Preparing for pregnancy
Congratulations you are pregnant! You may feel happy and excited, or shocked, confused and upset, the mix of emotions you are feeling is perfectly normal and may be caused by changes in your hormone levels – so don’t worry!
In this guide we will outline what happens during your pregnancy (in terms of your appointments/scans) as well the different things to think about during your pregnancy.
Make an appointment with your GP as soon as you know that you are pregnant, ideally this should be by 10 weeks to ensure that you receive all the care you require. The care that you will receive during your pregnancy is known as antenatal care. Your antenatal appointments will be with the community midwives and are held at a GP surgery, children’s centre or hospital.
You may want to tell your family and friends immediately, or wait a while until you know how you feel. Or you may want to wait until you have had your first ultrasound scan, when you're around 12 weeks pregnant, before you tell people.
Some of your family or friends may have mixed feelings or react in unexpected ways to your news. You may wish to discuss this with a midwife.
If you’re entitled to paid maternity leave, you must tell your employer you’re pregnant no later than the 15th week before your baby is due.
You must tell them:
- You’re pregnant
- The date of the week your baby is due (your employer can ask to see a medical certificate or 'MAT B1 form' – you get this from your doctor or midwife once you’re 20 weeks’ pregnant)
- The date you want to start maternity leave
They should give you information about:
- Folic acid supplements
- Nutrition, diet and food hygiene
- Lifestyle factors – such as smoking, drinking and recreational drug use
- Antenatal screening tests - you should be told about the risks, benefits and limits of these tests.
Screening for sickle cell disease and thalassaemia should be offered before 10 weeks. This is so you can find out about all your options and make an informed decision if your baby has a chance of inheriting these conditions.
It's also important to tell your midwife or doctor if:
- There were any complications or infections in a previous pregnancy or delivery, such as pre-eclampsia or premature birth
- You’re being treated for a long-term condition, such as diabetes or high blood pressure
- You or anyone in your family has previously had a baby with a health condition (for example, spina bifida)
- There’s a family history of an inherited condition (for example, sickle cell or cystic fibrosis)
- You know that you're a genetic carrier of an inherited condition such as sickle cell or thalassaemia – you should also tell the midwife if you know the baby's biological father is a genetic carrier of these conditions
- You have had fertility treatment and either a donor egg or donor sperm
If you choose to have your baby at home, the community midwifery service offers a service that supports this. Please discuss further with your midwife.
8-14 weeks dating scan - this is the ultrasound scan to estimate when your baby is due, check the physical development of your baby, and screen for possible conditions, including Down's syndrome.
At 16 weeks pregnant - your midwife or doctor will give you information about the ultrasound scan you'll be offered at 18 to 20 weeks
18 to 20 weeks - you'll be offered an ultrasound scan to check the physical development of your baby. This is also known as the 20-week scan.
25, 28, 31 weeks pregnant - these check-ups will be to measure the size of your uterus, your blood pressure and test your urine for protein
34 weeks - as well as the same checks you had at 25, 28 and 31 weeks; Your midwife or doctor should give you information about preparing for labour and birth, including how to recognise active labour, ways of coping with pain in labour, and your birth plan.
36 weeks - as well as the same checks you had at 34 weeks; Your midwife or doctor should also give you information on breastfeeding, caring for your newborn baby, tell you about vitamin K and screening tests for your newborn baby, discuss your own health after your baby is born and advise you about the "baby blues" and postnatal depression
38 weeks - as well as the same checks you had at 36 weeks; Your midwife or doctor will discuss options and choices about what happens if your pregnancy lasts longer than 41 weeks
40 weeks - as well as the same checks you had at 38 weeks; Your midwife or doctor will discuss options and choices about what happens if your pregnancy lasts longer than 41 weeks
41 weeks - as well as the same checks you had at 40 weeks; Your midwife or doctor will offer a membrane sweep and discuss the options and choices for induction of labour
If you have not had your baby by 42 weeks and have chosen not to have an induction, you should be offered increased monitoring of the baby.
There are lots of things you can do and avoid to keep you and your baby healthy during your pregnancy. The below is not an exhaustive list but things we hope will help you:
It’s essential not to miss any of your antenatal appointments as tests and checks are done to ensure the health of you and your baby. They are also planned at particular times of your pregnancy to be able to spot any problems or anomalies.
The next section will discuss eating well during your pregnancy but in general maintaining a healthy and varied diet will ensure you and your baby are getting essential nutrients and vitamins.
Alcohol and Smoking
It is not recommended to drink any alcohol or smoke during your pregnancy as it can lead to long-term harm to the baby.
It is recommended that you take folic acid when you’re planning on having a baby and up until the first twelve weeks of your pregnancy. Folic Acid reduces the risk of problems in your baby's development. It is also recommended to take a daily Vitamin D supplement. You can get supplements from pharmacies and supermarkets, or a GP may be able to prescribe them for you.
It’s important to remember that not all medicines are safe to take when you’re pregnant. Always check with your doctor, pharmacist or midwife before taking any medication.
Light, gentle exercise is recommended during pregnancy. The more active and fit you are during pregnancy, the easier it will be for you to adapt to your changing shape and weight gain. It will also help you to cope with labour and get back into shape after the birth.
A daily walk, running, yoga for as long as you feel comfortable are great forms of exercise.
Protect against getting ill
Be aware of the symptoms if you are feeling unwell and how to avoid infections that may harm your baby - here.
You are entitled to receive the following vaccinations for free as you’re pregnant:
the flu vaccination (offered between September and March
the whooping cough vaccination
Your baby’s movements
You will start to feel your baby’s movements around 16-24 weeks – at first it will feel like a flutter and as your pregnancy progresses you’ll feel the kicks! Find out more about here.
Work and Pregnancy
If you are working and you’re pregnant it’s important for you to be aware of your rights and what you are entitled to.
Your employer must protect your health and safety, and you may have the right to paid time off for antenatal care. You're also protected against unfair treatment.
If you have any worries or concerns about your health whilst you are at work, talk to your doctor, midwife or occupational health nurse. Find out more here.
Travelling during your pregnancy
You can travel when you’re pregnant, it is however advisable to be mindful of the necessary precautions, knowing when you can travel, to get travel insurance and be informed about vaccinations. It would also be wise to know what the healthcare facilities are like at your destination in case you need to seek urgent medical attention.
Some airlines will ask for a letter confirming your due date depending on when you are choosing to fly. It differs depending on the airline so please check before booking. Ferry companies also have their own restrictions so would recommend checking their policy too. Find out more about travelling here.
Maintaining a healthy diet and lifestyle is important at any time in your life, but when you’re pregnant it’s especially vital.
Growing a human is no mean feat and that doesn’t mean you have to eat a specific diet, it just means being more mindful on what you are eating to ensure you get the right balance of nutrients for you and your baby.
Whilst you may be hungrier or crave certain foods, there is no need to eat for 2! Starting the day with a healthy breakfast will help you avoid snacking on sugary and salty snacks throughout the day. We don’t recommend cutting out all of your favourite foods but eating a varied diet and introducing new foods will be beneficial. The Eatwell Guide has some useful information on what you should eat and what food groups your food needs to come from.
Eating plenty of fruit and veg rich in nutrients, vitamins and fibre helps support better digestion and can prevent constipation.
The general guidance is 5 pieces of fruit and veg a day - canned, frozen, dried or juiced all count!
Eating carbohydrates such as bread, rice, potatoes, pasta, oats, yam and cornmeal are an important energy source and can help you feel full for longer. Opt for oven chips as they are lower in fat and salt. Instead of white bread, pasta, rice, try wholegrain or higher fibre options, brown bread, brown rice, wholewheat pasta.
Meat, Fish and Dairy
Eating lean meat with the skin removed is a great source of protein. It is important for all meat and fish to be cooked thoroughly ensuring there are is no pink meat and juices have no blood in it.
Try to eat two portions of fish a week, one of which should be an oily fish. When you’re pregnant or trying to get pregnant it is advisable to avoid eating certain fish – shark, swordfish. When you’re pregnant avoid eating more than two portions of oily fish a week because it can contain toxins.
You should also avoid eating some raw, undercooked or runny eggs due to the risk of salmonella. The only exception to this are eggs that are produced under the British Lion Code of Practice. These eggs have a red lion logo stamped on their shell and are safe for pregnant women to eat raw or partially cooked, as they come from flocks that have been vaccinated against salmonella. Pregnant women can eat these raw or partially cooked (for example, soft boiled eggs).
Eggs that have not been produced under the Lion Code are considered less safe, and pregnant women are advised to avoid eating them raw or partially cooked, including in mousse, mayonnaise and soufflé. These eggs should be cooked until the white and the yolk are hard.
Milk, cheese, fromage frais and yoghurt are important in pregnancy as they contain calcium which are nutrients that you and you baby need. Try to opt for a low fat variant, semi skimmed, low sugar, skimmed milk, yoghurt or cheese. If you prefer a dairy free go for unsweetened, calcium-fortified versions.
There are some cheeses you should avoid in pregnancy, including unpasteurised cheeses. To find out which cheeses you should not eat when you're pregnant on our page about foods to avoid in pregnancy.
Saturated fats and sugary foods
Most foods high in sugar and fat are calorific which can contribute to weight gain, and if sugary can lead to tooth decay
Foods such as crisps, chocolates, cakes, biscuits, ice cream and fizzy drinks should be consumed in moderation so try and have these less often and in small amounts. Easier said than done if you are craving something sweet!
Healthy snacks to enjoy instead include can be dried fruit, low fat yoghurt, fresh fruit, a fruit loaf, hummus with wholegrain pitta. Find out more about healthy food swaps.
There are some vaccinations that are recommended during pregnancy:
During pregnancy, your immune system (the body's natural defence) is weakened to protect the pregnancy. This can mean you're less able to fight off infections. As the baby grows, you may be unable to breathe as deeply, increasing the risk of infections such as pneumonia.
These changes can raise the risk from flu – pregnant women are more likely to get flu complications than women who are not pregnant and are more likely to be admitted to hospital. Having the flu vaccine means you're less likely to get flu.
Whooping cough vaccine
Whooping cough is a very serious infection, and young babies are most at risk. Most babies with whooping cough will be admitted to hospital.
When you have the whooping cough vaccination in pregnancy, your body produces antibodies to protect against whooping cough. These antibodies pass to your baby giving them some protection until they're able to have their whooping cough vaccination at 8 weeks old.
Coronavirus (COVID-19) vaccine
You can have the coronavirus (COVID-19) vaccine during pregnancy. You'll be invited when your age group are offered it or earlier if you have a health condition or reason that means you're eligible.
It's preferable for you to have the Pfizer/BioNTech or Moderna vaccine. This is because they've been more widely used during pregnancy in other countries and have not caused any safety issues.
When you're offered a vaccine, speak to your GP surgery to arrange an appointment. This is to make sure you go to a vaccination centre offering the Pfizer/BioNTech or Moderna vaccine.'
Find out more about vaccination in pregnancy on nhs.uk.