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If you have a scan related query or to change your scan appointment, please contact: 

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If you have a scan related query or to change your scan appointment, please contact: 

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thh.antenatalultrasound@nhs.net
or
01895 279 905

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Please note: We are unable to guarantee that a female sonographer will be available at scans

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Please note: We are unable to guarantee that a female sonographer will be available at scans

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If a female sonographer is not available, and you do not wish to be scanned by a male, then your scan will be rebooked for another day

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Screening tests for you and your baby | NHS

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Translates images instantly into over 100 languages - this can be used to navigate things such as websites and posters  via your phone

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See our 'Reduced fetal movements in languages other than English' padlet

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Hillingdon Perinatal Mental Health Services

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Hillingdon Perinatal Mental Health Services

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Hillingdon Perinatal Mental Health Service :: Central and North West London NHS Foundation Trust

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The Hillingdon Perinatal Mental Health Service works in partnership with The Hillingdon Hospitals NHS Foundation Trust Maternity Service, primary care community services including community midwifery, health visitors and GPs, Improving Access to Psychological Therapies (IAPT), Hillingdon Children and Adult social care services and voluntary organisations.

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@hillingdonmaternity on Instagram

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Please use the website links if you have any questions. For clinical help, please contact maternity triage. This page is for information only.

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Available in:
34 different languages

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You can get depression when you are pregnant. This is called antenatal depression.
With help and support most people with antenatal depression are able to manage the condition.

If antenatal depression is not treated symptoms can get worse and may continue after the baby is born ( postnatal depression). So it is important to get help if you need it.

Symptoms

Some mood changes are normal in pregnancy, like feeling tired or irritable. But if you're feeling low and hopeless all the time, and no longer enjoy the things you used to, talk to a midwife or GP.

Signs and symptoms of antenatal depression include:

feeling sad, a low mood, or tearful a lot of the time

feeling irritable, or getting angry easily

losing interest in other people and the world around you

not wanting to eat or eating more than usual

negative thoughts, such as worrying you will not be able to look after your baby

feeling guilty, hopeless or blaming yourself for your problems

having problems concentrating or making decisions

Contact a GP immediately if:

You, or a friend or relative who is pregnant:

starts hearing or seeing things that are not real (hallucinations)

develop strong beliefs not shared by others (delusions)

If it is not possible to contact a GP, call NHS 111 or your local out-of-hours service.

Treatment

Speak to a GP or your midwife as soon as possible if you think you might have antenatal depression.

With appropriate treatment and support, most people are able to manage their symptoms, though it can take time.

Self-help

A GP or midwife may recommend a number of self-help tips that can help improve your mood. These include:

Psychological therapy

A GP may recommend a self-help course or refer you for therapy, such as cognitive behavioural therapy (CBT) or counselling.

It may take several weeks to see a therapist or counsellor. CBT can be done 'face to face' with a counsellor or online, using a computer.

A GP should be able to explain more about different ways you can have CBT.

Antidepressants

Antidepressant medicines may be recommended for you if you have moderate or severe depression and:

you do not want to use psychological therapy

psychological therapy has not worked for you

you prefer to take medicine

Some people may benefit from having both psychological therapy and taking antidepressants.

Talk to a GP (or doctor in charge of your care) about antidepressants that are safer to take during pregnancy.

The doctor will usually offer the type with the lowest risk for you and your baby.

Your doctor can explain the risks and the benefits, and will help you decide which treatment is best for you and your baby.

Find out more about antidepressants and pregnancy on the Mind website.

You can search for your medicine on Bumps medicines you can use in pregnancy A-Z

Further support

Other mental health conditions

Other mental health conditions that can develop during pregnancy, or get worse because you are pregnant, include:

anxiety disorders, including generalised anxiety disorder (GAD), social anxiety, post-traumatic stress disorder (PTSD) and panic disorder

obsessive compulsive disorder (OCD), where intrusive, unwanted and unpleasant thoughts, images or urges repeatedly enter a person's mind, causing them anxiety and leading to repetitive behaviours

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You can get depression when you are pregnant. This is called antenatal depression. With help and support most people with antenatal depression are able to manage the condition. If antenatal depression is not treated symptoms can get worse and may continue after the baby is born ( postnatal depression).

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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 more information

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See all the wonderful things Hillingdon Maternity has made

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The 20-week screening scan looks for some physical abnormalities in the baby. Find out what happens at this screening scan, whether you have to have it, and what to expect if the scan shows a possible problem.

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Personalised care plans are important to ensuring that your voice is heard and that the right plans are made for you and your baby.

Your midwife will complete these for your pregnancy, your birth and the postnatal period.

Your thoughts for care plans can be updated in the mum and baby app and then discussed with your midwife at appointments

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See our 'multiple pregnancy' padlet for information about twins, triplets and more

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Your baby can hear you from around 16 weeks. Babies hear their mother’s voices most clearly, but anyone can talk and sing to them – your baby will love to hear from anyone

Talking and singing to your baby helps them with getting to know voices that will help them feel safe and secure after birth

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Please ask your community midwife for your MatB1 from 20 weeks

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If you need help with stopping smoking, please ask your midwife to refer you to one of our clinics

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Smoking and your unborn baby

Protecting your baby from tobacco smoke is one of the best things you can do to give your child a healthy start in life. It can be difficult to stop smoking, but it's never too late to quit.

Every cigarette you smoke contains over 4,000 chemicals, many of which are dangerous, so smoking when you are pregnant harms your unborn baby. Cigarettes can restrict the essential oxygen supply to your baby. As a result, their heart must beat harder every time you smoke.

Benefits of stopping smoking in pregnancy

Stopping smoking will help both you and your baby immediately. Harmful gases, such as carbon monoxide, and other damaging chemicals will clear from your body. When you stop smoking:

you will reduce the risk of complications in pregnancy and birth

you are more likely to have a healthier pregnancy and a healthier baby

you will reduce the risk of stillbirth

your baby is less likely to be born too early and have to face the breathing, feeding and health problems that often go with being premature

your baby is less likely to be born with a low birth weight. Babies of smokers are, on average, lighter than other babies, which can cause problems during and after labour. For example, they are more likely to have problems keeping warm and are more likely to get infections

you will reduce the risk of sudden infant death syndrome (SIDS), also known as "cot death"

Stopping smoking now will also help your baby later in life. Children whose parents smoke are more likely to suffer from asthma and other serious illnesses that may need hospital treatment.

The sooner you stop smoking, the better. But even if you stop in the last few weeks of your pregnancy this will benefit you and your baby.

Secondhand (passive) smoke harms your baby

If your partner or anyone else who lives with you smokes, their smoke can affect you and your baby before and after their birth. You may also find it more difficult to stop if someone around you smokes.

Secondhand smoke can also reduce your baby's birthweight and increase the risk of sudden infant death syndrome (SIDS), also known as "cot death". Babies whose parents smoke are more likely to be admitted to hospital for bronchitis and pneumonia during their first year.

To find out more about quitting and to get support, your partner can call the National Smokefree helpline on 0300 123 1044 from 9am to 8pm Monday to Friday, and 11am to 4pm Saturday and Sunday.

Nicotine replacement therapy

You can use nicotine replacement therapy (NRT) during pregnancy if it will help you stop smoking and you're unable to stop without it. Stop smoking tablets such as Champix (varenicline) or Zyban (bupropion) are not recommended during pregnancy and are not currently available.

NRT contains only nicotine and none of the damaging chemicals found in cigarettes, so it is a much better option than continuing to smoke. It helps you by giving you the nicotine you would have had from a cigarette.

You can be prescribed NRT during pregnancy by a GP or an NHS stop smoking adviser. You can also buy it over the counter without a prescription from a pharmacy.

NRT is available as:

If you have pregnancy-related nausea and vomiting, patches may be a better solution.

NRT patches should be used for no more than 16 hours in any 24-hour period. The best way to remember this is to remove the patch at bedtime.

Before using any of these products, speak to a midwife, GP, a pharmacist or a specialist stop smoking adviser.

By getting this specialist advice you can be sure that you're doing the best for your baby and for you.

Call the National Smokefree helpline on 0300 123 1044 from 9am to 8pm Monday to Friday, and 11am to 4pm Saturday and Sunday.

Remember, you are twice as likely to be successful at quitting if you get some support from a trained adviser.

Liquorice-flavoured nicotine products

Pregnant women are advised to avoid liquorice-flavoured nicotine products. Although there is no known risk with small amounts of liquorice flavouring, the manufacturers advise caution.

This caution is based on information about the adverse effects associated with excessive amounts of liquorice root. As other flavours are available, pregnant women are advised to choose an alternative, such as fruit or mint.

Find out more about stop smoking treatments.

E-cigarettes in pregnancy

E-cigarettes are fairly new and there are still some things we do not know. However, current evidence on e-cigarettes indicates they are much less risky than smoking.

Cigarettes deliver nicotine along with thousands of harmful chemicals. E-cigarettes allow you to inhale nicotine through a vapour rather than smoke. By itself, nicotine is relatively harmless.

E-cigarettes do not produce tar or carbon monoxide, the 2 main toxins in cigarette smoke. Carbon monoxide is particularly harmful to developing babies. The vapour from an e-cigarette does contain some of the potentially harmful chemicals found in cigarette smoke, but at much lower levels.

If using an e-cigarette helps you to stop smoking, it is much safer for you and your baby than continuing to smoke.

Unlike nicotine replacement therapy (NRT), such as patches or gum, e-cigarettes are not available on an NHS prescription. If you want to use an e-cigarette, you can still get free expert help from a stop smoking adviser.

Call the National Smokefree helpline on 0300 123 1044 for more information, or ask a midwife to refer you.

Find out more about using e-cigarettes to stop smoking.

National Smokefree helpline

The National Smokefree helpline offers free help, support and advice on stopping smoking and can give you details of local support services.

You can also sign up to receive ongoing advice and support at a time that suits you.

National Smokefree helpline: 0300 123 1044

9am to 8pm Monday to Friday, and 11am to 4pm Saturday and Sunday.

To find your nearest NHS Stop Smoking service talk to:

a midwife

a health visitor

a nurse at your GP surgery

a pharmacist

NHS Stop Smoking services can offer 1-to-1 or group sessions with trained stop smoking advisers and may have a pregnancy stop smoking specialist.

They can also offer advice about dealing with stress, weight gain and support the use of NRT (such as patches or gum), if appropriate, to help you manage your cravings.

Find out more about the effects of smoking in pregnancy, and getting support to quit, at Better Health: Start for Life

Find stop smoking services near you.

Get Better Health: Start for Life's pregnancy and baby emails

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

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Find out why you should stop smoking in pregnancy, and how smoking can harm your unborn baby. Plus where to go for support to help you quit.

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Visit this page to see if you are eligible for Healthy Start vouchers towards purchasing milk, fruit and vegetables

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Applying online

If you get Universal Credit, you can apply online if:

you're more than 10 weeks pregnant or have at least one child under 4 years old

your family's monthly 'take-home pay' (also called 'earned income') is £408 or less from employment

If you get Child Tax Credit, you may be eligible for Healthy Start if:

your family's annual income is £16,190 or less

you do not get Working Tax Credit

Most people who get Child Tax Credit can apply online. You can apply online if you're either:

more than 10 weeks pregnant and have children under the age of 4

not pregnant but have children under the age of 4

If you're more than 10 weeks pregnant and have other children who are all aged 4 or older, you'll need to apply by email or phone.

To apply online, you'll need your:

name

address

date of birth

National Insurance number

baby's due date (if you're pregnant)

benefit award letter if you're over 18 - make sure you enter the exact details shown on your benefit award letter

Make sure that your details are up to date with HMRC or DWP - you may wish to contact them to check or update your details before you apply.

Applying by email or phone

You can apply by email or phone if you're more than 10 weeks pregnant, or have at least one child under 4 years old, and get either:

Income Support

Income-based Jobseeker's Allowance

Pension Credit (which includes the child addition)

You can also apply by email or phone if you're more than 10 weeks pregnant and either:

under 18 years old and not getting any benefits

getting Income-related Employment and Support Allowance (ESA)

If you get Child Tax Credit, you'll need to apply by email or phone if you're more than 10 weeks pregnant and have other children who are all aged 4 or older.

You can apply by either:

Phone lines are open 8am to 6pm Monday to Friday (except public holidays). Find out about call charges (opens in a new tab).

If you're not a British citizen but your child is

You might be eligible for Healthy Start depending on your immigration status.

You can get Healthy Start if all the following are true:

Your biometric residence permit (BRP) or your online immigration status (opens in a new tab) will say if you cannot claim public funds. You might also have a letter from the Home Office about it.

To apply for Healthy Start, ask for an application form via email. Only use this email address if you think you cannot claim public funds because of your immigration status.
Healthystartclaim@dhsc.gov.uk

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If you get Universal Credit, you can apply online if: you're more than 10 weeks pregnant or have at least one child under 4 years old your family's monthly 'take-home pay' (also called 'earned income') is £408 or less from employment If you get Child Tax Credit, you may be eligible for Healthy Start if: your family's annual income is £16,190 or less you do not get Working Tax Credit Most people who get Child Tax Credit can apply online.

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Click here to view our 'Pelvic Health' padlet

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A whooping cough vaccine is recommended between 16 - 32 weeks

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The whooping cough vaccination is now recommended for all pregnant women, ideally between 16 and 32 weeks pregnant. Find out how this vaccine may help protect your baby’s health.

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Diabetes Specialist Midwives

01895 279678

Antenatal Clinic

01895 279442

Diabetic Clinic

01895 279882

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The Hillingdon Hospitals NHS Foundation Trust

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The Hillingdon Hospitals NHS Foundation Trust

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The majority of women experience very normal pregnancies and birth journeys and we have a full range of options for maternity care. As well as our fantastic midwifery-led care we also provide an excellent obstetric model of care to include specialist support for more complex pregnancies and health conditions with an excellent fetal medicine unit.

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** Please note: we do not currently have a birthing pool available within the hospital building, people choosing a birthing pool during a homebirth are unaffected **

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The Hillingdon Hospitals NHS Foundation Trust

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Hillingdon Hospital Maternity Virtual Tour

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Your flu vaccine can be given safely at any stage in your pregnancy

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It's recommended that all pregnant women have the flu vaccine, whatever stage of pregnancy they're at. It's free for pregnant women.

Why are pregnant women advised to have the flu vaccine?

A flu jab will help protect both you and your baby.

There is good evidence that pregnant women have a higher chance of developing complications if they get flu, particularly in the later stages of pregnancy.

One of the most common complications of flu is bronchitis, a chest infection that can become serious and develop into pneumonia.

If you have flu while you're pregnant, it could cause your baby to be born prematurely or have a low birthweight, and may even lead to stillbirth or death.

Is the flu vaccine safe in pregnancy?

Yes. Studies have shown that it's safe to have a flu vaccine during any stage of pregnancy, from the first few weeks up to your expected due date.

Women who have had a flu vaccine while pregnant also pass some protection on to their babies, which lasts for the first few months of their lives.

It's safe for women who are breastfeeding to have a flu vaccine if they're eligible (for example, because of a long-term health condition).

When should I have the flu jab?

The best time to have a flu vaccine is in the autumn, before flu starts circulating. If you've missed this time, you can be vaccinated later in the winter although it's best to get it earlier.

Do not worry if you find that you're pregnant later in the flu season - you can have the vaccine then if you have not already had it.

How do I get the flu vaccine?

Contact your midwife or GP surgery to find out where you can get a flu vaccine. It's a good idea to get vaccinated as soon as possible after the vaccine becomes available in September.

In some areas, you can get a flu vaccine at an antenatal clinic. In others, you'll need an appointment at a GP surgery or a pharmacy that offers the flu vaccine.

If I had the flu jab last year, do I need to have it again now?

Yes, because the viruses that cause flu change every year. This means the flu strains the vaccines are designed to prevent this year may be different from last year.

If you had the flu vaccine during the last flu season because you were pregnant (same pregnancy or a previous pregnancy), or because you're in a vulnerable group, you need to have it again this year.

Find out more about how the flu vaccine works.

Will the flu jab give me flu?

No. Flu jabs do not contain any live viruses, so cannot cause flu. Some people get a slightly raised temperature and aching muscles for a couple of days afterwards, and you may feel sore at the injection site.

Find out more about flu vaccine side effects.

Can I have the flu jab at the same time as the whooping cough vaccine?

Yes, you can have a flu vaccine at the same time as the whooping cough vaccine, but do not delay your flu jab so you can have both at the same time.

Pregnant women are at risk of severe illness from flu at any stage of pregnancy, so you need to have a flu vaccine as soon as possible.

The best time to get vaccinated against whooping cough is from 16 weeks up to 32 weeks of pregnancy.

If you miss having the vaccine for any reason, you can still have it up until you go into labour.

Find out more about the whooping cough vaccine in pregnancy.

I'm pregnant and think I have flu. What should I do?

Talk to a GP as soon as possible. If you do have flu, there's a prescribed medicine you can take that might help, or reduce your risk of complications, but it needs to be taken very soon after symptoms appear.

More information

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It's recommended that all pregnant women have the flu vaccine, whatever stage of pregnancy they're at. It's free for pregnant women. A flu jab will help protect both you and your baby. There is good evidence that pregnant women have a higher chance of developing complications if they get flu, particularly in the later stages of pregnancy.

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Your first, second or booster dose of the Covid-19 vaccine can be given safely at any time in your pregnancy

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If you're pregnant, it's important to get vaccinated to protect you and your baby. The antibodies your body produces in response to the vaccine can also give your baby protection against COVID-19.

You're at higher risk of getting seriously ill from COVID-19 if you're pregnant. If you get COVID-19 late in your pregnancy, your baby could also be at risk.

Evidence shows that most pregnant women with COVID-19 who need hospital treatment or intensive care in the UK have not been vaccinated.

If you're pregnant and have not had your first 2 doses and booster dose yet, it's important to get your vaccinations as soon as possible.

If you're pregnant and have been vaccinated, you should have a seasonal booster dose this autumn.

It's safe to have the vaccine during any stage of pregnancy, from the first few weeks up to your expected due date. You do not need to delay vaccination until after you have given birth.

Getting vaccinated against COVID-19 reduces the risk of having a stillbirth.

There's no evidence COVID-19 vaccination increases the risk of having a miscarriage, pre-term birth or other complications in your pregnancy.

The COVID-19 vaccines do not contain any live viruses and cannot give you or your baby COVID-19.

They have been widely used during pregnancy in other countries and there have been no safety concerns. In the UK, over 100,000 pregnant women have been vaccinated.
Find out how to get a COVID-19 vaccine

You'll be able to discuss having a COVID-19 vaccine during pregnancy at your vaccination appointment.

You can also speak to a GP or your maternity team for advice.

You may find the COVID-19 vaccination in pregnancy decision aid from the Royal College of Obstetricians and Gynaecologists (PDF, 405KB) helpful.

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If you're pregnant, it's important to get vaccinated to protect you and your baby. The antibodies your body produces in response to the vaccine can also give your baby protection against COVID-19. You're at higher risk of getting seriously ill from COVID-19 if you're pregnant.

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You are able to self refer on the following email address:

thh.hillingdonhomebirthteam@nhs.net

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Click here to see our 'Infant Feeding' padlet for further information

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See all the wonderful things Hillingdon Maternity has made

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Find out what food and drink you can have and what you should avoid or be careful with during pregnancy, such as some cheeses, meats, fish, eggs, nuts, caffeine and alcohol.

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A maternity prescription exemption entitles you to free prescriptions and free NHS dental treatment. It is valid during your pregnancy and for 1 year after your baby is born

Ask your midwife to complete an online form for your exemption certificate

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Learning how to look after your baby is important at this stage to make sure you're fully prepared for your new arrival. Dad's should get involved too!
You might want to consider watching videos, researching and/or practicing:-

How to change a nappy

Understanding feeding

How to bath your baby

Caring for your baby's skin

Care of the umbilical cord

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Hillingdon caring for your baby tutorials

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Hillingdon caring for your baby tutorials

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Share your videos with friends, family, and the world

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North West London birth preparation videos

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North West London birth preparation videos

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North West London Pregnancy, Birth and Beyond

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North West London maternity hospitals have worked together to produce a series of videos that cover all the topics usually presented during traditional face ...

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Know the signs

There are several signs that labour might be starting, including:

contractions or tightenings

a "show", when the plug of mucus from your cervix (entrance to your womb, or uterus) comes away

backache

an urge to go to the toilet, which is caused by your baby's head pressing on your bowel

your waters breaking

The early (latent) stage of labour can take some time.

Latent phase of labour

The start of labour is called the latent phase. This is when your cervix becomes soft and thin, and starts opening for your baby to be born. This can take hours or sometimes days.

You'll probably be advised to stay at home during this time. If you go to the hospital or maternity unit, they may suggest you go back home.

Find out more about the stages of labour and what you can do at home during the latent phase.

Call your midwife if you're unsure or worried about anything.

What do contractions feel like

When you have a contraction, your womb tightens and then relaxes. For some people, contractions may feel like extreme period pains.

You may have had contractions during your pregnancy, particularly towards the end. These tightenings are called Braxton Hicks contractions and are usually painless.

Your contractions tend to become longer, stronger and more frequent as your labour progresses. During a contraction, the muscles tighten and the pain increases. If you put your hand on your abdomen, you'll feel it getting harder; when the muscles relax, the pain fades and you will feel the hardness ease.

The contractions are pushing your baby down and opening the entrance to your womb (the cervix), ready for your baby to go through.

Your midwife will probably advise you to stay at home until your contractions become frequent.

Call your midwife or maternity unit for guidance when your contractions are in a regular pattern and:

last at least 60 seconds

come every 5 minutes or

you think you are in labour

Read more information on when to go to hospital

Backache often comes on in labour

You may get backache or a heavy, aching feeling.

A "show" can signal the start of labour

During pregnancy, there's a plug of mucus in your cervix. This mucus comes away just before labour starts, or when in early labour, and it may pass out of your vagina. This sticky, jelly-like pink mucus is called a show.

It may come away in 1 blob or in several pieces. It's pink because it contains a small amount of blood.

If you're losing more blood, it may be a sign something is wrong, so phone your hospital or midwife straight away.

A show indicates that the cervix is starting to open. Labour may quickly follow or may take a few days. Sometimes there is no show.

What happens when my waters break

It's likely your waters will break during labour, but it can also happen before labour starts.

Your baby develops and grows inside a bag of fluid called the amniotic sac. When it's time for your baby to be born, the sac usually breaks and the amniotic fluid drains out through your vagina. This is your waters breaking. Sometimes when you're in labour, a midwife or doctor may offer to break your waters.

If your waters break naturally, you may feel a slow trickle or a sudden gush of water you cannot control. To prepare for this, you could keep a sanitary towel (but not a tampon) handy if you're going out, and put a protective sheet on your bed.

Amniotic fluid is clear and pale. Sometimes it's difficult to tell amniotic fluid from urine. When your waters break, the water may be a little bloodstained to begin with.

Tell your midwife immediately if:

the waters are smelly or coloured

you're losing blood

This could mean you and your baby need urgent attention.

If your waters break before labour starts, call your midwife. Use a sanitary pad (not a tampon) so your midwife can check the colour of the waters.

If labour does not start after your waters break

It's usual to go into labour within 24 hours of the waters breaking. You'll be offered an induction if you do not because, without amniotic fluid, there's an increased risk of infection for your baby.

Until your induction, or if you choose to wait for labour to start naturally, tell your midwife immediately if:

your baby moves less than usual

there's any change in the colour or smell of any fluid coming from your vagina

You should take your temperature every 4 hours when you're awake, and tell your midwife if it's raised. A raised temperature is usually above 37.5C, but you may need to call before this - check with your midwife.

There's no evidence that having a bath or shower after your waters have broken increases your risk of infection, but having sex might.

How to cope when labour begins

At the beginning of labour, you can:

walk or move about, if you feel like it

drink fluids - you may find sports (isotonic) drinks help keep your energy levels up

have a snack, if you feel like it

try any relaxation and breathing exercises you've learned to deal with contractions as they get stronger and more painful - your birth partner can help by doing these with you

have your birth partner rub your back - this can help relieve pain

take paracetamol according to the instructions on the packet - paracetamol is safe to take in labour

have a warm bath

Find out what happens during labour and birth, and what you can do for pain relief in the early stages of labour.

Get Start4Life pregnancy and baby emails

For information and advice you can trust, sign up for weekly Start4Life pregnancy and baby emails.

Community content from HealthUnlocked

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There are several signs that labour might be starting, including: contractions or tightenings a "show", when the plug of mucus from your cervix (entrance to your womb, or uterus) comes away backache an urge to go to the toilet, which is caused by your baby's head pressing on your bowel your waters breaking The early (latent) stage of labour can take some time.

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See our 'Antenatal education' page for more information about giving birth and beyond

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The more relaxed you are at home, the more likely it is that you will progress in labour.

Try turning down the lights and creating a relaxing environment around you. You could also use the following pain relief methods before you come into hospital:-

*TENS machine
*Warm bath
*Paracetamol
*Breathing techniques

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Unicef UK Baby Friendly Initiative | Meeting baby for the first time

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The time it takes to labour can vary. Here is some information to help you understand the process of labour

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Latent stage of labour

The latent stage of labour is where your cervix starts to soften and open (dilate) so your baby can be born.

You may begin to feel irregular contractions, but it can take many hours, or even days, before you're in established labour. It's usually the longest stage of labour.

At this stage, your contractions may range from being slightly uncomfortable to more painful. There's no set pattern to how many contractions you get or how long they last.

During the latent stage, it's a good idea to have something to eat and drink because you'll need energy for when labour is established.

If your labour starts at night, try to stay comfortable and relaxed. Sleep if you can.

If your labour starts during the day, stay upright and gently active. This helps your baby move down into your pelvis and helps your cervix to dilate.

Breathing exercises, massage and having a warm bath or shower may help ease pain during this early stage of labour.

Established labour (1st stage of labour)

Established labour is where your cervix has dilated to about 4cm and your contractions are stronger and more regular.

When to contact a midwife

Call your midwife or maternity unit if:

your contractions are regular (every 5 minutes or more often)

your waters break

your contractions are very strong and you feel you need pain relief

you're worried about anything

If you go into hospital before your labour has become established, they may suggest you go home again for a while.

Once labour is established, your midwife will check on you from time to time to see how you're progressing and offer you support, including pain relief if you need it.

You can either walk around or get into a position that feels comfortable to labour in.

Your midwife will offer you regular vaginal examinations to see how your labour is progressing. If you do not want to have these, you do not have to - your midwife can discuss with you why she's offering them.

Your cervix needs to open about 10cm for your baby to pass through it. This is what's called being fully dilated.

In a 1st pregnancy, the time from the start of established labour to being fully dilated is usually 8 to 18 hours. It's often quicker (around 5 to 12 hours), in a 2nd or 3rd pregnancy.

When you reach the end of the 1st stage of labour, you may feel an urge to push.

Monitoring your baby in labour

Your midwife will monitor you and your baby during labour to make sure you're both coping well.

This will include using a small handheld device to listen to your baby's heart every 15 minutes. You'll be free to move around as much as you want.

Your midwife may suggest electronic monitoring if there are any concerns about you or your baby, or if you choose to have an epidural.

Electronic monitoring involves strapping 2 pads to your bump. One pad is used to monitor your contractions and the other is used to monitor your baby's heartbeat. These pads are attached to a monitor that shows your baby's heartbeat and your contractions

Sometimes a heart monitor called a foetal scalp electrode can be attached to the baby's head instead. This can give a more accurate measurement of your baby's heartbeat.

You can ask to be monitored electronically even if there are no concerns. Having electronic monitoring can sometimes restrict how much you can move around. Your midwife can discuss this with you.

If you have electronic monitoring with pads on your bump because there are concerns about your baby's heartbeat, you can take the monitor off if your baby's heartbeat is shown to be normal.

A foetal scalp electrode will usually only be removed just as your baby is born, not before.

Speeding up labour

Labour can sometimes be slower than expected. This can happen if your contractions are not coming often enough, are not strong enough, or if your baby is in an awkward position.

If this is the case, your doctor or midwife may talk to you about 2 ways to speed up your labour: breaking your waters or an oxytocin drip.

Breaking your waters

Breaking the membrane that contains the fluid around your baby (your waters) is often enough to make contractions stronger and more regular. This is also known as artificial rupture of the membranes (ARM).

Your midwife or doctor can do this by making a small break in the membrane during a vaginal examination. This may make your contractions feel stronger and more painful, so your midwife will talk to you about pain relief.

Oxytocin drip

If breaking your waters does not work, your doctor or midwife may suggest using a medicine called oxytocin (also known as syntocinon) to make your contractions stronger. This is given through a drip that goes into a vein, usually in your wrist or arm.

Oxytocin can make your contractions stronger and more regular and can start to work quite quickly, so your midwife will talk to you about your options for pain relief.

You will also need electronic monitoring to check your baby is coping with the contractions, as well as regular vaginal examinations to check the drip is working.

2nd stage of labour

The 2nd stage of labour lasts from when your cervix is fully dilated until the birth of your baby.

Finding a position to give birth in

Your midwife will help you find a comfortable position to give birth in. You may want to sit, lie on your side, stand, kneel, or squat, although squatting may be difficult if you're not used to it.

If you've had lots of backache while in labour, kneeling on all fours may help. It's a good idea to try some of these positions before you go into labour. Talk to your birth partner so they know how they can help you.

Find out what your birth partner can do.

Pushing your baby out

When your cervix is fully dilated, your baby will move further down the birth canal towards the entrance to your vagina. You may get an urge to push that feels a bit like you need to poo.

You can push during contractions whenever you feel the urge. You may not feel the urge to push immediately. If you have had an epidural, you may not feel an urge to push at all.

If you're having your 1st baby, this pushing stage should last no longer than 3 hours. If you've had a baby before, it should take no more than 2 hours.

This stage of labour is hard work, but your midwife will help and encourage you. Your birth partner can also support you.

What happens when your baby is born

When your baby's head is almost ready to come out, your midwife will ask you to stop pushing and take some short breaths, blowing them out through your mouth.

This is so your baby's head can be born slowly and gently, giving the skin and muscles in the area between your vagina and anus (the perineum) time to stretch.

Sometimes your midwife or doctor will suggest an episiotomy to avoid a tear or to speed up delivery. This is a small cut made in your perineum.

You'll be given a local anaesthetic injection to numb the area before the cut is made. Once your baby is born, an episiotomy, or any large tears, will be stitched closed.

Find out about your body after the birth, including how to deal with stitches.

Once your baby's head is born, most of the hard work is over. The rest of their body is usually born during the next 1 or 2 contractions.

You'll usually be able to hold your baby immediately and enjoy some skin-to-skin time together.

You can breastfeed your baby as soon as you like. Ideally, your baby will have their 1st feed within 1 hour of birth.

Read more about skin-to-skin contact and breastfeeding in the first few days.

3rd stage of labour

The 3rd stage of labour happens after your baby is born, when your womb contracts and the placenta comes out through your vagina.

There are 2 ways to manage this stage of labour:

active - when you have treatment to make it happen faster

physiological - when you have no treatment and this stage happens naturally

Your midwife will explain both ways to you while you're still pregnant or during early labour, so you can decide which you would prefer.

There are some situations where physiological management is not advisable. Your midwife or doctor can explain if this is the case for you.

What is active management?

Your midwife will give you an injection of oxytocin into your thigh as you give birth, or soon after. This makes your womb contract.

Evidence suggests it's better not to cut the umbilical cord immediately, so your midwife will wait to do this between 1 and 5 minutes after birth. This may be done sooner if there are concerns about you or your baby - for example, if the cord is wound tightly around your baby's neck.

Once the placenta has come away from your womb, your midwife pulls the cord - which is attached to the placenta - and pulls the placenta out through your vagina. This usually happens within 30 minutes of your baby being born.

Active management speeds up the delivery of the placenta and lowers your risk of having heavy bleeding after the birth (postpartum haemorrhage), but it increases the chance of you feeling and being sick. It can also make afterpains (contraction-like pains after birth) worse.

Read more about preventing heavy bleeding after birth.

What is physiological management?

No oxytocin injection is given, and the 3rd stage of labour happens naturally.

The cord is not cut until it has stopped pulsing. This means blood is still passing from the placenta to your baby. This usually takes around 2 to 4 minutes.

Once the placenta has come away from your womb, you should feel some pressure in your bottom and you'll need to push the placenta out. It can take up to an hour for the placenta to come away, but it usually only takes a few minutes to push it out.

If the placenta does not come away naturally or you begin to bleed heavily, you'll be advised by your midwife or doctor to switch to active management. You can do this at any time during the 3rd stage of labour.

Read more about what happens straight after you give birth.

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Find out what happens during labour and birth, including the 3 stages of labour, contractions, dilation, birth positions and monitoring your baby.

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This class will cover:

Exercising safely in pregnancy

The role of the pelvic floor muscles and how to exercise them

Bladder and bowel symptoms you may experience

Perineal tears and how to reduce them

What to expect after birth

Getting back to yourself and sex

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Include your birth partner when completing your birth plan so they can support all of your wishes

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Whoever your birth partner is - the baby's parent, a close friend, partner, or a relative - there are many practical things they can do to help you.

The most important thing your birth partner can do is just be with you.

Talk to your birth partner about the type of birth you'd like and the things you prefer not to do so they can help support your decisions. It can help to go through your birth plan together.

There's no way of knowing what your labour is going to be like or how each of you will cope, but there are many ways a partner can help.

Whatever kind of birth you're planning for, your birth partner can:

keep you company and help pass the time during the early stages

hold your hand, wipe your face and give you sips of water

massage your back and shoulders, and help you move about or change position

comfort you as your labour progresses and your contractions get stronger

remind you how to use relaxation and breathing techniques, perhaps breathing with you if it helps

support your decisions, such as the pain relief you choose, even if they're different from what's in your birth plan

help you explain to the midwife or doctor what you need - and help them communicate with you - which can help you feel more in control of the situation

tell you what's happening as your baby is being born if you cannot see what's going on

Your birth partner may be able to cut the umbilical cord - you can talk to your midwife about this.

You can also read about feelings and relationships in pregnancy, including worries about the birth and sex in pregnancy.

Make sure you and your birth partner both know what to pack for the birth, and what to expect at the hospital or maternity unit if you're planning to have your baby there.

Find maternity services near you.
Community content from HealthUnlocked

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Find out how your birth partner can help during labour, such as reminding you of relaxation techniques, massaging you and holding your hand.

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@Hillingdonhospitalmaternity on Facebook

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This is the official Facebook page of the Maternity Department at Hillingdon Hospital to give you... Pield Heath Road, UB8 3NN Uxbridge, UK

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Indigestion, also called heartburn or acid reflux, is common in pregnancy. It can be caused by hormonal changes and the growing baby pressing against your stomach.

You can help ease indigestion and heartburn by making changes to your diet and lifestyle, and there are medicines that are safe to take in pregnancy.

Symptoms of indigestion and heartburn

Symptoms of indigestion and heartburn include:

a burning sensation or pain in the chest

feeling full, heavy or bloated

burping or belching

feeling or being sick

bringing up food

Symptoms usually come on soon after eating or drinking, but there can sometimes be a delay between eating and developing indigestion.

You can get symptoms at any point during your pregnancy, but they are more common from 27 weeks onwards.

Things you can do to help with indigestion and heartburn

Changes to your diet and lifestyle may be enough to control your symptoms, particularly if they are mild.

Eat healthily

You're more likely to get indigestion if you're very full.

If you're pregnant, it may be tempting to eat more than you would normally, but this may not be good for you or your baby.

Find out more about a healthy diet in pregnancy and foods to avoid.

Change your eating and drinking habits

You may be able to control your indigestion with changes to your eating habits.

It can help to eat small meals often, rather than larger meals 3 times a day, and to not eat within 3 hours of going to bed at night.

Cutting down on drinks containing caffeine, and foods that are rich, spicy or fatty, can also ease symptoms.

Keep upright

Sit up straight when you eat. This will take the pressure off your stomach. Propping your head and shoulders up when you go to bed can stop stomach acid coming up while you sleep.

Stop smoking

Smoking when pregnant can cause indigestion, and can seriously affect the health of you and your unborn baby.

When you smoke, the chemicals you inhale can contribute to your indigestion. These chemicals can cause the ring of muscle at the lower end of your gullet to relax, which allows stomach acid to come back up more easily. This is known as acid reflux.

Smoking also increases the risk of:

There's lots of help available to stop smoking. Talk to your midwife or call the NHS Smokefree helpline on 0300 123 1044. Find out more about stopping smoking in pregnancy.

Avoid alcohol

Drinking alcohol can cause indigestion. During pregnancy, it can also lead to long-term harm to the baby. It's safest to not drink alcohol at all in pregnancy.
Find out more about alcohol and pregnancy

When to get medical help

See your midwife or GP if you need help managing your symptoms or if changes to your diet and lifestyle do not work. They may recommend medicine to ease your symptoms.

You should also see your midwife or GP if you have any of the following:

difficulty eating or keeping food down

weight loss

stomach pains

Your midwife or GP may ask about your symptoms and examine you by pressing gently on different areas of your chest and stomach to see whether it's painful.

If you're taking prescription medicines

Speak to your GP if you're taking medicine for another condition, such as antidepressants, and you think it may be making your indigestion worse. They may be able to prescribe an alternative medicine.

Never stop taking a prescribed medicine unless you're advised to do so by your GP or another qualified healthcare professional who's responsible for your care.

Medicines for indigestion and heartburn

Medicines for indigestion and heartburn during pregnancy include:

antacids - to neutralise the acid in your stomach (some are available over the counter from a pharmacist)

alginates - to relieve indigestion caused by acid reflux by stopping the acid in your stomach coming back up your gullet

You may only need to take antacids and alginates when you start getting symptoms. However, your GP may recommend taking them before symptoms come on - for example, before a meal or before bed.

If you're taking iron supplements as well as antacids, do not take them at the same time. Antacids can stop iron from being absorbed by your body.

If antacids and alginates do not improve your symptoms, your GP may prescribe a medicine to reduce the amount of acid in your stomach. 2 that are widely used in pregnancy and not known to be harmful to an unborn baby are:

Causes of indigestion in pregnancy

Symptoms of indigestion come when the acid in your stomach irritates your stomach lining or your gullet. This causes pain and a burning feeling.

When you're pregnant, you're more likely to have indigestion because of:

hormonal changes

the growing baby pressing on your stomach

the muscles between your stomach and gullet relaxing, allowing stomach acid to come back up

You may be more likely to get indigestion in pregnancy if:

you had indigestion before you were pregnant

you've been pregnant before

you're in the later stages of pregnancy

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Indigestion, also called heartburn or acid reflux, is common in pregnancy. It can be caused by hormonal changes and the growing baby pressing against your stomach. You can help ease indigestion and heartburn by making changes to your diet and lifestyle, and there are medicines that are safe to take in pregnancy.

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Pregnancy nausea, vomiting and hyperemesis

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Pregnancy nausea, vomiting and hyperemesis

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This information is for you if you want to know more about nausea and vomiting of pregnancy or about hyperemesis gravidarum, which is the most severe form of the condition.

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

The information here aims to help you better understand your health and your options for treatment and care. Your healthcare team is there to support you in making decisions that are right for you. They can help by discussing your situation with you and answering your questions.

This information covers:

What nausea and vomiting of pregnancy is and what hyperemesis gravidarum is

How it feels to have pregnancy sickness

What it means for your baby

What you can do to help if you have pregnancy sickness

When you should seek medical help and what will happen if you do

About anti-sickness medication you may be offered

See full glossary of medical terms.
Key points

Nausea and vomiting of pregnancy is a common condition that usually settles by 12-14 weeks of pregnancy.

Hyperemesis gravidarum is a severe form of this condition and can affect up to 1 to 3 in 100 pregnant women.

Nausea and vomiting and hyperemesis gravidarum can affect your mood, your work, your home situation and your ability to care for your family. Extra support from family, friends and healthcare professionals can help you.

While most women can be treated at home or as outpatients in hospitals, some may need admission to hospital for treatment.

A variety of anti-sickness medicines are available that may help your symptoms. While some of these medicines may not be licensed for use in pregnancy, there is no evidence that they are harmful to your baby.

Further information

NHS Choices: Nausea and morning sickness ( www.nhs.uk/conditions/pregnancy-and-baby/pages/morning-sickness-nausea.aspx)

Pregnancy Sickness Support: www.pregnancysicknesssupport.org.uk

For further information on molar pregnancy, see the RCOG patient information Gestational trophoblastic disease.

Sources and acknowledgements

This information has been developed by the RCOG Patient Information Committee. It is based on the RCOG Green-top Clinical Guideline The Management of Nausea and Vomiting of Pregnancy and Hyperemesis Gravidarum.

This leaflet was reviewed before publication by women attending Birmingham Women's Hospital, by the RCOG Women's Network and by the RCOG Women's Voices Involvement Panel.

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Pregnancy sickness (nausea and vomiting of pregnancy and hyperemesis gravidarum)

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This information is for you if you want to know more about nausea and vomiting of pregnancy or about hyperemesis gravidarum, which is the most severe form of the condition. It may also be helpful if you are a partner, relative or friend of someone who is in this situation.

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Less common symptoms of iron deficiency anaemia (that are not usually connected to pregnancy) include:

headaches

hearing ringing, buzzing or hissing noises inside your head (tinnitus)

food tasting strange

feeling itchy

a sore tongue

hair loss - you notice more hair coming out when brushing or washing it

wanting to eat non-food items, such as paper or ice (pica)

finding it hard to swallow (dysphagia)

painful open sores (ulcers) in the corners of your mouth

spoon-shaped nails

restless legs syndrome

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Read about iron deficiency anaemia, including what the symptoms are, when to get medical help, the tests and treatments you may have, and the possible causes.

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Find out why you will probably have more vaginal discharge in pregnancy, and when you need to see a doctor.

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Also known as symphysis pubic dysfunction (SPD)

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Shared Decision Making

If you are asked to make a choice, you may have lots of questions that you want to ask. You may also want to talk over your options with your family or friends. It can help to write a list of the questions you want answered and take it to your appointment.

Ask 3 Questions

To begin with, try to make sure you get the answers to 3 key questions, if you are asked to make a choice about your healthcare:

1. What are my options?

2. What are the pros and cons of each option for me?

3. How do I get support to help me make a decision that is right for me?

*Ask 3 Questions is based on Shepherd et al. Three questions that patients can ask to improve the quality of information physicians give about treatment options: A cross-over trial. Patient Education and Counselling, 2011;84:379-85

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Shared Decision Making If you are asked to make a choice, you may have lots of questions that you want to ask. You may also want to talk over your options with your family or friends. It can help to write a list of the questions you want answered and take it to your appointment.

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Hormonal changes in your body may cause you to become constipated even early on in your pregnancy.

To help prevent constipation, you can:

*eat foods that are high in fibre, such as wholemeal breads and cereals, fruit and vegetables, and pulses such as beans and lentils
*exercise regularly
*drink plenty of water

Contact your local pharmacy or GP for medication advice

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You are able to self refer on the following email address:

thh.hillingdonhomebirthteam@nhs.net

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Obstetric Anal Sphincter Injury (OASI) bundle

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Obstetric Anal Sphincter Injury (OASI) bundle

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Reducing the rate of 3rd and 4th degree tears during childbirth

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Click here to access our Infant feeding padlet for help with preparing to feed your baby

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Antenatal, labour and postnatal information

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Antenatal, labour and postnatal information

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Available in:
Pashto and Dari

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Select the language required at the top of the page to view relevant 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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Labour and postnatal information for diet controlled GDM

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Also called cervical suture or cervical cerclage

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Use the heading column to find the information you need

Scroll down the column to see information related to that heading

Click on the links to view the information

Scroll right to find other headings

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'Welcoming our baby' - is a 6 session programme, held over 3 weeks. They are currently being held virtually but soon to be back face to face

**FREE FOR THOSE BOOKED AT HILLINGDON**

See our 'Parent Education' padlet and for booking information

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There are a number of research studies running at Hillingdon Maternity at any one time.

Some of these require input and consent from service users

See below for information about the current research:

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Labour and postnatal information for medicated GDM, Type 1 and Type 2 diabetes

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This service is open 24 hours a day for anyone 18 weeks and over for pregnancy related problems or advice

Call your GP or 111 for non - pregnancy related problems

Only use emergency services (999) if you have a life threatening emergency or you are advised to do so by a healthcare professional

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📞 Antenatal Clinic: 01895 279442                                       💌thh.antenatalenquiries@nhs.net

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📞 Antenatal Clinic: 01895 279442                                       💌thh.antenatalenquiries@nhs.net

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Between 9.00am and 3.00pm

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📞 Main hospital switchboard: 01895 238282

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📞 Main hospital switchboard: 01895 238282

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If you cannot get through on the numbers provided above - please call the main hospital switchboard