During your pregnancy

You will be asked information about your health, given information about staying healthy in pregnancy and offered information about support to stop smoking if you or anyone in your household smokes. The midwife will explain information about routine blood tests, and screening choices offered in pregnancy.

Please visit our Community Midwifery page for more information.

Across Bradford, we are introducing different models of care during pregnancy, called ‘Continuity of Carer’ teams. Evidence from a number of studies has shown that having care delivered by the same small team of midwives during pregnancy, birth and after your baby is born is better for you and your baby, as richer relationships are formed.

We currently have seven Continuity of Carer teams in Bradford.

Screening is the process of identifying women and babies who may be at an increased risk of a disease or condition and may require further information, tests and treatment.

Please access the online information at GOV.UK – Screening tests for you and your baby or use the QR code below.

It is important that you read this information prior to your midwife booking appointment and inform your midwife of any relevant conditions that you, your partner or your immediate families may have.

Screening is important as it can save lives or improve quality of life through early risk identification and/or reduce the risk of developing a serious condition or its complication.

Contact us: call 01274 364532 or 01274 364531.

What is the Maternity Assessment Centre (MAC)?

MAC is a 4 bedded triage and assessment unit.  It is situated on the ground floor of the Women’s and Newborn Unit, near the Antenatal Clinic. You may be referred to MAC by your GP, midwife or another health professional or after a visit to A&E.  You can also contact us directly.

When to contact us

Please contact us if you are more than 16 weeks pregnant and have concerns about:

• Bleeding
• Tummy pain
• You think you are going into labour
• You think your waters may have broken
• Any other pregnancy related concerns

Also contact us if your baby has been born in the last 28 days and you have concerns about either your or your baby’s health.

Contact 999 if you have a medical emergency including sudden shortness of breath and chest pain.

When are we are open?

We are open 24 hours a day, 7 days a week, so are always available to offer support and advice.

What happens when you phone us?

You will speak to a midwife. They will ask you questions about:

• The reason you are phoning
• Your current pregnancy
• Your baby’s movements
• Any medical problems you have
• Any medications you may take

At the end of your conversation, we may ask you to attend the unit or arrange for you to be seen in A&E or at your GP practice.

Attending MAC

Please note we operate a triage system, similar to A&E.  This means women will be triaged by a midwife when they arrive and those who need urgent care will be seen first.  You may have to wait during busy times but be assured we will see everyone who attends.

What happens when you attend?

• You will be assessed by a midwife
• Your blood pressure and urine will be checked
• Your baby’s heartbeat will be monitored
• You may need to be seen by a doctor
• You may need extra tests including blood tests or scans

What happens next?

You will be either admitted to the Maternity Unit or discharged. If you are discharged, you will continue your antenatal care with your community midwife.  However, you may be asked to return to the hospital for extra tests or appointments.

During your pregnancy you may be asked to attend antenatal clinics at the Bradford Royal Infirmary Maternity unit. This could be because you have pre- existing medical problems, have had problems in your previous pregnancies or may be at risk of developing complication in your current pregnancy.

Your midwife will discuss with you at your booking visit if a referral to antenatal clinic is required. Sometimes you will get referred to antenatal clinic during your pregnancy if any concerns develop. Most people will have the majority of their care with their community midwife.

During your antenatal clinic appointment you will be seen by your obstetrician or a member of their team. You may need to have additional scans, blood test or monitoring so try to allow plenty of time for these visits.

Together we will develop an individual care plan for your pregnancy to ensure your pregnancy is as healthy and safe as possible.

Specialist clinics

• Diabetes specialist clinics
• Maternal medicine clinics
• Twins clinic

Most people with underlying medical problems will have healthy pregnancies. If you have a medical condition and are considering a pregnancy, it is important to optimise your care before you fall pregnant. When considering getting pregnant we would like you to make an appointment with your GP to discuss your health and ideally be referred to our pre-conception clinic.

When you first discover you are pregnant it is important to book early with your midwife. We would then aim to see you in one of our specialist maternal medicine antenatal clinics at around 8-16 weeks. It is important to continue taking any medication you usually take, unless you have been advised to stop by a specialist in your condition, or following your pre-conception care advice. Stopping medication without advice can cause your condition to deteriorate, which will be harmful to your pregnancy.

These clinics run from the usual antenatal clinic area in the maternity block. You will be seen by a consultant obstetrician, who has a specialist interest in medical problems in pregnancy, a medical consultant from your condition’s specialty, and a nurse specialist.

• Haematology clinics (problems with your blood) run on the first and third Fridays of every month
• Epilepsy clinics (problems with seizures or fits) run on the second and fourth Wednesday of each month
• Infectious disease clinics (infections such as HIV or hepatitis) run on Wednesday mornings
• Rheumatology clinics (problems with joints or autoimmune conditions) run on Wednesday mornings
• Endocrine clinics (conditions related to hormones like your thyroid) run on Tuesday afternoons
• Cardiac clinics (heart problems) run on Thursday afternoons. Our specialist department works closely with the cardiac unit in Leeds. You may be asked to attend for scans or appointments

Working together in this way will allow you to have access to the best possible care in your pregnancy, to help you and your baby remain healthy through pregnancy and beyond.

In Bradford we offer a comprehensive service for women with diabetes who become pregnant as well as for those women who develop diabetes in pregnancy.

Women with diabetes who are planning on getting pregnant:

You should have the best possible management of your blood sugars and take 5mg folic acid which is only available on prescription before you try to get pregnant. Please get your GP to refer you to our pre-pregnancy planning clinic. Here we will help you prepare for pregnancy.  This is vital for getting the best start to pregnancy.

Women with diabetes who are pregnant:

We want to see you as early as possible in pregnancy. You do not need to see your own midwife first. Just ring ……….. to arrange an appointment. You need to start taking 5mg folic acid which is only available on prescription from your GP or the antenatal clinic. In clinic you will be seen by a team of obstetricians, diabetologists, diabetes specialist nurses, midwives and dieticians. They will look after you and your baby. We usually plan for you to give birth between 37 and 38 weeks.

Developing diabetes in pregnancy:

You may be offered a glucose tolerance test during pregnancy. If this is raised, you will be given an appointment in the diabetes clinic. In clinic you will be seen by a team of obstetricians, diabetologists, diabetes specialist nurses, midwives and dietitians.  You will be taught to monitor your own blood glucose and manage your blood sugar levels through diet, exercise and, if necessary, Metformin tablets or insulin injections. Your baby’s growth will be monitored with scans. We usually plan for you to give birth between 37 and 41 weeks.

• Please prepare for long stays in clinic. This is because you may need to see a number of different members of staff and have a scan
• Please ensure you do not leave clinic before seeing all the different staff that you need to at that visit
• Please ask for help with language support if you require it

Please visit our Smoking Cessation page for more information.

Contact us

Call us on 01274 364856.

What is the Antenatal Day Unit (ANDU)?

ANDU is a 4 bedded clinical assessment unit situated next to antenatal clinic. You may be asked to attend ANDU by your doctor or midwife for extra monitoring while you are pregnant. The midwifery team working in this area are specialists in looking after women with more complicated pregnancies.

Why would you be asked to come to ANDU?

You may be asked to attend for additional monitoring if:

• You are having frequent ultrasound scans in between clinic appointments
• Your midwife requests an urgent ultrasound scan
• You require your baby’s heartbeat to be monitored (CTG)
• You need frequent blood pressure monitoring
• You are anaemic and require an iron transfusion

When are we are open?

We are open Monday to Friday 8am-8pm by appointment only.  For any pregnancy related concerns, please contact the Maternity Assessment Centre.

What happens when you arrive?

You will be seen by a midwife and sometimes a doctor depending on why you are there. At the end of your of you appointment you may be asked to arrange another ANDU appointment or a clinic appointment. Please allow plenty of time for your appointment as this type on monitoring can sometimes take a long time.

Ultrasound uses sound waves that bounce off structures to create a picture and help diagnose a large number of medical conditions.

The maternity ultrasound suite is a seven-room department within the basement of the Women’s and Children’s unit. It is used mostly for scanning pregnant women but is sometimes used for scanning men and women during general ultrasound scans too.

For your scan to be as successful as possible you are more often than not asked to fill your bladder, as the baby is often better seen. We suggest drinking two pints of water an hour before your scan.

One adult can attend the scan with you. Children are not allowed in during the scan, as sonographers need to concentrate.

Types of scan

Dating scan: usually completed around 12 weeks. This scan will ‘date’ your pregnancy and give you an estimated due date.

or

The Nuchal Translucency scan is completed alongside the dating scan if you have consented to the combined screening test. The test uses ultrasound measurements and components of your blood to work out if you have a higher chance of delivering a baby with Down’s, Edwards’ or Pataus syndromes. This scan is done between 12 and 14 weeks.

If you choose to have the 20-week scan, it is carried out between 18 and 21 weeks of pregnancy.

The scan screens for 11 different conditions that:

• benefit from treatment before or after birth
• need treatment in a specialist setting after birth
• mean the baby may die shortly after birth

Other issues with the development of the baby can sometimes be picked up by this scan.

If something unexpected is found on any of your scans, you will usually be offered a scan with a doctor who is specially trained, for a second opinion. Sometimes, you may be referred for more specialist tests at a fetal medicine unit in Leeds or Sheffield.

Growth scans are done in the third trimester. These can be single scans if the midwife or consultant is worried about something or scans done every two-to-four weeks if your pregnancy is at higher risk, to monitor the growth of the baby and identify issues as early as possible.

Scan photos can be purchased (£6 for 2 pictures) but are printed during the scan, so please ask the sonographer for them at the beginning of the scan. Photos later in your pregnancy are not always possible, due to the way your baby is laid and being too big for the screen.

There is a huge amount of information relating to pregnancy, birth and the postnatal period. Information can be helpful to inform and prepare you for pregnancy, birth and beyond.

The Bradford Antenatal Birth and BeYond (BABY) service aims to provide you with the best quality information which is easily accessible and can help you to make choices about many aspects of your care such as choice of place of birth, pain relief in labour and how to feed your baby.

Our parent education modules are designed to give you information about labour, birth and parenthood. You can book all classes and stork walks on Eventbrite and access the training material on the parent education page.

Attending virtual classes allow you to be involved in group sessions whilst being in the comfort of you own home.

We do offer a one-to-one service for ladies with complex needs and this is usually via telephone or a video call. Speak to your midwife or doctor who can refer you for this. We also have a Facebook page which you are able to gain up-to-date information regarding the Women’s and Newborn Unit, as well as information regarding pregnancy, birth, infant feeding and beyond.

We have also produced a short film on the latent phase of labour.

Bradford Teaching Hospitals is a research active trust. Research helps us find the evidence we need to provide high quality care and outcomes for women and their babies. We have a Maternal and Child Health research team with specialist research midwives and you may be offered the opportunity to take part in studies that are relevant to you.

If you would like more information about research please contact the team on 01274 364506 or email research.midwives@bthft.nhs.uk.