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The Hillingdon Hospitals NHS Foundation Trust

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Building a relationship with your new baby

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Unicef UK Baby Friendly Initiative | Hand expression

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Understand birth on a muscular and hormonal level

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Understand birth on a muscular and hormonal level

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Early/latent Labour Phase
From the onset of regular contractions, although they may be irregular in the pre and Early stages, until the cervix is dilated to 3 cms.

Established Labour Phase
From 3 cm until the cervix is dilated to 7 cm.

Transitional Labour Phase
Parents experience this between 8 - 10 cms dilated.

Recovery Stage

For Mother and Baby(s) post birth

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Exercises during pregnancy and after birth

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Exercises during pregnancy and after birth

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Antenatal Classes at The Hillingdon Hospital NHS Foundation Trust

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Antenatal Classes at The Hillingdon Hospital NHS Foundation Trust

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Antenatal classes at Hillingdon and beyond - The Hillingdon Hospitals’ Podcast

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A podcast from The Hillingdon Hospitals NHS Foundation Trust.

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The Hillingdon Hospitals NHS Foundation Trust

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The Hillingdon Hospitals NHS Foundation Trust

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MLU is a 4 bedded low risk birth setting, located on the 2nd floor. The unit is midwifery-led and is intended to create a home from home environment for intrapartum care. Birthing stools and balls are available to use, upon request.

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Pelvic floor exercises during and after pregnancy

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Pelvic floor exercises during and after pregnancy

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How and when should I do pelvic floor exercises? | NHS

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How to sterilise bottles and expressing pumps

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How to sterilise bottles and expressing pumps

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The Hillingdon Hospitals NHS Foundation Trust

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How to clean and sterilise your baby's bottles

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Tablets and capsules

- Massage and relaxation techniques

- Water: Bath/ Shower or birthing pool

- TENS machine

- Gas and air (Entonox)

- Pethidine, Meptid and Diamorphine

- Epidural/ Spinal

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The Hillingdon Hospitals NHS Foundation Trust

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We offer a selection of pain relief options for your labour and birth at Hillingdon, depending on which birth setting you choose to have your baby.

Tablets and capsules

We can provide paracetamol and/or dihydrocodeine (sometimes called co-dydramol)

They can take up to 30-60 minutes to start providing some pain relief and last for around 4-6 hours

They can be effective to reduce pain during the early stage of labour, you will most likely need to consider some other method(s) to go alongside these

Side effects include feeling sick (nausea) and feeling dizzy.

Massage and relaxation techniques

Massage and other relaxation techniques such as hypnobirthing, playing peaceful music, breathing techniques and dimming lights are methods that can help you relax and control your breathing. This helps you focus on something else other than your contractions

Pain relief from these methods begins as you start using them and they can be used throughout labour and birth if you choose to use them

If you wish to use aromatherapy, reflexology or homeopathy you will need to discuss this with your midwife or obstetrician first, as these methods will need to be provided by an experienced and trained person due to potential side effects that can occur.

Water and birthing pool

Water and using the birthing pool can work in a similar way to massage and other relaxation techniques by helping you relax and feel more in control

Pain relief begins from when entering the pool and lasts as long as you stay in the pool. The pool will be maintained at around 37 degrees for the duration.

You cannot use a TENS machine or have an epidural whilst in the pool

You can use water and opioids (see below for information about opioids) during labour but not at the same time. Your midwife will advise when you are able to get into the pool after opioid medication.

TENS machine

TENS stands for Transcutaneous Electrical Nerve Stimulation and passes a small electrical current through four pads that are stuck onto your lower back. It disturbs the nerve signals that cause you to feel pain and lowers your overall pain levels

Pain relief begins as soon as you start using it and stops when you remove it

You will feel a tingling and tapping feeling and you can control the strength of the current yourself, providing extra pain relief during a contraction

You are able to use a TENS machine alongside all pain relief options except with an epidural or water

You will have to provide your own TENS machine, but these are easily hired or brought online.

Gas and air (Entonox)

Gas and air (sometimes called Entonox) is a mixture of oxygen and nitrous oxide gas

You breathe in the gas through a mouthpiece during a contraction. The gas takes around 20 seconds to start working and the effects wear off within a few minutes of stopping use.

It works better when breathed in slowly and you can use gas alongside all other methods of pain relief

It may make you feel lightheaded, sick or sleepy.

Opioid injections (pethidine and others)

Opioid injections offered at Hillingdon are pethidine, meptid and diamorphine

They make you feel relaxed, which can help you rest and sleep

It is given by a single injection into your buttock or thigh muscle along with an anti-sickness medication

They take around 15-20 minutes to start working and last for around 2-4 hours

Opioid medication can travel through the placenta to the baby, this can cause them breathing problems if born soon after the injection is given. Your midwife will assess which injection is most appropriate depending on how advanced in labour you are.

As a side effect opioids can make you feel sick, dizzy and tired.

Epidural and spinal

Epidurals involve a small tube being inserted into your back by an anaesthetist. By putting the tube into a specific space in your back, pain relief is targeted at your lower body which numbs the area to provide pain relief.

Pain relief medicine is given through the tube hourly and you are able to have extra by pressing a button if needed

It can take 15-20 minutes to begin working effectively and lasts the whole time that medicine is given

Sometimes the tube can come out of place or only give pain relief on one side, this sometimes means that you would have to have the tube re-sited

Epidurals can stop you being able to feel when you need to go to the toilet, so a urinary catheter may be needed for the duration of labour and after birth

You may be able to mobilise and you will still be able to feel touch on your skin

As a side effect having an epidural can make you feel itchy and shivery. You may get a headache and have low blood pressure.

Spinal anaesthetic works similarly to an epidural except it is given by a single injection, mainly used for caesarean section.

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The Hillingdon Hospitals NHS Foundation Trust

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There are a number of pain relief options and techniques for you

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Video of guided box breathing to relieve anxiety during labour

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Video of guided box breathing to relieve anxiety during labour

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Guided Box Breathing - 20 Minute Meditation (4-4-4-4)

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Perineal Health Parents Information Leaflet

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Perineal Health Parents Information Leaflet

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Reducing your risk of perineal tears (In different languages)

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Reducing your risk of perineal tears (In different languages)

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The following animation explains what an OASI is, the four components of the OASI Care Bundle and how women can reduce their risk of sustaining an OASI in childbirth.

Clinicians can use this animation to support discussions with women and pregnant people about OASI in the antenatal period.

If you are experiencing any of these issues because of childbirth, talk to your midwife, doctor, health visitor or GP about the support available in your area.

Download this patient information document to learn more: Perineal Health in Pregnancy, Birth and Beyond

How to reduce the severity of tearing

First- and second-degree perineal tears are most common type and are unlikely to cause long-term problems.

For third- and fourth-degree tears, there is often no clear reason why this happens, and it is not possible to predict. However, it is more likely if:

This is your first vaginal birth

Your baby is over 4kg (9lb)

You have a long second stage of labour (the stage during which you push your baby out)

Your baby's shoulder gets stuck behind the pubic bone (shoulder dystocia)

You have an instrumental vaginal birth (forceps or vacuum assisted)

This page provides information on perineal massage while pregnant, and perineal protection at the time of birth.

Perineal massage while pregnant

From 35 weeks onwards, you or your partner can use daily perineal massage until your baby is born which may reduce your risk of tearing.

This is particularly beneficial for first-time mothers. You may choose to ask your partner to help you with this.

Perineal massage tips

Warm bath
Sit in a warm bath before you start. This may help you to relax before the massage and loosen the muscles around your perineum.

Short nails
The tissues in your vagina and perineum are very delicate. Make sure your nails are short to prevent scratching the skin, or any discomfort to the area.

Comfortable position
You need to be relaxed during the massage, so it's important you find a comfortable position. The best place to perform this massage is in bed. Prop yourself up with pillows to support your back and bend your knees.

Lubricant
Use a lubricant like vitamin E oil, almond oil or olive oil.

Thumbs
Hold your thumbs in the position shown for about 1 minute (diagram below). Press down towards the anus and to the sides of the vagina walls. Hold your thumbs in this position for about 1 minute. You will begin to feel a stretching sensation. Breathe deeply.

Gentle massage
Gently massage the lower half of your vagina using a U shaped movement for 2-3 minutes. Repeat this 2-3 times.

Repeat daily or when possible
It may take a couple of weeks of daily massage before you notice more elasticity in your perineal area.

Perineal protection at the time of birth

Birth position

Your healthcare professional will work with you so that you can birth in your chosen position. A kneeling, or all-fours position, or lying on your side, may be beneficial and reduce the severity of tearing.

Warm compress

Your healthcare professional can gently place a warm compress (pad, swab or gauze) on the perineum as the baby's head stretches the perineal tissues. This can help to reduce the severity of tearing.

A 'hands-on' birth

Your healthcare professional can support your perineum as your baby is being born. This is called manual perineal protection, or a 'hands on birth'.

Manual perineal protection can be provided in any birth position, apart from in the water or on a birthing stool.

It is only used for a short period, during the birth of your baby and it can help to reduce the severity of tearing.

Your healthcare professional should also work with you to ensure that you have a slow and controlled birth.

If you are concerned about tears or have any questions, speak to your healthcare professional. They will be able to discuss any increased risk factors related to your birth, and what they and you can do to try to prevent them.

Further information

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The following animation explains what an OASI is, the four components of the OASI Care Bundle and how women can reduce their risk of sustaining an OASI in childbirth. Clinicians can use this animation to support discussions with women and pregnant people about OASI in the antenatal period.

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Supporting parents who have experienced birth trauma. This charity is working towards a world where fewer parents are traumatised by the experience of birth.

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"I was broken after the birth of my son. My journey to healing started after finding the BTA. It was the first time I felt hope that I would get better, and that I wasn't alone."

- BTA Facebook group member, 2023

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BTA is the only charity in the UK solely dedicated to supporting women and families who have experienced traumatic birth. We work to support parents and families, improve parents' experience of birth, and engage with health professionals and research.

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Talk about your worries, concerns with partner, family member, friend, GP, Midwife, CNWL Talk Therapies

Find a release: Yoga, aqua aerobics, walking...

Move your mind:

- meditation,

- acupuncture (by a registered practitioner specialised in pregnancy acupuncture),

- massage therapy (by a registered practitioner specialised in pregnancy massage)

Deep breathing exercises for 20-30 mins per day

Rest anywhere in your home that makes you feel comfortable

Start a journal to keep your thoughts

Empower yourself - Keep your thoughts on your baby, enjoy your pregnancy, attend antenatal classes to help you prepare to cope with pain during your labour and birth journey.

Anxiety during pregnancy is common. It’s also highly individual, so what may work to help your friend may not alleviate your own worries. Keep the lines of communication open with the people you love, try some stress management techniques, and keep your doctor and midwife informed so they can also provide or signpost you to get the help needed. The sooner you get help, the sooner you’ll be able to gain peace of mind for your health and the health of your growing baby.

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Reducing the risk of perineal tearing with perineal massage

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Reducing the risk of perineal tearing with perineal massage

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Published: October 2019

Please note that this information will be reviewed every 3 years after publication.

This information is for you if you are pregnant and would like to know more about perineal tears during childbirth

It may also be helpful if you are a partner, friend or relative of someone who is in this situation.

Within this information, we may use the terms 'woman' and 'women'. However, it is not only people who identify as women who may want to access this information. Your care should be personalised, inclusive and sensitive to your needs, whatever your gender identity.

A glossary of medical terms is available at A-Z of medical terms.

Read, listen, or download versions of the poster.
Black and white printable version
You can find further information on the RCOG perineal tears hub.

Text version: Perineal tears during childbirth

What you need to know during pregnancy

After the birth of your baby a healthcare professional will offer you an examination to see if you have a tear. They will advise you if you need stitches. Most tears heal within 6 weeks with no long-term problems. For women who do have problems after a tear (such as pain, difficulty going to the toilet, incontinence or mental health problems) specialist help is available.

Approximately 6 out of 100 women giving birth for the first time and 2 out of 100 women who have given birth vaginally before will have a deeper tear involving the back passage/anal sphincter muscle (a 'third- or fourth-degree tear'). These deeper tears will need repair in an operating theatre. You will be supported by healthcare professionals including physiotherapists after your recovery from a third- or fourth-degree tear.
Image 1: Anatomy of the perineum without tears
Perineal massage and 'hands-on' birth

A kneeling or all-fours birthing position may be beneficial and reduce the severity of tearing.

You can ask your healthcare professional to support your perineum as your baby is being born, which reduces the risk of a third- or fourth-degree tear. This is called 'hands-on' birth.

From 35 weeks onwards, you may choose to try perineal massage until your baby is born, which has been shown to reduce the risk of tears. This is particularly beneficial for first-time mothers. You may wish to ask your partner to help with this.
Image 2: Example of perineal massage
Top tips

1. Use lubricant like vitamin E oil, almond oil or olive oil.

2. Hold one or both of your thumbs in the position shown for about one minute. You will begin to feel a stretching sensation. Keep breathing.

3. Gently massage the lower half of your vagina using a U-shaped movement for 2-3 minutes. Do this 2-3 times.

4. Repeat the massage daily, or when possible.

For more information about the types of tears that can happen in childbirth, and what can be done to help your recovery if you do tear, visit the RCOG perineal tears hub.

Sources and acknowledgements

This information has been developed by the OASI Care Bundle Project Team, OASI Care Bundle Clinical Champions and the RCOG Patient Information Committee.

It is based on the RCOG Green-top Guideline No. 29 The Management of Third- and Fourth-degree Perineal Tears, published in June 2015, and on expert opinion of the OASI Care Bundle Project Team, Clinical Champions, key stakeholders and the RCOG patient Information Committee, in line with RCOG due process. The guideline contains a full list of the sources of evidence we have used.

Before publication this information was reviewed by the public, by the RCOG Women's Network and by the RCOG Women's Voices Involvement Panel.

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Perineal tears during childbirth - patient information poster

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This information is for you if you are pregnant and would like to know more about perineal tears during childbirth. It may also be helpful if you are a partner, friend or relative of someone who is in this situation.

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Cry-sis Support for Crying and Sleepless Babies

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Cry-sis Support for Crying and Sleepless Babies

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Who we are

In 1981 a small group of parents, who were experiencing problems with their crying and sleepless babies, set up a support group. They discovered how important support is and how reassuring it can be to talk to someone. Today that support group has become Cry-sis, the only UK charity offering help and support to parents with babies who cry excessively or have sleeping problems. From modest beginnings Cry-sis has become a well-respected national charity which:

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Support For Crying And Sleepless Babies | Cry-sis

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Cry-sis, the only UK charity offering help and support to parents with babies who cry excessively or have sleeping problems. Call the helpline now...

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Home-Start is a local community network of trained volunteers and expert support helping families with young children through their challenging times. We are there for parents when they need us the most because childhood can’t wait.

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Parenting and Family Support - Family Lives (Parentline Plus) | Family Lives

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Parenting and family support from Family Lives (formerly Parentline Plus) through our website, helpline 0808 800 2222, email service at askus@familylives.org.uk, live chat and local services.

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Twins Trust - Supporting Multiple Births

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Twins Trust - Supporting Multiple Births

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Twins Trust - We support twins, triplets and more...

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Supporting you through every milestone of your journey with twins, triplets or more. From being pregnant with twins, triplets or quads through to parenting twins, triplets or quads, we are here for you.

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EPI-NO is a balloon attached to a dial and a small pump, which is used to prepare the perineum for childbirth by gently stretching it

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Assisted vaginal birth (Ventouse/ Forceps)

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Assisted vaginal birth (Ventouse/ Forceps)

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Sometimes called instrumental birth

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When to start and how to do perineal massage

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When to start and how to do perineal massage

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When to start and how to do perineal massage

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Overview

What happens

Recovery

Risks

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Find out why caesarean sections are carried out, whether you can ask for one, what they involve, and what the risks are.

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Our antenatal classes offer a safe space for all expectant parents and all sessions share the same information.

Four (4) Sessions in Person: Hillingdon Hospital (Saturday), Colham Manor Children Centre (Monday) and/or Yeading Children Centre (Fridays).

Partners or Birth Partners are welcome to attend.

Three (3) sessions on Mondays from 18:00 - 20:00hrs. This is Online via Microsoft Teams.

Our virtual sessions are available to access from the comfort of your home or abroad. It is interactive, parents are encouraged to ask any questions. Partners and birth partners are also welcomed to attend.

Monthly face to face session on Saturday from 10:00am - 17:00 (including breaks). Venue: Hillingdon Hospital

Partners or Birth Partners are welcome to attend.

(Places are depending on availability)

We also accommodate parents with special requirements such as language barriers, learning needs and more.

For more information please click on the link 'Your bump and beyond' antenatal classes | The Hillingdon Hospitals NHS Foundation Trust and complete the online form.

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During pregnancy parents will normally see a small number of healthcare professionals, who want to make you feel as comfortable as possible while you're pregnant and when you have your baby.

You may want to get to know the people caring for you through your pregnancy pathway and during the birth of your baby. The NHS is trying to make this happen, but in some cases you may see several different healthcare professionals who are part of a maternity team.

At each appointment, the professionals you see will introduce themselves and explain what they do. It will also be great for you to introduce yourself and anyone attending with you.

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You might like to pack with your partner/birth partner so they can find things for parent and baby quickly, when you’re busy in labour and after birth when needed.

Maternity Notes​

Comfortable front opening nightdresses, big T-shirts or pyjamas

Socks​ and Slippers

Dressing gown/ Night gown ​

Loose fitting underwear​

Maternity pads​ (Full pack)

Toiletries for personal hygiene​ including lip balm

Comfortable bras and breast pads​

Food, Snacks, Drinks​

Handheld fan​ and spray bottle

Phone and charger

Books, iPad and or games

Comfortable pillow​ (with waterproof covering)

Flannels

Clothes and shoes for going home​

Any medications prescribed or kits provided during pregnancy please bring with you when in labour.

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As well as packing for the hospital, have a few things ready and waiting, such as car seat to bring your baby home and essentials for the early days. It is a good idea to have everything ready by 37 weeks, but recommended starting from 32weeks.

Vests x5

Baby Grows x5

Hats x5

Nappies: New-born Size 0 and 1 (Half pack of each)​

Baby Blankets​ or shawl

Cotton pads ​

Muslin cloth

Going home clothes and blanket for baby

Car seat

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NHS Healthy Start is the UK’s food welfare scheme for pregnant women and young children in low-income families. The scheme is there to help families who are most in need of this support. Families will get help to buy healthy food and drink including fresh, frozen and tinned fruit and vegetables, fresh, dried and tinned pulses and infant formula milk. Families will also be able to access free Healthy Start vitamins

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Who qualifies for NHS Healthy Start?

Women who are at least 10 weeks pregnant or have a child under 4 years old, and parents or their family receive any of the following:

Income Support, or

Income-based Jobseeker's Allowance, or

Pension Credit (which includes the child addition)

Child Tax Credit (with a family income of £16,190 or less per year)

Universal Credit (with a family take home pay of £408 or less per month).

The following are also eligible for NHS Healthy Start:

All pregnant women under 18 years, even if they don't get any of the above benefits

Pregnant women (over 10 weeks pregnant) who claim income-related Employment and Support Allowance (ESA)

Families who get Working Tax Credit run-on only. (Working Tax Credit run-on is the Working Tax Credit you receive in the 4 weeks immediately after you have stopped working for 16 hours or more per week)

There will be many families in your setting meeting the eligibility criteria who will qualify for the NHS Healthy Start scheme (particularly families entitled to free childcare for their 2 year old)!

Please Note: Claiming doesn't affect families other financial benefits

Healthy Start to include families with No Recourse to Public Funds (NRPF)

In June 2021, the Department of Health and Social Care (DHSC) agreed to temporarily extend the Healthy Start scheme to British children (aged under four), whose parent or guardian meets the financial eligibility
criteria and are excluded from claiming public funds as a consequence of their immigration status, or their lack of immigration status.

To qualify for the temporary extension, applicants must meet all of the following criteria:

have a child, or more than one child, who is aged under four;

their family's take-home pay is less than £408 per month

they are excluded from claiming public funds as a consequence of their immigration status or their lack of immigration status

If families meet the eligibility criteria and would like to apply, they should email Healthystartclaim@dhsc.gov.uk and DHSC will contact them to discuss the application process.

The Application Process

Families can apply to the NHS Healthy Start scheme online at www.healthystart.nhs.uk

If someone cannot apply online, they can apply over the telephone by calling the NHS Healthy Start helpline on 0300 330 7010.

A telephone translation service is also available when calling the helpline.

The NHS Healthy Start helpline is available Monday to Friday from 8am to 6pm.

The online application process enables someone to apply on the applicant's behalf. The claimant must be present during the application process to confirm their personal information and accept the prepaid
card terms and conditions.

Beneficiaries can contact the automated service on 0300 330 2090 to activate their card, check their balance, get their PIN or report a card as lost or stolen. This line is available 24 hours a day, seven days a week.

Please note: While most families can apply online for NHS Healthy Start, applicants who receive a legacy benefit and those who are under 18 and not on a passporting benefit currently need to apply using a paper application form. This is a new application form for the NHS Healthy Start scheme and is different to the form used for the old paper voucher scheme. If you work with families who can't currently apply online, please signpost them to the NHS Healthy Start helpline so they can be provided with the appropriate form by emailing healthy.start@nhsbsa.nhs.uk or calling 0300 330 7010.

What will families receive?

Families who qualify for Healthy Start will receive money added onto their card every 4 weeks to spend on certain food and milk. Families can also use their card to get free Healthy Start vitamin supplements.
Food and Drink
They will get:

£4.25 each week of your pregnancy (from the 10th week of your pregnancy)

£8.50 each week for children from birth to 1 year old

£4.25 each week for children between 1 and 4 years old

which they can use in local shops to buy (they must display a Mastercard symbol):

plain cow's milk - whole, semi-skimmed or skimmed. It can be pasteurised, sterilised, long life or UHT. (This does not include milk which has had chemicals, vitamins, flavours or colours added or removed)

fruit and vegetable- plain fresh, frozen or tinned (fruit and vegetables with no added ingredients), whole or chopped, packaged or loose

pulses - fresh, dried, tinned pulses, including but not limited to lentils, beans, peas and chickpeas but not those to which fat, salt, sugar or flavouring have been added

infant formula milk that is based on cow's milk and can be used from birth (stage one)

Here are some example of what families can buy using the vouchers they receive for under 1's and over 1's:

Healthy Start Vitamins

Families can also use their card to get free vitamin supplements. Vitamins can be collected every eight weeks from a registered distributor. To collect their free Healthy Start vitamins, beneficiaries in England and Wales will need to present their NHS Healthy Start prepaid card as evidence of their entitlement. No payment is taken from the card.

The NHS Healthy Start vitamins are tablets for women and drops for children. Pregnant women, women with a baby under one year old and children aged up to their fourth birth will receive Healthy Start vitamins.

Healthy Start women's vitamin tablets contain Folic acid, vitamin C, vitamin D (70 milligrams of vitamin C, 10 micrograms of vitamin d, 400 micrograms of folic acid).

Healthy Start children's vitamin drops contain vitamin A, vitamin C and vitamin D (233 micrograms of vitamin A, 20 milligrams for vitamin C, 10 micrograms of vitamin D3).

You can find out more information on children's Vitamin D requirements in our blog Vitamin D recommendations for Infants and Toddlers.

Where can the NHS Healthy Start Card be used?

Parents and carers receiving NHS Healthy Start card should be offered information on how to use them to increase the amount of fruit and vegetables in their family's diet. The Healthy Start website details local retailers that accept the Healthy Start card (they must display a Mastercard symbol), based on the families address. For more information click on this link to be able to see some frequently asked questions.

Families can use their card to get Healthy Start Vitamin which are distributed through primary care trusts. Vitamins are suitable for vegetarians and free from wheat, fish, egg, salt. No colours, flavours or preservatives are used and they do not contain gluten.

Can the card part pay for a food shop?

The paper vouchers could be used to part pay for a larger food shop. Unfortunately, the pre-paid cards do not yet offer this same simplicity. Instead, users must separate out their Healthy Start items from their wider shop and pay for them separately with the card.

On First Using the Healthy Start Card

Families will need to activate their card before first using it in a shop. They will need to contact the Healthy Start team and will need to have their card, date of birth, client ID (located at the top of the letter that came with the card). Families will receive the card PIN two days after the card is sent to families.
Tips on Activating the card:
Users can activate their card calling 0300 330 2090, pressing 1 and going through the automated service which should take no more than a few minutes. On this number families can also check their balance or report their card as missing or stolen.

If families want to talk to an advisor or an intepreter call 0300 330 7010.

It's worth knowing that these numbers are included free of charge in some pay plans, but not all. If it's not included in yours or you're not on a pay plan you could be charged between 3 - 55p a minute from a mobile.

Universal Free Healthy Start Vitamins

In some areas, Healthy Start vitamins are free to all families - contact local health visiting teams to find out if they're free where you live. For example the London Borough of Newham provides free universal vitamins.

London Borough of Newham Universal Free Healthy Start Vitamin scheme?
All families with children under the age of 4, pregnant and breastfeeding mums in Newham are entitled to the free vitamins.
Who are the distributing partners in Newham?
You can find details for Newham's Children's Centres here! Families who have not yet registered for the Healthy Start scheme that may be eligible for help to buy certain milk and food, please continue to promote this and direct families to the Healthy Start website www.healthystart.nhs.uk to complete the online application.

You can download posters to display in your setting here Healthy Start Flyer A5 and Healthy Start Poster A3

Supporting Families to Buy Food and Drink using their card

There are lots of ways you can support families to use their Healthy Start card and prepare healthy meals. Let's consider some of the resources available to you and your setting that will help to inspire families to get cooking:

Eat In With Early Start Recipe Videos

Share our 'Eat in with Early Start' recipe videos with families and highlight how simple they are to prepare and how cost effective they are.
Eat in with Early Start Recipe Videos
Start for Life and Better Health Healthier Family Recipes

Start for Life and Better Health have a number of fun, simple and cost effective recipes for the whole family. The provide ideas and inspiration for tasty, healthy recipe with easy to follow instructions, and a shopping list of all the ingredients needed.
Better Health Healthier Families Website Start for Life Website Cook Together Better Health
Eat Smart Shop Smart

We have a number of blogs to support families including:

How to support families - our 5 Step Guide

Staff working in the early years and health teams play a vital role in helping to increase the uptake of Healthy Start in your area, for example:

1. Do you routinely check if families qualify for NHS Healthy Start?

Ensure to check with families when they register with your setting. Include the question on your registration form! Families who meet the eligibility criteria for the free 15 hours meet the same criteria as Healthy Start. Ensure all families receiving free education and childcare for their 2 years are signed up to the Healthy Start scheme!

2. Support families to complete the online application form

You can help to ensure Healthy Start is available and promoted in your setting and staff/volunteers can support families to apply.
Details on applying for Healthy Start should be readily available in your setting and should be included in relevant support information that parents may receive.
You can support families to apply online:

Signpost families to the online application form here

To apply online families will need:

name

address

date of birth

National Insurance number

baby's due date (if pregnant)

Please note for families currently receiving paper vouchers for Healthy Start:

these will stop once families complete the online application. Families can still use their Healthy Start vouchers until their expiry date (the expiry date is printed on vouchers).

families are currently being contacted to transfer to the new digital card

Don't miss out on your FREE NHS Healthy Start Scheme
3. Display Boards

A display board in your setting, or an information folder, is a great way to share the information above with families and ensuring those that qualify are aware of this important scheme.

Add posters and information on to an eye-catching display

The NHS team have created a package of resources you can use to help promote the scheme. These include social media graphics, a social media toolkit and a guide on how to use these materials. Materials are available in a range of languages including Welsh, Urdu, Indian Punjabi and Bengali. You can find these resources via the following communications toolkit and include email signatures, banners, stickers, social media graphics, leaflets and easy read leaflets.

4. Promoting Healthy Start locally - Media

Include an article or news bite in your next newsletter

Put a link to Healthy Start on your website http://www.healthystart.nhs.uk/

Share information on your employers social media accounts - Example of information to include in your newsletter/website

Did you know that with Healthy Start you get help to buy milk, plain fresh and frozen fruit and vegetables and infant formula? If you're eligible, you'll be sent a Healthy Start card with money on it that you can use in some UK shops. Your benefit will be added onto this card every 4 weeks. You also get free vitamins!

You'll get:

£4.25 each week of your pregnancy from the 10th week

£8.50 each week for children from birth to 1

£4.25 each week for children between 1 and 4

If you are pregnant or have children under the age of 4 you could qualify if you are on benefits or under 18 and pregnant

Applying for Healthy Start is really easy. Contact a staff member today to discuss your eligibility or for more information and to see if you qualify, check out the Healthy Start website!

Promoting Healthy Start locally - speak to parents visiting your setting

Have a conversation with families about the vitamins, this could be at a meeting or during a group session or at registration

Find out your local Healthy Start vitamin stockists and make families aware. For a list of vitamin stockists here!

Signpost them to the online healthy start application form.

5. Training for Early Years teams

Don't forget to book on our Vitamin D - Healthy Start Training to lots more advice and support!

Important Contacts

Website: www.healthystart.nhs.uk
Call the NHS Healthy Start helpline: 0300 330 7010* (Open Monday - Friday, 8am - 6pm).
Customer service email address: healthy.start@nhsbsa.nhs.uk

Automated line: 0300 330 2090* (Available 24 hours a day, seven days a week for card queries).
To contact the NHS Healthy Start team: nhsbsa.healthystart@nhs.net
For enquiries about promoting the scheme: nhsbsa.communicationsteam@nhs.net

* Calls to 0300 numbers are charged at the same rate as dialling an 01 or 02 number. If your landline or mobile service has inclusive minutes to 01 / 02 numbers, then calls to 0300 are counted as part of this inclusive call volume

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What can you do to increase the uptake of the Healthy Start scheme? - Early Start Group

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Women who are at least 10 weeks pregnant or have a child under 4 years old, and parents or their family receive any of the following: Income Support, or Income-based Jobseeker's Allowance, or Pension Credit (which includes the child addition) Child Tax Credit (with a family income of £16,190 or less per year) Universal Credit (with a family take home pay of £408 or less per month).

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We've got healthy eating advice for everyone - whether you have type 1, type 2 or another type of diabetes. It's also relevant if you are newly diagnosed or have been told you are at risk of diabetes.

An important part of managing your condition is to eat a healthy, balanced diet. There's no such thing as a 'diabetic' diet or 'diabetic' recipes.

You'll find advice and tips on everything from healthy swaps, understanding food labels, how to cook healthier meals, meal planning and shopping on a budget. If you're in need of healthier mealtime inspiration, go to our recipe finder.

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We've got healthy eating advice for everyone - whether you have type 1, type 2 or another type of diabetes. It's also relevant if you are newly diagnosed or have been told you are at risk of diabetes. An important part of managing your condition is to eat a healthy, balanced diet.

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Tasty recipes for people with Gestational Diabetes

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Tasty recipes for people with Gestational Diabetes

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What can I eat with Gestational Diabetes?

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What can I eat with Gestational Diabetes?

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Click on the picture for more information.

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Understanding your diet and eating healthily is an important part of your treatment for gestational diabetes. It will help you keep your blood sugar levels in the safe range so you're more likely to enjoy a healthy pregnancy and give birth to a healthy baby.

If you are diagnosed with gestational diabetes you should be referred to a dietitian for individual advice. If this has not happened ask your maternity care team to refer you. We have come up with some tips and recipes to support you too.

To help you get started, we've got some options to try for breakfast, lunch, snacks and dinner. It's important to be physically active every day as well, to help you manage your sugar levels.

Some women with gestational diabetes can keep their sugar levels in the safe range by any necessary changes to their diet and keeping active. Some women may also need insulin and/or a diabetes medication called metformin.

There are some foods you should avoid when you're pregnant, including raw shellfish. The NHS have more information about what foods to avoid or take care with when you're pregnant.

Seven tips for eating well with gestational diabetes

These healthy eating tips for women with gestational diabetes are general. Your care team should talk to you about making changes to your diet and refer you to a dietitian for individual advice that's right for you.

1. Choose healthier carbohydrates (carbs)

All carbs affect your blood sugar levels, so you need to know which foods contain carbs.

The type and amount of carbs you eat or drink makes a difference to your blood sugar levels. The amount makes the biggest difference. And your dietitian will give you advice on the portion sizes that are right for you. It's important too, to choose healthier carbs.

Easy swaps for healthier carbs

Swap white bread for multigrain, wholegrain, wholemeal, rye, linseed or pumpernickel.

Swap chapatti and roti made with white flour to those made with wholemeal flour.

Swap white pittas for brown pittas.

Swap chips and mash for wholemeal pasta, baked plantain or sweet potato.

Swap white rice for brown rice.

Swap cereals like Cornflakes and Rice Krispies for porridge with jumbo oats, made with single cream and water

Other healthier carbs

Vegetables

Pulses like chickpeas, beans and lentils

Dairy like unsweetened yogurt and milk. If you are using a non -dairy milk, check they are unsweetened and fortified with vitamins and minerals.

Fruit - it's best to eat fruit in-between meals and avoid smoothies and fruit juice.

You can check food labels when you're looking for foods high in fibre if you're unsure.

2. Cut down on sugar

Cutting down on sugar is important to keep your blood sugar levels in the healthy range.

Easy ways to cut down on excess sugar:

Swap sugary drinks, energy drinks and fruit juices with water or decaffeinated tea and coffee.

Try low or zero-calorie sweeteners, also known as artificial sweeteners, instead of using sugar.

Know the other names for sugar on the food label. These are sucrose, glucose, dextrose, fructose, lactose, maltose, honey, invert sugar, syrup, corn sweetener and molasses.

Read more about how to cut down on sugar.

3. Perfect your portion sizes

Use our tips on carb portion sizes. This will help you manage your blood sugar levels and avoid too much weight gain during pregnancy. Talk to your care team about what weight gain is right for you. Your weight may be monitored closely while you're pregnant.

4. Plan for snack attacks

Spreading carbs out during the day, and not having a big portion in one go, can help keep your sugar levels stable between meals. If you do need to snack when you have gestational diabetes, swap cake, biscuits, crisps and chocolate for:

Greek yogurt topped with nuts, seeds or fruit such as an apple, pear or satsumas/tangerines

Unsalted nuts

Seeds and vegetables like cherry tomatoes, paired with chopped egg, meat or fish, which will have a small effect on your sugar levels.

Two oatcakes with a matchbox-sized portion of cream cheese

A pot of sugar-free jelly

But watch your portion sizes still - it'll help you keep an eye on your weight.

5. Avoid diabetic foods

In 2016 the law was changed so that manufacturers are no longer allowed to label food as diabetic or suitable for diabetics. They don't have any special health benefits, they're expensive, could still affect your blood sugar and may cause an upset stomach.

The glycaemic index (GI) is a measure of how quickly foods containing carbs affect your blood sugar levels after you eat them. Some foods affect sugars levels quickly and so have a high GI, and others take longer to affect blood sugar levels and so have a low GI.

To help you manage your blood sugar levels, go for carbs with a lower GI. You'll still need to think about your portion sizes. It's the amount of carbs in the meal that will affect your blood sugar levels the most. And not all low GI foods are healthy, so make sure you read food labels and make a healthy choice.

7. Manage your weight

If you gain too much weight in pregnancy it can make it harder to keep your blood sugar levels in the healthy range and can increase your blood pressure and affect your health. However, evidence suggests that pregnancy isn't the time to be on a really strict diet and you shouldn't aim to lose weight. Making changes to your diet and physical activity levels can help you avoid gaining too much weight, and your care team will help you with this. It'll also help you keep your blood sugar within a safe range.

Making changes to your diet and physical activity levels can help you avoid gaining too much weight. It'll also help you to keep your blood sugar within a safe range.

Breastfeeding is one of the ways you can help reduce your risk of developing type 2 diabetes after giving birth.

It's important to keep going with your healthier lifestyle after you've had your baby and keep to a healthy weight. This will reduce your risk of developing gestational diabetes in future pregnancies. And it will also help to reduce your future risk of developing type 2 diabetes too.

Meal and snack ideas for gestational diabetes

Try to include protein foods and vegetables with each of your main meals, to help fill you up and help manage your sugar levels.

Breakfast

You may need to split your usual breakfast into two sittings. Many care teams recommend that you limit carbohydrate at breakfast to 15-20g and then have another 15-20g a few hours afterwards. Women find having 40g at breakfast causes their sugar levels to go higher than their target levels. In practice this means a slice of toast at one sitting with the other a few hours afterwards.

A bowl of jumbo oats made with single cream and water semi-skimmed milk

2 slices of wholegrain toast with unsaturated low-fat spread or cream cheese, topped with chopped cucumber eggs

A boiled or poached egg with salad and a slice of toast.

A pot of yogurt and nuts

Or you could try making:

Lunch

An egg, cheese, fish or chicken salad sandwich, made with wholegrain bread or chapatti/roti made with wholemeal flour. You can pack it full of tasty, crunchy salad such as grated carrot, sliced tomatoes, cucumber and crisp lettuce.

A small pasta salad, with plenty of veggies

Soup - containing lots of veggies and pulses - with a wholegrain roll. Some soup contains lots of added salt and sugar so check the label. Try our homemade chilli bean soup.

Or you could try making:

Dinner

Try serving dinners with our Cauliflower pilaf instead of rice.

Get more recipe ideas - you can search by type of meal, ingredient and filters include vegetarian, vegan and gluten free.

For each portion, you'll see how many carbs, sugars, fat, fibre, salt, fruit and veg portions, and calories there are.

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What can I eat with gestational diabetes?

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Understanding your diet and eating healthily is an important part of your treatment for gestational diabetes. It will help you keep your blood sugar levels in the safe range so you're more likely to enjoy a healthy pregnancy and give birth to a healthy baby.

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A healthy South Asian meal plan for diabetes - Diabetes Care Community

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A healthy South Asian meal plan for diabetes - Diabetes Care Community

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Are you looking for a South Asian meal plan for diabetes? There are lots of ways you can adapt traditional South Asian recipes and ingredients into your meal planning, to ensure that the foods you eat are healthy and tasty.

The plate method for a South Asian meal plan

The plate method is an excellent way of determining how much - and which kind - of foods you should eat at any given meal. At dinnertime, for example, your plate should look something like this:

Starchy foods - such as rice and roti - should comprise one-quarter of the plate.

High-protein foods - such as chicken, fish, beans, lentils, tofu and paneer - should comprise one-quarter of the plate.

Vegetable curries and salads should be one-half of your plate. In place of starchy vegetables - such as potatoes, corn and peas - use vegetables such as cauliflower, green beans, and eggplant in your favourite dishes.

On the side, add a milk or milk alternative - such as low fat raita or lassi - along with a piece of fruit, to complete your meal.

Tips for preparing South Asian dishes

Here are some tips for preparing traditional South Asian dishes that are flavourful and healthy!

One great aspect of South Asian cooking is that it is full of flavour because of the array of spices that are used. Take advantage of the bounty of flavours that spicing allows, instead of seasoning dishes with salt.

If cream is necessary for a traditional dish - for example, makhani murgh (butter chicken) - use lower fat cream (5% MF), or even 2% milk, rather than whipping cream (35% MF). Be sure to add it at the end of the recipe, to avoid curdling.

When making curries that are tomato-based, use fresh tomatoes or "no salt" canned tomatoes.

When cooking vegetable dishes and curries, use non-starchy vegetables such as green beans, cabbage, okra, eggplant or bitter gourd.

When making breads, such as naan or roti, use gram flour. Made from dried and ground chickpeas, gram flour is a good source of fibre and will not raise your blood sugar level as high as if you use white flour. Mixing whole wheat flour with gram flour adds a nice texture to the dough and keeps it soft.

Store-bought paneer is made with full fat milk, so it's high in fat. You can make paneer at home, using skim or 2% milk. While it takes a little time, your homemade version will have less fat, commercial additives and salt.

Instead of buying pre-made curry powders and mixes, make your own spice blends. There will be fewer additives and much less salt in your homemade versions.

Raita, the traditional South Asian condiment made with yogurt, is a great way to cool off spicy dishes. Adding raita to your meal is an excellent way to increase calcium and vitamin D in your meal plan, and it's easy to make at home with low-fat or no-fat yogurt.

Eating healthily doesn't mean that you have to give up your favourite traditional dishes. With a little planning, you can enjoy South Asian foods without sacrificing flavour!

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A healthy South Asian meal plan for diabetes - Diabetes Care Community

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A South Asian meal plan for diabetes can incorporate the foods that you love and can also be healthy! Here are some tips for South Asian meal plans.

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Physical activity and exercises in Pregnancy 

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Physical activity and exercises in Pregnancy 

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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.

Keep up your normal daily physical activity or exercise (sport, running, yoga, dancing, or even walking to the shops and back) for as long as you feel comfortable.

Exercise is not dangerous for your baby. There is evidence that active women are less likely to experience problems in later pregnancy and labour.

Exercise tips for pregnancy

Do not exhaust yourself. You may need to slow down as your pregnancy progresses or if your maternity team advises you to. If in doubt, consult your maternity team.

As a general rule, you should be able to hold a conversation as you exercise when pregnant. If you become breathless as you talk, then you're probably exercising too strenuously.

If you were not active before you got pregnant, do not suddenly take up strenuous exercise. If you start an aerobic exercise programme (such as running, swimming, cycling or aerobics classes), tell the instructor that you're pregnant.

Remember that exercise does not have to be strenuous to be beneficial.

Exercise tips when you're pregnant:

always warm up before exercising, and cool down afterwards

try to keep active on a daily basis - 30 minutes of walking each day can be enough, but if you cannot manage that, any amount is better than nothing

avoid any strenuous exercise in hot weather

drink plenty of water and other fluids

if you go to exercise classes, make sure your teacher is properly qualified and knows that you're pregnant, as well as how many weeks pregnant you are

you might like to try swimming because the water will support your increased weight. Some local swimming pools provide aqua-natal classes with qualified instructors. Find your local swimming pool

exercises that have a risk of falling, such as horse riding, downhill skiing, ice hockey, gymnastics and cycling, should only be done with caution. Falls carry a risk of damage to your baby

Exercises to avoid in pregnancy

do not lie flat on your back for long periods, particularly after 16 weeks, because the weight of your bump presses on the main blood vessel bringing blood back to your heart and this can make you feel faint

do not take part in contact sports where there's a risk of being hit, such as kickboxing, judo or squash

do not go scuba diving, because the baby has no protection against decompression sickness and gas embolism (gas bubbles in the bloodstream)

do not exercise at heights over 2,500m above sea level - this is because you and your baby are at risk of altitude sickness

Exercises for a fitter pregnancy

If you are pregnant, try to fit the exercises listed in this section into your daily routine. These types of exercise will strengthen your muscles to help you carry the extra weight of pregnancy. They'll also make your joints stronger, improve circulation, ease backache, and generally help you feel well.

Stomach-strengthening exercises

As your baby gets bigger, you may find that the hollow in your lower back increases and this can give you backache. These exercises strengthen stomach (abdominal) muscles and may ease backache, which can be a problem in pregnancy:

start in a box position (on all 4s) with knees under hips, hands under shoulders, with fingers facing forward and abdominals lifted to keep your back straight

pull in your stomach muscles and raise your back up towards the ceiling, curling your trunk and allowing your head to relax gently forward. Do not let your elbows lock

hold for a few seconds then slowly return to the box position

take care not to hollow your back: it should always return to a straight/neutral position

do this slowly and rhythmically 10 times, making your muscles work hard and moving your back carefully

only move your back as far as you can comfortably

Pelvic tilt exercises

stand with your shoulders and bottom against a wall

keep your knees soft

pull your tummy button towards your spine, so that your back flattens against the wall: hold for 4 seconds then release

repeat up to 10 times

Pelvic floor exercises

Pelvic floor exercises help to strengthen the muscles of the pelvic floor, which come under great strain in pregnancy and childbirth. The pelvic floor consists of layers of muscles that stretch like a supportive hammock from the pubic bone (in front) to the end of the backbone (spine).

If your pelvic floor muscles are weak, you may find that you leak urine when you cough, sneeze or strain. This is quite common, and there is no reason to feel embarrassed. It's known as stress incontinence and it can continue after pregnancy.

You can strengthen these muscles by doing pelvic floor exercises. This helps to reduce or avoid stress incontinence after pregnancy. All pregnant women should do pelvic floor exercises, even if you're young and not suffering from stress incontinence now.

How to do pelvic floor exercises:

make yourself comfortable by sitting or lying down with your knees bent

squeeze in and tighten the muscles around your back passage as if you were trying to stop yourself peeing and farting

breathe in as you squeeze in and tighten the muscles, and then breathe out while relaxing the muscles

at first, try to do this exercise quickly

then do it slowly, holding the squeezes for as long as you can before you relax: try to count to 10

try to do 3 sets of 8 squeezes every day: to help you remember, you could do a set at each meal

As well as these exercises, practice tightening the pelvic floor muscles before and during coughing and sneezing.

Find out more about incontinence.

Find out more about keeping fit and healthy after you've had your baby.

How and when should I do pelvic floor exercises?

In this video, a midwife explains how to do pelvic floor exercises and when you can practise them.

Need activity ideas for the rest of the family?

For ideas to help get your family more active visit the Better Health - Healthier Families website.

Please bear in mind that the activity plans are not designed for use during pregnancy but can be useful for your partner, children and other family members.

Video: What can I do during pregnancy to make birth easier?

In this video, a midwife describes things women can do during pregnancy to help make giving birth easier.

Get Better Health: Start for Life pregnancy and baby emails

Sign up for Better Health: Start for Life weekly emails for expert advice, videos and tips on pregnancy, birth and beyond.

Community content from HealthUnlocked

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Find out about the benefits of exercise in pregnancy, including which kinds of exercise you can do, such as yoga and swimming, and which you should avoid.

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How does smoking affect my baby?

It's hard to imagine when you cannot see your baby, but everything you breathe in passes through to your baby (including secondhand smoke). Each cigarette contains more than 4,000 chemicals.

When you smoke, carbon monoxide and other harmful toxins travel from your lungs into your bloodstream, through your placenta and into your baby's body.

When this happens, your baby struggles for oxygen. When your baby cannot get enough oxygen, this affects their development.

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Smoking and alcohol during pregnancy - Start for Life

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By giving up smoking and drinking, you are protecting your baby and reducing the risks to their development and future health. Find out why.

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10 steps to your quit (stop smoking) plan in pregnancy

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10 steps to your quit (stop smoking) plan in pregnancy

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Preparing for labour and birth from 36 weeks of pregnancy

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Preparing for labour and birth from 36 weeks of pregnancy

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Discussing labour and birth pathways from 36 weeks of pregnancy, considering parents may have various pregnancy care pathways based on obstetric/ surgical/ medical history. Discussion about positions and ways to help start labour naturally from 37 weeks of pregnancy.

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What are Braxton Hicks?

Braxton Hicks are when the womb contracts and relaxes. Sometimes they are known as false labour pains.

Not all women will have Braxton Hicks contractions. If you do, you'll usually feel them during the second or third trimester.

Braxton Hicks are completely normal and many women experience them during pregnancy. Your midwife will probably talk to you about them at some point, and you can ask questions at any time. You may also learn more about them during antenatal classes.

What do Braxton Hicks feel like?

They may be uncomfortable, but they are not painful. Women often describe Braxton Hicks contractions as feeling like mild menstrual cramps or a tightening in a specific area of the stomach that comes and goes.

"I find them like a mild stitch that goes almost as quickly as it comes. Not painful but you're definitely aware it's there. You will soon realise when you do go into labour that Braxton Hicks cannot be mistaken for labour pains."

Claire

"I have had Braxton Hicks, but I didn't know I was experiencing it - it was only because I was at the day assessment unit because I was concerned with the movements of baby that the midwife told me I was experiencing them. I asked the midwife that saw me if they were 'practice contractions' and she said they weren't contractions."

Kim

"For me the Braxton Hicks make my bump feel really tight as if my skin is being stretched, my bump also goes solid! Although not painful they can feel intense when I am out on a long walk with my family!"

Sarah

Why will I get Braxton Hicks?

We don't really know why women get Braxton Hicks contractions. But we do know some of the things that trigger them, such as:

being very active

having a full bladder

having sex

being dehydrated.

What's the difference between Braxton Hicks and labour contractions?

Unlike labour contractions, Braxton Hicks contractions:

vary in length and strength

happen infrequently, are unpredictable and non-rhythmic

are more uncomfortable than painful

do not increase in frequency, duration or intensity

lessen and then disappear, only to reappear at some time in the future.

Compared with Braxton Hicks, labour contractions:

are noticeably, and increasingly, longer

are more regular

are more frequent

are painful

increase in intensity.

Nearer the end of your pregnancy, Braxton Hicks contractions may form more of a pattern and increase in frequency and intensity. Lots of women often mistake Braxton Hicks contractions for the start of labour. But, unlike labour contractions, Braxton Hicks contractions do not cause the cervix (the entrance to the womb) to open (dilate).

How are Braxton Hicks contractions treated?

There is no treatment for Braxton Hicks contractions. But there are things you can do to ease them, such as:

changing position

lying down if you've been very active - find out more about exercise in pregnancy

going for a walk if you've been sitting down for a long time

relaxing, such as taking a warm bath, having a massage, or having a nap

drinking some water to rehydrate.

When should I contact my midwife?

It's always best to contact your midwife or maternity unit for advice if you are not sure whether you are having Braxton Hicks or labour contractions.

It's also a good idea to call them if the tightenings continue, especially if you are less than 37 weeks pregnant.

Call your midwife or maternity unit straight away if:

you have any vaginal bleeding

your waters break

you have strong contractions every five minutes that last 30-60 seconds)

these twinges become very painful

you have any concerns about your baby's movements.

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Braxton Hicks are when the womb contracts and relaxes. Sometimes they are known as false labour pains. Not all women will have Braxton Hicks contractions. If you do, you'll usually feel them during the second or third trimester. Braxton Hicks are completely normal and many women experience them during pregnancy.

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See Box Breathing Video

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Changing positions in labour has many benefits for parent and baby.

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Role of partner/ birth partner is to help you feel calm, confident and excited for your baby's birth.

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At the end of your pregnancy, you may have some signs that your baby will arrive very soon, even though you may not go into labour for a little while yet.

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London Borough of Hillingdon Council - Special Educational Needs and Disabilities (SEND)

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London Borough of Hillingdon Council - Special Educational Needs and Disabilities (SEND)

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Information, advice and guidance for parents of children aged 0 - 25 years with special educational needs and disabilities (SEND).

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Hillingdon’s local offer provides information for children and young people with SEND and their parents/carers with information and advice on what they can expect from a range of local services and how to access them.

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Our Maty Triage service is opened 24 hours, 7 days a week for anyone 18 weeks pregnant and over.

Please contact contact 01895279054 if you have any concerns including:

If you are leaking fluid, heavy clear wet discharge or know that your waters have released

Experiencing spotting or bleeding

Constant vomiting

Painful urination

Persistent severe headache

Swelling in feet, face, hands or legs

Blurred vision (seeing spots)

Contractions or cramps

Severe itching especially on hands, feet

Experiencing sharp continuing abdominal pain

Pelvic pain

If you are concerned about your baby movements. Movements has slowed down or pattern changes.

Have a high temperature

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Welcome to the Greater London Authority's Asylum Welcome Toolkit, which aims to support local authorities to improve social integration outcomes for people seeking asylum.

The toolkit was developed with input from 11 London boroughs who participated in a series of Design Lab workshops in 2023, commissioned by the Mayor as part of his Asylum Welcome Programme and delivered by British Future and Refugees in Effective and Active Partnership (REAP), who also produced the toolkit.

The toolkit contains guidance, case studies and resources and is set out into individual pages covering different areas of a borough's asylum response. Click on a theme below to start exploring.

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Explore the GLA's Asylum Welcome Toolkit, which aims to support local authorities to improve social integration outcomes for people seeking asylum.

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Click on the picture for more information.

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Available in 33 different languages.

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About our translations

We are now expanding our portfolio of translations of our main publications beyond the 20 most common languages used in the UK following feedback at meetings and our enquiries page. We are really grateful to the charity Translators without Borders who are helping us to reach mothers and families of all nationalities. Newer additional translations have been generously provided by OAA members to help us to support some other languages. Where possible, these have been quality assured by professionals and/or peer colleagues. We trust these translations to be as accurate as possible and hope that they are useful to you.

Can you help grow our range of translations?

We are always looking for volunteers to help us expand the range of translated material we offer. If you are able to help translate our materials into new languages we would love to hear from you.
Get in touch

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We are now expanding our portfolio of translations of our main publications beyond the 20 most common languages used in the UK following feedback at meetings and our enquiries page. We are really grateful to the charity Translators without Borders who are helping us to reach mothers and families of…

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What happens when you get Refugee Status?

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What happens when you get Refugee Status?

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The Right to Remain Toolkit

A guide to the UK immigration and asylum system

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Last updated: 19 June 2024

After receiving your refugee status, it can be confusing to know where you can access support. Although it is a relief to receive a grant of status, it is often a very overwhelming experience. Almost overnight, you need to learn what to do about how to get housing, social care, benefits, work, or bringing family to join you in the UK.

This page provides a simple guide to help you navigate through this change, and signposts to other helpful resources.

If your initial asylum claim was refused by the Home Office and you are unsure of what steps to take next, read our Toolkit page on refusals here.

On this page, you will find the following information:

If the Home Office decides that you have a need for protection because you in particular are at risk of persecution in your country of origin, and your asylum claim falls under the grounds for protection in the Refugee Convention, you will be granted refugee status for a period of 5 years.

Refugee status is a form of immigration status in the UK. Refugees are not (yet) citizens in the UK, but they do have access to a number of rights, as outlined in this guide.

If the Home Office does not think that you in particular are at risk of persecution in your country of origin, but concedes (this means agrees) that your country would be generally unsafe for you to return to, you may be granted Humanitarian Protection status, which you read more about here.

After you receive a decision letter from the Home Office granting your refugee status, you are meant to receive a Biometric Residence Permit (BRP) card. Your BRP card is a small card with your name, date and place of birth, your fingerprints and a picture of you. It has information about your immigration status on it. You can use your BRP card as proof of your identity.

Your BRP card can be used to show your:

identity

right to study

right to any public services/benefits you're entitled to (see more in the sections below)

your National Insurance Number, if you have one

The BRP card is different to the ARC (application registration) card - this is the card you have if you are seeking asylum in the UK and have not yet received a decision from the Home Office.

Many people are experiencing delays or other problems (such as incorrect information) with their BRP cards. You can learn more about BRP cards and how to respond to issues that may arise in our simple Legal Update blog.

A grant of refugee status in the UK lasts for 5 years.

After the 5 years have passed, you will be eligible to apply for Indefinite Leave to Remain (often referred to as 'ILR' or 'settlement').

When you obtain ILR, after one year you will be eligible to apply for British Citizenship if you want to become a British citizen or apply for a British passport.

Read the sections below to find out more about these processes.

How to apply for Indefinite Leave to Remain (settlement)

Indefinite Leave to Remain (ILR) is permanent settlement in the UK (as opposed to being a temporary visa). It gives you the right to live, work, and study in the UK without a time limit. It also enables you to apply for benefits if you are eligible.

It is also the route to applying for British citizenship (see below).

There are different ways to apply for indefinite leave to remain based on your circumstances. Crucially, this section only outlines the route to ILR after a grant of refugee status.

To apply for ILR after a grant of refugee status, you must:

Have the grant of refugee status for at least 5 years.

Apply during the last month of your current permission to be in the UK (just before it reaches 5 years).

The application must be made online using the SET(P) Form which you can access here.

Once you have started your application, you can save your form and complete it later.

You may include supporting documents or evidence with your application, such as any travel documents that have been issued, any time you have spent outside the UK, evidence you have established a life in the UK, and more.

If you are applying for ILR as a refugee, there is no application fee for making an application.

Your family may be able to join your ILR application as dependants if:

your family is already in the UK; and

you became a family before you left your home country (so it cannot be someone you met and formed a family with or children you had after your arrival in the UK)

If your family is not in the UK, you may be able to apply for them to join you in the UK under the Family Reunion rules (see below).

With ILR, you can travel outside the UK using a Home Office travel document. You can learn more about applying for a travel document here.

It is important to note that your indefinite leave to remain may be taken away if you:

Travel back to the country you claimed asylum from.

Stay outside the UK for more than 2 years - you may need to apply before you can return to the UK.

Children of refugee parents

Children born to parent(s) who are in or who have been through the asylum system have different entitlements to status, depending on the stage of the process that their parent(s) are in.

For example, if a child is born in the UK while their parent(s) asylum claim is still being processed, they will be treated as a dependant child on the asylum claim. The Home Office just needs to be notified of the child's birth. You can read more on page 29 of the guidance here, under the title ' Including UK born dependants in asylum claims '.

A child born in the UK to parent(s) who are settled / have Indefinite Leave to Remain, the child will automatically be a British citizen. Those with refugee status who later become settled will also be able to register their child as a British citizen.

Leave in line - children born in the UK

This section concerns what happens if a child is born in the UK to parent(s) who have protection (refugee or humanitarian) status.

Before July 2023, parents could simply ask that the newborn child be granted refugee status in line with them - this is where the term 'leave in line' comes from. This could be done without an application or fee to pay.

Since July 2023, changes have been made to the guidance. There is still no formal application form or fee, but parents must directly request protection status for their child from the Home Office, and the Home Office will then write to the parents to request the relevant evidence. Then, an asylum claim for the baby will need to be registered in person. See page 30 of the guidance under the title ' Children not included in the initial claim or born to parents granted protection status '.

The relevant evidence the Home Office may request could include:

Passport photographs of the child

Original birth certificate of the child

Copy of the parent(s) Biometric Residence Card (BRP)

Copy of the parent(s) decision letter granting refugee status

Issues

This gives rise to a number of possible issues.

Firstly, claiming asylum for a newborn child falls under legal advice, and so families will require the help of a legal adviser or lawyer. This means they will likely face delays in obtaining status for their child, as there is a backlog in receiving legal advice because the demand is so high.

Secondly, the Home Office often refuses to grant a convention travel document to children born in the UK who have been granted leave in line without refugee status. According to Free Movement:

" If the baby is unable to get a convention travel document, then the alternative is a certificate of travel which is obviously inappropriate as it would require the refugee parent(s) to make contact with their embassy, which can create further problems. It is also considerably more costly. "

British citizenship

Following a grant of refugee status for 5 years, and a grant of Indefinite Leave to Remain (ILR) for 1 year or more, you can apply for British citizenship if you meet the 'good character' requirements.

Applying for British citizenship is sometimes called 'naturalisation'.

The other requirements are that you must also:

You can learn more about applying for British citizenship on the government website below.

Those who receive refugee status can apply to have their family members join them in the UK under a process called 'family reunion'.

Free Movement and Refugee Legal Support have drafted a user-friendly, detailed guide to family reunion which you can use to understand this process.

Button: Read the Family Reunion guide here https://freemovement.org.uk/refugee-family-reunion-a-users-guide/

The Refugee Legal Assistance Project at the University of Bedfordshire assists people with their family reunion applications. Their campus is in Luton. You can email rlap@beds.ac.uk to book an appointment - but please note that this may take some time because they receive many requests.

Shortcomings of Family Reunion

In June 2024, Refugee and Migrant Forum Of Essex & London (RAMFEL) published a report called Safe Routes to Nowhere: The UK's Broken Promises on Family Reunion. The report highlights the realities of the family reunion process, and how difficult it is for people with status in the UK to bring their families to join them.

The report draws on RAMFEL's casework experience and government data. The report reveals that:

Many people in conflict zones are prevented from even applying for family reunion as they cannot attend a Visa Application Centre (VAC) to enrol their biometrics. As of February 2024, the government had only allowed one person to be exempted from this requirement.

The government's default position is to refuse family reunion applications. In one of the few family reunion routes open, Appendix CNP, the government refused 83% of applications between April and September 2023, whilst in another route, Appendix Adult Dependant Relative, the refusal rate was 96% between 2017 and 2020.

Despite this, the vast majority of people succeed in overturning family reunion refusals at the Immigration Courts. Between 2019 and 2022, around two-thirds of refusals were overturned on appeal, whilst RAMFEL have never failed to overturn a family reunion refusal.

Governmentdelays in processing family reunion applications are compounded by an average waiting time of 43 weeks for a court date if they refuse the application.

Those with refugee status are able to work in the UK. We know that entering (or re-entering) the work force can be a challenging experience, especially after being in the asylum process for a long time.

A number of organisations provide support to those with refugee status who seek employment or training for employment. We have listed their details here.

Refugee Council can support you into employment and understand the barriers refugees face in trying to access work in the UK. You can learn more here.

The Refugee Employability Programme supports refugees to find work and settle into their local communities. Different providers carry out the programme across the UK, helping people with many skills, from language lessons and interview practice, to writing a strong CV. You can find the contact details of the providers in different regions of the UK here.

HIMILO is a training provider, delivering vocational training courses, careers advice and employment opportunities. You can learn more here.

Micro Rainbow provides support for recently granted refugees to access benefits and prepare for employment. They also run a fellowship programme for LGBTQI+ people seeking asylum and refugees to gain skills and experience in immigration law, communication, and leadership.

Breaking Barriers help refugees in Birmingham, Glasgow, Liverpool, London and Greater Manchester, acquire the knowledge, confidence and experience to get stable, fulfilling employment.

People with refugee status are able to study in the UK, but they face many obstacles (from accessing funding, to long waiting lists).

The following organisations provide information and support to young people with refugee status who wish to pursue an education in the UK.

Refugee Education UK (REUK) provides a range of services which help people aged 14-25 to access and do well in education. You can learn more about what they do (including mentoring, training, and resources) here.

Asylum Welcome assists people seeking asylum and refugees over the age of 16 who wish to continue their education and gain qualifications so they can work in the UK.

Student Action for Refugees (STAR) is a network of students in universities across the UK who stand in solidarity with refugees. They campaign for access to university for people in the asylum system and those with refugee status, and also compile lists of institutions that provide scholarships, bursaries and fee waivers. You can learn more here.

There has been a significant increase in the number of evictions (and halting of asylum support payments) from Home Office asylum accommodation for those who have refugee status since August 2023.

This is difficult in itself, but what has made it harder is the very short notice people receive. In reality people were getting as little as a week or even 4 days' notice from the Home Office to find somewhere new to live, and money to survive. This has since increased to 28 days. You can read our simple Legal Update about evictions from asylum support accommodation here.

So, if you have been living in asylum accommodation and/or receiving asylum support payments, these will stop 28 days after receiving refugee status.

Because of this, it is very important that you open a bank account if you do not already have one, so that if you claim benefits or start working, the money you receive has somewhere to land.

Universal Credit

When you receive a grant of refugee status, you are eligible to claim certain benefits, such as Universal Credit (UC).

Universal credit (UC) is a cash social security benefit for people aged under 66, administered by the Department for Work and Pensions (DWP). It helps you with living expenses (including rent) if you have a low income.

To qualify for universal credit you must:

make a valid claim;

sign a 'claimant commitment' and comply with any work-related requirements set out in it; and

be an eligible person.

To apply for UC as a refugee, you must send a form of identification (ID) to the Department of Work and Pensions (DWP). This ID can be in the form of your BRP card, or if you have not yet received your BRP card, you can use your ARC card and your decision letter from the Home Office as ID. The ARC card and decision letter must be presented together to qualify as a form of ID.

You can learn more about claiming Universal Credit and eligibility in our guide on Destitution and Housing.

Child benefit for refugees

If you have been granted refugee status and have or look after a child, you can claim Child Benefit backdated to the date of your asylum claim (the date you claimed asylum for the first time).

You (the main person who claimed asylum) must claim Child Benefit within three months of:

Receiving refugee status, or

From when the child was born, or

Within three months of children arriving via family reunion.

You should claim within this three month period, even if your BRP card or other evidence has not yet arrived or is not yet available. It takes a very long time for His Majesty's Revenue and Customs (HMRC) to process your claim, so the earlier you submit it, the better.

The amount of Child Benefit is not reduced by any asylum support you received.

For further information, take a look at this useful page on the Maternity Action website.

There has been a significant increase in the number of evictions from Home Office asylum accommodation for those who have refugee status since August 2023.

This is difficult in itself, but what has made it harder is the very short notice people receive. In reality people were getting as little as a week or even 4 days' notice from the Home Office to find somewhere new to live, and money to survive. This has since increased to 28 days. You can read our simple Legal Update about evictions from asylum support accommodation here.

So, if you have been living in asylum accommodation, you will need to leave 28 days after receiving refugee status.

Some people are able to move in with friends, or to have help with renting privately. Others need more help, and can take a look at the resources we have listed below.

Finding a room

Refugees at Home is a UK charity which connects those with a spare room in their home to refugees and people seeking asylum who are in need of somewhere to stay. They provide support to both hosts and guests. If you would like to explore the option of finding a room through Refugees at Home, click here and read through their information for guests before getting in touch.

The No Accommodation Network (NACCOM) is a network made up of member organisations providing accommodation and support to those facing destitution across the UK - including refugees. The accommodation provided by NACCOM members ranges from hosting to renting. You can find a map of NACCOM's members across the UK by clicking here.

Applying as homeless to a local council

The Chartered Institute of Housing Rights has a very helpful resource outlining what it means to apply as homeless to a local council, and when/how to do this. You can access the full guide here.

If you are in Scotland, housing law is slightly different, for example, there is no 'priority need'. You can learn more about housing in Scotland here.

It says -
Local councils have a responsibility to make sure free housing advice and information is available to anyone in their area. This is to prevent homelessness or help homeless people find accommodation. But if, even after following the advice and using the information, you are still homeless or threatened with homelessness, you may be able to ask the council for more help, including temporary accommodation and help finding long-term accommodation.

you are legally homeless or threatened with homelessness within 56 days (i.e. you don't have a home in the UK or abroad where you can reasonably live);

you are in priority need (because in your household there is an eligible child, pregnant woman or vulnerable person);

you are not intentionally homeless (for example, you didn't pay your rent or you gave up a home where you could reasonably have lived); in Wales some councils may not apply this rule; :

you have a 'local connection' with the area where you are making the application (such as work, you lived there before or you have family members living there),

you have no connection with any area.

So, to apply to a local council for support with homelessness, you must:

Be eligible (check here for different eligibility criteria, which depend on whether you are a British/EEA citizen or a non-EEA citizen)

Be legally homeless or know you will be homeless within 56 days

Be in 'priority need' (due to vulnerability)

Not be 'intentionally' homeless (this means on purpose, if you have alternative options)

Have a 'local connection' (this means a tie to the place, for example if it was your asylum dispersal location) OR no connection to any local council area in the UK. This is because local councils have a duty to house someone who has a connection to their constituency, or who is in their constituency and does not have a connection to anywhere else in the UK.

The concept of a 'local connection' is very important to bear in mind for people who have just obtained refugee status and may wish to relocate to a location away from their asylum dispersal accommodation. Refugees in the UK have a unique, permanent local connection to the place they are living in at the time they receive their grant of status from the Home Office.

For example, this means that if you receive refugee status while you are living in the London Borough of Tower Hamlets, you will have a local connection to Tower Hamlets council for the purpose of a homelessness application. If you were living in Leicester at the time when you received Refugee Status, you will have a local connection to Leicester City Council but if you move to London, you will not have a connection to any local councils in London. People outside of London coming into London are within the general homelessness cohort and will not be prioritised.

You can never lose an existing local connection, but you can always add to it. For example, if you used to live in London but then start a family and start working in Sheffield, you will have a new local connection in Sheffield.

You can learn more in our guide about Destitution and Housing.

The Migration Justice Project(part of Law Centre NI) published an excellent Refugee Transition Guide, which is a support guide for people who have recently received refugee status, humanitarian protection, or discretionary leave.

The guide covers topics such as what your rights are when you transition from being an asylum seeker to a refugee, your Biometric Residence Permit, what the end of asylum support means, social security, working and National Insurance, and many other useful topics. It is available for download in English, Arabic, Farsi, Somali and Tigrinya.

Please do note that some sections of the Migration Justice Project guide are specific to people who live in Northern Ireland.

Rainbow Migrationhas a guide to help you move forward with education, support, housing, help with mental health and looking for work after you have been granted refugee status. You can access the guide by clicking here.

You can contact your local Citizens Advice Bureau for advice after you receive refugee status. They also have an information sheet which you can access here.

There may be other local groups who may be able to help you with this. If you type in the name of the area you live in, followed by 'asylum support groups' on Google or any search engine, you should be able to find them. Or, you can also access our Directory of groups by clicking here.

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What happens when you get Refugee Status?

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Although it is a relief to receive refugee status, it is often a very overwhelming experience. Almost overnight, you need to learn what to do about how to get housing, social care, work, or bringing family to join you.

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You will not be offered a test specifically for Group B Strep (GBS) carriage routinely during your pregnancy,  as it is not recommended in the UK by either the UK National Screening Committee or the Royal College of Obstetricians. Current evidence does not support universal screening in view of the potential risks associated with large numbers of women receiving antibiotics during labour. A ‘risk-based’ approach is recommended in the UK where women with certain risk factors are identified and assessed (e.g., preterm labour, pre-labour rupture of membranes, prolonged rupture of the membranes or fever during labour); in these circumstances additional tests are carried out and if found to be GBS positive IV antibiotics will be offered during labour.

Click on the link above for more information.

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Group B strep is a type of bacteria called streptococcal bacteria.

It's very common in both men and women and usually lives in the bottom (rectum) or vagina. It affects 2 to 4 women in 10.

Group B strep is normally harmless and most people will not realise they have it.

It's usually only a problem if it affects:

pregnant woman - it could spread to the baby

young babies - it can make them very ill

elderly people or those who are already very ill - it can cause repeated or serious infections

This page focuses on group B strep in pregnancy and babies.

Group B strep in pregnancy

Group B strep is common in pregnant women and rarely causes any problems.

It's not routinely tested for, but may be found during tests carried out for another reason, such as a urine test or vaginal swab.

Risks in pregnancy

If you have group B strep while you're pregnant:

your baby will usually be healthy

there's a small risk it could spread to your baby during labour and make them ill - this happens in about 1 in 1,750 pregnancies

there's an extremely small risk you could miscarry or lose your baby

What to do if you're worried

If you're worried about group B strep, speak to your midwife or GP for advice.

Talk to them about the risks to your baby and ask their advice about whether to get tested.

Routine testing is not currently recommended and tests are rarely done on the NHS, but you can pay for one privately.
Find out more about getting tested for group B strep on the Group B Strep Support website
What happens if you have group B strep

If tests find group B strep, or you've had a baby that's been affected by it before, you may need extra care and treatment.

You may be advised to:

speak to your midwife about your birth plan - they may recommend giving birth in hospital

contact your midwife as soon as you go into labour or your waters break

have antibiotics into a vein during labour - this can significantly reduce the risk of your baby getting ill

stay in hospital for at least 12 hours after giving birth so your baby can be monitored - this is not always necessary

Group B strep in babies

If you had group B strep during pregnancy, there's a small risk it could spread to your baby and make them very ill.

If this happens, it's usually soon after they're born. Your baby may be monitored in hospital for up to 12 hours to check for any problems.

They'll be given antibiotics into a vein if they develop symptoms.

What to look for after leaving hospital

Occasionally, symptoms of a group B strep infection can develop up to 3 months after birth.

Call 999 or go to A&E if your baby gets any of these symptoms:

being floppy or unresponsive

grunting when breathing, or working hard to breath when you look at their chest or stomach

very fast or slow breathing

a very fast or slow heart rate

an unusually high or low temperature

changes in their skin colour or blotchy skin

not feeding well or vomiting milk up

an unusually fast or slow heart rate

They may need treatment with antibiotics in hospital immediately.

Risks in babies

Most babies with a group B strep infection make a full recovery if treated.

Some babies may develop serious problems like sepsis or meningitis.

This can cause lasting problems like hearing loss or loss of vision. Sometimes it can be fatal.

More information

Page last reviewed: 12 March 2021
Next review due: 12 March 2024

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Group B strep is a type of bacteria called streptococcal bacteria. It's very common in both men and women and usually lives in the bottom (rectum) or vagina. It affects 2 to 4 women in 10. Group B strep is normally harmless and most people will not realise they have it.

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Group B Strep information in different language - Group B Strep Support

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Group B Strep information in different language - Group B Strep Support

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List of Languages available:

Arabic

Bengali

Chinese

English

French

Hebrew

Latvian

Lithuanian

Polish

Portuguese

Punjabi

Romanian

Somali

Urdu

Welsh

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Group B Strep information in your own language - Group B Strep Support

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The information leaflet Group B Streptococcus (GBS) in pregnancy and newborn babies is now available in 14 languages in addition to English.

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Click on the picture for more information.

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Why general anaesthetic is used

A general anaesthetic is used for many different types of operation (surgery) or procedure.

It's done so that during the procedure:

you're asleep (unconscious)

you do not feel any pain

you're not aware of what's happening

you're not moving and your muscles are relaxed, so doctors can treat you safely

A general anaesthetic is used if other types of anaesthetic are not suitable. These include a local anaesthetic or regional anaesthetic (where you're awake but the part of your body being treated is numbed) or sedation (where you're relaxed but not unconscious).

How to prepare for having a general anaesthetic

If you're going to have a general anaesthetic, you'll be given advice about things you can do to prepare.

If your procedure is planned in advance, you can help your recovery and help make your treatment more successful by:

making sure any long-term conditions are managed as well as possible, such as diabetes, high blood pressure or anaemia

keeping as physically active as possible, including doing exercise that raises your heart rate if you can

stopping smoking

getting treatment for any problems with your teeth, to reduce the risk of them being damaged by the breathing tube that's used during the general anaesthetic

Pre-operative assessment

You'll usually be asked to go to an appointment a few weeks before your procedure (a pre-operative assessment). This is to make sure you're well enough to have the procedure and the general anaesthetic.

It might involve having tests such as blood tests, an X-ray, an electrocardiogram (ECG) to check your heart and a fitness test.

You might also meet the specialist doctor (anaesthetist) who will give you the general anaesthetic when you have your operation or procedure.

Tell the doctor or nurse if:

you take any medicines

you have any health conditions

you've ever had an allergic reaction to a general anaesthetic or any other medicine

you have any concerns about the procedure, for example, if you have a fear of needles

Before your general anaesthetic

You'll be given advice about what to do in the few days before your general anaesthetic. It's important to follow instructions you're given about:

when to stop eating and drinking, usually a few hours before the general anaesthetic - this is to make sure your stomach is empty

whether to keep taking your usual medicines

washing - you may be given a disinfecting shower gel to use for a few days

removing jewellery, piercings and nail varnish

What happens when you have a general anaesthetic

A general anaesthetic is given in hospital. The anaesthetic team, led by a specialist doctor (consultant anaesthetist), will monitor you and adjust the anaesthetic when they need to.

You may be given other medicines before the general anaesthetic. This may include medicines to help you relax, reduce stomach acid, stop you feeling sick or help with pain.

The type of general anaesthetic that's used depends on the procedure you're having and what's best for you. It can be given as:

an injection through a small tube (cannula) into a vein in your arm

a gas that you breathe in through a mask - this is usually only used if it's difficult to find a vein in your arm

The general anaesthetic starts to work quickly. You'll fall asleep (become unconscious) within about a minute and will not be aware of anything until you wake up after the procedure.

During the procedure an anaesthetist will stay with you all the time. They will:

monitor your heart rate, blood pressure and oxygen levels

put a tube into your throat while you're asleep to help you breathe

give you fluids through a drip into a vein

How long you're asleep (unconscious) depends on the type of procedure you're having. It can be from a few minutes to several hours.

You'll wake up either in the operating theatre after the procedure is over, or in the recovery room.

Recovering from a general anaesthetic

After a general anaesthetic you'll start to wake up soon after the medicine is stopped at the end of the procedure.

You'll feel drowsy at first. You may have an oxygen mask to help you breathe. This will be removed when you're fully awake. Staff will look after you and give you medicines for any pain or sickness (nausea).

You can usually start eating and drinking again when you feel ready.

The effects of a general anaesthetic can last around 24 hours. How long it takes to fully recover depends on the type of procedure you had.

You may be able to go home within a few hours. Someone will need to collect you from the hospital and take you home by car or taxi.

What to do while you recover

You'll be given advice about what to do and things to avoid for at least 24 hours after having a general anaesthetic.

Do

have someone stay with you

eat and drink as usual, unless your hospital team gives you different advice

move around and keep active if you can - follow advice you're given about when to go back to your usual activities

contact the hospital if you have any concerns after you go home

be careful about things like posting on social media, as you may not be thinking clearly

Side effects of a general anaesthetic

A general anaesthetic can cause side effects, including:

feeling thirsty

feeling drowsy

a hoarse voice or a sore throat caused by the tube in your throat during the procedure

shivering

feeling sick or being sick

pain, bruising or soreness from the injection or from lying still during the procedure

feeling confused or memory loss

Side effects will usually get better within a few minutes or hours. You may need medicines to help with side effects, such as pain or sickness.

Possible complications of a general anaesthetic

Complications can happen during or after a general anaesthetic, but these are rare. Your doctor will explain the risks to you before the procedure.

Possible complications can include:

a serious allergic reaction to the anaesthetic

breathing difficulties

a chest infection

damage to your teeth or mouth from the breathing tube

damage to your eyes

damage to your nerves, which can cause numbness, tingling or weakness

longer lasting confusion, particularly in older people

Your care team at the hospital will check for any complications and give you treatment if you need it.

It's very rare to become accidentally aware or conscious during the procedure. The anaesthetist will monitor you carefully to make sure you have the right amount of anaesthetic to keep you asleep.

More information

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Find out about having a general anaesthetic, including how to prepare for it, what happens, recovery and side effects.

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We believe every woman should have safe, compassionate care throughout her pregnancy, birth and early motherhood.

Birth Companions works to improve the lives of women and babies who experience inequality and disadvantage.
We provide services for women and babies, and work to create positive change in the maternity, criminal justice, social care and immigration systems.

Birth Companions is here to ensure every mother can give her baby the best possible start in life, whatever her circumstances.

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We believe every woman should have safe, compassionate care throughout her pregnancy, birth and early motherhood.

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Preventing Traumatic Head Injury in Babies by PHE in Partnership with ICON

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The Hillingdon Hospitals NHS Foundation Trust

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Online Webinar: Scan the QR Code above for event dates and to book your place.

These classes will cover:

Exercising safely in pregnancy

The role of the pelvic floor muscles and how to do pelvic floor exercises

Bladder and bowel symptoms you may experience during pregnancy and post birth

Perineal tears and how to reduce it

What to expect after birth

Getting back to yourself and having sex post birth

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POSTER Pelvic Health Awareness and Education Event 2025

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Five (5) essential things you do everyday to help your child's growing brain

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Five (5) essential things you do everyday to help your child's growing brain

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This process begins once baby is born and starts the Golden Hour.

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Research information about feeding your baby. Being prepared can make your feeding experience better.

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Colostrum can be harvested from 36 weeks of pregnancy and can help protect your baby.

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Before staring the steps above it is recommended to:

- Have a warm bath or shower or

- Use a warm compress on both breasts

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Prevention of Sudden Infant Death Syndrome (SIDS) 

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Prevention of Sudden Infant Death Syndrome (SIDS) 

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It is important to make sure that your baby’s room is a comfortable temperature – not too hot or too cold. The chance of SIDS is higher in babies who get too hot, so try to keep the room temperature between 16 -20°C

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Babies cry, you can cope When babies cry it can be stressful and overwhelming. Help is out there and all you need to do is ask. Latest news Testimonials

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Breastfeeding at Hospital/ Home Birth/ MLU

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Breastfeeding at Hospital/ Home Birth/ MLU

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At Hillingdon Hospital we encourage you to breastfeed your baby as this is the healthiest choice for your baby and you. Breastfeeding reduces the chance of your baby developing:

Tummy upsets

Chest, urinary and ear infections

Allergies

Diabetes

Obesity

Sudden Infant Death Syndrome (SIDS)

Mothers who breastfeed have reduced rates of:

Breast cancer

Ovarian cancer

Osteoporosis in later life

Cardiovascular disease

Midwives, Maternity Support Workers and Breastfeeding Volunteers will be able to support you with learning to feed your baby.

You can read information and advice about how to breastfeed on the NHS website or go to Infant feeding (padlet.com) for more information.

Infant Feeding Support Available:

Our infant feeding team is available on the postnatal ward from Monday to Friday: 01895 279723

National Breastfeeding Helpline: 0300 100 0212

Drop in Sessions at Children Centres

Health Visitor - Duty Line: 01895 891302;

09:00am-05:00pm Mon – Friday (closed Weekends and Bank Holidays)

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How to Give Baby CPR - First Aid Training - St John Ambulance

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ICON Resources - Available in Translatable Resources

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ICON Resources - Available in Translatable Resources

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Printed resources If you would like to purchase printed options of ICON resources please use the link below to visit our print partner.

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First aid: What to do if your baby is choking

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First aid: What to do if your baby is choking

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What to do if Your Baby is Choking - First Aid Training - St John Ambulance

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How to store breast milk

Breast milk can be stored in a sterilised container, or special storage bags - remember to label and date it.

Store it in small quantities to avoid wasting any. Your breast milk can then be kept:

at the back of the fridge - not the door - for up to 8 days (at 4C or colder)

in the ice compartment of the fridge for up to 2 weeks

in the freezer for up to 6 months (at -18C or colder)

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It's important to store breast milk correctly so that it's safe to feed your baby. Find out the best ways to store breast milk.

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Research information about feeding your baby. Being prepared can make your feeding experience better.

Click here to see our 'Infant Feeding' padlet for lots more information about infant feeding.

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We offer a range of free antenatal education sessions for all parents booked at Hillingdon Hospital. This Padlet is to be used as a resource only in addition to attending your antenatal classes, which help parents to prepare for pregnancy, labour, birth and the early days after baby is born.

We hope you find these resources helpful. If you notice any broken links or inaccurate information please e-mail thh.welcomingourbaby@nhs.net

Thank you.

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24 hours/ 7 days a week help with breastfeeding

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24 hours/ 7 days a week help with breastfeeding

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Immunisation Nurse

Opening times: 08:00am - 15:30hrs

Walk in Service (No appointment is required)

Please call 01895279838 or

E-mail: thh.maternityimmunisations@nhs.net

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Immunisation Nurse

Opening times: 08:00am - 15:30hrs

Walk in Service (No appointment is required)

Please call 01895279838 or

E-mail: thh.maternityimmunisations@nhs.net

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IHV - Promoting excellence in health visiting practice to benefit all children, families and communities

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New NHS vaccination programmes against respiratory syncytial virus (RSV) - IHV

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From 1 September 2024, there will be two new vaccination programmes against respiratory syncytial virus (RSV) - during pregnancy (for infant protection) and older adults in England, Wales and Northern Ireland, with the rollout in Scotland already commenced in August. The new vaccinations have been introduced following guidance from the Joint Committee on Vaccination and

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Immunisation Nurse

Opening times: 08:00am - 15:30hrs

Walk in Service (No appointment is required)

Please call 01895279838 or

E-mail: thh.maternityimmunisations@nhs.net

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Infant Feeding - Mothers and caregivers Videos - Global Health Media Project

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Infant Feeding - Mothers and caregivers Videos - Global Health Media Project

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Select the language required at the top of the page to view the videos.

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Mothers and caregivers Videos - Global Health Media Project

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© 2022 Global Health Media Project | a 501(c)(3) nonprofit

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How is the placenta delivered?

What can parents do with their placenta?

Stem Cell Collection

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NHS Hospitals you can donate cord blood/stem cells

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NHS Hospitals you can donate cord blood/stem cells

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Cord Blood Bank - NHS Blood and Transplant

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You can donate to the NHS Cord Blood Bank at six hospitals where we have dedicated, trained staff who work throughout the day and night. We have deliberately targeted our resources so that we collect from hospitals with the widest ethnic mix.

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Video - How to safely change a baby's nappy

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Video - How to safely change a baby's nappy

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The Hillingdon Hospitals NHS Foundation Trust