Practice as often as you can in different positions.
These can be standing, lying on your side, leaning your
back against the wall or leaning forwards holding the back
of a chair.
Lifting
Assess the weight to be lifted. Being pregnant, ask
yourself before you lift, will you hurt yourself if you lift, if
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the object is too awkward or too heavy? Find help if
needed. When lifting, brace your tummy and pelvic floor
muscles, keeping the curve in your lower back, as you
bend your hips and knees.
If you have Back Pain what have you been doing 2 hours
before?
Remember to do the exercises on this page. When sitting
place a rolled towel in your lower back and try the
exercises. Carry equal weights in both hands where
possible.
 Reduce or stop lifting or delegate.
 Rest when you need.
 Pace yourself and do a small amount each day as
needed. Try to cut down your speed of activities.
If this advice does not reduce pain, ask your GP or
midwife to refer you to a Physiotherapist.
Toning up your pelvic floor muscles
Why?
The pelvic floor muscle forms a sling between the pubic
bone at the front and the bone at the bottom of your spine.
During pregnancy, the muscles that control your bladder
and bowel (the pelvic floor muscles) may be weak.
How?
Rest on your side or sit or stand and drawn in the back
passage as if to stop passing wind. Let go. Now draw in
the front passage as if to stop your flow of urine. Let go.
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Then squeeze back and front passages and draw up the
muscles between the two. Let go.
Squeeze Back, Front, Draw Up The Middle And Hold.
Let Go.
Aim to build up slowly to hold for ten seconds or longer
and repeat until your muscles are tired. Your muscles will
only become stronger if you draw up and hold for longer
and increase the number you do.
.
When?
1. After using the toilet or washing your hands.
2. After having a drink.
3. At work or during a rest.
4. While watching T.V. or at any time.
5. After you have had your baby.
What then?
The muscles need to work quickly when you cough,
sneeze or lift anything, so draw up your muscles quickly
and let go. Now try as many times as you can. Do both
exercises often.
What if?
If you still leak urine, try these exercises more often but if
you need more help contact your midwife or GP to refer
you to a physiotherapist.
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Tips
1. Avoid tightening your thighs when doing these
exercises.
2. Test your control once a week by stopping your urine
flow midstream.
Driving
 All drivers or passengers including pregnant women
must wear a seatbelt, unless they have a doctors’
exemption certificate. The lap-strap should go across
the hips, under your bump and the diagonal between
the breasts around your bump. When sat in front of an
airbag the seat should be as far back as possible.
Diet
 Eat a varied diet and ensure it is healthy, including
fresh vegetables and fresh fruit.
 Ensure you wash fruit and vegetables thoroughly if
eaten raw.
 Avoid soft cheeses, raw egg and products made from
raw egg, such as homemade mayonnaise or mousse,
liver products such as pate. Milk should be
pasteurized. Peanuts should be avoided if there is a
history of nut allergy in your family
 Eating fish products is good for you and your baby but
tuna and marlin should be limited to a small portion
once a week. You should be cautious with ‘sea-foods’
such as prawns, ensuring that they are fresh and
cooked well.
 Alcohol can severely affect unborn babies’
development and wellbeing. It should be avoided if
possible.
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 It is recommended by the National Institute for Health
and Clinical Excellence (NICE) that all women should
consider taking 10 micrograms of Vit D daily to ensure
the best start for their babies.
 You should also consider taking folic acid 400
microgram supplements daily to reduce the risks of
spina bifida. Ideally, folic acid should be started before
conception and taken for the first 12 weeks of
pregnancy
Sexual activity
 There are no known harmful affects
 If you have had vaginal bleeding you should seek
advice from your midwife or GP and you may be
advised to abstain for a short time
Travel
 If you are planning a trip abroad speak to your
midwife or GP about vaccinations and insurance
 If you fly you are at a higher risk of ‘deep vein
thrombosis’ – speak to your midwife or GP
Medication
 If you take prescription medication speak to GP
before pregnancy or as soon as you are able
 Very few over-the-counter medications are safe in
pregnancy – speak to your midwife, GP or pharmacist
Complementary therapies
 It is recommended that you seek qualified advice on
all therapies including aromatherapy oils; some are
not recommended in pregnancy
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6. Methicillin Resistant Staphylococcus Aureus
(MRSA) screening in pregnancy
What does ‘MRSA’ stand for?
MRSA stands for Methicillin Resistant Staphylococcus
Aureus
What does this mean?
Staphylococcus Aureus (sometimes called ‘staph’) are
bacteria found on the skin or in the nose and throat of
healthy people.
Occasionally it may cause infection. Pimples and boils are
examples of minor infection caused by staph. These
infections can be easily treated with antibiotics such as
flucloxacillin.
Staph bacteria can sometimes cause more serious
infections such as surgical wound infections or
pneumonia.
Over the last 50 years it has become more difficult to treat
these infections because the bacteria have become
resistant to various antibiotics including penicillin.
These resistant forms of staph bacteria are known as
MRSA. MRSA is found in hospitals in the United Kingdom
and in many other countries too.
Is MRSA always a problem?
No, not always. Staph bacteria and MRSA can be found
on the skin and in the nose of some people without
causing illness. This is called colonisation and individuals
are called carriers.
Approximately 25-30% of the general population are
carriers of Staph and they are healthy and unaffected by it.
Infection occurs when there is tissue damage (for example
following an operation) and the Staph bacteria or MRSA
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cause disease. These infections generally require
treatment with special antibiotics.
How does it spread?
The infection is spread mainly through direct physical
contact, for example, touching objects (towels, sheets,
wound dressings) that have been contaminated by the
skin of an infected or colonised patient.
Unwashed hands are the main source of infection.
Midwives, nurses and doctors have a lot of hand contact
with patients. MRSA can be carried on their hands from
patient to patient if they do not wash properly between
patients.
Airborne contact (through coughing and sneezing) is only
thought to be responsible for a small percentage of MRSA
cross-infections
Can it spread to others?
Friends and family are very unlikely to get MRSA
especially if they wash their hands after contact with a
patient known to be a carrier. Healthy people, including
babies, children and pregnant women are at no extra risk
of getting infected
Which pregnant women do we screen for MRSA?
We screen all pregnant women at approximately 28
weeks. We also screen all women who have to come into
hospital and stay at least overnight. This means you may
be screened more than once during your pregnancy.
Why are we screening you for MRSA?
The reason we want to screen you for MRSA is to
try and reduce the risk of you developing a wound
infection or an infection in the blood stream if you are an
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MRSA carrier. This could occur if you have a wound
around the time of your delivery, such as a caesarean
section, or an episiotomy or tear of the perineum.
Try and reduce the risks to your baby and reduce the
potential of spreading MRSA from one baby to another
whilst in hospital.
What will you do if you find I am a carrier of MRSA?
If we identify that you are a MRSA carrier we will
recommend treatment to suppress the MRSA.
If you are due to have a planned caesarean section your
treatment will start 2 days before you are due to come to
hospital and continue for 3 days afterwards. The treatment
is designed to reduce the risk of wound infection at the
time of surgery.
For women who are planning to have a normal delivery we
will not know when you are going to come into hospital
either antenatally or in labour. In these circumstances, we
will make sure you are cared for in a single room and
commence treatment straight away. This will help to
prevent bacteria spreading to other patients.
Is my baby at risk of becoming seriously ill if I am a
carrier?
No. It is very unlikely that your baby will pick up the
infection from you. It is mainly very small, premature and
sick babies, or those who themselves have an operation
who are more vulnerable.
The chances of your baby picking up an MRSA infection
from you, if you are a carrier, are extremely low.
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Can my baby catch MRSA in the womb before he or
she is born?
No.
How will I be treated?
The treatment programme is for 5 days:
Apply the prescribed body wash directly to the skin using a
flannel. Ensure you cover all areas, especially under arms
and between the legs, then rinse well and dry as normal.
You should do this once a day. On the first day and day 5
you will also need to shampoo your hair with the same
solution and then follow with a normal shampoo.
Place a pea size amount of the prescribed nasal cream
into each nostril and massage gently upwards. You should
do this three times a day.
7. Managing common problems in pregnancy
Nausea and vomiting
 this is common and usually stops between 16 -20 wks
 if excessive and / or persistent beyond 20 weeks, and
especially if you are unable to tolerate water, please
seek advice from your GP
 there are many aids and remedies that may help so
please ask your midwife for recommended treatments
Heartburn
 Can be a frequent problem in pregnancy. Please
speak to your midwife for advice and, if persistent, ask
you GP about antacid treatment
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Constipation
 please speak to your midwife or GP about dietary
advice
Haemorrhoids
 please speak to your midwife or GP as dietary advice
can often alleviate this painful condition
Backache
 Can be very common in pregnancy. Massage, water
exercise / aquanatal may be beneficial
Varicose veins
 These are not harmful. Support stockings may be
beneficial. Please speak to your GP if they become
painful
Vaginal discharge
 normally increases in pregnancy but if it smells
unpleasant, or if you become itchy or sore and you
have pain passing water, please speak to your
midwife or GP. Treatment may be required.
Thrush
 Can be very common. Please speak to your midwife
or GP
8. When to call the midwife, GP or hospital
Hospital labour ward phone: (01752) 763610
Call your GP:
 If you have a medical condition or are feeling
generally unwell.
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 If you have abdominal pain or bleeding and are less
than 20 weeks pregnant.
Call GP or community midwife:
 To make an additional appointment to the schedule if
you are concerned about the pregnancy or your baby
 If you have reduced movements after 24 weeks
Call community midwife or labour ward
 If you have any bleeding after 20 weeks
 If you have any abdominal pain after 20 weeks
 If you have any signs of infection, such as a urine
infection
Call the labour ward (triage) as soon as possible :
 If you suddenly have a lot of swelling, are
experiencing headaches or visual disturbances.
 If you have any blood loss or severe abdominal pain
 If you have not felt your baby move as much as usual
 For advice in early labour / or unsure if in labour
 If you think your ‘waters’ have broken
 When you are experiencing regular contractions
(1:10mins) or sooner if you feel the need for support
Call the labour ward immediately:
 If you have heavy blood loss or severe abdominal
pain
 If you have strong contractions less than 5 mins apart
 If labour has started and you know you are planned to
have a caesarean or your baby is in the breech
position
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9. How will I give birth to my baby?
Normal birth
Birth is a normal and natural process. At Derriford
Hospital the doctors and midwives want to make the birth
of your baby a safe and satisfying experience.
At Derriford Hospital most babies are born normally, but
some (20%) are born by a Caesarean section, and others
(14%) are delivered with the help of forceps or suction
(ventouse).
What is a Caesarean section?
A Caesarean section is an operation to allow the baby to
be born through the abdominal wall instead of through the
birth canal. The operation is usually done under a spinal or
epidural anaesthetic, which means you are awake during
the operation. Occasionally a general anaesthetic is used
so that you are asleep.
There are two kinds of Caesarean section, elective and
emergency.
 An elective Caesarean is one that is planned by the
woman and her obstetrician before labour begins.
 An emergency Caesarean is one where a decision is
made (usually when you are already in labour) to
carry out a Caesarean because an unexpected
problem has arisen and the baby needs to be born
quickly.
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What are the advantages of a Caesarean section?
Sometimes a Caesarean section is unavoidable and it is
simply the safest way to deliver your baby. Sometimes
your doctor will recommend a Caesarean section because
it appears that the benefits of a Caesarean section
outweigh the risks. Feel free to ask questions so that you
understand why your doctor is suggesting this.
Sometimes women feel that they want to have a
Caesarean because they
 are worried that labour may be long and painful
 are worried about losing their dignity in labour
 are worried about damage to the vagina during the
birth
 have had a previous difficult labour
 want to plan the birth and feel in control
 are worried that a vaginal birth may cause problems
with bowel or bladder control
If you are worried about any of these then you should
discuss it with your doctor or midwife. Parentcraft classes
can also provide you with a lot of useful information.
What are the risks of a Caesarean section?
A Caesarean birth involves major abdominal surgery, so
the benefits need to be weighed against the risks in each
case.
For the woman:
A vaginal birth is overall four times safer for a woman than
having a Caesarean (although an elective Caesarean is
thought to be slightly safer than an emergency Caesarean)
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Following a Caesarean operation, women are at more risk
of health problems such as:




wound or uterine infection
haemorrhage (heavy bleeding)
blood clots in the legs or on the lungs
damage to the bowel or bladder resulting from the
operation
Although we try to prevent these problems occurring,
they do sometimes occur and can be very serious or
even life threatening.
Women vary in their ability to recover from a Caesarean
section. A Caesarean will usually:
 require a hospital stay of between 1 and 3 days
 make getting out of bed, standing and walking around
difficult and painful to begin with
 once at home, make it difficult to use stairs and to
carry anything, including the baby, for the first few
days
 make it difficult to do activities which require bending
down, lifting or stretching, for several weeks
Some women experience a sense of loss or failure as a
result of having a Caesarean. They take time to recover
emotionally as well as physically, and may need extra
support.
For the baby:
the major risk for the baby is breathing difficulties, which
are four times more likely in a baby born by Caesarean.
24
(The severity of breathing difficulties can be reduced by
waiting until at least 39 weeks to have a Caesarean)
sometimes there is a risk that the baby can receive a small
cut as the womb is opened during the surgery. This is
extremely rare.
Having a baby by Caesarean does not mean that a
woman has to have a Caesarean birth next time.
Avoiding a Caesarean
Sometimes a Caesarean section will be unavoidable, but
there are ways which may help to reduce the likelihood of
a Caesarean section:
 if your baby is breech, having the baby turned by
external cephalic version (ECV).
 during labour, keeping upright and mobile so that
labour progresses well
 having a supportive person with you in labour
Requesting a Caesarean
Obstetricians do not agree on whether a woman should be
able to have a Caesarean on request, in the absence of
any medical problem.
 Some believe that unnecessary operations should be
avoided because of the risks associated with them,
when compared to a vaginal birth.
25
 Others believe that an elective Caesarean is safe and
should be available as a choice for women who are
fully informed of the risks.
Any woman requesting a Caesarean for whatever reason
should ensure she is fully informed of all the facts.
What about forceps or ventouse delivery?
Sometimes complications occur at the very end of labour,
at the stage where the neck of the womb is fully open and
the woman is starting to push the baby out.
The most common problems at this time are either that the
woman is unable to push the baby out or that the baby
gets tired or distressed and needs to be delivered more
quickly
Often at this stage in the labour it is possible for the doctor
to help the woman give birth to her baby by using forceps
or a suction cap (ventouse). By doing this a Caesarean
section can be avoided. The doctor would only perform a
forceps or ventouse delivery if it were absolutely
necessary, as it is obviously better if you have a normal
delivery.
The advantage of a forceps or ventouse delivery is that the
baby is delivered more quickly than it would be naturally,
and at times this is important.
The disadvantages are that
 It is less natural
 the woman is more likely to need stitches for a vaginal
tear or an episiotomy (cut at the opening of the vagina)
 there is an increased risk of damage to the muscle
surrounding the anus (back passage)
26
 there is often some bruising to the baby’s face or
scalp, which will heal within a few days.
If there is a concern that the delivery is likely to be difficult,
and that a Caesarean section may be necessary, then we
may suggest moving you into the operating theatre before
trying. If the forceps or ventouse is not successful then
there is no delay in carrying out the birth of your baby by
Caesarean section.
Everyone is an individual. Whilst most women have
normal births, sometimes birth by Caesarean section,
forceps or ventouse is more appropriate. We will do our
best to make it a safe and satisfying experience for you.
If you are worried about anything in pregnancy then it is
important that you discuss it with your midwife or doctor.
They are there to support you through the pregnancy and
birth.
10. Choices for pain relief in labour
Labour is painful, so it’s important to learn about all the
ways you can relieve pain in labour and how your partner
or labour supporter can help you. Ask your midwife or
doctor to explain what is available so that you can decide
what is best for you. Write down your wishes in your birth
plan, but remember you may need to be flexible. You may
27
find that you want more pain relief than you had planned,
and more effective pain relief may be advised to assist
with the birth.
Types of pain relief
Self-help
Using relaxation and breathing techniques, keeping mobile,
having a partner to support and massage you, and having
confidence in your own body will all help.
Water
Many women find a warm bath relaxing and effective in
relieving pain especially during early labour. The buoyancy
and freedom provided by a larger birthing pool also
provides pain relief throughout labour and during birth.
However, a waterbirth is only recommended for low risk
labour as this does not permit continuous fetal monitoring.
‘Gas and air’ (Entonox)
This is a mixture of oxygen and another gas called nitrous
oxide. You breathe it in through a mask, which you hold for
yourself. You’ll probably have a chance to practise using
the mask if you attend an antenatal class. ‘Gas and air’
won’t remove all the pain, but it can help by reducing it and
making it easier to bear. Many women like it because it’s
easy to use and you control it yourself. The gas takes 15–
20 seconds to work, so you breathe it in just as a
contraction begins. There are no harmful side effects for
you or the baby, but it can make you feel lightheaded.
Some women also find that it makes them feel sick or
sleepy or unable to concentrate on what is happening. If
this happens, you can simply stop using it. If you try ‘gas
and air’ and find that it does not give you enough pain
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relief, you can ask for an injection of a pain relieving drug
as well.
TENS
This stands for transcutaneous electrical nerve stimulation
It lessens the pain for many, but not all, women. There are
no known side effects for either you or the baby, and you
can move around while using it. Electrodes are taped on to
your back and connected by wires to a small batterypowered stimulator known as an ‘obstetric pulsar’. You
hold the pulsar and can give yourself small, safe amounts
of current. It is believed that TENS works by stimulating
the body to increase production of its own natural
painkillers, called endorphins. It also reduces the number
of pain signals that are sent to the brain by the spinal cord.
If you’re interested in TENS, you should learn how to use it
in the later months of your pregnancy. A TENS is not
always available from the hospital so you may wish to find
out how to obtain one from another source. Ask your
midwife or physiotherapist for advice.
Injections
Another form of pain relief is the intramuscular injection of
a pain relieving drug, usually diamorphine. It takes about
20 minutes to work and the effects last between two and
four hours. It will help you to relax, and some women find
that this lessens the pain. However, it can make you feel
very ‘woozy’, sick and forgetful. If it hasn’t worn off when
you need to push, it can make it difficult. You might prefer
to ask for half a dose initially to see how it works for you.
Epidural anaesthesia
An epidural is a special type of local anaesthetic. It numbs
the nerves, which carry the feelings of pain from the birth
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canal to the brain. So, for most women, an epidural gives
complete pain relief. It takes about 20 minutes to get the
tube set up and then another 15–20 minutes for it to work.
An epidural can be very helpful for those women who are
having a long or particularly painful labour, or who are
becoming very distressed. It takes the pain of labour away
for most women and you won’t feel so tired afterwards. But
there are disadvantages:
 your legs may feel heavy and that sometimes makes
women feel rather helpless and unable to get into a
comfortable position;
 you may find it difficult to pass water, and a small tube
called a catheter may need to be put into your bladder
to help you;
 you will need to have a drip on your arm to give you
fluids and help maintain adequate blood pressure;
 you may not be able to get out of bed and move around
during labour. This reduction in mobility may reduce
your ability to give birth effectively and thereby increase
the likelihood that your labour will have to be
augmented by use of a hormone drip. You may not be
able to get out of bed for several hours after the birth.
 your contractions and the baby’s heart will need to be
continuously monitored by a machine. This means
having a belt round your abdomen and possibly a clip
attached to your baby’s head
What you can do for yourself
Fear makes pain worse, and everyone feels frightened of
what they don’t understand or can’t control. So learning
about labour from antenatal classes, from your doctor or
midwife, and from information leaflets and books, is an
important first step.
 Learning to relax helps you to remain calmer.
30
 Birth classes place emphasis on being fit and what your
choices are in labour so that you feel you have more
control in labour.
 Your position can also make a difference. Some women
like to kneel, walk around or rock backwards and
forwards. Some like to be massaged, but others dislike
being touched.
 Feeling in control of what is happening to you is
important. You are working with the midwife and she
with you, so don’t hesitate to ask questions or to ask for
anything you want at any time.
 Having a partner, friend or relative you can ‘lean on’,
and who can support you during labour, certainly helps.
It has been shown to reduce the need for pain relief. But
if you don’t have anyone, don’t worry – your midwife will
give you the support you need.
 And finally, no one can tell you what your labour will feel
like in advance. Even if you think you would prefer not
to have any pain relief, keep an open mind. In some
instances, it could help to make your labour more
enjoyable and fulfilling.
Alternative methods of pain relief
Some mothers want to avoid the above methods of pain
relief and choose aromatherapy, homeopathy, hypnosis,
massage and reflexology. If you would like to use any of
these methods, it’s important to let the hospital know
beforehand. Discuss the matter with your midwife or
doctor and make sure that the practitioner you use is
properly trained and experienced.
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11. Useful advice for when you come into
hospital
Visiting times for wards
Due to restriction of space and to reduce the risk of cross
infection, numbers are limited to preferably two at any one
time and mother’s own children only.
Partners : Open visiting
Others:
4 - 8 pm only
There is hand-gel for your use at each entrance and
bedside. Please ask your visitors to use the hand-gel
when entering and leaving the ward and before they hold
your baby.
There is NO visiting on the delivery suite.
Locker space: there is limited space for your belongings
so please bring what you (and your baby) require for an
overnight stay only
Telephones: there is a television / telephone system which
you may purchase ‘time on a card’ for the use of. You may
also use your mobile phone on the wards (Not Delivery
Suite or Neonatal Intensive Care) but we do ask you to
keep it on silent mode please and to be sensitive to other
mothers in the ward who may be resting.
Security: all doors to the wards and delivery suite are
locked, so you must use the doorbell with an intercom /
camera system to gain access. When leaving the wards
we ask you not to permit others to enter without ringing the
bell. At night the Maternity entrance and internal corridor
32
are also locked. The doorbell is situated to the right of the
main doors.
Parking: When attending for appointments please allow
ample time to locate a parking space. You will need
change for the ticket machine. There is a very regular bus
available from all areas around the city. For arrival in
labour, there is emergency parking available in front of the
maternity department. Please don’t block the front doors
as this is frequently used by ambulances.
Meals and provision of food
Meal times are as follows:
08:00 – 08:30
12:00 – 12:30
18:00 – 18:30
Breakfast
Lunch
Supper
Outside of meal times a restricted supply of cold snacks
are available.
Please note there is a limited selection at mealtimes.
However, you are welcome to bring in non-perishable
foodstuffs that can be stored in your cupboard space.
No meals are supplied in the delivery suite – see below.
When you come to the delivery suite:
 A small overnight size bag is suitable for all you need;
towel, toiletries, light weight / large cotton T shirt,
dressing gown, slippers, sanitary towels, a nursing bra
if you intend to breast feed and items of clothing for
your baby.
33
 You may also choose to bring some small change,
mobile phone (not for use on delivery suite), soft drink
of your choice, a few biscuit / sweet type snacks and
a battery operated music player.
 We ask that you have no more than two birthing
partners to support you, as space is limited.
 There are no facilities on the delivery suite to provide
food and drink for birthing partners, so please come
prepared
 It would be wise to remove most of your jewelry items,
especially any piercings, in the event of an emergency
caesarean section.
 It is not necessary to remove nail varnish or acrylic
nails
 It is important to telephone in advance to let us know
you plan to come in so that a room can be prepared
for you and your main hospital notes made available.
TEL: 763610
 There is a NO visiting whilst you are on the delivery
suite.
How long will I be in hospital after the birth of
my baby?
If you choose to have your baby in hospital, and
providing you and your baby are well after delivery, you
will probably be discharged home between 2 and 6
hours following the birth or the following morning if you
deliver during the night.
If you have a caesarean you will usually stay for
between 1 - 3 days to ensure you recover well from the
operation.
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If you need to stay in hospital we will do all that we can
to ensure your privacy and dignity whilst maintaining
safety for you and your baby. In order to do this we
value the need to be able to observe all patients and
therefore request that the bed curtains remain open
where possible.
Before you go home, we provide discharge advice. A
member of staff will go through all the information you
need in order to be able to look after yourself and your
baby in the first few days following birth. She will also
explain when the community midwife will visit you at
home. You will have plenty of opportunity to ask
questions.
Hygiene
 You should wash your hands BEFORE and after going
to the toilet. This helps to prevent throat / mouth
bacteria being transferred from your hands to your
perineum and gaining entry to your blood stream via the
tear or episiotomy.
 Have a bath or shower at least once a day.
 Change your sanitary towel regularly (usually every time
you go to the toilet, and wash your hands both before
and after you do so).
Postnatal visits at home
Once you have been discharged from hospital a
community midwife will visit you or telephone you the
next day at home to ensure all is well and arrange further
35
visits with you as necessary. If no one has visited or
telephoned you by 3 pm on your first full day at home
please telephone the ward you were on in hospital
(phone numbers will be given to you to take home) to
make sure a midwife knows to visit. If you are well
enough, most postnatal visits can be made at a
Children’s Centre rather than in your home if you wish.
This gives you more flexibility to book an appointment
time which suits you.
12. Vitamin K and your newborn baby
What is vitamin K?
Vitamin K is a substance that is found naturally in the
body. It plays an essential role in the normal process of
blood clotting.
Why is it important for my baby?
Newborn babies have low levels of vitamin K in their blood
and occasionally start to bleed. This is called Vitamin K
Deficiency Bleeding (VKDB) in newborn babies and used
to be called haemorrhagic disease of the newborn, or
HDN. If your baby develops VKDB, in the first few months,
he or she may have obvious bleeding:
• from the umbilical stump;
• in the urine;
• from the bottom;
• from the skin and mucous membranes, for example
the nose and gums;
• appearing as bruises on the skin
There is also the risk of internal bleeding, for example
inside the head which may not be obvious to you.
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Bleeding because of a vitamin K deficiency only occurs in
a very small number of babies: approximately one in every
10,000. The impact of VKDB can vary, from being mild to
fatal. Approximately 30% of babies with VKDB are left with
mental impairment because of bleeding to the brain, and
about 7% of babies with VKDB die.
Which babies are most at risk?
Babies are more at risk if:
• they were born prematurely (before 37 weeks);
• they were delivered by forceps or caesarean section;
• they are bruised after delivery;
• they had breathing difficulties at birth
• you were on certain drugs during your pregnancy, such
as anticonvulsants (medication for epilepsy).
• the baby is a boy who is going to be circumcised.
Babies who are entirely breastfed are more likely to
develop VKDB compared to babies who are bottle-fed.
This is because manufacturers add vitamin K to formula
milk.
Why should my baby be given vitamin K?
Even if your baby is not at a higher risk of developing
VKDB, he or she could still develop a vitamin K deficiency.
About one third of babies with VKDB do not have any of
the risk factors listed above. VKDB is completely
preventable by giving your baby extra vitamin K after he or
she is born. Therefore paediatricians, Department of
Health and The National Institute for Clinical Excellence
(NICE) strongly recommend that all newborn babies
receive vitamin K soon after birth to prevent VKDB until
they build up their own supplies.
How is given vitamin K?
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We offer every baby delivered here a dose of vitamin K as
soon as possible after birth. NICE recommends injection of
vitamin K into a muscle as the best method to give your
baby vitamin K. If you don’t want your baby to have the
injection, vitamin K can be given by mouth, unless your
baby cannot accept feeds by mouth.
Are there any drawbacks to vitamin K
supplements?
In the early 1990’s it was suggested that vitamin K
injections might increase the risk of leukaemia (a type of
cancer of the blood) in children. However, since then
there have been many more reports disproving this.
Current well informed scientific opinion is that there is no
link.
Are there any alternatives?
The alternative is not to give vitamin K for the prevention
of VKDB. This increases the risk of the baby getting VKDB
10 to 100 fold.
Will further doses be necessary?
As an injection, a single dose of vitamin K is enough.
Given by mouth, 3 doses are necessary:
• the first dose soon after delivery
• a second dose when your baby is around seven days
old (given by your midwife); and
• a third dose when your baby is about 28 days old
(given by your health visitor or GP).
If you are bottle feeding your baby formula milk, he or she
will only need the first 2 doses, as vitamin K is added to all
formula milk. However, although formula milk contains
higher levels of vitamin K than breast milk, this is not a
reason to bottle feed your baby. Breast feeding is always
38
the best choice for your baby. This plan also follows the
recommendations of the Royal College of Paediatrics,
Child Health and NICE.
Does my baby have to be given vitamin K?
As a parent you have the right to refuse. However, we
strongly encourage you to allow your baby to have this
simple treatment, which lowers the risk of death or
permanent handicap in a healthy baby. If you do not wish
your baby to have vitamin K please discuss this with your
midwife or Paediatrician in order to get further information
before making your decision.
13. Choosing how to feed your baby
Policy Statement: ‘We are working towards UNICEF
UK Baby Friendly Initiative.’
Introduction
Choosing how to feed your new baby is a very important
decision as it can have an effect on both your baby’s
health and your own. This leaflet gives you some
information about the benefits of breastfeeding for you to
consider before you make up your mind. There are also
tips to help get breastfeeding off to a good start and
information about the support you can expect from your
midwife and, later on, your health visitor. Your baby is
referred to as ‘he’ in order to avoid confusion.
Breast milk contains antibodies to protect your baby from
infection. It also protects your own health. For the first 6
months, your baby will benefit most from having only your
milk. He will get all the food and drink he needs and be
protected against a range of illnesses. After this age,
continuing to breastfeed while your baby is being
39
introduced to other foods will have benefits for both of you,
especially during his first year. You can carry on
breastfeeding for as long as you both wish. YOUR breast
milk is perfect for YOUR baby and adapts to meet your
baby's changing needs.
Benefits for baby:
 Protection against ear infections
 Protection against diarrhoea, gastro-enteritis and
tummy upsets
 Less smelly nappies
 Protection against chest infections and wheezing
 Lower risk of diabetes
 Less eczema
 Better mental development
 Better mouth formation and straighter teeth
 Benefits for mother:
o Lower risk of breast cancer
 Lower risk of ovarian cancer
 Faster return to prepregnancy figure
 Stronger bones in later life
Ways in Which We Will Help Mothers to
Breastfeed Successfully
 All the staff have been specially trained to help you to
breastfeed your baby.
 During your pregnancy, you will be able to discuss
breastfeeding individually with a midwife or health
visitor who will answer any questions you may have.
 We recommend that you hold your new baby against
your skin as soon as possible after birth. The staff will
40








not interfere or hurry you but will be there to support
you and to help you with your first breastfeed.
A midwife will be available to explain how to put your
baby to the breast correctly and to help with feeds in
the early days. A health visitor will provide support
later on.
We will show you how to express your breast milk and
we will give you a written sheet about this.
We recommend that you keep your baby near you
whenever you can so that you can get to know each
other. We will give you information and advice about
bed-sharing and infant safety. If any medical
procedures are necessary in hospital, you will always
be invited to accompany your baby.
We will encourage you to feed your baby whenever
he or she seems to be hungry.
We recommend that you avoid using bottles,
dummies and nipple shields while your baby is
learning to breastfeed. This is because they can make
it more difficult for your baby to learn to breastfeed
successfully and for you to establish a good milk
supply.
Most babies do not need to be given anything other
than breast milk until they are 6 months old. If for
some reason your baby needs some other food or
drink before this, the reason will be fully explained to
you by the staff.
We will help you to recognise when your baby is
ready for other foods (normally at about 6 months)
and explain how these can be introduced.
We welcome breastfeeding in all areas of our
premises. If you would prefer somewhere private,
please ask a member of staff.
41
 We will give you a list of people who you can contact
for extra help and support with breastfeeding, or who
can help if you have a problem.
A good start
No matter how you choose to feed your baby, spending
some time quietly holding him in skin-to-skin contact
straight after the birth is very important because it: helps to
calm your baby and keeps him warm, steadies your baby’s
breathing, and gives you time to bond with your baby. It
also helps get breastfeeding off to a good start. Provided
you and your baby are both well, you will be able to hold
him straight away. Usually, the midwife will dry him quickly
and then give him to you. A blanket over both of you will
help keep your baby warm. If you have a Caesarean
delivery, or if you have to be separated from your baby for
a while after the delivery, you will both still benefit from
skin contact as soon as you are able.
The first days
Colostrum - the milk you will produce in the first few days is full of antibodies to protect your baby against infections.
You will produce the right amount to meet your baby’s
needs. Your midwife will show you how to hold your baby
for feeding and how to make sure that he attaches
properly to the breast. This is very important as it will help
you both to breastfeed successfully - most of the problems
experienced by breastfeeding mothers in the first few
weeks (sore nipples, for example) happen because the
baby is not attached to the breast in the best way. In
hospital, your baby will sleep next to you. That way you
will get to know him well and will quickly know when he
needs feeding. This is especially important at night when
you can feed him as soon as he’s ready without either of
you being disturbed too much.
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Ask your midwife for a copy of the ‘Essential Guide to
Breast feeding in the Plymouth Area’.
Breast feeding workshops are available at many
locations including Children Centres and local Parentcraft
sessions. The workshops are designed to inform and
prepare you for the initiation of breast feeding. You will be
ready to get off to a good start.
Breast feeding support groups are known locally as
LATCH ON GROUPS, and are also available at many
locations such as Children’s Centres and Tesco’s at
Transit way. You can just drop in during pregnancy as well
as with your baby after the birth. Trained professionals and
peer supporters support them.
For further information: www.plymouthlatchon.org.uk
14. Birth Afterthoughts service
On occasion there are experiences, which continue to
cause distress to the individual long after the event. It is
often referred to as Post Traumatic Stress Disorder.
Would you like to discuss your birth experience to clarify
the events, fill-in the time gaps or just have a greater
understanding of what or why something happened?
We have a small team of ‘Birth Afterthoughts’ midwives
who are able to provide a ‘listening service’ for you. There
is not a time limit for this service but you must have had
your baby in Plymouth, as we are unable to access notes
from other hospitals.
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The appointment takes approximately one hour and your
partner is welcome too.
To request an appointment
TEL: 01752 431336 between 09.30 – 13.00hrs
Mon –Fri
15. Supervisors of Midwives
For urgent concerns there is a Supervisor of Midwives on
call 24 hours a day.
They can be contacted via the hospital switchboard or via
the Maternity Message Handling Service where you can
ask for the on call Supervisor of Midwives to be paged.
The supervisor will then contact you.
For most common concerns or questions your named
Midwife should be able to assist or arrange for a
Supervisor of
Midwives to contact you.
Alternatively for non-urgent issues you can email your
requests, concerns or queries to the Supervisor’s mail box.
We will make every effort to respond as swiftly as
possible.
Email: Plymouth.som@nhs.net
44
For more information about Supervisors of Midwives :
www.midwife.org
www.nmc-uk.org/nurses-and -midwives
/midwifery/supervisor-of-midwives
For more Information about supervision of midwives:
www.midwife.org.uk
www.nmc-uk.org/Nurses-and-midwives/Midwifery/Supervisor-of-midwives
16. Patient involvement in Maternity services
We are always very keen to receive your comments about
the Maternity service you receive in order for us to develop
the service in line with your requirements. You can do this
by speaking to your midwife, using the ‘comments’ boxes,
which can be found in reception and the ward area, or by
writing us a letter addressed to:
Head of Midwifery,
Maternity Unit,
Derriford Hospital,
Plymouth
PL6 8DH.
Tel: (01752) 432092
If you wish to become more involved with the development
of Maternity services and are able to attend monthly or two
monthly meetings we would welcome you as a member
the Maternity Services Liaison Committee. For further
information please contact the Head of Midwifery at the
address given above.
We look forward to hearing from you.
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17. Children’s centres
Children’s Centres have many facilities with health
professionals and community workers available on a daily
basis to support you and your growing family.
Midwives, Health Visitors and community workers provide
Great Expectations and parent craft sessions. They are
group sessions that are designed to provide you with the
information you need to get the best from your pregnancy
and prepare for the birth and becoming a parent.
Ask your Midwife and Health Visitor about what groups are
available near you or telephone your nearest Children’s
Centre.
Your Partner is, of course, welcome to attend these
sessions with you.
Plym Bridge Children’s Centre,
Miller Way, Estover, Plymouth PL6
8UN
Southernway Children’s Centre,
Beechwood Primary School, Rockfield
Avenue, Southway, Plymouth PL6
6DX
Whitleigh Children’s Centre,
Wood View Learning Campus,
Lancaster Gardens, Whitleigh,
Plymouth, PL5 4AA
Four Woods Children’s Centre,
415 Crownhill Road, West Park,
Plymouth, PL5 2LN
Tamar FOLK Children’s Centre,
Victoria Road Primary School,
Trelawney Avenue, St Budeaux,
Plymouth, PL5 1RH
Green Ark Children’s Centre,
Tel: 01752 786444
Email(s): reception@plymbridge.net
jhamlyn@plymbridge.net
Tel: 01752 775849
Email(s): southernway-info@whitleigh-pri.plymouth.sch.uk
alisonroberts@woodview.plymouth.sch.uk
Tel: 01752 237691
Email(s): childrenscentre-info@whitleigh-pri.plymouth.sch.uk
alisonroberts@woodview.plymouth.sch.uk
Tel: 01752 366795
Email: Helen.Huntley@childrenssociety.org.uk
Tel: 01752 431600
Email(s): info.tamarfolk@plymouth.gov.uk
Ernie.Edgcumbe@plymouth.gcsx.gov.uk
Tel: 01752 565555
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Leander House, Fore Street,
Devonport, Plymouth, PL1 4DW
Keystone Manor Street Children’s
Centre, 25 Manor Street, Stonehouse,
Plymouth, PL1 1TL
Keystone Morice Town Children’s
Centre, Charlotte Street, Devonport,
Plymouth, PL2 1RJ
LARK Children’s Centre,
99 North Prospect Road, North
Prospect, Plymouth, PL2 2NA
Nomony Children’s Centre,
27 St John's Road, Cattedown,
Plymouth, PL4 0PA
D.E.L.L. Children’s Centre,
High View Primary School, Torridge
Way, Efford, Plymouth, PL3 6JQ
Plum Tree Children’s Centre,
Plympton St Maurice Primary School,
Plympton, PL7 1UB
Plymstock Children’s Centre,
Dunstone Primary School, Shortwood
Crescent, Plymstock, PL9 8TQ
Crownlands Children’s Centre,
Austin Farm Community Primary
School, Delamere Road,
Eggbuckland, Plymouth, PL6 5XQ
Sweet Peas Children’s Centre,
23 Brandreth Road, Mannamead,
Plymouth, PL3 5HQ.
Popin Children’s Centre,
St. Pancras Church, Honicknowle
Lane, Plymouth, PL2 3QT
SeaMoor Children’s Centre,
(Ivybridge)
Town Hall, Erme Court, Leonards
Road, Ivybridge, PL21 0SZ
Kingsbridge Children’s Centre,
Belle Cross Road, Kingsbridge, TQ7
1NL
Tavistock Children’s Centre,
Abbey Rise, Tavistock, PL19 9FD
Email(s): greenarkcc@childrenssociety.org.uk
Clare.Wasey@childrenssociety.org.uk
Tel: 01752 208650
Email(s): reception@surestart-keystonems.co.uk
slewis@keyhamcp.org.uk
Tel: 01752 208660
Email(s): reception@surestart-keystonemt.co.uk
slewis@keyhamcp.org.uk
Tel: 01752 313293
Email(s): admin@lark.eclipse.co.uk
julieroberts_917@hotmail.com
Tel: 01752 667869
nomomycc@childrenssociety.org.uk
Email(s): johanna.hughes@childrenssociety.org.uk
Tel: 01752 306334
Email(s): info.dellcc@plymouth.gov.uk
claire.devereux@plymouth.gov.uk
Tel: 01752 283826
Email(s): plumtree@plymouth.gov.uk
Helen.Caine@plymouth.gov.uk
Tel: 01752 407496
Email(s): plymstock.children.centre@plymouth.gov.uk
Helen.Caine@plymouth.gov.uk
Tel: 01752 770321
Email(s): crownlands@plymouth.gov.uk
claire.devereux@plymouth.gov.uk
Tel: 07827 272041
Email(s): Sweetpeas@barnardos.org.uk
alison.walker@barnardos.org.uk
Tel: 01752 395302
Email: victoria.opie@4children.org.uk
Tel: 01752 896356
Email(s): seamoorcc@actionforchildren.org.uk
Karen.Pearce1@actionforchildren.org.uk
Tel: 01548 856383
Email(s): kingsbridgecc@actionforchildren.org.uk
www.southhamschildrenscentres.org.uk
Tel: 01822 614210
tavistockchildrenscentre@barnardos.org.uk
mary.matthews@barnardos.org.uk
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18. Antenatal classes
Antenatal classes are offered to all pregnant women and
their partners, friends or supporter of their choice. The
antenatal programme is delivered in partnership with your
local children’s centre.
Within the Plymouth and Cornwall area the ‘Great
Expectations’ antenatal programme is offered. This is a 6
week course consisting of 1 x 2 hour session per week,
which aims to provide parents-to-be/ with useful
information and practical skills, to help them feel more
comfortable about making choices for their new arrival,
whether it is their first baby or not.
The course includes:
 A healthy pregnancy
 Changes to relationships
 Preparation for birth
 Birth assistance
 Bonding with baby
 Parental support
To book contact your local children’s centre – see above .
Details can also be found on the Plymouth/Cornwall
Council website
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19. Smoking cessation
When you smoke, carbon monoxide and 4200 other
poisons pass into your lungs. This means that:
 when you are pregnant your baby gets less oxygen
and cannot grow as well as he should. He is therefore
more likely to be born underweight on average 200 g
(about 8 oz) lighter and be in need of medical
treatment following the birth
 when you are pregnant the nicotine makes your
baby’s heart beat faster
 you are more likely to give birth prematurely
 baby may have problems during and after labour.
Increased risks of smoking in pregnancy
Headaches Dizziness Nausea
Increased Morning Sickness
Miscarriage
Premature Birth
Fetal Malformation
Slower Fetal Growth
Placenta Separation
Low Lying Placenta
Reduced Blood Supply to Fetus
Stillbirth
Bleeding
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After delivery breathing in other people’s smoke makes
the baby more likely to suffer from
 Asthma & respiratory problems
 Low birth weight
 Behaviour problems & poor development
 Reduced breast milk supply & quality
 Sudden infant death syndrome
If you stop smoking now:
 you will have less morning sickness and fewer
complications in pregnancy
 you’re more likely to have a healthier pregnancy and
a healthy baby
 you will reduce the risk of stillbirth
 you will cope better with the birth
 your baby will cope better with any birth complications
 your baby is less likely to be born too early and have
to face the additional breathing, feeding and health
problems which so often go with prematurity
 you will reduce the risk of sudden infant death
syndrome
 your baby is less likely to be born underweight and
have extra problems in keeping warm.
The sooner you stop smoking, the better. Stopping
even in the last few weeks of pregnancy can be beneficial.
If anyone in your home smokes, their smoke can affect
you and the baby both before and after birth. They can
help you and the baby by giving up now. Perhaps you
could try to stop together.
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Protecting the fetus and new baby from tobacco smoke is
one of the best things you can do to give your child a
healthy start in life.
Antenatal care: During your pregnancy your midwife will
assess your carbon monoxide (CO) level. This is not
screening for whether you smoke, but to check the oxygen
available to your baby. If you smoke or your CO level is 4
or above, as part of your antenatal care, your midwife will
automatically refer you to the stop smoking service for
support.
Call Livewell Stop Smoking Service
01752 437177
for 1-1 support and advice home-visits possible
For what happens in an appointment go to
www.livewellplymouth.co.uk
Further info go to www.smokefree.nhs
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20. Domestic Abuse
Domestic abuse is defined as any incident of threatening
behaviour, violence or abuse (psychological, physical,
sexual, financial or emotional) between adults (18 years
and over) who are or have been intimate partners or family
members, regardless of gender and sexuality. (Family
members are defined as mother, father, son, daughter,
brother, sister and grandparents, whether directly related,
in-laws or step family.)
Domestic abuse is known to often start or become worse
during pregnancy; this can have serious consequences for
mothers and babies.
If you would like to talk to your midwife in private about this,
please ask.
21. How to find advice and support if you have
any concerns
Patient Advice and Liaison Service (PALS) is there to help
when you need advice, have concerns or don't know
where to turn.
As a patient, relative or carer sometimes you may need to
turn to someone for help, advice and support. This is
where PALS comes in.
PALS provide a confidential service, helping you to sort
out any concerns you may have about the care we provide
and guiding you through the different services available
from the NHS.
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PALS focuses on improving and developing local NHS
services and aims to:





offer information and advice about NHS services
help to sort out problems or concerns quickly on your
behalf
put you in touch with support agencies and other
organisations that can help
advise on how to make a complaint if that becomes
necessary
listen to comments about things that work well and
suggestions for ways to improve the care we provide
PALS is available between 9am and 5pm Monday to
Friday.
You can contact our PALS Co-ordinator Heather Wood by:
Telephone: (01752) 435204 or 0845 155 8121 and ask to
be put through to PALS. You can also contact the service
on 07879 401397.
Email: pals.pct@plymouth.nhs.uk
Post:
Heather Wood
Patient Advice & Liaison Service (PALS) Co-ordinator
NHS Plymouth
Local Care Centre
Mount Gould
Plymouth
PL4 7PY
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22. Research in the Maternity Unit
"The care that you receive from the Obstetricians and
Midwives in your pregnancy is based on the best research
evidence that is currently available. This evidence has
been gained from the results of previous studies in which
pregnant women agreed to take part.
In order to continually improve the care we give women
and their babies in the future there are many research
studies taking place within NHS maternity units across the
country and within Derriford hospital. It is therefore very
likely that you will be approached during your current
pregnancy and asked to consider taking part in a study.
All studies will have been given Research and
Development and ethical approval and judged to be safe
for pregnant women to take part in.
The studies running at the moment are advertised around
the maternity unit and if you are interested in taking part
then you can ask any member of staff to bleep the
research midwife or you can contact them yourself.
Contact details are on all the posters or patient information
leaflets in the department.
You should be given a Patient Information sheet to take
away and read and the opportunity to have all your
questions answered. Then, should you wish to take part,
you will be asked to sign a consent form and be entered
into the study.
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You are of course under no obligation to take part in any
studies and you should feel able to accept or decline any
such invitation without it affecting your care in any way."
Useful contacts
Hospital labour ward: Tel: (01752) 763610
Women Day Services:
Early Pregnancy Unit and Day Assessment.
Monday – Friday 08:00 – 20:00
Tel: (01752) 763676 OR (01752) 245212.
Aquanatal classes
Held at local swimming pools with an Aqua trained midwife.
 Plympton
Monday
 Central Park Tuesday
 China Fleet Friday
11.00 – 12.00
9.00 – 10.00
9.45 – 10.30
Pregnancy pilates
A 6 week course is available at YMCA John Kitto Centre.
Honicknowle.
TEL: 201918 for information.
Pregnancy yoga
Ashburton.
Kingsbridge
Monday 18.30 – 19.45
Julia : 01364 653214
Tuesday 18.30 – 20.30
Leib Seel : 01548 854774
Maternity unit tours
A photographic tour of the maternity unit can be found on
the Plymouth Hospitals website by following the links to
the Maternity Services: www.plymouthhospitals.nhs.uk
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Helpful Telephone Numbers
Citizen’s Advice Bureau
01752 845515
National Council for One-parent families
0800 0185 026
Naval Family Welfare
01752 555041
24hr National Domestic Violence Helpline
0808 2000 247
Plymouth Women’s Refuge
01752 562286
Police Domestic Abuse Investigation Unit
01752 720484
Plymouth Domestic Abuse Service
01752 252033
Useful websites
www.nhsdirect.nhs.uk or telephone 0845 4647
www.nctpregnancyandbabycare.com National Childbirth Trust
www.bda.uk.com The British Dietetic Association
www.plymouthlatchon.org.uk Breast feeding Latch-on groups
www.lalecheleague.org Breast Feeding advice & support
www.homebirth.org.uk homebirth support & advice
www.nice.org.uk NICE / care guidelines
www.surestart.gov.uk Sure Start enterprise
www.activebirthcentre.com managing ‘labour’ advice
www.pelvicpartnership.org.uk advice on painful ‘hips’
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This leaflet is also available
in large print.
Contact : The Patient
Involvement Manager
Tel.01752 245136
57
Version 3
Issue date: Dec 13
For review: Nov 16
Ref: B-188/SF/Information for Parents about Pregnancy and Birth
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