The Pregnancy Book 2009 NHS.pdf

The

Pregnancy

Book

Your complete guide to:

A healthy pregnancy

Labour and childbirth

The irst weeks with your new baby

The Department of Health would like to thank all those involved in shaping the updated edition of

The Pregnancy Book , including the mothers and fathers, medical and health professionals, and the

many individuals and organisations. In particular, the Department extends thanks to:

Community Practitioners’ and Health Visitors’ Association

Department for Children, Schools and Families

Department for Work and Pensions

Food Standards Agency

NCT

National Institute for Health and Clinical Excellence

Royal College of Anaesthetists

Royal College of General Practitioners

Royal College of Midwives

Royal College of Obstetricians and Gynaecologists

Royal College of Paediatrics and Child Health

UK Medicines Information

Sheena Byrom, Jill Cooper, Anne Edington, Dr David Elliman, Kathryn Gutteridge, Sue Henry,

Dr Judy Shakespeare and Dr Helen Scholeield.

This book is given free to all expectant mothers.

Every effort has been made to make this book relect the most up-to-date medical advice at the time

of publication. Because developments can be very rapid, signiicant changes will always be notiied to

doctors and other health professionals at once. They will then be incorporated into the text for the next

reprint. For the most up-to-date information and advice, visit the online version of the book (pregnancy

planner) at www.nhs.uk/pregnancyplanner

The information on rights and beneits is correct at the time of going to press but may change and

should be checked against the latest information.

Produced by COI for the Department of Health.

Design and layout by the Rafferty Consultancy.

Cartoons by Alex Hallatt. Medical illustrations by Anne Wadmore and Florence Woolgar.

The photographs have been reproduced with the permission of the following:

Alamy – front cover (bottom left), 1, 2 (bottom), 4 (middle left), 10, 13 (top and bottom), 14 (bottom),

15 (middle left and bottom right), 17 (top), 18, 23, 40 (top and bottom), 47, 49 (middle left), 51, 58,

60 (bottom), 66 (top), 67 (bottom), 68 (top), 69, 72 (top left and bottom), 75 (top), 76 (middle and

bottom), 78 (bottom), 89 (middle), 90 (top and middle), 94 (bottom), 95 (bottom), 99 (bottom), 101 (top

and bottom middle), 107 (top), 110 (bottom left), 118 (top), 121 (middle right), 129, 134 (bottom), 137

(bottom), 142 (bottom middle), 144 (middle), 145 (top), 155, 156 (top), 161, 162 (top); Banana Stock –

146 (bottom); Bubbles Photo Library – 89 (top); Corbis – front cover (middle), 93 (bottom right), 147

(middle); Department of Health – 2 (top), 4 (bottom left), 15 (bottom), 28 (top right), 29 (bottom),

35, 36, 40 (middle left and right), 42 (top), 44 (top and bottom middle), 45 (middle), 46, 48 (bottom

right), 52, 54, 55, 56 (top), 60 (middle), 67 (top), 68 (bottom right), 70 (bottom), 71 (middle), 73, 74,

77, 78 (middle), 79 (top), 81 (bottom), 86 (middle), 87 (top), 88 (top), 91 (top), 92 (top and middle

right), 94 (middle left), 96 (top), 97, 99 (top), 102 (top), 103 (top middle and bottom), 104, 106 (top),

109 (bottom left), 110 (top right), 111 (top and middle), 114 (top middle and bottom), 115, 116 (top),

120 (middle and bottom), 121 (bottom), 126 (middle right), 127 (bottom), 128 (top left), 130, 131, 134

(top right), 136, 141 (bottom right), 142 (middle right), 152 (top), 156 (bottom middle), 158 (top), 172

(bottom), 176, 177; Digital Vision – 33, 113; Dreamstime – 5 (top), 66 (bottom); East Essex Hospital

– 72 (top right); The Food Standards Agency – 25 (middle); Getty Images – front cover (top left), 15

(top middle), 16 (top right), 17 (middle left), 44 (middle), 48 (top), 61 (top), 68 (bottom left), 71 (top),

83, 91 (bottom middle), 94 (top), 98 (top), 101 (bottom right), 102 (middle), 122, 124, 127 (top), 137

(top), 141 (bottom middle), 147 (bottom), 148 (top); Harlow Printing – 123; Image Dictionary – 160

(middle); Image Source – 3, 13 (middle right), 92 (middle); Ingram Publishing – 27, 28 (top middle),

29 (top), 38 (top), 111 (top left and bottom), 139 (middle left); Istock Photo – front cover (top right),

4 (top right and bottom right), 5 (middle right and left, bottom), 6, 7, 8, 9, 13 (middle left), 14 (middle

left), 16 (top left), 17 (middle right), 24, 25 (bottom), 29 (middle left), 34, 37, 38 (bottom), 42 (middle),

43, 44 (middle left), 45 (bottom), 48 (bottom left), 49 (middle), 56 (bottom), 57, 59, 60 (top), 61

(middle and bottom), 62, 63 (top and bottom), 64, 65, 70 (top), 75 (bottom), 76 (top), 79 (middle and

bottom), 81 (top), 82, 84, 85, 86 (top and bottom), 87 (bottom), 88 (middle and bottom), 90 (bottom),

91 (middle right and bottom left), 93 (top and middle left), 96 (middle and bottom), 98 (middle and

bottom), 99 (middle left), 100, 103 (top right), 105 (middle), 106 (bottom), 107 (bottom right), 108, 109

(top), 114 (top left), 116 (bottom), 118 (bottom), 119, 120 (top), 121 (top), 126 (top), 128 (top right),

132, 133, 134 (top left), 135, 138, 139 (top and middle right), 140, 143, 144 (top and bottom), 146

(top and middle), 147 (top), 148 (bottom), 149, 150, 151, 152 (bottom), 154, 156 (bottom right), 157,

158 (bottom), 159, 160 (top), 162 (middle), 163, 166, 167, 170, 171, 172 (top), 173, 174, 175; Italia

Stock – 44 (bottom left); Jupiter Images – 128 (bottom); Masterile – 16 (bottom); The Meningitis

Trust – 145 (bottom); Photo Library – 32; Q Box – GU – 30–31; Science Photo Library – 19, 20, 21;

Shutterstock – front cover (bottom right), 125; Superstock Images – 63 (middle), 101 (middle left);

Unicef – 95 (top), 105 (bottom)

Pregnancy

Book

Your complete guide to:

A healthy pregnancy

Labour and childbirth

The irst weeks with your new baby

your complete guide

The

pregnancy

INTRODUCTION

Work hazards ................................... 39

Flying and travel ................................ 39

YOUR PREGNANCY

AT A GLANCE

ANTENATAL CARE

1 BECOMING PREGNANT

Antenatal appointments .................. 41

Early antenatal appointments ........... 44

Regular checks at every antenatal

appointment ..................................... 45

Appointments in later pregnancy .... 46

Blood tests ........................................ 46

Ultrasound scans .............................. 48

Tests to detect abnormalities ............ 49

Tests for Down’s syndrome

and other genetic disorders ............. 50

Diagnostic tests for Down’s syndrome

and other genetic disorders ............. 51

If a test detects an abnormality ......... 51

Making the most of antenatal care .. 52

Your antenatal team ......................... 54

Antenatal education ......................... 56

Male sex organs ............................... 10

Female sex organs ............................ 11

The female monthly cycle ................ 12

Conception ...................................... 12

Hormones ........................................ 13

Boy or girl? ................................... 13

The best time to get pregnant ......... 14

Twins, triplets or more ...................... 14

The signs of pregnancy ..................... 15

Pregnancy tests ................................ 15

Finding out that you are pregnant .. 16

Accessing antenatal care .................. 16

Help for young mums ...................... 17

HOW YOUR BABY

DEVELOPS

CONDITIONS AND

PROBLEMS IN PREGNANCY

Measuring your pregnancy ............... 18

Week 3 ............................................ 19

Weeks 4–5 ....................................... 19

Weeks 6–7 ....................................... 19

Weeks 8–9 ....................................... 19

Weeks 10–14 .................................. 20

Weeks 15–22 .................................. 21

Weeks 23–30 .................................. 22

Weeks 31–40 .................................. 23

Common minor problems ................ 58

More serious problems ..................... 67

CHOOSING WHERE

TO HAVE YOUR BABY

Safety ............................................... 70

Making an informed decision .......... 70

Home births ..................................... 71

Midwifery units or birth centres ........ 72

Birth in hospital ................................ 73

Birth plans ........................................ 74

YOUR HEALTH

IN PREGNANCY

What should you eat? ...................... 24

Foods to avoid ................................. 26

Preparing food ................................. 26

Vitamins and minerals ...................... 27

Vegetarian, vegan and special diets .. 28

Smoking ........................................... 30

Alcohol ............................................. 32

Pills, medicines and other drugs ....... 33

Illegal drugs ...................................... 33

X-rays ............................................... 34

Keeping active .................................. 34

Infections ......................................... 36

Inherited conditions ......................... 38

FEELINGS AND

RELATIONSHIPS

Feelings ............................................ 75

Depression and mental health

problems .......................................... 76

Worrying about the birth .................. 77

Concerns about disabilities ............... 77

Couples ............................................ 78

Sex in pregnancy .............................. 78

Single parents ................................... 79

Family and friends ............................ 80

Work ................................................ 80

After the birth .................................. 81

Mood changes that can develop

after the birth of a baby ................... 81

Domestic abuse ................................ 83

Bereavement .................................... 84

THE EARLY WEEKS:

YOUR BABY

137

Enjoying your baby ........................... 137

Registering the birth ......................... 138

Crying ............................................... 138

Sleep ................................................ 140

Changing your baby ......................... 142

Washing and bathing ....................... 144

Illness ............................................... 145

Getting support ................................ 146

8 LABOUR AND BIRTH

Getting ready .................................... 85

The signs of labour ........................... 87

Types of pain relief ............................ 88

When to go to hospital

or your midwifery unit ..................... 90

Arriving at the hospital or

midwifery unit .................................. 91

What happens in labour ................... 92

Special cases ..................................... 96

Twins, triplets or more ...................... 100

What your birth partner can do ........ 101

BABIES WHO NEED

ADDITIONAL CARE

147

Why babies need additional care ...... 147

Contact with your baby .................... 148

Feeding ............................................. 148

Incubators ........................................ 148

Newborn babies with jaundice ......... 149

Babies with disabilities ...................... 149

9 FEEDING YOUR BABY

102

Breastfeeding .................................... 103

Formula feeding ................................ 115

15 THE LOSS OF YOUR BABY

150

THE FIRST DAYS WITH

YOUR BABY

120

Ectopic pregnancy ............................ 151

Miscarriage ....................................... 151

Abnormal test results ........................ 152

Stillbirth and neonatal death ............ 153

How you feel .................................... 120

Postnatal care ................................... 121

Stitches ............................................. 122

Bleeding ............................................ 122

Sex and contraception ...................... 122

Your body ......................................... 123

Your baby’s health ............................ 124

Your baby’s appearance .................... 124

What your newborn baby can do .... 126

THINKING ABOUT THE

NEXT BABY?

154

It takes two ....................................... 154

Folic acid ........................................... 154

Things to consider ............................. 155

Work-related risks ............................. 155

17 RIGHTS AND BENEFITS

WHAT YOU NEED FOR

YOUR BABY

127

156

Beneits for everyone ........................ 157

Tax credits ......................................... 158

Beneits if your income is low ........... 159

Maternity beneits ............................ 163

If you are unemployed ...................... 166

Maternity leave ................................. 167

Rights during maternity leave ........... 168

Returning to work ............................ 169

Other employment rights ................. 170

Other types of leave .......................... 171

Your rights under sex

discrimination law ............................. 174

Nappies ............................................ 127

Bathing ............................................. 128

Sleeping ............................................ 129

Out and about ................................. 130

In the car .......................................... 130

Feeding ............................................ 131

Clothes ............................................. 131

12 THE EARLY WEEKS: YOU

132

Partners ............................................ 132

Help and support ............................. 133

Looking after yourself ....................... 133

Your relationships ............................. 134

The ‘baby blues’ and

postnatal depression ........................ 136

Your postnatal check ........................ 136

The NHS Constitution 176

Glossary of useful terms 178

Useful organisations 182

Index 189

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