If you're pregnant, you may be unsure how coronavirus (COVID-19) could affect you, your baby and your pregnancy care.

It's important to tell your midwife or maternity team if you have symptoms of COVID-19. You can ask them for help with any other concerns as you usually would.

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.

It's strongly recommended that you get vaccinated against COVID-19 to protect you and your baby.

It's also important to follow advice to stop the spread of COVID-19 throughout your pregnancy. Especially when you're more than 28 weeks pregnant (in your 3rd trimester).

If you're from an ethnic minority group, evidence suggests you're more likely to be admitted to hospital if you get COVID-19. Maternity teams are taking extra steps to keep you safe if you're higher risk.

It may be possible for you to pass COVID-19 to your baby before they're born. But when this has happened, the babies have got better.

There's no evidence COVID-19 causes miscarriage or affects how your baby develops in pregnancy.

As soon as you find out you're pregnant speak to a GP or midwife.

They'll support you and give you all the information you need. They'll also make sure you receive safe and personal maternity care.

If you're pregnant, it's important to follow advice about how to avoid catching and spreading COVID-19, such as washing your hands regularly.

If you're more than 28 weeks pregnant it’s especially important to follow this advice.

You still need to go to all of your pregnancy (antenatal) scans and appointments unless you're told not to.

Information:

It's strongly recommended that you get vaccinated against COVID-19 if you're pregnant.

It's preferable for you to have the Pfizer/BioNTech or Moderna vaccine. This is because they've been more widely used during pregnancy in other countries and no safety concerns have been identified.

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

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

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

The NHS in England will offer you:

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

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

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

This appointment lasts around an hour.

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

They will ask about:

Find out more about what happens at your first midwife appointment.

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

Your appointments can take place at:

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

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

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

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

Information:

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

A birth preference is a record of what you would like to happen during your labour and after the birth. You don't have to create a birth preference but, if you would like one, your midwife will be able to help.

Discussing your birth preference with your midwife gives you the chance to ask questions and find out more about what happens in labour.

It also gives your midwife the chance to get to know you better, and understand your feelings and priorities, and allows you to think about or discuss some things more fully with your partner, friends and relatives.

You can change your mind about your wishes for labour and birth at any time.

Your birth preference is personal to you. It depends on what you want, your medical history, your circumstances and what is available at your maternity service.

You might be given a special form for your birth preference, or there may be room in your notes. It's a good idea to keep a copy of your birth plan with you.

The maternity team who care for you during labour will discuss it with you so they know what you want.

You need to be flexible and prepared to do things differently from your birth preference if complications arise with you or your baby, or if facilities such as a birth pool aren't available.

The maternity team will tell you what they advise in your particular circumstances. Don't hesitate to ask questions if you need to.

You can find out more about the things you need to think about when making a birth preference, such as:

You can work out whether there's anything you feel strongly about and might wish to include. 

You can also show your birth partner these tips to support you.

You can download a birth plan template

 

https://forms.gle/zZhdDwgcAHWm8GMm8 - Emotional Wellbeing 

 

https://forms.gle/bEuCTPTyNBxeckPz9 _ Peer Support 

 

https://forms.gle/KFZuiB2J35xv3Z7y7 - Maternity Voices Partnership 

 

https://forms.gle/YT4a3YPvE46GBU1j8 - Breastfeeding 

 

https://forms.gle/XzgEhenR42vXVyfs6  - Immunisation 

 

https://forms.gle/vqSudSDwhdZ5SMmf8 - Speech and Language Development 

 

https://forms.gle/weQ4e7UYuWZjmGnM6 - Access to Children’s Centres 

Skin-to-skin contact really helps with bonding. It's a good idea to have your baby lifted onto you as soon as they're born and before the cord is cut so you can be close to each other straight away.

When the cord is clamped, your baby is dried and then covered with a towel to stop them getting cold. You can continue to hold and cuddle your baby.

Read more about skin-to-skin contact.

Your baby may have some of your blood on their skin and perhaps vernix, the greasy white substance that protects your baby's skin in the womb.

If you prefer, you can ask the midwife to dry your baby and wrap them in a blanket before your cuddle.

Mucus may need to be cleared out of your baby's nose and mouth.

Some babies need a bit of help to get their breathing established.

Your baby may be taken to another part of the room to have some oxygen. They'll brought back to you as soon as possible.

Your baby will be examined by a midwife or paediatrician, then weighed and possibly measured, and given a band with your name on.

You'll be offered an injection of vitamin K for your baby. This helps prevent a rare bleeding disorder called haemorrhagic disease of the newborn.

Your midwife should have discussed the injection with you while you were pregnant.

If you'd prefer for your baby not to have an injection, they can have vitamin K by mouth instead, but they'll need further doses.

Small tears and grazes are often left without stitches because they usually heal better this way.

If you need stitches or other treatments, you should be able to carry on cuddling your baby.

If you have had a large tear or an episiotomy, you'll need stitches.

If you have already had an epidural, it can be topped up. If you haven't, you should be offered a local anaesthetic to numb the area.

Your midwife or maternity support worker will help you wash and freshen up before you go to the postnatal ward.

Postpartum haemorrhage (PPH) is a rare complication where you bleed heavily from the vagina after your baby's birth.

There are 2 types of PPH, depending on when the bleeding takes place:

Sometimes PPH happens because your womb doesn't contract strongly enough after the birth.

It can also happen because part of the placenta has been left in your womb or you get an infection in the lining of the womb (endometritis). 

To help prevent PPH, you'll be offered an injection of oxytocin as your baby's being born. This stimulates contractions and helps to push the placenta out.

If you've had a caesarean, see recovering from a caesarean.

If you've had stitches after tearing or an episiotomy (cut), bathe them every day to help prevent infection. Have a bath or shower with plain warm water then carefully pat yourself dry.

If your stitches are sore or uncomfortable, tell your midwife.

Painkillers can help. If you're breastfeeding, check with your pharmacist, midwife or GP before you buy over-the-counter painkillers.

Stitches usually dissolve by the time the cut or tear has healed, but sometimes they have to be taken out.

At first, the thought of peeing can be a bit frightening – because of the soreness. Drinking lots of water dilutes your urine, which may make it sting less.

Tell your midwife if:

You probably won't have a poo for a few days after the birth, but it's important not to let yourself get constipated.

Eat plenty of fresh fruit, vegetables, salad, wholegrain cereals and wholemeal bread, and drink plenty of water.

If you've had stitches, it's very unlikely you'll break them, or open up the cut or tear again.

It might feel better if you hold a pad of clean tissue over the stitches when pooing. Try not to strain.

Talk to your midwife or GP if you have constipation that won't go away. A gentle laxative may help.

Also tell your midwife or GP if poo is leaking or you're pooing when you don't mean to.

After having a baby, it's quite common to leak a bit of pee if you laugh, cough or move suddenly.

Pelvic floor exercises can help with this but tell your GP at your postnatal check if they aren't. They may refer you to a physiotherapist.

Piles are very common after birth but usually disappear within a few days.

Eat plenty of fresh fruit, vegetables, salad, wholegrain cereals and wholemeal bread, and drink plenty of water. This should make pooing easier and less painful.

Try not to push or strain – this will make the piles worse.

Let your midwife know if you feel very uncomfortable. They can give you a cream to soothe the piles.

You'll bleed from your vagina after the birth. It will be quite heavy at first, and you'll need super-absorbent sanitary towels. Change them regularly, washing your hands before and afterwards.

It isn't a good idea to use tampons until after your 6-week postnatal check because they could increase your chance of getting an infection.

See when you can start using tampons after birth.

You may notice the bleeding is redder and heavier when you breastfeed. This happens because breastfeeding makes your womb contract. You may also feel cramps similar to period pains.

The bleeding will carry on for a few weeks. It will gradually turn a brownish colour and decrease until it finally stops.

If you're losing blood in large clots, tell your midwife. You may need some treatment.

It's hard to be exact about when your periods will start again, as everyone is different.

If you bottle feed your baby, or combine bottle feeding with breastfeeding, your first period could start as soon as 5 to 6 weeks after you give birth.

If you fully breastfeed (including at night) without any bottle feeding, your periods may not start again until you start to reduce breastfeeding.

You can get pregnant as little as 3 weeks after the birth of your baby, even if you're breastfeeding and your periods have not started again yet.

Find out more about when you can use contraception after having a baby.

You should not use tampons until you've had your 6-week postnatal check. This is because you'll still have a wound where the placenta joined with the wall of your womb, and you may also have tears or cuts in or around your vagina.

Using internal sanitary products like tampons and menstrual cups before this wound has healed could increase your chance of getting an infection.

Use maternity pads or sanitary towels during this time while your body is still healing.

To begin with, your breasts will produce a yellowish liquid called colostrum for your baby.

On the third or fourth day, they may feel tight and tender as they start to produce milk.

Wearing a supportive nursing bra may help. Speak to your midwife if you're very uncomfortable.

Read more about breastfeeding in the first few days.

After delivery, your tummy will probably still be a lot bigger than before pregnancy. This is partly because your muscles have stretched.

If you eat a balanced diet and get some exercise, your shape should gradually return.

Breastfeeding helps because it makes your womb contract. You may feel quite painful period-like cramps while you're feeding.

You could also try these gentle postnatal tummy exercises.

If you notice anything that worries you about your baby, however small, speak to your midwife.

Within the first 24 hours, a health professional will offer to give your baby an injection of vitamin K. This is to prevent a rare but serious blood disorder.

You will also be offered a newborn physical examination for your baby in their first 72 hours. Among other things, their eyes, heart, hips and testicles (if they have them) will be checked for possible problems.

In their first few weeks, you baby will also have the:

Your newborn’s umbilical cord takes about a week to dry out and drop off. Keep it clean and dry until it does. If you notice any bleeding or discharge, tell your midwife, health visitor or GP.

On the top of your baby's head, near the front, is a diamond-shaped patch where the skull bones have not fused together yet. There is another, smaller, soft spot towards the back of their head. These are called the fontanelles.

It will probably be a year or more before the bones close over. Do not worry about the fontanelles as they are covered by a tough protective membrane.

At birth, the top layer of your baby's skin is very thin and easily damaged. Over the first month, or longer for premature babies, your baby's skin matures and develops its own natural protective barrier.

Vernix, the white sticky substance that covers your baby's skin while in the womb, should always be left on the skin. It's a natural moisturiser that also protects against infection in the first few days.

It's best to bath your baby with plain water only for at least the first month. Do not add cleansers to your baby's bath water or use skin lotions or medicated wipes.

Premature babies' skin is even more delicate. Staff in the neonatal unit will advise you on skincare.

Find out more about babies who need special care.

If your baby is overdue, their skin may be dry and cracked. This is because all the protective vernix has been absorbed before they were born.

Your newborn's eyes will be checked shortly after birth as part of their newborn physical examination. New babies can see, but their vision is not very focused. Their eyesight develops gradually over the first few months.

By the time your baby is 2 weeks old, you'll probably notice their eyes following your face. If they do not seem to be doing this, mention it to your health visitor or GP.

Your newborn's eyes may roll away from each other occasionally. This is called a squint and is normal in a newborn. It should go away by 3 months. Talk to your health visitor or GP if it does not.

It's common for a newborn baby to have some swelling and bruises on their head, and perhaps bloodshot eyes.

This is caused by squeezing and pushing during birth, and is particularly common in babies who have been delivered by forceps or ventouse. It will soon disappear but, if you're worried, you can ask your midwife about it.

The most common birthmarks in newborns are little pink or red V-shaped marks on the forehead, upper eyelids or neck. Some people call these stork marks or salmon patches. They gradually fade, but it may be a few months before they disappear completely.

Dark red and slightly raised strawberry marks (infantile haemangioma) are quite common. They sometimes appear a few days after birth and gradually get bigger. They may take a while to go away, but they usually disappear gradually.

See more about birthmarks.

Spots and rashes are very common in newborn babies. They may come and go, but if you also notice a change in your baby's behaviour – for example, if your baby is not feeding well, or is very sleepy or very irritable – tell your midwife or GP immediately.

Quite often, a newborn’s breasts are a little swollen and ooze some milk, whether they are a boy or a girl.

Your newborn's genitals may appear swollen initially but will look normal within a few weeks. Baby girls also sometimes bleed a bit or have a white, cloudy discharge from the vagina.

All this is caused by hormones passing from you to your baby before birth. Do not be concerned.

Boys' testicles develop inside their body and sometimes take a while to descend into the scrotum. A health professional will check whether they have descended as part of the newborn physical examination.

When they're about 2 to 3 days old, some babies develop mild jaundice. This will make their skin and the whites of their eyes look a bit yellow. It's caused by pigments released during the breakdown of old red blood cells.

It's more common in babies delivered by forceps or ventouse. It usually fades on its own within about 10 days, but more severe jaundice may need treatment.

Find out about newborn jaundice.

If your baby develops jaundice in their first 24 hours, they should be checked by a health professional straight away.

Babies are born knowing how to suck. During the first few days they learn to co-ordinate their sucking with their breathing during feeding.

Newborn babies also automatically turn towards a nipple or teat if it's brushed against their cheek, and they'll open their mouths if their upper lip is stroked.