Decisions you need to make when pregnant

Congratulations, you’re pregnant! But now come the important decisions. Our midwife offers her expert advice for each stage of your pregnancy…

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Just pregnant

Sharing your news

When to tell people is a very personal decision and many women choose to wait until after 12 weeks when the risk of miscarriage is lower. It’s understandable to feel cautious, particularly if you’ve had a previous miscarriage. But you may want to consider how you’d feel if your pregnancy was to end and no one knew of your loss. This can also be very hard for a couple. I think you have to trust your instincts – if you want to share your news at once, do!

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Delayed motherhood linked to increase in Down’s pregnancies

8-10 weeks

Screening tests

Your midwife will discuss screening tests with you. Most hospitals offer the nuchal fold scan, to assess your baby’s risk of Down’s syndrome, between 11 and 13 weeks. Such tests aren’t for everyone. Consider what, if anything, you’d do if you got bad news. You’re likely to be offered further tests, but none are 100 per cent reliable and some carry an increased risk of miscarriage.

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Your baby needs to be correctly latched on to your nipple and breast to feed successfully.

16 weeks

Breast or bottle

There are massive health benefits for you and your baby if you breastfeed, but ultimately you have to feel comfortable with the way you feed your baby. Start looking at the information now, so whatever you choose to do, you’ll be able to make an informed choice. Check www.breastfeeding.nhs.uk for further advice.

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When you think you are pregnant, first you need to visit your GP.

20 weeks

Antenatal classes

It’s never too early to think about where you’d like to give birth. Your options include hospital, a birth centre, or a home birth, although if you choose a home birth, prepare a plan B as they’re not recommended before 37 weeks. You may find it helpful to join a home birth group or to look around some local maternity units.

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Return to work with confidence

25 weeks

Telling your boss

This can be a tricky one, as legally you don’t need to inform your employer until you’re 25 weeks pregnant. But the sooner you inform them, the sooner you can benefit from your entitlements – such as paid time off for antenatal appointments and also a risk assessment to see if your job or hours pose any risk to your pregnancy.

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28-30 weeks

Maternity leave

You can start your maternity leave from 29 weeks, but lots of women prefer to save as much leave as they can for after the birth. Keep an open mind, though. If you decide to leave earlier than you originally planned, that’s fine, but you have to let your employer know in writing 28 days before your new leaving date.

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Hypnotherapy classes can help you relax during birth

30 weeks

Antenatal classes

This can be great for meeting other mums-to-be and also getting your partner involved in your pregnancy. Most classes start at around 30 weeks, but if you’re interested in birth hypnotherapy or NCT classes, you may need to book a lot earlier as classes get booked up quickly.

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Your birth partner can be your partner, a friend or family member.

32 weeks

Birth partner

Most birth units recognise the value of good support and are happy for you to have at least two people with you during your labour. Start thinking about who can provide you with the support you’ll need. Consider your mum or a friend who already has children.

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Understand what is written in your antenatal notes with the breakdown of terms used by midwives.

34 weeks

Pain relief

Inevitably you’ll be thinking more about the birth now. Ask your midwife what pain relief is available and make a birth plan. This may be easier to do once you’ve completed antenatal classes and talked through the advantages and disadvantages of what’s available. And don’t worry, your decision isn’t written in stone – like many things it can change on the day!

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Swimming is cooling, toning and energising all at the same time

37 weeks

Water birth

Contrary to popular belief, you don’t have to book the hospital birthing pool. Since you don’t know when you’ll need it, you’ll have to wait until the day to ask to use your hospital’s or birth centre’s pool. But if you’re having a home birth, your pool should be in place by 37 weeks as the baby can arrive at any time after that. Some companies offer a refund if you return a pool unused.

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Independent midwives are a common choice for those hoping for a home birth.

38 weeks

Induction

When you reach your due date, your midwife can perform an internal examination called a ‘stretch and sweep’, which can sometimes kick-start labour. Rather than have it sprung on you at your 40-week appointment, prepare yourself by asking her about it at your 38-week appointment. If you don’t want it, you can always change your mind back. It’s also fine to just wait and see if nature takes its course. After all, a normal gestation is 3742 weeks.

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Understanding what happens can help make a caesarean birth an involving experience.

In labour

Your placenta

If your labour has been straightforward, you might prefer to complete the third stage naturally – without an injection to help you expel the placenta. You can make this decision at the birth, as it’ll be influenced by the type of birth you’ve had. If you’ve had an intervention, such as forceps or an epidural, you’ll be advised to have the injection.

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If your newborn is hungry, she will will start with a murmer and build up to a more forceful cry as her need for food increases.

Straight after the birth

Vitamin K

Shortly after the birth you’ll be asked if you want your baby to have Vitamin K. It’s offered to all newborn babies as around 1 in 10,000 babies have a Vitamin K deficiency that can cause bleeding problems. Any baby can be affected. In the 1990s, it was suggested a possible link between leukaemia and Vitamin K injections existed, though later research disproved this. The Department of Health advises in favour of Vitamin K.

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The demands of working while your pregnant can really tire you out, but there are simple ways you can make your working day easier.

Mums’ stories

“I didn’t want everyone at work to know until I’d had my 12-week scan, but I needed time off for antenatal appointments before then. So I told my boss, but I swore him to secrecy!”

Samantha Hall, 25, from Hartlepool, 7 months pregnant

“I decided early on that I wanted my mum to be my birth partner. She was able to come to antenatal classes with me, which helped prepare us both. It was nice to think we were learning together.”

Mattie Rene, 20, from Kent, mum to Evie, 3 weeks

“I’d heard great things about NCT classes but was told they got booked up early. So I made sure I got my place – I put my name down almost as soon as I had a positive pregnancy test!”

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Joanne Mercer, 34, from Scottish Borders, mum to Will, 4 months

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