Pregnancy

Trying For A Baby

Advice about trying for a baby, including planning a pregnancy and LGBT+ routes into parenthood.

Being Pregnant

Trying to get pregnant

Pregnancy happens when sperm enters a vagina, travels through the cervix and womb to the fallopian tube and fertilises an egg.

You’re more likely to get pregnant around the time you are ovulating. This is when an egg becomes ready and you are at your most fertile.

If you are under 40 and have regular sex without using contraception, there is an 8 in 10 chance you will get pregnant within 1 year.

 

How to increase your chances of getting pregnant

There are things you and your partner can do to increase the chances of getting pregnant.

Do:

have sex every 2 to 3 days without using contraception – make sure sperm enters the vagina

try to have sex around the time you are ovulating – this is usually 12 to 16 days before your period starts

try to maintain a healthy weight, cut down or stop drinking alcohol and do not smoke – it can help if your partner does this too

See a GP if:

you have been trying to get pregnant for over 1 yearyou have a long term condition such as diabetes and want advice about pregnancythere is a risk of passing on a condition such as sickle cell disease to your babyyou regularly take medicines and want to get pregnant – some medicines can affect a pregnancyyou are aged 36 and over and want to get pregnant

Having a baby if you are LGBT+

The number of LGBT+ people becoming parents is increasing.

If you're thinking about having children, here's an overview of the various routes to parenthood available to you.

 

Donor insemination

This is where donated sperm is put inside the person who is going to carry the baby. This person can be single or in a relationship.

Donor insemination can be performed at home using sperm from a friend or an anonymous donor, or at a fertility clinic using an anonymous donor.

If you decide to look for donor insemination, it's better to go to a licensed clinic where the sperm is screened. This ensures that the sperm is free from sexually transmitted infections and certain genetic disorders. Fertility clinics also have support and legal advice on hand.

Lesbian couples who are civil partners at the time of conception and conceive a child through donor insemination – either at a licensed clinic or by private arrangement at home – are both treated as their child's legal parents.

Couples who are not civil partners at the time of conception but who conceive through donor insemination at a licensed clinic will also be treated as their child's legal parents.

But when non-civil partners conceive through donor insemination by private arrangement at home, the non-birth mother has no legal parenthood and will have to adopt the child to obtain parental rights.

For more information:

artificial inseminationProud 2 b Parents: pregnancyStonewall: donor insemination

 

Co-parenting

This is when 2 or more people team up to conceive and parent children together. Co-parenting arrangements can be made between 2 single people, a single person and a couple, or 2 couples.

As a co-parent, you will not have sole custody of the child. It's advisable to get legal advice at an early stage of your planning.

There are many details to be worked out, such as what role each parent will take, how financial costs will be split, and the degree of involvement each will have with the child.

For more information, read about co-parenting on the Stonewall website.

 

Adoption or fostering for LGBT+ couples

LGBT+ couples in the UK can adopt or foster a child together. You can apply to adopt or foster through a local authority, or an adoption or foster agency. You do not have to live in the local authority you apply to.

You will have to complete an assessment to become an adoptive or foster parent, with the help of a social worker and preparation training.

For more information, visit New Family Social, the charity for LGBT+ adoptive and foster parents.

Find out more about adopting a child.

If you feel ready to adopt, find an adoption agency near you using the First4Adoption agency finder.

 

Surrogacy

Surrogacy is when someone has a baby for a couple who cannot have a child themselves. For the intended father, surrogacy can be a route to having a child biologically related to them.

Surrogacy is legal in the UK, but it's illegal to advertise for surrogates. No financial benefit other than reasonable expenses can be paid to the surrogate.

The baby is not legally yours until a parental order has been issued after the child's birth. Until this order is issued the surrogate has the right to keep the baby.

For more information:

GOV.UK: having a child through surrogacyStonewall: parenting rightsSurrogacy UK

 

Trans and non-binary parents

When it comes to adoption and fostering, trans people have the same rights as anyone else who wants to be a parent.

If you're considering starting treatment to physically alter your body or you've already started treatment, find out about the options for preserving your fertility from the Human Fertilisation and Embryology Authority.

Getting pregnant if you have a mental health condition

If you have a mental health condition, or did in the past, being pregnant can make you unwell again.

Severe mental health conditions such as psychosis, schizophrenia or bipolar disorder are more likely to make you unwell again.

Everyone’s mental health journey is different, but whatever happens, you will have a team of people supporting you. This may include midwives, GPs and mental health specialists.

 

Speak to a GP:

if you have a mental health condition and are worried about getting pregnantif you’re taking medicine for a mental health condition and you want to get pregnant

 

Treatment

The 2 types of treatment for mental health problems in pregnancy are talking therapies and medicine.

If you take medicine while you’re pregnant your doctor will explain how this may affect your baby. Try not to worry – you’ll be offered the safest medicine at the lowest dose that will still work.

 

Further support

Mental health in pregnancyTommy’s: mental health before, during and after pregnancyMind: postnatal depression and perinatal mental healthNICE: Questions to ask about mental health problems in pregnancy has some ideas about questions to ask your GP or midwife

Planning your pregnancy

You can improve your chances of getting pregnant and having a healthy pregnancy by following the steps on this page.

 

Take a folic acid supplement

It's recommended that you should take a daily supplement of folic acid when you're pregnant, or there's a chance you might get pregnant.

You should take a 400 microgram supplement of folic acid every day before you get pregnant, and every day afterwards, up until you're 12 weeks pregnant.

A microgram is 1,000 times smaller than a milligram (mg). The word microgram is sometimes written with the Greek symbol μ followed by the letter g (μg).

Folic acid reduces the risk of your baby having a neural tube defect, such as spina bifida.

A neural tube defect is when the foetus's spinal cord (part of the body's nervous system) does not form normally.

You might be advised to take a higher dose supplement of 5 milligram (5mg) every day.

You may need to take a 5mg supplement of folic acid if:

you or the baby's other biological parent have a neural tube defectyou previously had a pregnancy affected by a neural tube defectyou or the baby's other biological parent have a family history of neural tube defectsyou have diabetesyou take anti-epilepsy medicine

Talk to a GP if you think you need a 5mg dose of folic acid, as they can prescribe a higher dose.

You can get folic acid tablets at pharmacies, or talk to a GP about getting a prescription.

Do not worry if you get pregnant unexpectedly and were not taking a folic acid supplement at the time. Start taking them as soon as you find out, until you're past the first 12 weeks of pregnancy.

 

Stop smoking

Smoking during pregnancy has been linked to a variety of health problems, including:

premature birthlow birth weightsudden infant death syndrome (SIDS), also known as cot deathmiscarriagebreathing problems or wheezing in the first 6 months of life

Quitting can be hard, no matter how much you want to, but support is available.

NHS Smokefree offers free help, support and advice on stopping smoking, including when you're pregnant, and can give you details of local support services.

Smoke from other people's cigarettes can damage your baby, so ask your partner, friends and family not to smoke near you.

 

Cut out alcohol

Do not drink alcohol if you're pregnant or trying to get pregnant. Alcohol can be passed to your unborn baby.

Drinking in pregnancy can lead to long-term harm to your baby, and the more you drink, the greater the risk.

Find out about alcohol and pregnancyalcohol units and tips for cutting down.

 

Keep to a healthy weight

If you're overweight, you may have problems getting pregnant and fertility treatment is less likely to work.

Being overweight (having a BMI over 25) or obese (having a BMI over 30) also raises the risk of some pregnancy problems, such as high blood pressuredeep vein thrombosis, miscarriage and gestational diabetes.

Before you get pregnant you can use the BMI healthy weight calculator to find out your BMI. But this may not be accurate once you're pregnant, so consult your midwife or doctor.

Having a healthy diet and doing moderate exercise are advised in pregnancy, and it's important not to gain too much weight.

You can keep to a healthy weight by having a balanced diet and doing regular exercise.

 

Know which medicines you can take

Not all medicines are safe to take when you're pregnant or planning a pregnancy, whether they're on prescription or medicines you can buy in a pharmacy or shop.

 

Information:

If you take prescribed medicine and you're planning to get pregnant, talk to a doctor.

Do not stop taking your medicine without talking to a doctor.

Find out about medicines in pregnancy.

 

Vaccinations and infections

Some infections, such as rubella (German measles), can harm your baby if you catch them during pregnancy.

Most people in the UK are immune to rubella, thanks to the uptake of the measles, mumps and rubella (MMR) vaccination.

If you have not had 2 doses of the MMR vaccine, or you're not sure if you have, ask your GP surgery to check your vaccination history.

If you have not had both doses or there's no record available, you can have the vaccinations at your GP surgery.

You should avoid getting pregnant for 1 month after having the MMR vaccination, which means you'll need a reliable method of contraception.

 

Talk to a doctor if you have a long-term condition

If you have a long-term condition, such as epilepsy or diabetes, it could affect the decisions you make about your pregnancy – for example, where you might want to give birth.

Before you get pregnant, have a discussion with your specialist or a GP about getting pregnant.

If you're taking medicine for a condition, do not stop taking it without talking to a doctor.

 

Testing for sickle cell and thalassaemia

Sickle cell disease (SCD) and thalassaemia are inherited blood disorders that mainly affect people whose ancestors come from Africa, the Caribbean, the Mediterranean, India, Pakistan, south and Southeast Asia, and the Middle East.

If you are pregnant and live in England you will be offered screening tests for these disorders, but you do not have to wait until you're pregnant before you have a test.

If you or your partner are concerned you may be a carrier for 1 of these disorders, perhaps because someone in your family has a blood disorder or is a carrier, it's a good idea to get tested before starting a family.

You can ask for a free blood test from either a GP or a local sickle cell and thalassaemia centre.

Find out more about screening for sickle cell and thalassaemia in pregnancy

Doing a pregnancy test

If you have missed a period and recently had unprotected sex, you may be pregnant. Pregnancy tests are most reliable from the first day of your missed period.

 

When you can do a pregnancy test

You can carry out most pregnancy tests from the first day of a missed period. If you don't know when your next period is due, do the test at least 21 days after you last had unprotected sex.

Some very sensitive pregnancy tests can be used even before you miss a period.

You can do a pregnancy test on a sample of urine collected at any time of the day. It doesn't have to be in the morning.

 

Where you can get a pregnancy test

You can buy pregnancy testing kits from pharmacists and some supermarkets. They can give a quick result and you can do the test in private.

The following places provide free pregnancy tests:

sexual health servicessome young people's services – call the national sexual health helpline on 0300 123 7123 for detailsBrook centres for under-25s – find your nearest Brook centre

You may also be able to get a pregnancy test free of charge from your GP.

 

How does a pregnancy test work?

All pregnancy tests detect the hormone human chorionic gonadotrophin (hCG), which starts to be produced around 6 days after fertilisation.

Most pregnancy tests come in a box that contains 1 or 2 long sticks. You pee on the stick and the result appears on the stick after a few minutes. All tests are slightly different, so always check the instructions.

 

Pregnancy test results

Home pregnancy tests are accurate as long as you follow the instructions correctly.

A positive test result is almost certainly correct. However, a negative test result is less reliable.

The result may not be reliable if you:

do not follow the instructions properlytake the test too early

Some medicines can also affect the results.

If you get a negative result and still think you're pregnant, wait a few days and try again. Speak to your GP if you get a negative result after a second test but your period has not arrived.

 

Continuing with the pregnancy

If you're pregnant and want to continue with the pregnancy, contact your GP or a midwife to start your antenatal care. You can use the pregnancy due date calculator to work out when your baby is due.

 

If you're not sure you want to be pregnant

If you're not sure about continuing with the pregnancy, you can discuss this confidentially with a healthcare professional. Your options are:

continuing with the pregnancy and keeping the babyhaving an abortioncontinuing with the pregnancy and having the baby adopted

As well as a GP or a nurse at your GP surgery, you can also get accurate, confidential information – from the age of 13 – from the following:

sexual health servicesthe MSI Reproductive Choices websitethe British Pregnancy Advisory service websitethe National Unplanned Pregnancy Advisory service website

All these services – including community contraceptive clinics – are confidential. If you're 13 or older, the staff won't tell your parents. They'll encourage you to talk to your parents, but they won't force you. 

If you're under 25 and would prefer advice specifically for young people, the sexual health charity Brook provides a range of services for young people. The Brook website contains information on pregnancy choices. You can also use the Ask Brook 24/7 service.

Signs and symptoms of pregnancy

Early signs of pregnancy

If you have a regular monthly menstrual cycle, the earliest and most reliable sign of pregnancy is a missed period.

In the first few weeks of pregnancy you may have a bleed similar to a very light period, with some spotting or only losing a little blood. This is called implantation bleeding.

Every pregnancy is different and not everyone will notice all of these symptoms.

 

Feeling sick during pregnancy

You may feel sick or be sick. This is commonly known as morning sickness, but it can happen at any time of the day or night.

Morning sickness symptoms usually start when you’re around 4-6 weeks pregnant

If you're being sick all the time and cannot keep anything down, see a GP.

You may have hyperemesis gravidarum, a serious condition in pregnancy that causes severe vomiting and needs treatment.

 

Feeling tired is common in pregnancy

It's common to feel tired, or even exhausted, during pregnancy, especially during the first 12 weeks or so.

Hormonal changes in your body at this time can make you feel tired, sick, emotional and upset.

 

Sore breasts in early pregnancy

Your breasts may become larger and feel tender, just as they might do before your period. They may also tingle.

The veins may be more visible, and the nipples may darken and stand out.

 

Peeing more often suggests pregnancy

You may feel the need to pee more often than usual, including during the night.

Other signs of pregnancy you may notice are:

constipationmore vaginal discharge (without any soreness or irritation)

Strange tastes, smells and cravings

During early pregnancy, you may find you no longer like some foods or drinks you used to enjoy.

You might notice:

a strange taste in your mouth, which some describe as metallicyou crave new foodsyou lose interest in certain foods or drinks you used to enjoy, such as tea, coffee or fatty foodyou lose interest in smokingyou have a more sensitive sense of smell than usual – for example, the smell of food or cooking

If you're worried about any symptoms you're having, talk to a GP or your midwife.

 

If your pregnancy test is negative

A positive test result is almost certainly correct, as long as you have followed the instructions correctly.

A negative result is less reliable. If you get a negative result and still think you may be pregnant, wait a week and try again.

If you're pregnant, use the pregnancy due date calculator to work out when your baby's due.

Find maternity services near you

 

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How long does it usually take to get pregnant?

It's impossible to say how long it takes to get pregnant because it's different for each woman.

Many factors can affect a couple's chances of conceiving, such as:

your ageyour general healthyour reproductive healthhow often you have sex

Some women become pregnant quickly, while others take longer. This may be upsetting, but it's normal.

 

Fertility

Most couples (about 84 out of every 100) will get pregnant within a year if they have regular sex and don't use contraception.

But women become less fertile as they get older. One study found that among couples having regular unprotected sex:

aged 19 to 26 – 92% will conceive after 1 year and 98% after 2 yearsaged 35 to 39 – 82% will conceive after 1 year and 90% after 2 years

The effect of age on men's fertility is less clear.

 

What does 'regular sex' mean?

Having regular sex means having sex every 2 to 3 days throughout the month.

Some couples may try to time having sex with when the woman ovulates (releases an egg).

But guidance from the National Institute for Health and Care Excellence (NICE) advises that this can be stressful and it isn't recommended.

 

Fertility problems

Fertility problems affect 1 in 7 couples in the UK.

Lots of factors can cause fertility problems, including:

hormonal (endocrine) disorders, such as polycystic ovary syndrome (PCOS) and problems with the thyroid or pituitary glandsphysical disorders, such as obesity, anorexia nervosa or excessive exercisedisorders of the reproductive system, such as infections, blocked fallopian tubes, endometriosis or a low sperm count

Some of these factors affect either women or men. In around 40% of infertile couples, there's a problem with both the man and woman.

The most common cause is ovulation failure (which can be caused by lots of different things) and sperm disorders.

In 25% of couples, fertility problems can't be explained.

Read more detailed information about the causes of infertility.

 

Getting help

If you have been trying for a baby for 1 to 2 years without success, see your GP for advice.

 

Further information

How can I tell when I'm ovulating?How can I improve my chances of getting pregnant?How soon can I do a pregnancy test?Can I get pregnant just after my period has finished?Pregnancy and baby guideInfertilityNICE guidelines: assessment and treatment for people with fertility problems

Planning another pregnancy

You can increase your chances of getting pregnant again if you are in good health.

It is also important that your partner is healthy. A bad diet, smoking, drinking and unhealthy working conditions can affect the quality of sperm and prevent pregnancy happening.

 

Folic acid

You should take a 400 microgram folic acid tablet every day while trying to get pregnant up until you're 12 weeks pregnant.

It reduces the risk of having a baby born with defects of the brain, spine or spinal cord, such as spina bifida. You can get these tablets from a supermarket or pharmacist.

It's also good to eat foods that contain this important vitamin. These include leafy green vegetables, and breakfast cereals and breads with added folic acid.

You'll need a bigger dose of folic acid if:

you or the baby's other biological parent have defects of the brain, spine or spinal cord (these are known as neural tube defects)you or the baby's other biological parent have a family history of neural tube defectsyou have had a previous pregnancy that was affected by a neural tube defectsyou have coeliac diseaseyou have diabetesyou take anti-epileptic medicineyou take anti-retroviral medicine for HIVyou have a BMI of 30 or over

Ask a GP for advice.

 

Rubella (german measles) and pregnancy

Rubella is rare nowadays in the UK thanks to the uptake of the measles, mumps and rubella (MMR) vaccination.

But if you get the infection in early pregnancy, it can lead to serious birth defects and miscarriage.

If you're not sure whether you've had 2 doses of the MMR vaccine, ask your GP practice to check.

You can have the vaccinations at your GP practice if you have not had both doses or there's no record available.

You should avoid getting pregnant for 1 month after having the MMR vaccination.

Be aware that the MMR vaccine is not suitable if you are already pregnant.

 

Diabetes and epilepsy

Talk to your doctor before you try to get pregnant if you have diabetes. You'll need some extra care during pregnancy.

You should also talk to your doctor if you have epilepsy. Some medicines used to treat epilepsy can cause birth defects.

There should be alternative epilepsy medicines that your doctor can recommend.

 

Mental health and pregnancy

If you previously experienced a mental health condition such as postnatal depressionpostpartum psychosis or PTSD, talk to your doctor before you try to get pregnant.

You may have experienced a birth trauma and are anxious about having another baby. Your doctor or midwife will listen to any concerns you have and can personalise your care.

 

Vaginal birth after caesarean section

If you previously had a caesarean section, it is likely that you can have a vaginal delivery with your next baby.

It partly depends on why you had a caesarean section and how many caesareans you've had. A GP, midwife or obstetrician will be able to advise you.

You'll be advised to have a caesarean with your next baby if you:

previously had a uterine rupture (a tear in the wall of your womb)previously had womb surgeryhave a vertical scar on your uterushave placenta praevia (where the neck of the uterus is blocked by the placenta)

After 1 caesarean section, you are likely to go on and have a vaginal delivery with your next pregnancy if the pregnancy is straightforward.

But if problems occur throughout labour, the midwife and obstetrician could advise that you have a caesarean section. This is because of the risk of complications that may arise as a result of previous scarring.

 

Cervical screening test

If you're due to have a cervical screening (smear) test, you should have this test before you try to get pregnant.

If you're asked to come for a routine smear test while you're pregnant you should tell your GP or clinic you're pregnant. You will usually be advised to reschedule the test for a date around 12 weeks after your baby is born.

 

You and your partner’s weight and fertility

It can improve your chances of getting pregnant if you and your partner are a healthy weight.

This is particularly important if you or your partner are obese (have a BMI or 30 or more) as this means you're likely to have lower fertility.

Before you get pregnant, you can find out whether you're a healthy weight and get tailored advice with the BMI healthy weight calculator.

Speak to a GP or practice nurse if you need help or advice.

 

Medicines and drugs while trying

Some medicines can harm your baby if you take them while you're pregnant, while others are safe to take.

If either you or your partner take medicine regularly, talk to your doctor about any possible effects on fertility or pregnancy.

Do this ideally before you start trying for a baby or as soon as you find out you're pregnant.

Check with your doctor, midwife or pharmacist before you take any over-the-counter drugs, including any herbal remedies.

See more about medicines in pregnancy.

Illegal drugs may affect your ability to conceive or the development of your baby if you're pregnant.

For friendly, confidential advice, contact:

Frank, the drugs information line, on 0300 123 6600Narcotics Anonymous on 0300 999 1212

See more about illegal drugs in pregnancy.

 

Sexually transmitted infections (STIs)

STIs can affect your health and your ability to get pregnant. If there's any chance you or your partner have an STI, it's important to get it diagnosed and treated before you get pregnant.

STIs can be passed on through unprotected sex with an infected person. Some STIs can be passed on from one person to another without penetration.

HIVhepatitis B and hepatitis C can also be passed on by sharing equipment for injecting drugs, such as needles.

If you're HIV positive, you can pass the virus on to your baby during pregnancy, at birth, or by breastfeeding. See living with HIV to find out more about pregnancy and HIV.

 

Fertility and where you work

If you or your partner are exposed to X-rays or pesticides where you work, it may affect your fertility.

Talk to a GP if you're concerned. They can advise you about any possible risks to your fertility.

 

Finding it hard to get pregnant?

It can take a while to get pregnant the second or third time around, even if it happened very quickly the last time.

Information about being pregnant and what to do during pregnancy

Labour And Birth

How to tell if you’re in labour and what happens during labour and birth.

Pregnancy week-by-week

Find out what to expect from every week of your pregnancy. 

Pregnancy-related conditions

What to do about common symptoms, complications and existing conditions.

Finding out you're pregnant

See a GP or midwife as soon as you find out you're pregnant. It's important to see a midwife or GP as early as possible to get the pregnancy (antenatal) care and information you need to have a healthy pregnancy.

You can find out about local maternity services.

Your pregnancy can be treated confidentially, even if you are under 16. A GP or midwife can tell you about your choices for pregnancy (antenatal) care in your local area. Being pregnant may affect the treatment of any current illness or conditions you have or later develop.

Read about the signs and symptoms of pregnancy and doing a pregnancy test.

 

Knowing that you're pregnant

When you find out you're pregnant, you may feel happy and excited, or shocked, confused and upset. Everybody is different.

Some of this may be caused by changes in your hormone levels, which can make you feel more emotional.

If you are feeling anxious or worried it will help to talk to someone, read about mental health in pregnancy.

 

Partners

Partners may also have mixed feelings when they find out you are pregnant. They may find it hard to talk about their feelings because they do not want to upset you. Both of you should encourage each other to talk about your feelings and any worries or concerns.

However you're feeling, contact an NHS professional (such as a midwife, GP or practice nurse) so you can start getting antenatal (pregnancy) care. This is the care that you'll receive leading up to the birth of your baby.

Find out about your schedule of antenatal appointments.

 

Telling people that you're pregnant

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.

Read about dealing with feelings and relationships in pregnancy.

 

Flu and pregnancy

The seasonal flu vaccine is offered if you are pregnant and at any stage of pregnancy. If you are pregnant and catch the flu virus, you are at an increased risk of complications and flu-related hospital admissions.

Find out about the flu jab and pregnancy.

Talk to a GP or midwife if you're unsure about which vaccinations you should have.

 

Further information

You may also find the information from Sex Wise about being pregnant and not knowing what to do is helpful in explaining the choices you have.

Your NHS pregnancy journey

See a midwife or GP as soon as you find out you're pregnant. This is so they can book your pregnancy (antenatal) care and make sure you get all the information and support you need to have a healthy pregnancy.

Your first appointment with a midwife should happen before you're 10 weeks pregnant.

If you're more than 10 weeks pregnant and have not seen a GP or midwife, contact a GP or midwife as soon as possible. They'll see you quickly and help you start your pregnancy (antenatal) care.

 

What is pregnancy (antenatal) care?

This is the care you have while you're pregnant to make sure you and your baby are as well as possible.

The NHS in England will offer you:

10 pregnancy appointments (7 if you've had a child before) to check the health and development of you and your babyscreening tests to find out the chance of your baby having certain conditions, such as Down's syndromeblood tests to check for syphilis, HIV and hepatitis Bscreening for inherited blood disorders (sickle cell and thalassaemia)

You'll be offered more appointments if you or your baby need them.

Depending on your health and where you live, you may see:

a midwife for all your appointmentsa midwife for some appointments and a GP for others

 

How do I start my pregnancy care?

As soon as you find out you're pregnant you can book an appointment with:

local midwife services (find maternity services near you)

Your first midwife appointment

This appointment lasts around an hour.

Your midwife will ask questions to make sure you get the care that's right for you.

They will ask about:

where you live and who you live withyour partner, if you have onethe baby's fatherany other pregnancies or childrensmoking, alcohol and drug useyour physical and mental health, and any issues or treatment you've had in the pastany health issues in your familyyour job, if you have one

When and where will my appointments be?

Find out more about when you'll have your antenatal appointments.

Your appointments can take place at:

your homea Children's Centrea GP surgerya hospital

You'll usually go to the hospital for your pregnancy scans.

 

What can I do now for me and my baby?

It's important not to miss any of your antenatal appointments. Some of the tests and measurements that can find possible problems have to be done at specific times.

There are also things you can do to keep you and your baby as healthy as possible in pregnancy, including:

not smokingnot drinking alcoholgetting some exercise that's safe in pregnancyhaving a healthy pregnancy dietknowing which foods to avoid in pregnancytaking a folic acid supplement and thinking about taking a vitamin D supplementknowing how to avoid infections that may harm your unborn baby, and symptoms to look out forhaving the flu vaccinationknowing about baby movements in pregnancyknowing how to cope with feelings, worries and relationships in pregnancy

What if I have a health condition?

If you have a health condition, for example diabetes or asthma, these can affect your pregnancy. Pregnancy can also affect any conditions you have.

Information:

Do not stop taking your medicine until you've talked with your doctor.

Your first midwife appointment

As soon as you find out you are pregnant, contact a GP or midwife and they will help you book your first appointment.

Your first midwife appointment (also called the booking appointment) should happen before you're 10 weeks pregnant. This is because you'll be offered some tests that should be done before 10 weeks.

If you're more than 10 weeks pregnant and have not seen a GP or midwife, contact a GP or midwife as soon as possible.

You'll still have your first midwife appointment and start your NHS pregnancy journey.

 

Where the first appointment happens

Your first appointment may take place in:

your homea hospitala GP surgerya Children's Centre

Where the appointment happens depends on the pregnancy services in your area.

 

How long the appointment lasts

The appointment usually takes around an hour.

 

What your midwife may ask

Your midwife will ask some questions to help find out what care you need.

They may ask about:

where you live and who you live withthe baby's fatherany other pregnancies or childrensmoking, alcohol and drug useyour physical and mental health, and any issues or treatment you've hadany health issues in your familydomestic abusefemale genital mutilation (FGM)your job, if you have onewhether you have people around to help and support you, for example a partner or family members

The first appointment is a chance to tell your midwife if you need help or are worried about anything that might affect your pregnancy. This could include domestic abuse or violence, sexual abuse, or female genital mutilation (FGM).

FGM can cause problems during labour and birth. It's important you tell your midwife or doctor if this has happened to you.

 

Tests at your first appointment

Your midwife will ask if they can:

measure your height and weight, and work out your body mass index (BMI)measure your blood pressure and test your urine for signs of pre-eclampsiatake a blood test to see if you have HIV, syphilis or hepatitis B

They'll also offer you a blood test for sickle cell and thalassaemia (blood disorders that can be passed on to the baby) if they think there's a high chance you might have them. They'll work out your chance by asking some questions.

 

Things your midwife may discuss with you

Your midwife may give you information about:

how the baby develops during pregnancya healthy pregnancy diet and foods to avoid in pregnancypregnancy exercise and pelvic floor exercisesyour NHS pregnancy (antenatal) carebreastfeedingantenatal classesbenefits you can get when you're pregnant, such as free prescriptions and free dental careyour options for where to have your babythe tests and scans you'll be offered in pregnancy

Ask questions if you want to know more or do not understand something.

 

Your maternity notes

At the end of the first appointment, your midwife will give you your maternity notes in a book or a folder.

These notes are a record of your health, appointments and test results in pregnancy. They also have useful phone numbers, for example your maternity unit or midwife team.

Information:

You should carry these notes with you all the time until you have your baby. This is so health care staff can read about your pregnancy health if you need urgent medical care.

Health things you should know in pregnancy

There are things you can do, and things you can avoid, to keep you and your baby as healthy as possible in pregnancy.

 

Go to your pregnancy (antenatal) appointments

It's important not to miss any of your antenatal appointments. These appointments are part of your NHS pregnancy journey.

The tests, scans and checks you'll have help look after the health of you and your baby.

Some of the tests and measurements that can find potential problems have to be done at specific times of pregnancy, which is why you have appointments at certain weeks.

There are also things you can do to keep you and your baby as healthy as possible in pregnancy.

 

Food

have a healthy pregnancy dietknow which foods to avoid in pregnancy

 

Alcohol

don't drink alcohol

 

Not smoking

if you smoke, stop smoking

 

Vitamins

take a folic acid supplement and think about taking a vitamin D supplement

 

Medicines

Not all medicines are safe to take when you're pregnant. This includes prescribed medicines and medicines you can buy in a pharmacy or shop.

Information:

Check with a doctor, pharmacist or midwife before you take any medicines when you're pregnant.

If you're already taking prescribed medicine, do not stop taking your medicine without talking to your doctor first.

• find out about medicines in pregnancy

 

Exercise

do some safe pregnancy exercise

 

Protect against getting ill

know how to avoid infections that may harm your baby and symptoms to look out forhave the flu vaccination (offered between September and March, and it's free if you're pregnant)have the whooping cough vaccination, free if you're pregnant

 

Baby movements

know about baby movements in pregnancy, and when to seek help

 

Your mental wellbeing

know how to cope with feelings, worries and relationships in pregnancymental health issues in pregnancy

 

Your dental health

You're entitled to free NHS dental treatment if you're pregnant when you start your treatment and for 12 months after your baby is born. To get free NHS dental treatment, you must have:

a MATB1 certificate issued by your midwife or GPa valid prescription maternity exemption certificate (MatEx)

 

Sleeping well

get tips on sleeping well in pregnancy

 

Travel

travelling safely in pregnancy, including flying, long journeys and travel vaccinations

 

DVT (blood clots)

know the risks, symptoms and ways to prevent blood clots in pregnancy

 

X-rays during pregnancy

For all X-rays, you should let the hospital know if you're pregnant.

X-rays are not usually recommended for pregnant people unless it's an emergency

 

Cervical screening during pregnancy

You will not usually need to have cervical screening if you're pregnant, or could be pregnant, until at least 12 weeks after you've given birth. This is because pregnancy can make it harder to get clear results.

If you're already pregnant and due for a cervical screening test then tell the GP or clinic.

You will usually be advised to reschedule the test for a date around 12 weeks after your baby is born.

If you've previously had an abnormal result from a cervical screening test, you may need to be screened while you're pregnant. Your GP or midwife may ask you to have a cervical screening test at your first antenatal appointment. This test will not affect your pregnancy.

 

What if I have a health condition?

If you have a health condition, for example diabetes or asthma, these can affect your pregnancy. Pregnancy can also affect any conditions you have.

Information:

Don't stop taking your medicine until you've talked with your doctor.

Your pregnancy to-do list

Stay organised throughout your pregnancy

You can print the list on this page to keep track of things you need to do during your pregnancy, such as book antenatal classes, tell your work you're pregnant and think about where you'd like to have your baby.

 

⬜ Take a pregnancy test: doing a pregnancy test

⬜ Learn about the benefits you are entitled to: maternity and paternity benefits and leave

⬜ Stay active, start exercising: exercise in pregnancy

⬜ Take folic acid: vitamins, supplements and nutrition in pregnancy

⬜ If you smoke, get help to quit: stop smoking in pregnancy

⬜ Make an appointment to see your midwife or GP: your antenatal care

⬜ Book antenatal classes: antenatal classes

⬜ Claim free milk, fruit and vegetables through Healthy Start: get help to buy food and milk

⬜ Make sure you've been offered all your screening tests: antenatal checks and tests

⬜ Make an appointment to see a dentist: dentists

⬜ Find out about your rights at work: GOV.UK: maternity pay and leave

⬜ Ask to hear your baby's heartbeat: your antenatal care

⬜ Visit the maternity unit you plan to give birth in: where to give birth: the options

⬜ Start buying the things you'll need for your baby: what you'll need for your baby

⬜ Feeling hungry? Stick to a sensible diet: have a healthy diet in pregnancy and foods to avoid in pregnancy

⬜ Start making your birth plan: how to make a birth plan

⬜ Write to your employer 15 weeks before you plan to stop work: GOV.UK: maternity pay and leave

⬜ Claim Maternity Allowance after week 26: GOV.UK: maternity allowance

⬜ See if you're eligible for a Sure Start Maternity Grant: GOV.UK: Sure Start Maternity Grant

⬜ Make sure you know the signs of labour: signs that labour has begun

⬜ Pack a bag ready for labour and birth: pack your bag for labour

⬜ For birth partners, prepare for the birth: tips for your birth partner

⬜ When in labour, phone the maternity unit before leaving home: what happens at the hospital or birth centre

Pregnant with twins

Fertility treatments and the fact pregnancies are happening later in life has made multiple births more common.

 

Different types of twins

One-third of all twins will be identical and two-thirds non-identical.

 

Identical twins

Identical (monozygotic) twins happen when a single egg (zygote) is fertilised.

The egg then divides in 2, creating identical twins who share the same genes.

Identical twins are always the same sex, so if your twins are identical, you'll have 2 girls or 2 boys.

 

Non-identical twins

Non-identical (dizygotic) twins happen when 2 separate eggs are fertilised and then implant into the womb (uterus).

These non-identical twins are no more alike than any other 2 siblings.

Non-identical twins are more common. The babies may be of the same sex or different sexes.

 

Are you carrying twins?

You might think you're carrying more than 1 baby if:

you seem bigger than you should be for your datestwins run in your familyyou have had fertility treatment

It's usually possible to find out if you're having twins through 12-week scan.

At the scan, you should be told whether the babies share a placenta (meaning they're identical) or if they have 2 separate placentas (meaning they can be identical or not).

If this is not clear from the first scan, you should be offered another one.

 

What causes twins?

Nobody knows what causes identical (monozygotic) twins. Everyone has the same chance of having identical twins: about 1 in 250.

Identical twins do not run in families. But there are some factors that make having non-identical twins more likely:

non-identical twins are more common in some ethnic groups, with the highest rate among Nigerians and the lowest among Japaneseif you’re pregnant and over 35 you’re more likely to have non-identical twins because you’re more likely to release more than 1 egg during ovulationnon-identical twins run on the mother's side of the family, probably because of an inherited tendency to release more than 1 egg

IVF can increase the chance of twins, as more than 1 embryo may be transferred.

 

How can I tell if my twins are identical?

The most accurate way to tell if twins are identical is through a DNA test. This can only be done after your babies are born.

The placenta could also provide clues. If your first ultrasound scan is done before 14 weeks, it should be possible to tell accurately what kind of placenta your twins have.

Otherwise, the placenta can be examined after your babies are born.

For more information on this and birth options, read about giving birth to twins.

Read more about the different types of twins on the Twins Trust website.

More detailed information on DNA testing and how to find out whether twins or triplets are identical is available on the Multiple Births Foundation website.

Support

Advice for things you might need support with during pregnancy.

Self-Referral to Antenatal clinic

You do not have to see your GP to be referred to an antenatal clinic. To refer yourself, complete the online form:

Your local GP practice or Children’s Centre (check your local council) are able to give details of your local midwifery service and antenatal clinic.