Professional Documents
Culture Documents
05
20
Pre nancy g
byw gyda’ch babi newydd
the
yr esgor a’r geni
feichiogrwydd iach
Arweiniad cyflawn i:
book
g
Pre nancy
book
to pregnancy, childbirth
9 PROBLEMS
3 HOW THE BABY DEVELOPS Common minor problems 77
How the baby develops 28 More serious problems 83
17
12 WHEN PREGNANCY THINKING ABOUT
GOES WRONG THE NEXT BABY?
Ectopic pregnancy 104 Fathers too 128
Miscarriage 104 Getting and staying healthy 128
Termination 105 Work hazards 129
Losing a baby 106
18
RIGHTS AND BENEFITS
13 THE FIRST DAYS Benefits for all 130
WITH YOUR NEW BABY Benefits if your income is low 131
You 107 Maternity benefits 136
Your baby 110 If you are unemployed 138
Maternity leave 139
Other employment rights 142
14 BABIES WHO NEED Other types of leave 143
SPECIAL CARE Return to work on child
Contact with your baby 112 friendly working hours 144
Feeding 112
Incubators 113 USEFUL ORGANISATIONS 147
Newborn babies with jaundice 113
A baby with disabilities 113 INDEX 151
Your pregnancy
at a glance
0-8 weeks 8-12 weeks 12-16 weeks
• Pregnancy test – you can have
one from the first day of a
• You’ll probably attend your first • Find out about antenatal classes
antenatal appointment. if you have not already done so
missed period, if you wish Appointments will usually be (see Antenatal care and
(see Finding out, page 26). monthly at first (see Antenatal antenatal classes, page 51).
care and antenatal classes,
• Make an early appointment to
see your GP or a midwife if you
page 51). • want
Begin to think about how you
to feed your baby
know you’re pregnant or think
you may be (see Finding out,
• and
Ask about your rights at work
the benefits available
(see Feeding your baby,
page 66).
page 26). Begin to think about (see Rights and benefits,
where you want your baby to
be born (see Deciding where
page 130). • Make sure you’re wearing a bra
which supports well.
to have your baby, page 33). • Iforyou’re on Income Support
Ask about antenatal care (see
Antenatal care and antenatal
income-based Jobseeker’s
Allowance, you can claim free
• You may be offered an
ultrasound scan which will
classes, page 51). milk tokens (see Rights and show your baby moving. Your
benefits, page 136). partner may like to see this too
• Some mothers start to feel sick (see Antenatal care and
or tired around this time or
have other minor physical
• Make a dental appointment.
Dental care is free during
antenatal classes, page 51).
4
Your pregnancy at a glance
• IfAllowance,
you’re claiming Maternity
do so as soon as you
can after you are 26 weeks
pregnant (see Rights and
benefits, pages 136–137).
5
Your pregnancy at a glance
the idea of a new baby. • You may be more aware of your • The last few weeks can seem
womb tightening from time to very long. Plan some interesting
• Check that your shoes are
comfortable. If you get tired, try
time. These are mild
contractions (see Labour and
things to do to take your mind
off waiting.
to rest with your feet above the birth, page 90).
level of your heart. • Telephone your hospital or
• You may feel quite tired. Make midwife if you have any worries
• You’ll probably now attend for
antenatal care every fortnight.
sure you get plenty of rest. about labour or the birth.
6
Introduction
Every parent is different, just as every baby is different. So there
can’t be many rules to having a baby. But you will find a lot of
information in these pages which should help you to decide what
you will do, how you will cope and, most of all, how you can best
enjoy both pregnancy and your baby.
Chapter 1 is about what you can do to make sure you and your
baby stay healthy during your pregnancy. The book then takes
you through pregnancy, birth and the first two weeks of caring for
your baby. You may want to read some chapters several times, or
look up specific things which interest or concern you. To find a
topic quickly, just look at the index at the back of the book.
7
1 Your health
in pregnancy
T
his chapter describes some of the things you should think about
to make sure you and your baby stay healthy during pregnancy.
W H AT S H O U L D YO U E AT ?
A healthy diet is an important part There’s no need to ‘eat for two’ when
of a healthy lifestyle at any time, you are pregnant. It’s the quality not the
but particularly if you are pregnant quantity that’s important. With a few
or are planning a pregnancy. exceptions you can continue to eat all
Eating healthily during pregnancy the foods you enjoy (see Take care with
will help your baby develop and some foods, page 11). Eating healthily
grow and will help keep you fit often means just changing the amounts
and well. You don’t need to go of different foods that you eat rather
on a special diet, but make sure than cutting out all your favourites.
that you eat a variety of different The Balance of Good Health illustrates
foods every day in order to get the mixture of different foods you
the right balance of nutrients need in your diet and the proportions
that you and your baby need. you should eat them in. This is
You should also avoid certain illustrated below.
foods to be on the safe side.
FOLIC ACID
• Dairy products, fish with edible
bones like sardines, bread, nuts
This vitamin is special (see page 12) and green vegetables These are available from pharmacies
(see this page). You need to are rich in calcium, which is vital and supermarkets or your GP may
take a 400 microgram (0.4 for making bones and teeth. be able to prescribe them for you.
milligram) tablet every day Ask your GP or pharmacist for
from the time you start
trying to conceive. Continue
• Margarine, oily fish (like sardines)
and taramasalata contain vitamin
advice if you are unsure.
• Ready-to-eat
prunes
apricots, figs or
• Fresh fruit
• Baked beans on toast or
baked potato
11
Your health in pregnancy
FURTHER READING
• Avoid eating all types of
paté and mould-ripened
soft cheese, like Brie and
• The Food Standards
Agency publishes some
Camembert, and similar blue-
veined varieties, like Stilton or
useful leaflets, including Danish blue, because of the risk
Thinking of having a of Listeria infection. You can
baby and While you eat hard cheeses such as cheddar
are pregnant. and parmesan, and other cheeses
Contact: made from pasteurised milk such
Food Standards Agency as cottage cheese, mozzarella
PO Box 369 cheese and cheese spreads.
Hayes UB3 1UT Although Listeria is a very rare
tel. 0845 6060667 disease, it is important to take
special precautions during
• Folic acid: what all
women should know
pregnancy because even the mild
form of the illness can lead to
is available free from miscarriage, stillbirth or severe
your doctor, clinic or illness in the newborn. FOR GENERAL HYGIENE
pharmacist.
(In Northern Ireland ask • Drink only pasteurised or
UHT milk which has had the • Wash your hands before
for Folic Acid: one of harmful germs destroyed. If only and after handling any food.
life’s essentials) raw or green-top milk is available,
boil it first. Don’t drink
• Thoroughly wash all fruit and
vegetables, including ready-prepared
unpasteurised goat’s or sheep’s salads, before eating. Peel and top
milk or eat their milk products. carrots before eating them.
SMOKING
YOUR ACTION PLAN
ALCOHOL
There is no evidence that light or If you have difficulty cutting down,
IF YOU’RE DRINKING occasional drinking in pregnancy talk to your doctor or midwife.
WITH FRIENDS: will harm your baby. But research Confidential help and support is
shows that heavy or frequent available from local counselling
• find a non-alcoholic
drink you enjoy;
drinking can seriously harm your
baby’s development. To be on the
services (look in the telephone
directory or contact Alcohol
safe side, stop altogether or stick to Concern). See page 147 for
• ifsipyouit slowly
drink alcohol,
to make
no more than one or two ‘units’ of
alcohol once or twice a week.
national agencies who can help.
it last;
1 UNIT EQUALS
• ifyoupeople try to pressure
into drinking,
refuse politely but or or or
firmly;
1/
2pint ordinary a single measure of a small (125ml) a small glass of
strength beer, spirit (whisky, gin, glass of wine sherry or a measure
• avoid getting drunk. lager or cider bacardi, vodka, etc.) (9% ABV) of vermouth
These units apply to the 25 ml measure used in most of England and Wales. In some places,
pub measures are larger than this. In Northern Ireland, a pub measure is 35 ml or 11/2 units.
In Scotland, it can either be 35 ml or 25 ml. Home measures are usually more generous.
Not all ‘natural’ remedies are Some pills and medicines can harm those used to treat epilepsy and
safe in pregnancy. Make sure your baby’s health so, to be on the diabetes, than to leave the illness
that your practitioner is safe side, you should: untreated.
qualified (contact the Institute Illegal drugs (street drugs) can
for Complementary Medicine,
see page 147) and tell him or
• assume that all medicines are
dangerous until a doctor or
harm your baby. Taking cocaine or
smoking crack may be especially
her that you are pregnant. pharmacist can tell you they are harmful because both cause a sudden
Tell your midwife or doctor safe; drop in blood and oxygen to the
which remedies you are using. placenta. It’s important to talk to your
• make sure your doctor or dentist
knows you’re pregnant before
doctor or midwife straightaway so
they can refer you to a maintenance
prescribing anything or giving reduction programme. For more
you treatment; information contact one of the
organisations on page 148, or the
• talk to your doctor at the first
possible moment if you take
Drugs Information Helpline on 0800
776600.
regular medication. X-rays should be avoided in
pregnancy if possible. Make sure
But do remember that it is safer to your dentist knows you are pregnant.
14 take some medicines, for example
Your health in pregnancy
P H YS I C A L AC T I V I T Y
15
Your health in pregnancy
EXERCISES FOR A
FITTER PREGNANCY Pelvic floor exercises help
strengthen the muscles of the pelvic
Every pregnant woman should try floor which come under great strain
to fit these exercises into her daily in pregnancy and childbirth.
routine. They will strengthen The pelvic floor consists of layers
muscles to take a bigger load, make of muscles which stretch like a
joints stronger, improve circulation, supportive hammock from the
ease backache and generally make pubic bone (in front) to the end of
you feel well. the backbone. If your pelvic floor
muscles are weak, you may find that
Stomach strengthening exercises you leak urine when you cough or
These strengthen abdominal muscles sneeze. This is quite common and
and ease backache, which can be a you needn’t feel embarrassed.
problem in pregnancy. As your baby
gets bigger you may find that the However, you can strengthen the
hollow in your lower back increases. muscles by doing the following
This can give you backache. exercise:
• fours)
Start in a box position (on all
with knees under hips,
• close up your back passage as if
trying to prevent a bowel
hands under shoulders with movement;
fingers facing forward and
abdominals lifted to keep the
back straight;
• atvagina
the same time, draw in your
as if you are gripping a
tampon, and your urethra as if
• pull in the abdominals and raise
the back up towards the ceiling,
to stop the flow of urine;
SEXUALLY TRANSMITTED
INFECTIONS
17
Your health in pregnancy
ANIMALS
Cats’ faeces may contain an
organism which causes
toxoplasmosis – a disease which can
damage your baby. Avoid emptying
cat litter trays while you’re pregnant
or, if no one else can do it, use
disposable rubber gloves. Trays
should be cleaned daily and filled
with boiling water for five minutes.
Avoid close contact with sick cats
and wear gloves when gardening –
even if you don’t have a cat – in case
the soil is contaminated with faeces.
PARVOVIRUS B19 (SLAPPED Wash your hands and gloves after
gardening. If you do come into
CHEEK DISEASE)
contact with cat faeces, make sure
you wash your hands thoroughly.
Parvovirus B19 infection is common Follow the general hygiene rules
in children and causes a characteristic under Take care with some foods
red rash on the face, so is often
(page 11). For further information
called ‘slapped cheek disease’.
on toxoplasmosis contact Tommy’s
Although 60% of women are immune
Campaign (see page 149).
to this infection, since parvovirus is
highly infectious and can be harmful Lambs and sheep can be a source
to the baby, any pregnant woman of an organism called Chlamydia
who comes into contact with psittaci which is known to cause
someone who is infected should seek miscarriage in ewes. They also carry
advice from the doctor. Immunity Toxoplasma. Avoid lambing or
can be checked with a blood test. In milking ewes and all contact with
most pregnant women who are newborn lambs. If you experience
infected with parvovirus flu-like symptoms after coming into
the baby is not affected. contact with sheep, tell your doctor.
WO R K HAZARDS
VDUS
COPING AT WO R K
20
2 Conception
T
o understand about conception and pregnancy, it helps to know
about the male and female sexual organs. This information is
useful in pregnancy too, when you want to ask questions and
be clear about what you are told.
THE M A N ’ S S E X UA L O R G A N S
Bladder Prostate gland
Hood of clitoris
Clitoris
Urinary opening
Vulva
Opening of vagina
Perineum
Anus 21
Conception
Fallopian tube
Ovary
Womb or uterus
Bladder
Cervix
Vagina
Urethra or water passage
Rectum
Anus
Perineum
Pelvis The baby will pass
through the pelvis when he
or she is born.
22
Conception
THE WO M A N ’ S M O N T H LY C Y C L E
Egg being released Fallopian tube Egg progressing down the fallopian tube
Ovary
Vagina Womb lining
being shed
1. Each month a ripe egg or ovum 2. The ripe egg begins to travel down 3. If the egg is not fertilised by a
(occasionally two) is released from one the fallopian tube. It is here that it sperm, it passes out of the body
of the ovaries. This is called ovulation. may be fertilised by a man’s sperm if through the vagina. It is so small that
The ‘fingers’ at the end of the fallopian a couple have intercourse at this time. it cannot be seen. The lining of the
tube help to direct the egg down into By now the lining of the womb is womb is also shed in the monthly
the tube. At the same time, the lining thick enough for the egg, if it is period of bleeding.
of the womb begins to thicken and the fertilised, to be implanted in it.
mucus in the cervix becomes thinner so
that sperm can swim through it more
easily.
CONCEPTION
Egg Egg being fertilised Attached embryo
Penis
1. A woman is most likely to conceive 2. Most of the sperm leak out of the 3. During the week after fertilisation,
just after the time when she ovulates – vagina again, but some begin to swim the fertilised egg, or embryo, moves
when an egg has been released from up through the cervix. At the time of slowly down the fallopian tube and
one of her ovaries. During sexual ovulation the mucus in the cervix is into the womb. It is already growing.
intercourse, sperm are ejaculated from thinner than usual to let the sperm pass The embryo attaches itself firmly to
a man’s penis into the woman’s vagina. through more easily. The sperm swim the specially thickened womb lining.
In one ejaculation, there may be more into the womb and so into the fallopian Hormones released by the embryo
than 300 million sperm. tube. One sperm may then join with and by the woman’s ovary prevent
the egg and fertilise it. Conception is shedding of the womb lining.
said to have taken place. The woman ‘misses’ her period.
23
Conception
HORMONES HEREDITY
Hormones are chemicals which Every normal human cell contains
circulate in the blood of both men 46 chromosomes, except for the
and women. They carry messages to male sperm and female eggs. They
different parts of the body, regulating contain 23 chromosomes each.
certain activities and causing certain When the sperm fuses with the egg
changes to take place. The female and fertilisation takes place, the 23
hormones, which include oestrogen chromosomes from the father pair
and progesterone, control many of with the 23 from the mother,
making 46 in all.
The chromosomes are tiny thread-
A sperm is about 1/25 th of a like structures which each carry
millimetre long and has a about 2000 genes. It is the genes
head, neck and tail. The tail that determine the baby’s inherited
moves from side to side so characteristics, such as hair and eye
that the sperm can swim up colour, blood group, height and
the vagina into the womb and build.
fallopian tubes. The fertilised egg contains one sex
chromosome from the mother and
one from the father. The sex
chromosome from the mother’s egg
is always the same and is known as
the X chromosome. But the sex
chromosome from the father’s sperm
may be an X or a Y chromosome.
If the egg is fertilised by a sperm
containing an X chromosome,
the baby will be a girl (XX). If the
sperm contains a Y chromosome,
24 then the baby will be a boy (XY).
Conception
THE B E S T T I M E TO G E T P R E G N A N T
27 28 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
• • • • • •
First day of last period
You are most likely to conceive
if you have intercourse
about this time.
TWINS
Identical twins are the result of one to find out by about the end of the
fertilised egg splitting into two second month of your pregnancy.
separate cells. Each cell grows into a An ultrasound scan is needed (see
baby. Because they originally came page 56) to make the diagnosis at this
from the same cell, the babies have stage. You should be told at this point
the same genes – they are the same whether the babies are in separate
sex and look very like each other. sacs or offered a further scan to
Non-identical twins are common. determine this. Twin and other
They are one result of two eggs being multiple pregnancies (e.g. triplets)
fertilised by two sperm at the same carry a higher risk of most of the
time. The babies may not be the same complications associated with
sex and will probably look no more pregnancy, particularly premature birth.
alike than any other brothers and sisters. You will probably be encouraged to
Twins happen about once in every have regular scans during your
80 pregnancies. A couple is more likely pregnancy to check the babies’
to have twins if there are twins in the growth. You may be advised to
woman’s family. Triplets are much more have a Caesarean section. Discuss
rare and quads rarer still, although this with your doctor. You can still
nowadays the use of drugs in the breastfeed with twins. With triplets,
treatment of infertility has made or more, this may be more difficult.
multiple births more common. You It is a good idea to contact
may suspect that you are carrying twins support groups like TAMBA (Twins
if you are very sick in early pregnancy, and Multiple Births Association)
seem bigger than your ‘dates’, they and the Multiple Births Foundation
run in your family or you have had (see pages 141 and 142) before the
fertility treatment. It is usually possible babies are born. 25
Conception
FINDING OUT IF
YO U ’ R E P R E G N A N T
Whether or not you have The earliest and most reliable sign of
had a pregnancy test, you pregnancy, for women who have a
should see your doctor as regular monthly cycle, is a missed
soon as you think you are period. Sometimes women who are
pregnant. Being pregnant pregnant have a very light period,
may affect your GP’s losing only a little blood. Other signs
treatment of any current or of pregnancy are listed below.
future illness. Your GP will
also be able to advise you
about antenatal care in your
• even
Feeling sick – you may feel sick, or
be sick, not necessarily in the
area and put you directly in morning, but at any time. If you
touch with a midwife if you are being sick all the time and can’t
wish. keep anything down, tell your
doctor.
Information about the
services available is given in
the chapters on Deciding
• Changes in your breasts – often
the breasts become larger and feel
PREGNANCY TESTS
where to have your baby tender, rather as they may do before Pregnancy tests can be carried out
and Antenatal care and a period. They may tingle. The on a sample of urine from the first
antenatal classes (see pages veins may show up more and the day of a missed period – that is,
33 and 51). It may help to nipples may darken and stand out. about two weeks after conception.
look at these chapters before You can collect urine at any time of
you talk to your doctor. • Needing to pass water more
often. You may find that you have
the day. Use a clean, soap-free, well-
rinsed container to collect it. You can
to get up in the night to do so. get pregnancy tests free or for a small
charge from your GP or family
• Being constipated. planning clinic. Many pharmacists and
most pregnancy advisory services also
• An increased vaginal discharge
without any soreness or irritation.
offer tests, usually for a small fee. You
can also buy do-it-yourself pregnancy
testing kits from pharmacists. They
• Feeling tired. can be expensive but give you a
quick result and you can do the test
• Having a strange taste in your
mouth – many women describe
in private. Follow the instructions to
be sure of a reliable result.
it as metallic.
THE RESULTS OF THE TEST
• ‘Going off ’ certain things like
tea or coffee, tobacco smoke or A positive test result is almost
fatty food, for example. certainly correct. A negative result is
less reliable. You could wait a week
Some women don’t even need these and try again, or go straight to your
signs. They just ‘know’ that they are doctor.
pregnant.
26
Conception
K N OW I N G T H AT YO U ’ R E P R E G N A N T
You may feel very happy or excited pregnancy, or, in England and Wales, ‘I thought when I first
when you discover that you are will give you advice if you are not got pregnant, ‘‘This is
pregnant, but you shouldn’t worry happy to continue with it. You may fantastic, it’s really
if you don’t. Even if you have been want to share the news with family different, it’s never
looking forward to pregnancy, it is not and friends immediately or wait a while happened to me before.” ’
unusual for your feelings to take you until you’ve sorted out how you feel.
by surprise. And if your pregnancy was Others in your family/extended ‘I wasn’t very pleased at
unplanned, then you may feel quite family may have mixed feelings. first. I was a bit shocked,
confused. Give yourself a little time to You’ll need to talk about these I think, more than
adjust to the idea of being pregnant. feelings. But do begin to think anything, and it took me
Even though you may feel rather about your antenatal care (that is, about three months to get
anxious and uncertain now, this does the care you’ll receive leading up to used to the idea that
not mean that you won’t come to the birth of your baby) and where I was pregnant.
enjoy your pregnancy or to welcome you would like to have your baby. I don’t think I could
the idea of the baby. Discuss your The earlier you begin to organise believe it at first.’
feelings with your midwife or doctor this, the more chance you will have
who will help you to adjust to your of getting what you want.
HELP A N D A DV I C E F O R T E E N AG E R S
Life as a young mother can be Practical advice on things like SOMEWHERE TO LIVE
difficult, especially if your partner or benefits, education, employment
family are unable to give much help. and childcare are available from Many young mothers want
However, there are a wide range of the Maternity Alliance on to carry on living with their
services you can draw on. 020 7490 7638 or own family until they are
If you think you may be pregnant, www.maternityalliance.org.uk ready to move on. If you
you can get confidential advice are unable to do so, your
from the Sexwise helpline on 0800 CARRYING ON WITH local authority will take
282930 and further information from YOUR EDUCATION responsibility for housing
the website www.ruthinking.co.uk you. In some cases it may be
Becoming a teenage mother need possible to provide specialised
not mean the end of your education. accommodation where
If you become pregnant while still at young mothers can live
school, your school will not exclude independently while getting
you on grounds of pregnancy, and support and advice from
should keep you in learning even if trained workers. Seek advice
you are unable to attend for a while. from your local authority.
27
3 How the
baby develops
Week 1
D
octors and midwives in the UK time pregnancy from the first
day of a woman’s last menstrual period, not from conception.
So what is called ‘four weeks’ pregnant’ is actually about two
First day of your last
menstrual period weeks after conception. Pregnancy normally lasts for 37 to 42 weeks
Week 2 from the first day of your last period. The average is 40 weeks. If you’re
not sure about the date of your last period, then an ultrasound scan (see
page 56) may give a good indication of when your baby will be due.
You conceive at
about this time
Week 3
H OW THE BABY DEVELOPS
Egg being
released from
ovary Embryo implanting
in womb lining
28 Ovary
How the baby develops
29
How the baby develops
The placenta
The placenta is rooted to the lining of the womb and
separates the baby’s circulation from the mother’s. In the
placenta, oxygen and food from the mother’s bloodstream
pass across into the baby’s bloodstream and are carried to
the baby along the umbilical cord. Antibodies, giving
resistance to infection, pass to the baby in the same way,
but so too can alcohol, nicotine and other drugs.
Week 14
ACTUAL SIZE HEAD TO BOTTOM
ABOUT 85 MM
WEEKS 10-14
WEEKS 15-22
The baby is now growing quickly.
The body grows bigger so that the
head and body are more in
proportion and the baby doesn’t
look so top heavy. The face begins
to look much more human and the
hair is beginning to grow as well as
eyebrows and eyelashes. The
eyelids stay closed over the eyes.
The lines on the skin of the fingers
are now formed, so the baby already
has its own individual fingerprint.
Finger and toenails are growing Week 22
and the baby has a firm hand grip. ACTUAL SIZE HEAD TO BOTTOM
At about 22 weeks, the baby ABOUT 27 CM
becomes covered in a very fine, soft
hair called ‘lanugo’. The purpose
of this isn’t known, but it is thought
that it may be to keep the baby at
the right temperature. The lanugo
disappears before birth, though
sometimes just a little is left and
disappears later.
At about 16 to 22 weeks you
will feel your baby move for the
first time. If this is your second
baby, you may feel it earlier – at
about 16 to 18 weeks after
conception. At first you feel a
fluttering or bubbling, or a very WEEKS 23–30
slight shifting movement, maybe a
bit like indigestion. Later you can’t The baby is now moving about
mistake the movements and you vigorously and responds to touch
can even see the baby kicking and to sound. A very loud noise
about. Often you can guess which close by may make it jump and
bump is a hand or a foot and so on. kick. It is also swallowing small
amounts of the amniotic fluid in
which it is floating and passing tiny
amounts of urine back into the
fluid. Sometimes the baby may get
hiccups and you can feel the jerk of
each hiccup. The baby may also
begin to follow a pattern for waking
and sleeping. Very often this is a
different pattern from yours so,
when you go to bed at night, the
baby wakes up and starts kicking.
The baby’s heartbeat can now be
heard through a stethoscope. Your
partner may even be able to hear it
by putting an ear to your abdomen,
31
How the baby develops
WEEKS 31-40
32
4 Deciding
where to have
your baby
T
he choice you have about where to have your baby and how
you are cared for will depend to some extent on where you live. SEE YOUR MIDWIFE
But what should be the same everywhere is that the care and OR DOCTOR AS SOON
the place should feel right for you. AS POSSIBLE IF:
33
Deciding where to have your baby
THESE ARE THE KINDS OF QUESTIONS YOU MAY WISH TO ASK ABOUT A HOSPITAL
Would I go to the hospital antenatal clinic for all or just some of my antenatal care appointments?
Does the hospital offer team midwifery care or the Domino Scheme for delivery (see page 34)?
Will I be shown round the labour and postnatal wards before the birth?
Does the hospital encourage women to move around in labour and find their own position for
the birth, if that is what they want?
What is the hospital policy on induction, pain relief, routine monitoring, diet or any other aspect
of labour that concerns me?
AFTERWARDS
Are babies usually put to their mother’s breast immediately after birth?
Are babies with their mothers all the time or is there a separate nursery?
Will the hospital encourage (and help) me to feed my baby ‘on demand’ if this is what I want to do?
B I RT H PLAN
37
Deciding where to have your baby
BIRTH PLAN
Do you want your partner, or a chosen Do you want your baby delivered straight on to your
companion(s), to be with you during labour? tummy or do you want your baby cleaned first?
Do you want your partner or companion to Do you have any feelings about the injection
be with you if you have a Caesarean section Syntocinon or Syntometrine usually given to you
or forceps delivery, for example? after the birth to help the womb contract?
Is equipment such as mats, a birthing chair or How do you wish to feed your baby?
beanbags available to you if you want it, or can
you bring your own?
Do you want your baby close to you all the time?
If you intend to breastfeed you should make a note
Are there special facilities, like special that you want your baby close by you all the time
rooms or birthing pools? or brought to you when hungry so that you can
feed on demand.
What position would you like Do you need someone who speaks your
to be in for the birth? first language?
If you think you would like pain relief, which sort Do you need a sign language interpreter?
do you want to try (see page 91)? If you want to
try to manage without pain relief, it’s a good idea
to note this in the birth plan too. Do you need a special diet?
38
5 Feelings and
relationships
‘I think you have
F
rom the minute you know you’re pregnant, things begin to change.
Your feelings change – feelings about yourself, about the baby, more extremes of
about your future. Your relationships change – with your partner, emotion. You get
other children and also with parents and friends. more easily upset
But you’re still yourself, and you still have to get on with your life, about things,
whether pregnant or not. For this reason, adjusting to the changes that and you can more
pregnancy brings isn’t always easy. This chapter is about some of easily get very happy
the worries that may crop up in pregnancy and some suggestions on about things.’
how to handle them. But, of course, what may be a problem for one
person may not be a problem for another. And what is helpful advice
for some people may not be right for you. So take from these pages
what you find useful, and don’t bother about the rest.
FEELINGS
When you’re pregnant it can feeling worried or down, just as it
sometimes seem as though you are brings many reasons for happiness. ‘It frightens me,
not allowed to have other feelings as Hormonal changes taking place in wondering what I’ve
well. People expect you to be looking your body are responsible for much got to go through.
forward to the baby, to be excited and of the tiredness and nausea that some People say different
to ‘bloom’ all the time. You, yourself, women feel in the early months and things, you know, so
may think that this is the way you for some of the emotional upsets you don’t know
ought to be. In fact, just like any other which can happen. You may find what to think.’
nine months in your life, you’re likely you cry more easily, lose your
to have times when you feel low. And temper more, and so on.
pregnancy does bring extra reasons for Of course, there are many other
‘I think it’s a lot to
do with mind over
matter. I think the
thing to do is just
try and relax and
not be frightened.
I mean, it’s happened
to thousands and
millions of people
before you.’
39
Feelings and relationships
‘I've enjoyed it. I’ve reasons why you may feel rather yourself well and get plenty of sleep
enjoyed the newness down. You may have money worries will also help. Anyone who is tired
of it. I’ve enjoyed or worries about work or where you and run down is likely to feel rather
thinking of the baby. are going to live. You may be low, whether they are pregnant or
The only thing I anxious about whether you will cope not. And don’t let the pregnancy take
haven’t enjoyed as a parent, or about whether you’re over your life. Keep on doing the things
is getting so big.’ really ready to be a parent at all. And you enjoy. Although it’s normal to have
many of these anxieties may be shared some worries while you are pregnant
by your partner or family as well. and to feel a bit down from time to
‘I loved every minute This may be your first baby but not time, it’s a real cause for concern if
of being pregnant your partner’s so you may see and feel you’re feeling depressed for most of
and went through a things differently. Talk through these the time. Whatever the reason for your
wonderful experience feelings together. unhappiness, or even if there doesn’t
with labour.’ Talking about your feelings to your seem to be any reason at all, explain
partner, or to someone who is close to how you feel to your doctor, midwife
you, is often a relief and can help you or health visitor. Make sure they
‘Antenatal classes really get things in proportion. It may help understand that you’re talking about
helped. I met lots of your partner too. Making sure you keep something more than just feeling low.
women there who had the
same fears as me.The
midwife made us more
confident by telling us W O R RY I N G A B O U T T H E B I RT H
what happens in labour.
I felt well prepared.’
One worry that a lot of women have be with you in labour. Remember
in pregnancy is whether labour and they may be anxious also. Together
birth will be painful and how they you can then work out ways in
will cope. It is difficult to imagine which to cope.
what a contraction might be like
and no one can tell you – though
many will try. However, factual
information about the options open
to you can help you to feel more
confident and more in control.
Begin by reading the chapter on
Labour and birth (page 89) with
your partner, or a friend or relative
who will be with you for the birth,
if possible. Ask your midwife or
doctor for any further information.
Antenatal classes will also help to
prepare you for labour and the
birth (see pages 64–5).
Think about the sort of labour
and birth you would like to have.
You will probably have an
opportunity to discuss this in more
detail with your midwife and to
draw up a birth plan during the later
months of pregnancy (see page 38).
Talk to your partner too, or to
someone close to you, and
40 particularly to the person who will
Feelings and relationships
W O R RY I N G ABOUT ABNORMALITY
41
Feelings and relationships
42
Feelings and relationships
FA M I L I E S AND FRIENDS
In some ways pregnancy is very there are some decisions that only ‘There’s the feeling that
private, just to do with you and your you can take and some things that you’re being looked after.
partner, but there may be a lot of you prefer to do on your own. Not just by your husband
people around you who are also You may also find that being and your parents and the
interested and concerned about your pregnant puts you on the receiving hospital, but by your
baby – parents, sisters, brothers and end of a lot of advice, and perhaps friends, by everybody.
friends. a bit of criticism too. Sometimes They’re there behind
People can offer a great deal of the advice is helpful, sometimes you. I suppose they’re
help in all sorts of ways and you will not. Sometimes the criticism can wrapping me up in cotton
probably be very glad of their really hurt. The important thing is wool, but it’s still a nice
interest and their support. But to decide what is right for you. feeling.’
sometimes it can feel as if you’re After all, it is your pregnancy and
being taken over. If so, it can help your baby.
everyone if you explain gently that
‘My mother starts telling
me “You must have this
for the baby, you must
have that”, and trying to
tell me what I should do.
And bringing things like
nappy pins and saying
“I didn’t think you’d
remember to get them.”
It’s irritating.’
43
Feelings and relationships
WO R K
If you enjoy your work and the satisfactory childcare arrangement
company of those you work with, and it may take you some time.
you may have rather mixed feelings Any decision you make about
when the time comes to stop work childcare will be determined both by
before your baby is born. Try to your income and by the kind of
make the most of these few weeks facilities available locally. You may
to enjoy doing the things you want be lucky enough to have a relative
to do at your own pace. It is also a willing to provide care. If not, you
good opportunity to make some should contact your local Children’s
new friends. You may meet other Information Service (CIS) for a list
mothers at your antenatal classes (see of registered childminders and
pages 64–5) or you may get to know nurseries. Few nurseries take babies
more people living close by, now and prices are usually high. You may
that you have more time to stop also want to consider organising care
and chat. in your own home, either on your
You may have decided that you own or sharing with other parents.
are going to spend some time at Care in your own home does not
home with your baby or you may be need to be registered but you should
planning to return to work, either satisfy yourself that your carer is
full or part time, fairly soon after the experienced and trained to care for
birth. If you know that you will be babies. Contact the National
going back to work, or even if you Childminding Association (see page
think you might be, you will need to 142) for more information.
start thinking about who will look
after your baby well in advance.
It is not always easy to find a
44
Feelings and relationships
COPING ALONE
47
Mainly for men
‘She became very Confide in friends who are already Believe it or not, men can get
absorbed in her own fathers and will know what you’re symptoms of pregnancy too! The
body, separate. I felt going through. You may want to most commonly reported ones are
lonely and frightened protect your partner from your sleeplessness, indigestion and nausea.
of not doing the worries but she will almost certainly They are probably caused by stress,
right thing.’ sense your concern. The more you but are no less uncomfortable for
keep it to yourself, the more she’ll that.
(A FATHER) feel that you’re moving away from
her – just when she badly needs you
to be there. If you’re giving her the
‘My worries are to support she needs, then there’s no
do with making sure need to leave your feelings out of
that she’s happy and the picture.
comfortable and that.’
(A FATHER)
S U P P O RT I N G YO U R PA RT N E R
48 (A FATHER)
Mainly for men
PRACTICAL SUPPORT
that you’re both happy about it. A checklist for the final
If you prefer not to be present, weeks
talk to your partner. You may
be able to think of a friend or
relative who could accompany
• Make sure your partner
can contact you at all
her instead. times.
BECOMING
A FAT H E R
T
hroughout your pregnancy you will have regular care, either at a
hospital antenatal clinic or with your own GP or community working, you have the right
midwife. This is to check that you and the baby are well and so to paid time off for your
that any problems can be picked up as early as possible. This is the time antenatal care (see page 142).
to get answers to any questions or worries and to discuss plans for your
baby’s birth.
If you don’t speak English,
telephone your clinic so that an
interpreter can be arranged for
THE FIRST VISIT when you have an appointment.
Most women have their first, and pregnancy are more common in
longest, antenatal check-up around some ethnic groups. LET YOUR MIDWIFE
the 8th to 12th week of pregnancy. There may also be questions about OR DOCTOR
The earlier you go the better. You your work or your partner’s work KNOW IF:
should allow plenty of time as you and what kind of accommodation
will probably see a midwife and a
doctor, and may be offered an
you live in, to see if there is anything
about your circumstances that might
• there were any
complications in a previous
ultrasound scan. affect your pregnancy. pregnancy or delivery,
All this information will help to such as pre-eclampsia or
build up a picture of you and your premature delivery;
QUESTIONS pregnancy so that any special risks
51
Antenatal care and antenatal classes
IF YOU’RE GOING TO
HAVE YOUR BABY IN
HOSPITAL,
IF YOU’RE GOING TO
(22–28 lbs) in pregnancy, most of
it after the 20th week. Read pages
• have
sugar – pregnant women may
sugar in their urine from
HAVE YOUR BABY IN 8-12 on what to eat in pregnancy, time to time but, if it is found
A GP OR MIDWIFE and take regular exercise. Much of repeatedly, you will be checked
UNIT OR AT HOME, the extra weight is due to the baby for diabetes (some women
growing, but your body will also be develop a type of diabetes in
then you will probably go storing fat ready to make breast milk pregnancy known as ‘gestational
to your own GP and after the birth. diabetes’ which can be controlled
community midwife for during pregnancy usually by a
most of your antenatal care. change of diet and, possibly,
You may need to visit the HEIGHT insulin; the condition usually
hospital for an initial disappears once the baby is born);
assessment and perhaps for Your height will be recorded on the
an ultrasound scan or for
special tests. Sometimes your
first visit because it is a rough guide
to the size of your pelvis. Some small
• protein, or ‘albumin’, in your
urine may show that there is an
midwife may visit you at women have small pelvises and infection that needs to be treated;
home. although they often have small it may also be a sign of
babies they may need to discuss their pregnancy-induced hypertension
baby’s delivery with their doctor or (see High blood pressure and
midwife. pre-eclampsia on page 84).
52
Antenatal care and antenatal classes
TESTS
53
Antenatal care and antenatal classes
54
Antenatal care and antenatal classes
HERPES
L AT E R VISITS
TESTS TO D E T E C T A B N O R M A L I T I E S
IN THE BABY
It is important to realise that no test IF A TEST DETECTS AN
can guarantee that your baby will be ULTRASOUND (see also page 56) ABNORMALITY,
born without abnormality. No test is
100% accurate and some abnormalities Since ultrasound provides an image you may like to contact the
may remain undetected. of the baby in the womb, it detects appropriate organisation
The tests below are designed to structural abnormalities, particularly (see page 147–150) for
detect structural abnormalities like of the spine and head. Recently, further information. They
spina bifida or genetic disorders like however, it has been found to be may be able to put you in
Down’s syndrome. Down’s syndrome useful in screening for Down’s touch with parents who have
is caused by an abnormal number of syndrome and some other decided to continue with a
chromosomes. Chromosomes are the abnormalities of chromosome pregnancy in which an
structures within every cell of a person’s number. Several research studies have abnormality has been
body which carry the individual shown that the thickness of the detected. ARC (Antenatal
genetic code or recipe to make that ‘nuchal fold’ at the back of the baby’s Results and Choices; see
person. Conditions like cystic fibrosis neck is related to the risk of Down’s page 149 under ‘Loss and
and achondroplasia (dwarfism) are syndrome. An ultrasound scan at 11 Bereavement’) will offer
caused by abnormalities within the to 14 weeks enables a measurement support and information if
chromosomes (so causing a ‘mistake’ to be taken. This measurement then you are considering
in the recipe). Talk to your midwife, allows a risk factor to be calculated. termination for abnormality.
GP or obstetrician about the tests The nuchal translucency scan is not
mentioned below as they are not widely available at present but it is
available in all hospitals. becoming more so.
When you are deciding whether
or not to have a test, think what you ALPHA-FETOPROTEIN (AFP) TEST
might do if the test suggests that
your baby has an abnormality. If a This test is performed at
screening test (serum screen or about 15 to 20 weeks to
nuchal translucency) suggests a find out the level of
‘high’ risk of genetic abnormality, alpha-fetoprotein (AFP)
you will be offered amniocentesis in your blood. This
or chorionic villus sampling protein is made by your
(CVS) to give a definite diagnosis. baby and passes into your
Since these carry a risk of blood during pregnancy.
miscarriage, you may decide not to High levels are associated with spina
have these tests or even a screening bifida and so an ultrasound scan will
test if you would choose to continue then be offered to check for this.
with the pregnancy. Having a test, High levels may be seen in normal
however, may reassure you that your pregnancy and also in twin
baby is likely to be born healthy, pregnancy. Low levels of AFP are
allow you to consider the associated with Down’s syndrome
termination of an affected baby or pregnancies. Ultrasound and
give you time to prepare for the amniocentesis will then be suggested
arrival of a baby with special needs. to achieve a diagnosis.
Discuss the issues with your partner, Some hospitals routinely offer the
midwife, doctor and friends. AFP test to all women; others don’t,
or restrict the test to older women
since the risk of Down’s syndrome,
and some other abnormalities of
chromosome number, increases with age. 57
Antenatal care and antenatal classes
SERUM SCREENING
59
Antenatal care and antenatal classes
‘There were some things Having regular antenatal care is answers to your questions or
that really annoyed me – important for your health and the the opportunity to discuss any
the gowns, and the health of your baby. However, worries. Sometimes this can take
lavatories, and one sometimes antenatal visits can seem quite a lot of determination.
midwife who called quite an effort. If the clinic is busy
everyone “sweetie”.
But there were other
or short-staffed you may have to wait
a long time and, if you have small
• Ifableyourto gopartner is free he may be
with you. He’ll be able
things I wouldn’t have children with you, this can be very to support you in discussing any
missed – like hearing exhausting. By increasing the worries or in finding out what
my baby’s heart beating, number of women that are cared for you want to know. It will also
and well, just knowing by their GP and community help him to feel more involved
she was all right. midwife, antenatal care should in your pregnancy.
Knowing I was all right become more convenient. Try to
too, come to that.’ plan ahead to make your visits easier
and come prepared to wait. Here are
• Ifperiods
you regularly wait for long
at your clinic, bring this
some suggestions. to the attention of the hospital
management.
‘I think it’s up to you to
make the most of it. You
• Inrefreshments.
some clinics you can buy
If not, take a snack
can find out a lot, but with you if you are likely to get
you have to ask. When hungry.
your blood pressure’s
taken, you have to say,
“Is that all right?”.
• Write a list of any questions you
want to ask and take it with you
Then they’ll tell you. to remind you. Make sure you get
And if it’s not all right,
you have to ask why not,
and talk about it. It’s the
same for everything. It’s
not being a nuisance, it’s
being interested. I think YO U R A N T E N ATA L N OT E S
the staff like it if you’re
interested.’
At your first antenatal visit, your while you are away from home,
doctor or midwife will enter your you will have the information
details in a record book and add to that’s needed with you.
them at each visit. Many hospitals The page opposite gives a
If you have a disability ask women to look after these notes sample of the information your
which means that you have themselves. Other hospitals keep the card or notes may contain, as each
special requirements for your notes and give you a card which clinic has its own system. Always
antenatal appointments or records your details. Take your notes ask your doctor or midwife about
for labour, let your midwife or card with you wherever you go. anything on your card which you
know so that arrangements Then, if you need medical attention would like to have explained.
can be made in advance.
60
Antenatal care and antenatal classes
DATE WEEKS WEIGHT URINE ALB BP HEIGHT PRESENTATION RELATION OF FH OEDEMA Hb NEXT SIGN. NOTES
SUGAR FUNDUS AND POSITION PP TO BRIM
15/6/99 13 58 kg nil 110/60 15 – – – – 12.0 20/7 CS u/s arranged for 17/7 to check
maturity
20/7/99 18 59.2 kg Nil 125/60 18–20 – – FMF – – 21/8 CS
28/10/99 30 66 kg Nil 125/70 30 ceph 5/5 FHH - - 27/11 CS Mat B1 given, Hb taken
61
Antenatal care and antenatal classes
WHO’S WHO
63
Antenatal care and antenatal classes
A N T E N ATA L CLASSES
Think about what you Antenatal classes can help to prepare to some of them, or you can go
hope to gain from antenatal you for your baby’s birth and for alone or with a friend. In some
classes so that, if there is a looking after and feeding your baby. areas there are classes especially for
choice, you can find the sort They can also help you to keep women whose first language is not
of class that suits you best. yourself fit and well during English, classes for single mothers
You need to start making pregnancy. They are often called and classes for teenagers. The kinds
enquiries early in pregnancy parentcraft classes and may cover of topics covered by antenatal classes
so that you can be sure of relaxation and breathing, and are:
getting a place in the class antenatal exercise. They’re a good
you choose. You can go to
more than one class. Ask
chance to meet other parents, to talk
about things that might be worrying
• health in pregnancy;
your midwife, or health
visitor, your GP, or the local
you and to ask questions – and to
make new friends. They are usually
• what
birth;
happens during labour and
64
Antenatal care and antenatal classes
• your own health after the birth; of the professionals involved in your
care and to ask questions and talk
‘It was great meeting
people who were going
• ‘refresher classes’ for those who
have already had a baby;
over any worries you may have. You
can find out about arrangements for
through the same things
I was.’
labour and birth and the sort of
• emotions surrounding pregnancy,
birth and the early postnatal
choices available to you. This can
help you in thinking about making
period. your own birth plan (see page 38).
You’ll usually be able to look round
Some classes will try to cover all the labour and postnatal wards. You
these topics. Others will concentrate may also be able to meet some of
more on certain aspects, such as the people who will be looking after
exercises and relaxation or babycare. you when the time comes for your
The number of different antenatal baby to be born.
classes available varies very much Classes can give you confidence ‘It was brilliant having
from place to place. Classes may be as well as information. You’ll be classes in the evening
run by your hospital, by your local able to talk over any worries and because it meant Phil
midwives or health visitors, by your discuss your plans, not just with could help me during
own GP or health centre. The professionals, but with other labour.’
National Childbirth Trust also runs parents as well.
classes, usually in the evenings and Speak to your community ‘Being shown the
in the leader’s home. The groups midwife if you can’t go to classes. delivery suite helped
tend to be smaller and may go into The midwife may have videos to us – just knowing
more depth. lend you or you may be able to what to expect made
Antenatal classes may give you the hire or buy one. it less scary.’
opportunity to get to know some
65
8 Feeding your
baby
‘It was so easy. I suppose
I
t’s never too early to start thinking about how you’re going to feed
it took me about a couple your baby. Once your baby is born there will be lots to occupy you!
of weeks to get used to it, You’ll need to discuss it with other people, the baby’s father, your
and from then on I just midwife, health visitor or other mothers.
didn’t have to think. Breastfeeding gives your baby the best possible start in life. Almost
It was the one thing that all women can breastfeed successfully and find it an easy and enjoyable
wasn’t any effort at all.’ experience. Breast milk is the best form of nutrition for babies as it
provides all the nutrients a baby needs, and is the natural way for your
baby to carry on feeding from your body as a continuation of the
previous nine months. Most babies need no other food or drink until
they are six months old.
Your baby does not need water between feeds. Even in very hot
countries no water is needed. This is true for both breast and bottle-fed
If you’re HIV positive, you babies. If your baby cries, offer another feed even if he or she has been
will be advised not to fed recently. It is important to feed on demand since babies often don’t
breastfeed because follow a routine. This is particularly important for breastfed babies
of the risk of passing the because they increase the milk supply by increasing the frequency
virus on to your baby of feeds.
through the milk. It is Exclusive breastfeeding is recommended for the first six months of a baby’s life.
a good idea to discuss this After six months your baby should be given breast milk, along with appropriate
with your midwife or doctor. first foods, until they are at least a year old. Breastfeeding has lots of benefits for
both mother and baby. These are explained in more detail later in this chapter. If
you like, you can breastfeed your baby for a year or more, but you may
decide to breastfeed for a shorter time, if for example you are returning
to work, and then change to bottle feeding. Whatever method of
feeding you choose, your midwife, health visitor, or breastfeeding
counsellor can explain how to do it.
It’s important to know that if you decide not to breastfeed, it’s very
difficult to change from bottle to breastfeeding if you change your mind
later.
The following information should help you decide what’s best for
you and your baby.
Across Wales, a growing number of NHS Trusts are taking part in the
UNICEF UK Baby Friendly Initiative which sets out clear standards for
providing support for mothers in the feeding choices they make for their
babies. Ask your midwife about this.
66
Feeding your baby
BREASTFEEDING
WHY BREAST IS
GOOD FOR BABIES
• Breast milk contains growth
factors and hormones to assist
your baby’s development.
• Breast milk is the only food
naturally designed for your baby. WHY BREAST IS
‘I didn’t want to
breastfeed. It was as
It contains all the nutrients your GOOD FOR MOTHERS simple as that. The
baby needs in the right amounts whole idea of it put me
for the first six months of life, and As one mother said, ‘It was feeling off and I just couldn’t
they are in a form that is very close, and being together, that was have done it.’
easily absorbed. Its composition what I liked’, but there are other
even changes as your baby grows. advantages to consider:
‘I had quite a few
• Breastfeeding helps to protect
your baby from infection because
• Breast milk costs nothing. problems at first with
sore nipples and one
antibodies are passed into the
milk. Your baby will be less likely
• There’s no need to prepare feeds
or wash and sterilise bottles, and
thing and another. It
made it difficult. I think
to get coughs and colds and other your baby isn’t kept waiting. I’d have given up if it
infections than bottle- fed babies. hadn’t been for the
The longer you breastfeed, the
longer this protection will last.
• Breastfeeding helps your womb
return to its normal size more
midwife. She was ever
so good. And after a
quickly and, because it uses up while it all sorted out
• Breast milk is easily digested and
absorbed and is less likely to cause
calories, it will help you to lose
some of the weight gained in
and now I’m glad
I did it.’
stomach upsets or diarrhoea. It pregnancy.
will also help to avoid
constipation in your baby. • It’s so much easier and more
practical in the middle of
• Breastfed babies are less likely to
get allergies like eczema, for
the night.
NURSING BRAS
67
Feeding your baby
You can get help from: needs. The make-up of the milk
gradually changes throughout the
• your midwife or health visitor; course of the feed. The first milk
which your baby takes flows quickly
Seven pints of cow’s milk
per week plus a
• asupport
breastfeeding counsellor or
group (contact your local and is thirst quenching. It means supplement of vitamins
branch of the National Childbirth your baby gets a drink at the start of are available free to
Trust, La Lèche League, the every feed. As the flow slows down pregnant and
Breastfeeding Network, or the during the feed, the amount of fat in
your milk increases and your baby breastfeeding mothers if
Association of Breastfeeding your family receives
Mothers page 147 – these will receive the necessary calories.
organisations give help and This is why you shouldn’t restrict the Income Support or
support through other mothers length of feeds or swap breasts after income based Jobseeker’s
who have experience of too short a time. Allowance or Pension
breastfeeding). Your breasts may become very Credit guarantee credit.
large and heavy for a while and may
Don’t worry if other mothers seem feel uncomfortable, or even painful, at Use the free milk as a
to be doing things differently. It is first. Milk may leak from your drink, on cereals or to
important to have confidence in nipples and you may feel more make sauces or puddings.
yourself and your baby so that comfortable wearing breast pads.
together you can work out what Change them frequently, and avoid
is best for both of you. those with plastic backs. Or you can
use clean cotton hankies, and at
STARTING BREASTFEEDING night, in bed, you could put a clean ‘I wasn’t sure if I’d be
towel under you instead of wearing able to breastfeed. My
In the beginning, it can seem that pads. Gradually the amount of milk mum bottle fed me so she
you are doing nothing but feeding, you produce will settle down and
but gradually your baby will settle your breasts will begin to feel more couldn’t help. Once I
into a pattern of feeding. Try to normal again. If you are very got going though, it was
relax into it and take each day as uncomfortable, ask your midwife, so easy. I can’t think
it comes. health visitor or breastfeeding now why I was so
You’ll want to get off to the best counsellor for help. unsure at first.’
start so, as soon as possible after the
birth, your midwife will give you
the baby to hold. It’s best if you hold HOW BREASTFEEDING WORKS
your baby, undressed, next to your Your milk supply
skin for a close, calming cuddle. Your breasts produce milk
After a while your baby will in response to your baby feeding
probably begin to look for a feed - at your breast. The more your
how long this takes varies from baby baby feeds, the more your
to baby but is usually longer than body makes milk, provided
half an hour. that your baby is correctly
It also helps in establishing positioned. If you reduce
breastfeeding if you and your baby the amount of feeding, you
aren’t separated in the early days and will make less milk.
if you avoid the use of any dummies
or bottles during the first few weeks. The ‘let-down’ reflex
For the first few days after Your baby’s sucking causes milk
birth your breasts produce a special to gather behind the nipple,
food called colostrum, which looks ready
like rich creamy milk and is for feeding. This is called the
sometimes quite yellow in colour. ‘let-down’ reflex; some mothers feel
This contains all the food your baby it as a tingling sensation. You will
needs, as well as antibodies which see your baby’s quick sucks change
pass your own resistance to certain to deep swallows once the milk
infections on to your baby. has begun to flow. Babies often
After about three days, the pause while they wait for more
change from colostrum to milk milk to be ‘delivered’. Anxiety or
begins. It becomes full breastmilk tiredness can stop the ‘let-down’
after about two weeks. The milk will reflex, so try to rest and relax as
look quite thin compared with much as you can while you are
colostrum - this is normal. It still breastfeeding.
contains all the goodness your baby
69
Feeding your baby
HOW TO BREASTFEED
1 Get comfortable. Sit 2 Turn your baby’s body
so that your back is towards your tummy.
straight and your lap Tuck your baby’s bottom
is flat. You can use under your elbow, or
a pillow to support support your baby by
your baby. using a pillow. Hold your
baby behind the neck and
shoulders.
You’ll need at least six bottles and Your baby will gradually settle into a
teats. This is to make sure that you routine. Babies vary in how often
Feeding is a time for getting always have at least one or two they want to feed and how much
to know your baby and bottles clean, sterilised and ready for they want to take. Some may be
feeling close. But remember, use. Ask your midwife, health visitor content with feeds every three to
even when your baby is a or other mothers if you want advice four hours and others may want
little older, he or she should on what kind to buy. smaller quantities more often.
never be left alone to feed You should always buy new Respond to your baby’s needs and
with a propped-up bottle in teats and it’s best if you can buy feed when he or she is hungry, just
case of choking. new bottles too. Check regularly as you would if you were
to make sure the bottles are in good breastfeeding. In the same way,
condition. If they’re badly scratched, don’t try to force your baby to
you won’t be able to sterilise them finish a bottle. He or she may
properly. If in doubt, ask your have had enough for the time
USING BOTTLED midwife or health visitor for advice. being or simply want a rest.
WATER
The temperature of the milk
If you use bottled water to MAKING UP THE FEED Before you start to feed your baby
make up a feed, for example always check that the milk is not too
on holiday, it must be boiled When you’re preparing infant hot by dripping some on the inside
and then cooled first. Use formula, always follow the of your wrist. Some babies don’t
spring water not mineral instructions on the tin exactly. mind cold milk. Others prefer it
water. Use still water, Remember to put the boiled water warm. If you want to warm the milk
not fizzy. into the bottle first. The milk a little, place the bottle upright in
powder has been very carefully some hot water, keeping the teat out
balanced for your baby, so don’t be of the water. Don’t keep the milk
tempted to add extra powder to warm for more than 20 minutes
make a ‘stronger feed’ as this could before the feed as germs can breed in
be harmful to your baby. Never use the warmth. Never warm the milk
less or more than instructed and in a microwave oven as this is unsafe.
don’t add any other ingredients such The milk continues to heat for a
as sugar, honey, rusks or baby rice. time after you take it out of the
If you’re worried, your midwife microwave, even though the outside
or health visitor will advise you of the bottle may feel cold. The milk
how much milk your baby is likely inside may be very hot and could
to need. If you make up more than scald your baby’s mouth.
your baby wants, throw away what is
left at the end of the feed. You will A comfortable position
probably find it suits your routine Have everything you need ready
to make up a number of feeds in before you start feeding.
advance. Cool the capped bottles Find a comfortable position in
quickly under cold running water which you can hold your baby while
and put them in the fridge as you are feeding. Give your baby
soon as possible. Don’t keep the time. Some babies take some milk,
made up milk for longer than pause for a nap and then wake up
24 hours. for more. So be patient.
74
Feeding your baby
75
Feeding your baby
• aquick
steam steriliser – this is a very
and efficient method of
2 Rinse thoroughly in clean
running water.
sterilising;
3 To make up the solution, follow
• a microwave bottle steriliser – a
microwave alone is not enough to
the instructions that come with
the sterilising tablets or liquid.
sterilise the bottles without this Put the bottles and teats and
equipment. other equipment (but nothing
metal) in the solution and leave
Ask your midwife, health visitor or for the time given in the
other mothers about the different instructions. The tank will have a
methods and which might be most floating lid that keeps everything
appropriate for you. If you buy under the water or you can use a
equipment, make sure you follow large plate to keep the bottles
the manufacturer’s instructions. immersed. Make sure there are no
air bubbles inside the bottles. Put
the teats and caps in upside down
to prevent air being trapped.
Once the equipment is sterilised
you should not add new items or
the whole solution will be
contaminated.
76
9 Problems
Y
our body has a great deal to do during pregnancy. Sometimes
the changes taking place will cause irritation or discomfort, and
on occasions they may seem quite alarming. There is rarely any
need for alarm but you should mention anything that is worrying you to
your doctor or midwife.
If you think that something may be seriously wrong, trust your own
judgement and get in touch with your doctor or midwife straight away.
We have listed, in alphabetical order, the changes you are most likely
to notice and their causes – where these are known – plus suggestions
on how to cope.
COMMON M I N O R P RO B L E M S
BACKACHE
If during or after birth you
During pregnancy ligaments become
softer and stretch to prepare you for
• work at a surface high enough
to prevent you stooping;
have pain in the hips, groin,
lower abdomen and inner
labour. This can put a strain on the thighs and have difficulty
joints of your lower back and pelvis • between
try to balance the weight
two baskets if you are
walking or climbing stairs
which can cause backache. As the you should inform your GP,
carrying shopping;
baby grows, the hollow in your midwife or hospital doctor.
lower back may increase and this
may also cause backache (see box).
• well
sit with your back straight and
supported.
This may be due to a gap in
a joint in the pelvic girdle,
which gaps naturally during
To avoid backache: A firm mattress can help to prevent the birth to allow for the
and relieve backache. If your baby’s head, not closing up.
mattress is too soft, a piece of
• avoid heavy lifting; hardboard under its length will
This condition is known
as Symphysis Pubic
• back
bend your knees and keep your
straight when lifting or
make it firmer.
Massage can also help, or you
Dysfunction (SPD).
It affects very few women
picking something up from the might like to try a support corset – but early diagnosis and
floor; these can be prescribed by your appropriate treatment will
doctor. Make sure you get enough
• heavy,
if you do have to carry something
hold it close to your body;
rest, particularly later in pregnancy.
help to minimise the pain
and avoid long term
If your backache is very painful, discomfort. If you are
• round
move your feet when turning
to avoid twisting your spine;
ask your doctor to refer you to an
obstetric physiotherapist at your
diagnosed with SPD you
can contact The Pelvic
hospital. He or she will be able to Partnership (see page 149)
• weight
wear flat shoes as these allow your
to be evenly distributed;
give you some advice and suggest for support and information.
some helpful exercises.
77
Problems
CONSTIPATION CRAMP
• muscles
exercise regularly to keep your
toned up; DISCHARGE FROM BREASTS
• water;
make sure you drink plenty of You may notice a discharge from
your nipples. This is very common
and nothing to worry about.
• constipation
avoid iron pills if they cause
– ask your doctor
However, see your doctor or
midwife if it becomes bloodstained.
whether you can manage without
them or change to a different
type; if not, you may have to FAINTNESS
accept having constipation.
Pregnant women often feel faint.
This happens when not enough
blood is getting to the brain. If the
oxygen level gets too low you may
actually faint. It’s more common in
pregnancy because of hormonal
changes taking place in your body.
You’re most likely to feel faint if you
stand still for too long or get up too
quickly from a chair or hot bath. It
often happens when you are lying
on your back.
• orTrylying
to get up slowly after sitting
down.
• still,
If you feel faint when standing
find a seat quickly and the
faintness will pass. If it doesn’t, lie
down on your side.
• your
If you feel faint while lying on
back, turn on to your side.
It’s better not to lie flat on your
back in later pregnancy or during
labour.
78
Problems
stop eating.
PASSING WATER OFTEN
• Drink plenty of fluids. Needing to pass water often is an
early sign of pregnancy. Sometimes it
• support.
Ask those close to you for extra
continues right through pregnancy.
In later pregnancy it’s the result of
the baby’s head pressing on the
• can.
Distract yourself as much as you
Often the nausea gets worse
bladder.
If you find that you’re having to
the more you think about it.
get up in the night, you could try
cutting out drinks in the late
• make
Avoid the foods and smells that
you feel worse. It helps if
evening but make sure you keep
drinking plenty during the day.
someone else can cook but, if
Later in pregnancy, some women
not, go for bland, non-greasy
find it helps to rock backwards and
foods such as baked potatoes,
forwards while they are on the toilet.
pasta and milk puddings, which
This lessens the pressure of the
80 are simple to prepare.
womb on the bladder so that you
Problems
VAGINAL DISCHARGE TI R E D N E S S
• periods
try to avoid standing for long
of time;
MORE S E R I O U S P RO B L E M S
SLOW-GROWING BABIES
Many of the tests in pregnancy check In the last weeks of pregnancy you
the growth of your baby. If you have may also be asked to keep track of
previously had a very small baby, or if your baby’s movements. If you
you smoke heavily, the midwives and notice your baby’s movements
doctors will already be monitoring becoming less frequent or slowing
your pregnancy closely. Blood down, or if they stop, contact your
pressure checks may also pick up midwife or doctor immediately.
signs of trouble. If there is concern If tests show that your baby is not
about your baby’s health, further tests growing well in the womb, early
may be carried out and more delivery by induction of labour or
frequent monitoring of your baby Caesarean section (see pages 101–2)
may be recommended. may be recommended.
83
Problems
COT SAFETY
B AT H I N G
Your baby will spend many hours
• long
Any large, clean bowl will do as
as it’s not metal. Or you can
alone in a cot so make sure it’s safe.
• which
You need baby soap or liquid
can also be used on babies’
• securely
The bars must be smooth,
fixed and the distance
hair. Ordinary toilet soap may between each bar should be not
irritate your baby’s skin. It isn’t less than 25 mm and not more
necessary to use baby shampoo. than 60 mm so that your baby’s
head can’t become trapped.
• There’s
Two towels, the softer the better.
no need for special baby
towels, unless you want them.
• The cot should be sturdy.
SA F E T Y Keep the towels for your baby’s
use only.
• smoothly
The moving parts should work
and not allow fingers or
Pillows and duvets are not clothing to become trapped.
safe for babies less than a
year old because of the risk SLEEPING • recommended
Cot bumpers are not
of suffocation. Duvets can as babies can
also make the baby too hot. For the first few months, you will overheat or become entangled
Baby nests and quilted need a crib, a carry cot or a Moses in the fastenings.
sleeping bags are not suitable basket. Your baby just needs
for your baby to sleep in at
any time when you are not
somewhere to sleep that is safe and
warm and not too far away from
• bibs,
Never leave anything with ties –
clothes, etc. – in the cot in
there, again because of the you. You also need: case they get caught around your
danger of suffocation. baby’s neck.
• the
a firm mattress which must fit
cot snugly, without leaving
spaces round the edges – the baby
• for
If you’re buying a new cot, look
the British Standard mark BS
could trap his or her head and 1753.
suffocate. It’s best if the mattress
has a built-in plastic cover but, if See page 121 for more information
not, you can put a waterproof on reducing the risk of cot death.
sheet under the bottom sheet Spend some time looking at what is
(never use thin plastic or a bin
liner as your baby could suffocate
in the loose folds);
• need
sheets to cover the mattress – you
at least four because they
need to be changed so often –
fitted sheets make life easy but
they are quite expensive; you
could use pieces of old sheet or
pillow cases instead;
This baby is sleeping in the ‘feet to foot’ position (see
• and
several light blankets for safety
warmth.
page 121). This means that the baby’s feet are right at
the end of the cot to prevent the baby wriggling under
86 the covers and overheating.
What you need for the baby
87
What you need for the baby
IN THE CAR C L OT H E S
F O R T H E BA B Y
If you’ve got a car, you must have a
safety restraint right from the start,
even coming home from the Babies grow very quickly. All you
hospital. It’s very dangerous to carry need for the first few weeks are
your baby in your arms, and illegal. enough clothes to make sure that
The best way for your baby to travel your baby will be warm and clean.
is in a rear-facing infant baby You’ll probably need:
restraint (car seat) either on the front
or back seat. This is held in place by
the adult safety belt. Make sure it’s
• night
six stretch suits for both day and
or four stretch suits and two
correctly fitted. Do not place a rear- nighties for the night – use socks
If your car has an airbag do facing infant baby restraint in the or bootees with the nightie if it’s
not place your baby restraint front passenger seat if your car is cold;
in the front seat. fitted with an air bag.
Do not buy a secondhand car seat
as it may have been damaged in an
accident. Look for European Standard
number R44/03 when you buy.
FEEDING
If you’re breastfeeding you will
probably want nursing bras. They
WASHING BABY should open at the front and have
CLOTHES adjustable straps. Cotton is best
because it allows air to circulate. If
If you use a washing you try on bras at about 36 to 38
machine, don’t use enzyme
(bio) powders, as they may
weeks they should fit when needed
later.
• rather
two cardigans, wool or cotton
than nylon, light rather
irritate your baby’s skin. A supply of breast pads may also than heavy – several light layers
Always rinse very thoroughly. be useful. of clothing are best for warmth;
Fabric softener may also If you’re going to bottle feed, you
cause a skin reaction. will need to get: • four vests;
• six bottles with teats and caps; • baby
a shawl or blanket to wrap your
in;
• sterilising equipment;
• mittens,
a woolly or cotton hat,
• a bottle brush ; socks or bootees for
going out if the weather is cold –
• this too far in advance and
infant formula milk – don’t buy it’s better to choose close-knitted
patterns for safety;
remember to check the ‘sell by
date’ on the pack. • weather
a sun hat for going out if the
is hot or the sun is
bright.
88
11 Labour
and birth
T
his chapter describes a hospital birth because that is where most
people have their babies, but the information will also be useful if
you are having a home birth.
GETTING R E A DY F O R T H E B I RT H
IMPORTANT
NUMBERS
PACKING FOR HOSPITAL • your washbag with toothbrush,
hairbrush, flannel, etc.; Keep a list of important
Pack a bag to take to hospital well in numbers in your handbag
advance. Many hospitals have a
printed list of what to pack. If you’re
• towels in a dark colour if possible; or near the phone. There’s
space for you to write them
having your baby at home your
midwife will give you a list of things
• hospital
change or a phone card for the
payphone;
down at the beginning of
this book.You need to include
you should have ready. your hospital or midwife,
You may want to include the
following:
• stereo
a book, magazines, personal
or some knitting, for
your partner or birth
companion, and your own
example, to help you pass the hospital reference number
• going
front-opening nighties if you’re
to breastfeed and an extra
time and relax; (it will be on your card or
notes) to give when you
one if you’re going to wear your
nightie, rather than a hospital
• wear
a loose comfortable outfit to
during the day;
phone in. If you don’t have
a phone, ask neighbours for
gown, during labour; the use of theirs when the
• ora small bag for labour with one time comes.
• dressing gown and slippers; two large T-shirts, a sponge or
water spray to cool you down, a STOCKING UP
• ordinary
two or three nursing bras, or
bras if you’re not
personal stereo with your
favourite music and anything else When you come home you
breastfeeding (remember, your which you feel will make labour may not want to do much
breasts will be much larger than more pleasant for you; more than rest and care for
usual); your baby, so do as much
• clothes and nappies for the baby. planning as you can in
• absorbent),
about 24 sanitary towels (super
not tampons;
advance. Stock up on basics
such as toilet paper, sanitary
For coming home pads (for you) and nappies
• five or six pairs of old pants, or
disposables – you’ll probably want
Pack loose, easy-to-wear clothes for
yourself, baby clothes (including a
(for the baby) and, if you
have a freezer, cook some
to change often to stay fresh; bonnet), some nappies and a shawl meals in advance.
or blanket to wrap the baby in.
89
Labour and birth
TRANSPORT
H OW TO R E C O G N I S E
W H E N L A B O U R S TA RT S
IF LABOUR
You’re unlikely to mistake the signs
of labour when the time really
• astarts,
‘show’ – either before labour
or early in labour, the plug
STARTS EARLY comes but, if you’re in any doubt, of mucus in the cervix, which has
don’t hesitate to contact your helped to seal the womb during
Sometimes labour starts hospital or midwife and ask for pregnancy, comes away and comes
early, even as early as 24 advice. out of the vagina. This small
weeks. If this happens, get amount of sticky pink mucus is
advice immediately from the called a ‘show’ – you don’t lose a
hospital. SIGNS THAT LABOUR lot of blood with a show, just a
IS BEGINNING little, mixed with mucus. If you
are losing more blood, it may be a
Regular contractions sign that something is wrong, so
You may have been feeling telephone your hospital or
contractions (Braxton Hicks’ midwife straight away;
contractions) – when your abdomen
gets tight and then relaxes –
throughout pregnancy. Lately you
• water
the waters breaking – the bag of
in which the baby is
will have become more aware of floating may break before labour
them. When they start to come starts (you could keep a sanitary
regularly, last more than 30 seconds pad (not a tampon) handy if you’re
and begin to feel stronger, labour going out, and put a plastic sheet
may have started. Gradually they will on the bed). If the waters break
become longer, stronger and more before labour starts, you will
frequent. notice either a slow trickle from
your vagina or a sudden gush of
Other signs of labour water that you can’t control –
You may or may not also have the phone the hospital or your
following signs: midwife, and you will probably
be advised to go in at once;
• feeling
backache or that aching, heavy
that some women get
with their monthly period;
• nausea or vomiting;
90 • diarrhoea.
Labour and birth
PA I N RELIEF IN LABOUR
Labour is painful, so it’s important to You’ll probably have a chance ‘Gas and air seemed to
learn about all the ways you can to practise using the mask or work for me, provided I
relieve pain in labour and how your mouthpiece if you attend an used it at the right time.
partner or labour supporter can help antenatal class. ‘Gas and air’ won’t The midwife was really
you. Ask your midwife or doctor to remove all the pain but it can help good and helped me with
explain what is available so that you by reducing it and making it easier my timing.’
can decide what is best for you. Write to bear. Many women like it because
down your wishes in your birth plan, it’s easy to use and you control it
but remember you may need to be yourself. The gas takes 15 to 20
flexible. You may find that you want seconds to work, so you breathe it in
more pain relief than you had planned just as a contraction begins. There
and more effective pain relief may be are no harmful side-effects for you
advised to assist with delivery. or the baby, but it can make you feel
lightheaded. Some women also find
that it makes them feel sick or sleepy
TYPES OF PAIN RELIEF or unable to concentrate on what is ‘I didn’t want to
happening. If this happens you can have any injections or
Self-help simply stop using it. anything, so my midwife
If you try ‘gas and air’ and find told me about TENS. It
that it does not give you enough sounded a bit weird when
pain relief, you can ask for an she told me what it was
injection as well. but, when the time came,
it actually did seem to
TENS work.’
Epidural anaesthesia
An epidural is a special type of local
• water
you may find it difficult to pass
and a small tube called a
‘I was really scared anaesthetic. It numbs the nerves catheter may need to be put into
about the pain so which carry the feelings of pain from your bladder to help you;
I chose to have an the birth canal to the brain. So, for
epidural. It was
great – I didn’t
most women, an epidural gives
complete pain relief.
• your
you will need to have a drip on
arm to give you fluids and
feel a thing!’ An epidural is given by an help maintain adequate blood
anaesthetist so, if you think you pressure;
might want one, check with your
midwife beforehand (perhaps when
you’re discussing your birth plan)
• bed
you may not be able to get out of
during labour and for several
about whether an anaesthetist is hours afterwards;
92
Labour and birth
• heart
your contractions and the baby’s
will need to be
to let the hospital
know beforehand.
continuously monitored by a Discuss the matter
machine. This means having a with the midwife or
belt round your abdomen and doctor. And make sure
possibly a clip attached to your that the practitioner
baby’s head (see Fetal heart you use is properly
monitoring, page 96); trained and
experienced. For
• contractions,
if you can no longer feel your
the midwife will
advice, contact the
Institute for
have to tell you when to push Complementary
rather than you doing it naturally Medicine (see
– sometimes less anaesthetic is page 147).
given at the end so that the
effect of the epidural wears off
and you can push the baby out
more effectively;
WHAT YOU CAN DO FOR YOURSELF
• some
some women get backache for
time after having an Fear makes pain worse and everyone feels frightened of what they
epidural. don’t understand or can’t control. So learning about labour from
antenatal classes, from your doctor or midwife, and from books like
In some hospitals, a mobile or this, is an important first step.
‘walking’ epidural is available. The
anaesthetist gives a different
combination of drugs which allows
• can
Learning to relax helps you to remain calmer and birth classes
teach ways of breathing that may help with contractions.
you to move your legs whilst still
providing effective pain relief. Ask if
this is available in your hospital.
• kneel,
Your position can also make a difference. Some women like to
walk around or rock backwards and forwards. Some like
If you don’t want any of these to be massaged, but others hate to be touched.
kinds of pain relief, you are free to
say so. And if you decide you do
want pain relief, ask for it as soon as
• areFeeling in control of what is happening to you is important. You
working with the midwife and she with you, so don’t
you feel you need it, without hesitate to ask questions or to ask for anything you want at any
waiting for it to be offered. time.
ALTERNATIVE METHODS
• can
Having a partner, friend or relative you can ‘lean on’, and who
support you during labour certainly helps. It has been shown
OF PAIN RELIEF to reduce the need for pain relief. But if you don’t have anyone,
don’t worry – your midwife will give you the support you need.
Some mothers want to avoid the
above methods of pain relief and
choose acupuncture, aromatherapy,
• inAndadvance.
finally, no one can tell you what your labour will feel like
Even if you think you would prefer not to have any
homeopathy, hypnosis, massage and pain relief, keep an open mind. In some instances, it could help
reflexology. If you would like to use to make your labour more enjoyable and fulfilling.
any of these methods, it’s important
93
Labour and birth
WHEN TO G O I N TO H O S P I TA L
OR GP O R M I DW I F E U N I T
If your waters have broken you will first baby, go sooner and make sure
probably be advised to go straight in. you leave plenty of time to get to
If your contractions start but your the hospital. Second and later babies
waters have not broken and you live often arrive more quickly. Don’t
near to the hospital or unit, wait forget to phone the hospital or
until they are coming regularly, unit before leaving home and
about five minutes apart, lasting remember your notes or card.
about 60 seconds, and they feel so If you’re at all uncertain about
strong that you want to be in whether or not it is time for you to
hospital. If the journey is likely to go into hospital, always telephone
take a while, either because of traffic the hospital or unit or your midwife
or the distance, or if this is not your for advice.
HOME/DOMINO DELIVERY
94
Labour and birth
AT T H E H O S P I TA L
95
Labour and birth
W H AT HAPPENS IN LABOUR
There are three stages to labour. In puffs. Some people find this easier
WHAT YOU CAN DO the first stage the cervix gradually lying on their sides, or on their
opens up (dilates). In the second elbows and knees, to reduce the
• moving
You can be up and
about if you
stage the baby is pushed down the
vagina and is born. In the third stage
pressure of the baby’s head on the
cervix.
feel like it. the placenta comes away from the
wall of the womb and is also pushed Fetal heart monitoring
• You may be able to have
sips of water, but once in
out of the vagina. Every baby’s heart is monitored
throughout labour. The midwife is
established labour you watching for any marked change in
will usually be asked not THE FIRST STAGE the heart rate which could be a sign
to eat anything. This is that the baby is distressed and that
mainly in case you need The dilation of the cervix action should be taken in order to
an anaesthetic later on. Contractions at the start of labour speed delivery. There are different
Some units, however, help to soften the cervix. Then the ways of monitoring the baby’s
allow fluids and/or a cervix will gradually open to about heartbeat.
light diet. 10 cm. This is wide enough to let
the baby out and is called ‘fully • baby’s
Your midwife may listen to the
• while
If you need the midwife
she is out of the
dilated’. Sometimes the process of
softening can take many hours
heart intermittently with
a hand-held ultrasound monitor
room you will be able to before what midwives refer to as (often called a Sonicaid). This
call her by ringing a bell. ‘established labour’. This is when method allows you to be free to
your cervix has opened (dilated) to move around in labour if you wish.
• stronger
As the contractions get
and more
at least 3 cm.
If you go into hospital before
painful, you can put into labour is established, you may be
practice the relaxation asked if you would prefer to go
and breathing exercises home again for a while, rather than
you learned during spending many extra hours in
pregnancy. hospital. Once labour is established,
the midwife will check again from
• can
Your partner or friend
help by doing them
time to time to see how you are
progressing. In a first labour, the
with you and by rubbing time from the start of established
your back to relieve the labour to full dilation is between 6
pain if that helps. and 12 hours. It is often quicker for
later ones.
Towards the end of the first stage,
you may feel that you want to push
as each contraction comes. At this
point, if the midwife isn’t already
with you, ring for her to come. The
midwife will tell you to try not to
push until your cervix is fully open and
the baby’s head can be seen. To help
yourself get over the urge to push,
try blowing out slowly and gently or,
if the urge is too strong, in little
96
Labour and birth
Pushing
You can now start to push each time
you have a contraction. Your body
will probably tell you how. If not, As the baby’s head moves into the
take two deep breaths as the vaginal opening you can put your
contractions start and push down. hand down to feel it, or look at it in
a mirror. When about half the head
can be seen, the midwife will tell
you to stop pushing, to push very
gently, or to puff a couple of quick
short breaths blowing out through
your mouth. This is so that your
baby’s head can be born slowly,
giving the skin and muscles of the
perineum (the area between your
vagina and back passage) time to
stretch without tearing.
Sometimes the skin of the
perineum won’t stretch enough and
may tear. Or there may be an
urgency to hurry the birth because
the baby is getting short of oxygen.
98 The midwife or doctor will then ask
Labour and birth
Once the baby’s head is born, the body Your baby may be born still covered
usually follows quite quickly and easily with some of the white, greasy vernix
with one more push. which acts as a protection in the womb.
100
Labour and birth
A vaginal breech delivery is a little on the first baby once the waters
more complicated than the usual have broken (see pages 96–7). You
‘head first’ delivery. An epidural is will be given a drip in case it is
usually recommended and forceps needed later and an epidural will
are often used to deliver the baby’s often be recommended. Once the
head (see page 101). In some units first baby has been born, the
you will be offered the option of an midwife or doctor will check the
external cephalic version (ECV). position of the second by feeling
The baby is turned into the usual your abdomen and doing a vaginal
head down position (cephalic) by examination. If the second baby is in
pressing on the woman’s tummy. a good position to be born, the
waters surrounding the baby will be
TWINS broken and the second baby should
be born very soon after the first
If you are expecting twins, labour because the cervix is already fully
may start early because the womb dilated. If contractions stop after the
becomes very stretched with two first birth, hormones will be added
babies. More people will usually be to the drip to restart them.
present at the birth – for example, a Triplets or more babies are almost
midwife, an obstetrician, and usually always delivered by elective
two paediatricians, one for each Caesarean section. If you’re
baby. expecting twins or more babies, you
The process of labour is the same might like to contact the Twins and
but the babies will be closely Multiple Births Association
monitored, usually by using an (TAMBA) for advice and support
electronic monitor, and a scalp clip (see page 148).
W H AT YO U R C O M PA N I O N C A N D O
Whoever your labour partner is – helps and comforts you as your
the baby’s father, a close friend, labour progresses and your
or a relative – there are quite a few contractions get stronger;
practical things that he or she can
do to help you, although probably
none of them are as important as
• and
remind you how to use relaxation
breathing techniques, perhaps
just being with you. You can’t know breathing with you if it helps;
in advance what your labour is going
to be like or how each of you will
cope. But there are many ways in
• example,
support your decisions about, for
pain relief;
For very many couples,
being together during labour
which a partner can help. and welcoming their baby
been due. With a later miscarriage, pregnancy. Many people find it helps
bleeding is likely to be accompanied to have something to remember
by pains that feel more like the pains their baby by. In early pregnancy you
that come with labour. might be able to have a picture of a
If you bleed or begin to have scan. After about four months you
pains, you should contact the person could ask for a photograph of the
who is giving you antenatal care, baby. If your miscarriage is very late
either at the hospital or your GP’s you may be able to see and hold
surgery. You may be told to lie down your baby, if you wish, as well as
quietly or to come into hospital having a photograph. Talking also
immediately. Sometimes the helps. Talk about your feelings with
bleeding stops by itself and your your partner and those close to you.
pregnancy will carry on quite The Miscarriage Association (see
normally. But if a miscarriage is page 149) can give you information
going to happen, there is very little and put you in touch with other
that anyone can do to stop it. women who have experienced a
After a miscarriage, you may have miscarriage.
a ‘D and C’ (that is, dilatation and
curettage) to empty the womb. This
is done under anaesthetic. The T E R M I N AT I O N
cervix is gently widened and the
lining of the womb scraped or If tests show that your baby has a
sucked away. The cervix narrows serious abnormality you may
again afterwards. consider whether or not to end your
pregnancy (see page 57). It is
AFTERWARDS important to find out as much
information as you can from the
One miscarriage will not affect your doctor about the particular
chances of having a baby in the condition and how it may affect
future. Even after three miscarriages your baby, so that you can make a
you still stand a good chance of decision that is right for you and
carrying a baby to term. If you have your family.
three or more miscarriages, you You will probably be very shocked
should be referred for further when you are first told the diagnosis
investigations. In some cases, all by the consultant and may not be
investigations will be normal and no able to take very much in. You may
precise cause found. need to go back and talk again,
A miscarriage can be very difficult preferably accompanied by your
to come to terms with. You may feel partner or someone close to you.
disappointed, angry, or even guilty, You will also need to spend time
wondering what you did wrong. talking things through with your
Some people fear that the miscarriage partner or with others close to you.
may have been caused by making An early termination, before 12 to
love, though this is extremely 14 weeks, will usually be done under
unlikely. In fact, whatever the cause, a general anaesthetic. For a later
it is very rarely anyone’s fault. termination you will probably go
You will almost certainly feel a through labour as this is usually the
sense of loss. You need time to safest way for you. You may wish to
grieve over the lost baby just as you think beforehand about whether you
would over the death of anyone want to see and perhaps even hold
close to you, especially if the your baby and give your baby a
miscarriage has happened later in name. It can make the baby more
105
When pregnancy goes wrong
real for you and your family and your loss. Many hospitals have a
SAYING GOODBYE TO help you to grieve. If you don’t wish bereavement counsellor (or
YOUR BABY to see your baby, it’s still a good voluntary support from someone
idea to ask hospital staff to take a whose baby has also died) who will
A funeral or some other way photograph for you. You may find help you to find the best way for
of saying goodbye may be a this comforting at a later date. It can you and your partner to cope with
very important part of be kept in your notes in case you your loss.
coming to terms with your wish to see it. One of the first questions you are
loss, however early it You may find your feelings quite likely to ask is why your baby died.
happens. If your baby hard to cope with after a The doctors and midwives may not
dies after 24 weeks of termination, whether it has been in know. A post-mortem examination
pregnancy the hospital must early or late pregnancy. It will help is usually advised and this may help
provide a death certificate to talk about them. If you would like to find out, although it doesn’t
and arrange a burial or to talk to people who have always provide the answer. Most
cremation. If you would like undergone a similar experience you hospitals will offer you an
to arrange it yourself or can contact ARC (Antenatal Results appointment with the consultant
organise a service you can do and Choices) (see page 149). who can explain to you what is
that. Just speak to the ward known. If you are not offered an
staff and they will tell appointment, you can ask for one.
you what the arrangements LOSING A It may also help to talk about your
are in your hospital. feelings with other parents who have
BABY lost a baby in a similar way. SANDS
(the Stillbirth and Neonatal Death
In the UK about 4000 babies every Society) is an organisation that can
year are stillborn – the baby is put you in touch with other parents
already dead when it is born. About who can offer friendly help (see page
the same number die soon after 149).
birth. Often the causes of these You may well want to arrange a
deaths are not known. cremation, funeral or service. You
If you lose a baby like this, you are should be able to do so. If the baby
likely to feel very shocked. But you was lost after 24 weeks, the loss will
and your partner may find it need to be officially registered as
comforting to see and hold your either a death or a stillbirth. If you
baby and give your baby a name. want to arrange a funeral or
You may also like to have a cremation and your baby was lost
photograph of your baby and to before 24 weeks, you will need a
keep some mementos such as a lock certificate from the hospital. Talk to
of hair or the shawl the baby was your midwife or doctor about what
wrapped in. All this can help you you want to do and to find out what
and your family to remember your arrangements are available locally.
baby as a real person and can, in You could also consult the hospital
time, help in coming to terms with chaplain or rabbi or your own
religious adviser.
106
13 The first
days with your
new baby
‘I don’t think I’ll ever
I
n the first few days after the birth, you and your baby are beginning
to get to know each other. Don’t feel you have to make a great forget those first few
effort. Just have your baby close to you as much as you can. days. Feeling so happy.
Partners also need plenty of opportunity to handle the baby and feel Though I don’t know
close. Many fathers feel a little left out, especially if they have to leave why. I couldn’t sleep,
you and the baby in hospital and return to an empty home. They may the ward was so noisy.
need support and encouragement to get involved, but the more you can I was sore. I couldn’t
both hold and cuddle your baby the more confident you’ll all feel. move about very well.
I missed Alan and
home. But I felt
happier than I can
YOU ever begin to say.’
You may feel tired for the first few For a lot of mothers the excitement ‘I couldn’t believe it.
days, so make sure you get plenty of and the pleasure of the new baby far I’d never been much of
rest. Even just walking and moving outweigh any problems. But some do a one for babies. And
about can seem like hard work. If begin to feel low (see page 117) or Dean wasn’t even a
you’ve had stitches they’ll feel sore rather depressed, especially if they are pretty baby, not at first.
and you may feel worried about very tired or feel that they are not Very spotty and
going to the toilet. making any progress or can’t look blotchy. But he was
Once your breasts start to fill with after their baby as they would like. perfect to me. He
milk they may feel uncomfortable or Giving birth is an emotional and bowled me over.’
painful for a day or so. If you’re tiring experience and your hormones
breastfeeding, it will help to feed change dramatically in the first few ‘I felt awful. I was
your baby as often as he or she needs days. Some women feel rather weepy so tired, on top of
(see page 69). You might also like to around the third day, especially if the everything else. But
apply a warm cloth just before a feed labour was difficult, or if they are there was one thing
to help relieve the engorgement. If very tired or have other worries. This about it. Bob got to
you intend to bottle feed from the is known as the ‘baby blues’. Some know the baby much
start you needn’t do anything but, on women worry because they don’t better than he would
the third or fourth day, your breasts love their baby immediately but, as have done if I’d been
may be tender as the milk is still with any relationship, it’s not always more on top. He was
being produced. Wearing a firm, love at first sight. You may just need holding her and
supportive bra may help. Speak to to give yourself time – you can still cuddling her right
your midwife if you are very care for your baby and provide all the from the start.’
uncomfortable. warmth and security he or she needs.
107
The first days with your new baby
PILES
STITCHES
Piles (see page 81) are very common
If you’ve had stitches, bathing the after delivery but they usually
area often will help healing. Use a disappear within a few days. Eat
bath, shower or cotton wool and plenty of fresh fruit, vegetables,
108 plain warm water. After bathing, salad, brown bread and wholegrain
The first days with your new baby
cereals, and drink plenty of water. YOUR SHAPE ‘That first week was
This should make it easier and less nothing but problems.
painful when you pass a stool. Try Your breasts will be larger at first and One thing after another,
not to push or strain as this will while you are breastfeeding regularly. first me and then the baby.
make the piles worse. Let the You need to wear a supportive Everybody was very
midwife know if you feel very nursing bra if you are breastfeeding. helpful, but it was still a
uncomfortable. She will be able to If you are not breastfeeding your week or two before I got
give you an ointment to soothe them. breasts will reduce in size in a week sorted out.’
or so.
Your abdomen will seem quite
BLEEDING baggy after delivery. Despite having CONTRACEPTION
delivered your baby plus the placenta
After the birth you will lose blood and a lot of fluid, you will still be (See also page 117)
and discharge from the vagina. The quite a lot bigger than you were Before you leave hospital, a
loss will probably be quite heavy at before pregnancy. This is partly midwife or doctor will
first which is why you will need because your muscles have stretched. probably talk to you about
super absorbent sanitary towels. Do If you eat a balanced diet and contraception. If this doesn’t
not use tampons until after your exercise, your shape should soon happen, you may want to
postnatal check since they can cause return to normal. Breastfeeding ask. Although it may seem
infections in the early weeks after helps because it makes the womb very early to be thinking
the birth. During breastfeeds you contract. Sometimes, because this is about making love again, it
may notice that the discharge is happening, you may feel a quite can be easier to sort out any
more red or heavier. You may also painful twinge in your abdomen or questions about contraception
have ‘after pains’. These are both period-type pain while you are while you are in hospital
because feeding causes the womb to feeding. Breastfeeding also uses up rather than later on.
contract. They are a good sign that more calories so it can help you to
everything inside you is going back lose some of the weight gained in
to normal. Bleeding often becomes pregnancy. Some women do not
heavier around seven to ten days return to their normal weight until RUBELLA
after delivery but, if you find you are after they have finished
losing blood in large clots, you breastfeeding. If you were not immune to
should save these towels to show the Postnatal exercises (see page 115) rubella (German measles)
midwife as you may need some will help to tone up the muscles of when tested early in your
treatment. Gradually, the discharge your pelvic floor and tummy and pregnancy, you will probably
will become a brownish colour and help you find your waist again! be offered immunisation
may continue for some weeks, They will also get you moving and before you leave hospital or
getting less and less. feeling generally fitter. You may be shortly afterwards by your
If you’re breastfeeding you may able to attend a postnatal exercise GP. If this doesn’t happen,
not have another period until you class while you are in hospital and ask. This is a good
stop feeding or even for some weeks afterwards. Ask your midwife or opportunity to get it done.
or months after that. If you are not physiotherapist. You should not get pregnant
breastfeeding, your first period It is quite common after having a again for one month after
might start as early as a month after baby to find it difficult to control the injection.
the birth. But it could be much later. your bladder if you laugh, or move
You can become pregnant before suddenly, and to leak some water.
your period starts even if you are Pelvic floor exercises (see page 16)
breastfeeding, so make sure you will help with this. If the problem
decide on a reliable form of persists after three months, see your
contraception before you and doctor who may refer you to a
your partner make love again physiotherapist.
(see page 117).
109
The first days with your new baby
• need
babies who are born early – babies born earlier than 34 weeks may
extra help breathing, feeding and keeping warm, and the earlier
they are born the more help they are likely to need;
• usually
babies who are very small or who have life-threatening conditions,
affecting their breathing, heart and circulation;
• very
babies born to diabetic mothers, or babies where the delivery has been
difficult, may need to be kept under close observation for a time;
C O N TAC T W I T H YO U R B A B Y
All babies need cuddling and visit too, to get to know the baby, if
touching, whether they are in the ward this is possible. When you first go
close by you or in an NNU. If your into the NNU you may be put off
baby is in an NNU, you and your by all the machines and apparatus.
partner should try to be with your Ask the nurse to explain what
baby as much as possible. Encourage everything is for and to show you
other members of your family to how to handle your baby.
FEEDING
Feeding is especially important for babies can’t suck properly at first and
premature babies. Those who get are fed by a fine tube which is passed
some of their mother’s milk do through the nose or mouth into the
better, so think seriously about stomach. You and your partner can
breastfeeding. Even if you can’t stay still touch and probably hold your
with your baby all the time, you can baby. The tube isn’t painful, so you
express milk for the nurses to give needn’t worry about it being in the
112 while you are away. Some small way or hurting your baby.
Babies who need special care
COPING
INVOLVING YOUR PARTNER want to have their partners with
them so that they will have a chance
‘Everybody tells you how The more you can share your baby’s to get to know the baby properly, as
much having a baby’s care, the more you will both enjoy well as helping with the work. It also
going to disrupt your life, your baby. Your partner may not be gives you some time to start
your relationships – able to breastfeed but he can help with adjusting to the changes in your life.
especially with your bathing, changing and dressing as If you’re on your own, or your
partner – but I didn’t well as cuddling and playing. He may partner is unable to be with you,
find that. Obviously, feel quite nervous of handling the perhaps your mother or a close
when you’re both tired, baby and need encouragement. Be friend can be there. Even with help
nerves get frayed, but patient if he seems awkward at first. you will probably feel tired. Cut
life’s tons better with a corners where you can.
baby than without.’
(A FATHER)
HELP AT HOME • ofCutdustdown on cleaning. A bit
won’t hurt.
You’ll probably need a lot of
full-time help at first, not just
with the chores, but also to give you
• eat
Keep meals simple. You need to
well but this needn’t involve a
emotional support. You’re bound to great deal of preparation and
feel up and down and to get easily cooking.
tired in the early days. Many women
• many
Try to space visitors out. Too
in a short time will be very
tiring. If visitors do come, don’t
feel you have to tidy up or lay
on a meal. Let them do things
for you.
• Friends
If you need extra help, ask.
or neighbours will
probably be very willing to do
114 some shopping, for example.
The early weeks: you
LOOKING A F T E R YO U R S E L F
REST
115
The early weeks: you
FOOD
YO U R R E L AT I O N S H I P S
When you bring your new baby Your relationship with the baby
home all the relationships around may not be easy either, particularly if
you will start to shift and change. you’re not getting much sleep. Don’t
Your mother, for example, may find feel guilty if you sometimes feel
the change alarming and feel quite resentful at the demands your baby
unsure of how much to get involved. makes, or if your feelings are not
You may find that she is trying to what you expected them to be. Talk
take you over or that she is so to your midwife or health visitor if
anxious to avoid bothering you that you’re upset, but remember, many
she doesn’t help at all. Try to let the mothers do not feel instant love for
people close to you know clearly just their baby. They come to love them
how much you do want from them. gradually over the weeks.
Your relationship with your
partner will also change. It’s very
easy in those exhausting early weeks
to just leave things to sort themselves
out. Take care. You may wake up six
months later to find that you haven’t
spent an hour alone together and
have lost the easy knack of talking
your problems through. You both
need time alone, without the baby,
to recharge your own batteries, and
time together to keep in touch with
each other.
116
The early weeks: you
117
The early weeks: you
• examined
Your breasts are unlikely to be
unless you have a
particular concern.
118
16 The early
weeks: your
baby
T
he baby’s birth must be registered within six weeks from the
date of birth at your nearest Registry Office. The address will
be in the telephone book under the name of your local
authority (in Northern Ireland, look under ‘Registration of births,
deaths and marriages’). If you are married, you or the father can
register the birth.
If you are not married you must go yourself, and if you want the
father’s name to appear on the birth certificate he must go with you.
C RY I N G
All babies cry. It’s their way of saying
that something isn’t right. Sometimes also be comforting. You can put
you’ll be able to find the reason for your baby to your breast or give
your baby’s distress and deal with it. your baby a dummy if you wish. But
At other times all you can do is try if you do, make sure it is sterilised.
to comfort or distract your baby. Do not dip the dummy in honey
If it’s not obvious why your baby or sugar to make your baby suck –
is crying, think of possible reasons. he or she will suck anyway. Using
Could it be: sugar will only encourage a craving
for sweet things which are harmful
• hunger? to children’s teeth.
• wet or dirty nappy? Some babies do cry more than
• colic?
wind? others and it’s not really clear why.
• feeling hot, cold or uncomfortable? Don’t blame yourself or your baby if
• feeling tired and unable to sleep? he or she cries a lot. It can be very
• feeling lonely and wanting exhausting so try to get rest when
• company? you can. Share soothing your baby
with your partner. You could ask a
• tofeeling
play?
bored and wanting friend or relative to take over for an
hour from time to time, just to give
you a break. If there’s no one to turn
It could be none of these things. to and you feel your patience is
Perhaps your baby simply feels running out, leave your baby in the
overwhelmed and a bit frightened cot, put on some music to drown
by all the new sights, sounds and the noise, and go into another room
sensations in the early weeks of life for a few minutes. Make yourself a
and needs time to adjust. Holding cup of tea, telephone a friend or find
your baby close and talking in a some other way to unwind. You’ll
cope better if you do.
Never shake your baby. Shaking
makes a baby’s head move violently.
It can cause bleeding and damage
the brain. Put the baby down safely
in a cot or pram and calm yourself;
don’t be angry with the baby. If you
feel you’re having difficulties in
coping with your baby’s crying, talk
to your midwife or health visitor. Or
contact CRY-SIS (see page 150),
who will put you in touch with
120 other parents who’ve been in the
same situation.
The early weeks: your baby
• clothing
give your baby one light layer of
(or bedding) more than
• from
remove any loose plastic covering
the mattress which could
you are wearing. If the room is come off and smother your baby.
too hot for you, keep your baby’s
clothes or bed-covering light;
CLEAN AIR
• don’t use duvets (quilts) until
your baby is a year old – they Babies should not be exposed to
get too hot; tobacco smoke, either before birth
or afterwards. If you, or anyone else
• when
keep your baby’s head uncovered
inside (unless it’s very cold)
who looks after your baby, smoke
then don’t smoke anywhere near the
as babies need to lose heat from baby. Ask friends to smoke outside
their heads and faces; or before visiting you. It would be
even better if everyone could make
• electric
never use a hot water bottle or
blanket as babies have
an effort to give up completely.
Babies and young children who
delicate skin which can scald breathe in cigarette smoke are also
easily; more likely to get coughs, asthma
and chest infections. For more advice
• any
ill or feverish babies do not need
extra bedding – in fact, they
on giving up smoking, see page 13.
• ribbons
avoid plastic sheets or bumpers,
and bits of string from NAPPIES
mobiles anywhere near your baby,
who could get entangled in them; Babies need their nappies changed
fairly often, otherwise they become
• the
make sure there’s no gap between
cot mattress and the sides of
sore. Unless your baby is sleeping
peacefully, always change a wet or
the cot which your baby’s body dirty nappy and change your baby
122 could slip through;
The early weeks: your baby
• wipe
Take off the nappy. If it’s dirty, Cloth nappies
away the mess from your
baby’s bottom with tissues or
• If the nappy is dirty, flush the
contents down the toilet and rinse
cotton wool. off the nappy in the flushing water.
• genitals
Wash your baby’s bottom and
with cotton wool and
• ready
Have a plastic bucket (with a lid)
filled with water and the
warm water and dry thoroughly. right amount of nappy sanitising Lay your baby carefully on to a
Or use baby lotion. For girls, powder. Follow the instructions clean nappy and liner.
wipe the bottom from front to on the packet. Make sure you
back, away from the vagina so keep the nappy powder out of
that germs won’t infect the vagina reach of small children.
or bladder. For boys, gently clean
the foreskin of the penis, but
don’t pull it back; clean under the
• bucket.
Put the dirty nappy to soak in the
• cause
Don’t use baby powder as it can
choking.
Most babies get soreness or a nappy
rash at some time, but some have
extra sensitive skins. If you notice
• fold
If you’re using a cloth nappy,
it and put a nappy liner
redness or spots, clean your baby
very carefully and change nappies
Bring over the second side piece and
fasten all three pieces together with a
inside, if you wish. Pin the more frequently. Better still, give
corners of the nappy together your baby time without a nappy nappy pin. Put on plastic pants
with a proper nappy pin or clip and let the air get to the skin (keep over the top.
which won’t spring open. a spare nappy handy to mop up).
You will soon see the rash start
to get better. 123
The early weeks: your baby
124
The early weeks: your baby
WA S H I N G A N D B AT H I N G
WASHING
You don’t need to bath your baby
1 Check that the water is not too
hot, just comfortably warm to
your wrist or elbow.
every day but you should wash your
baby’s face, neck, hands and bottom
carefully each day. You can do this
on your lap or on a changing mat.
2 Undress your baby, except for a
nappy, and wrap snugly in a
towel. Wash your baby’s face with
Choose a time when your baby is cotton wool and water as described
awake and contented and make sure above. Don’t use soap on your
the room is warm. You’ll need a baby’s face.
bowl of warm water, some cotton
wool, a towel and a fresh nappy.
3 Wash your baby’s hair with baby
soap or liquid, supporting the
125
The early weeks: your baby
WHERE TO G E T S U P P O RT
SUNSHINE
B I L I N G UA L LY
Being bilingual gives a child Perhaps either you and your
something special. The best partner, or both of you, speak
advice is to introduce both another language. In that case,
languages as soon as your baby is you are in an ideal position to
So far we have only talked about the born! introduce your child to two
things that have to be done to keep It is worth bearing in mind languages and to the benefits
your baby warm, fed and safe. In the that children who speak more which that brings.
first weeks those things can grow to than one language enjoy several For more information on
fill all the available time, but of advantages such as: support groups for ethnic
course they’re only a tiny part of minorities contact Race
what it means to be a parent. Every • creatively;
thinking more flexibly and Equality First (W) (see page
second that your baby is awake he or 147); or for information on
she is learning from you. Learning • more
learning other languages
easily;
using the Welsh language with
about what it feels like to be your baby contact The Welsh
touched gently, about the sound of • learning
having a head start when
to read;
Language Board (see page 148).
your voice and your very special
smell, about what the world is like • cultures;
being able to enjoy two
and whether it is a safe place to be
and, above all, what it feels like to • tests
tending to perform better in
and exams.
love and be loved. 127
17 Thinking
about the next
baby?
DIFFICULTY
A
s you hold your new baby in your arms, it may be impossible to
CONCEIVING imagine that you will ever have the energy to go through it all
again. Or you may be eager to increase your family as soon as
It can take several months you can. Either way, this is the time to stop and think about how you
or more to conceive even if it and your partner can prepare for the next pregnancy. Nobody can
happened really quickly the guarantee that a baby will be born healthy. However, if you had a low
first time. birthweight baby or a baby with a disability or special needs, or a
miscarriage or stillbirth, you may be particularly anxious to do
If you’re feeling very tired everything you can to create the best possible circumstances for your
looking after the first baby, next pregnancy. You’ll want to talk to your doctor about this. If both
it may be that you are parents are in good health at the moment of conception, that is the best
simply not making love at start you can possibly give to a new life. There are a few other steps you
the right time. Re-read the can take as well.
section on Conception
(pages 21–5) to remind
yourself when you are most F AT H E R S TO O GETTING AND
likely to succeed. If nothing
happens after a few months, A bad diet, smoking, drinking and S TAY I N G H E A LT H Y
and you feel anxious about unhealthy working conditions can
it, talk to your doctor or affect the quality of sperm and stop
family planning clinic. pregnancy from happening at all. Try
to make your lifestyle as healthy as
possible before you try to conceive.
contain this important vitamin such they are safe to take in pregnancy.
as green, leafy vegetables and Addictive drugs will affect your ability
breakfast cereals and breads with to conceive and, if you do conceive,
added folic acid. (See symbol on are likely to damage your baby’s
this page.) To make sure you get health. See page 148 for organisations
enough, you should also take a 400 which can help you to stop.
microgram (0.4 milligram) tablet Foods carrying this mark
every day. You can get these tablets Sexually transmitted infections have added folic acid.
from a supermarket or pharmacist. (STIs)
If you already have a baby with spina STIs can affect your ability to
bifida, if you have coeliac disease or conceive as well as affecting you. If
take anti-epileptic drugs, ask your GP there is any chance that either of you VAGINAL BIRTH
for more advice, since you will need has been in contact with an STI, it’s AFTER CAESAREAN
important to get it diagnosed and
to take a bigger dose of folic acid. SECTION
treated before starting another
pregnancy. STIs, including HIV and
THINGS TO THINK ABOUT hepatitis B, can be passed on through:
The majority of women who
have had a Caesarean
Here are some things that are worth section are able to aim for a
doing before having your next baby. • infected
sexual intercourse with an
person, especially vaginal delivery for their
without using a condom, and next baby. This depends,
Rubella (German measles) some STIs can be transmitted however, on the reason for
Rubella can badly damage a baby during sex without penetration; the first Caesarean section.
during pregnancy. If you were Women who are thought to
not already immune you should
have been offered immunisation
• passed
HIV and hepatitis B can also be
on by sharing equipment
have a small pelvis, for
example, may be advised to
immediately after your baby was for injecting drugs. have a ‘planned’ (elective)
born. Before trying for another baby, Caesarean section next time.
think about having a blood test to If you’re HIV positive, you could pass Your GP, or midwife, will be
check that you are immune to the virus on to your baby in the able to advise you. Most
rubella. The blood test will measure womb, at birth or by breastfeeding. women who are advised to
if you have enough protection Up to 1 in 6 children born to try for a vaginal delivery in
(antibodies) against rubella. Women mothers with the virus are likely to subsequent pregnancies do
with low or uncertain levels of be infected (see box, page 54). have normal deliveries.
antibodies can be immunised again.
Long-term medication WO R K
If either of you has a chronic illness
or disability and has to take long- HAZARDS
term medication, talk to your doctor SOME WAYS OF
in advance of pregnancy about any If you think that there may be a risk AVOIDING RISK
possible effects on fertility or involved in your work ask for a
pregnancy. It may be possible to risk assessment. If a significant risk • protective clothing
cut down the dosage. is found your employer should take
reasonable steps to remove the risk
• or dust
avoiding breathing fumes
Diabetes and epilepsy or prevent your exposure to it (see • avoiding skin contact
If you have diabetes or epilepsy,
talk to your doctor in advance.
box). If the risk cannot be avoided
your employer should offer you
• working
temporarily altering your
conditions or
suitable alternative work on similar hours of work
Medicines and drugs terms and condition as your present
These may endanger your baby’s job. If no safe alternative is possible
health. Don’t take any over-the- you should be suspended on full pay
counter drugs at the time you hope (ie given paid leave) for as long as
to conceive without making sure necessary to avoid the risk. 129
18 Rights and
benefits
I
t’s very important that you get help and advice as soon as you know that
you’re pregnant, to make sure that you know your rights and that you claim
all the benefits to which you’re entitled. Benefits have to be claimed on
different forms, from different offices, depending on what you are claiming.
The benefit rates are accurate at January 2005. Maternity rights are complex
and sometimes change, so you should get further advice if you are unsure.
There are many voluntary organisations that are happy to help, so don’t hesitate
to ask for advice or get an opinion. See the box on where to get advice.
131
Rights and benefits
132
Rights and benefits
Grant, free milk and vitamins, help with fares to ● Crisis loans are interest-free, repayable loans
hospital, Housing Benefit and Council Tax Benefit. for people (whether on benefits or not) unable
You may be able to get help with mortgage interest to meet their immediate short-term needs in
payments. See below for more information. a crisis.
How much are they?
£500 SURE START MATERNITY GRANT This depends on your personal circumstances, your
FROM THE SOCIAL FUND
ability to pay and on how much money is available.
What is it? Social Fund payments are not a right and there is a
A lump sum payment (a grant which you do limited amount of money to be distributed to all
not have to pay back) to help buy things for a those who apply.
new baby.
How do I claim?
Who gets it? For information about which Social Fund payment
Pregnant women and new parents who are getting to claim and how, contact you local Jobcentre Plus.
Income Support, income-based Jobseeker’s More information is also available in leaflets SB16
Allowance, Pension Credit, Working Tax Credit (Guide to the Social Fund) and GL 18 (Help from
where a disability or severe disability element is the Social Fund).
included in the award or Child Tax Credit payable Loans have to be repaid at a set amount per
at a rate higher than the family element. week, which will be taken directly from your
income if you are claiming other benefits. The
How much is it? amount you have to repay per week depends on the
£500 for each baby. size of the loan, the size of your income and any
How do I claim? other debts you may have.
Claim using form SF100 (Sure Start), which you Anything else?
can get from your local Jobcentre Plus/Social ● A Community Care Grant does not have to be
Security Agency (social security office). You can paid back.
claim any time from 11 weeks before the due date ● You cannot get a Budgeting loan or a Crisis
until three months after the birth. Loan for more than £1,000 and the total you
Part of the form will need to be completed by owe the Social Fund cannot be more than
your midwife, GP or health visitor. This is to £1,000.
confirm when your baby is due or actually born, ● Savings of more than £500 will usually affect
and that you have received advice about the health how much you can get (£1,000) if you or your
and welfare of yourself and your baby. partner are aged 60 or over.
If you can’t get Income Support, income-based
JSA, Pension Credit, Working Tax Credit or Child HOUSING BENEFIT – HELP WITH YOUR RENT
Tax Credit until after your baby is born, claim the (in Northern Ireland this will help with your rent and/or
Sure Start Maternity Grant before your baby is rates)
three months old.
What is it?
THE DISCRETIONARY SOCIAL FUND Housing Benefit will help you pay your rent (in
Northern Ireland rent and/or rates) if you are on
What is the Discretionary Social Fund?
income-based Jobseeker’s Allowance, Income
The discretionary social fund provides grants and
Support, or have a low income. If you are a
interest-free loans for needs that are difficult for
council/Housing Executive tenant it will be paid
people to meet out of their weekly benefits or
direct to the council/Housing Executive; if you are
regular income.
a private tenant, it will be paid either to you or
What are they and who gets them? direct to your landlord. In Northern Ireland if you
There are three types of payments available: are an owner occupier Housing Benefit will be paid
in the form of a rate rebate administered by the
● Community care grants for people getting
Rate Collection Agency.
income support (IS) or income-based JSA.
● Budgeting loans are interest-free, repayable
loans for people getting income support (IS)
or income-based JSA for at least 26 weeks.
133
Rights and benefits
How much is it? are an owner occupier get claim form F1 from the
It depends on the rent you pay, average rents in your Rate Collection Agency (RCA), Londonderry
area, the size of your home, your income, savings, House, 21–27 Chichester Street, Belfast BT1 4JJ,
other benefits, your age and your family size. It may tel: 02890 25 2757 or your local RCA.
not be the same amount as the rent you are actually
paying. You cannot get Housing Benefit if you have HELP WITH MORTGAGE INTEREST
savings of more than £16,000, and the amount you REPAYMENTS
get is reduced if you have savings of more than Who gets it?
£3000. If you’ve got a mortgage and you’re on income-
How do I claim? based JSA or Income Support, you may be able to
If you’re getting income-based Jobseeker’s get help with your interest payments, although there
Allowance (JSA) or Income Support you will get a is usually a waiting period during which you won’t
Housing Benefit claim pack with your JSA/Income get any help.
Support claim form. Otherwise, get a form from How much is it?
your local council. In Northern Ireland if you are a You can only get help with interest payments (not
tenant get claim form HB1 from your Northern repayments of capital or contributions to a linked
Ireland Housing Executive district office or if you PEP, endowment or insurance policy) and the
prescriptions
Free
treatment
Free dental
Grant
Start Maternity
£500 Sure
Fund loans
Social
Benefit
& Housing
Benefit (not NI)
Council Tax
with mortgage
Help
Free milk
Free vitamins
hospital
Fares to
claim
If you get
✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓
Income-
based JSA
✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓
Income
Support
Low
✓ ✓ ✓ X X ✓ X X X ✓
income
All ✓ ✓ ✓ X X X X X X X
mothers
Rights and benefits
You should apply for Maternity If you qualify for a Sure Start Maternity The date your baby is due.
Allowance about now. Grant from the Social Fund, claim it as
soon as possible.
amount is usually based on a standard average If you have Mortgage Protection insurance,
interest rate (which may not be the same as the contact your insurer immediately. Most insurance
interest you are paying). policies will pay out if you are receiving income-
If you took out your mortgage before 2 October based JSA or Income Support, but not if you are only
1995, you will get no help for eight weeks, half of receiving Statutory Maternity Pay or Maternity
the allowable interest for the next 18 weeks and Allowance, so check carefully.
then all the allowable interest after that.
If you took out your mortgage after 1 October COUNCIL TAX BENEFIT
1995, you will get no help for 39 weeks and then (Not applicable in Northern Ireland.)
all the allowable interest from week 40 of your What is it?
claim. If you claim benefit because of the death of A benefit to help you pay your Council Tax if your
your partner or because your partner has left you income is low.
and you have at least one child under 16, you are
treated as if you took out your mortgage before Who gets it?
2 October 1995. If your income is low or you’re getting income-
based JSA or Income Support, you may get
How do I claim? Council Tax Benefit.
Once you have claimed income-based JSA or
Income Support, your Jobcentre Plus/Social How much is it?
Security Agency (social security office) will You may get all of your Council Tax paid or just
automatically send you a form MI12 about your part of it. It will depend on your income, savings,
housing costs shortly before they become payable. whether other adults live with you, and an
You fill out part of the form and then send it to assessment of your circumstances.
your mortgage lender to fill out the rest. The How do I claim?
money will either be paid to you as part of your If you’re getting income-based JSA or Income
income-based JSA or Income Support, or it will Support, you will get a Council Tax Benefit claim
be paid directly to your mortgage lender. form with your JSA/Income Support claim form.
Anything else? Otherwise, get a form from your local council.
Tell your mortgage lender as soon as you get into FREE MILK AND VITAMINS
difficulties with your mortgage. If you are unable
to meet your repayments, you may be able to Who gets them?
negotiate a temporary agreement for reduced You can get these free if you are pregnant and in a
repayments (e.g. during your maternity leave). family receiving Income Support, income-based JSA
If you have a ‘flexible mortgage’, this should be or Pension Credit guarantee credit.
relatively easy to arrange. Some mortgage lenders If you have a child under 5, receive Child Tax
allow a few months’ ‘repayment holiday’ once Credit only and have a family income of £13,230
during the life of the mortgage. or less (2003/4) you qualify.
135
Rights and benefits
136
Rights and benefits
Who gets it? the due date if it is a Sunday) and count back 11
You get SMP if: Sundays from there. It is for you to decide when
● you have worked for the same employer for at you want to stop work. You can even work right
least 26 weeks by the end of your qualifying up until the date the baby is due, unless:
week (the 15th week before your expected week ● you have a pregnancy-related illness/absence in
of childbirth, which is approximately the 26th the last four weeks of your pregnancy. In this
week of pregnancy), i.e. you started the job case your employer can start your maternity
before you got pregnant; leave even if you are absent for only one day.
● you are still in your job in this qualifying week However, if you are ill only for a short time
(it doesn’t matter if you are off work sick, or on your employer may agree to let you start your
holiday); maternity leave when you had planned; or
● you actually receive at least £77 (before tax) per ● your baby is born before the day you were
week in earnings, on average, in the eight weeks planning to start your leave. In this case SMP
(if you are paid weekly) or two months (if you will start on the day after the birth and maternity
are paid monthly) up to the last pay day before leave will start on the day of the birth.
the end of the qualifying week. SMP is paid for 26 weeks and usually starts on
To find out which is your qualifying week, look the Sunday after you go on maternity leave. So if
on a calendar for the Sunday before your baby is your last day of work is a Friday or Saturday, it will
due (or the due date if that is a Sunday) and count start immediately. You cannot get any SMP for any
back 15 Sundays from there. You should use the week in which you work even part of a week. So if
due date on the MAT B1 certificate which your you return to work early, your SMP will stop.
midwife or GP will give you when you are about
20 weeks pregnant. How do I claim?
If you are not sure if you’re entitled to SMP, ask To get SMP you must give your employer 28 days
anyway. Your employer will work out whether or notice of the date you want to start your pay and
not you should get it, and if you don’t qualify they you cannot then change your mind. If it is not
will give you form SMP1 to explain why. If your reasonably practicable for you to give 28 days
employer is not sure how to work out your SMP or notice, you should give it as soon as you can (e.g.
how to claim it back, they can ring 08457 143 143 you may have to go into hospital unexpectedly).
for advice. The notice should be in writing if your employer
asks for this.
How much is it?
For the first six weeks you get 90% of your average
pay. After that you get the basic rate of SMP, which
IF YO U A R E
is £100 per week (or 90% of your average earnings, U N E M P L OY E D
if that is less) for 20 weeks.
The average is calculated from the pay you CONTRIBUTION-BASED JOBSEEKER’S
actually received in the eight weeks or two months ALLOWANCE (JSA)
up to the last pay day before the end of the What is it?
qualifying week. Your employer normally pays your An allowance which lasts for up to 26 weeks for
SMP in the same way as your salary is paid. S/he people who are unemployed or working less than
deducts any tax and National Insurance 16 hours a week.
contributions.
Who gets it?
When is it paid? You get it if you have paid enough National
The earliest you can start your SMP is 11 weeks Insurance contributions during the last two tax
before the expected week of childbirth. This is years that do not overlap the current calendar year.
when you are about 29 weeks pregnant, but you You have to be available for work for as many hours
have to use the due date on your MAT B1 as your caring responsibilities permit (not less
certificate, which your midwife or GP will give than 16 hours), and you have to be actively
you. Find the Sunday before your baby is due (or seeking work.
138
Rights and benefits
139
Rights and benefits
your maternity leave when you had planned, for HOW TO GIVE NOTICE
example, if they have arranged maternity cover;
When do I have to tell my employer
● your baby is born before the day you were
I’m pregnant?
planning to start your leave. In this case leave
The latest time you can tell your employer that you
will start on the day of birth and you should tell
are pregnant is the 15th week before your baby is
your employer as soon as you can that you have
due. There is nothing to say that you have to tell
given birth.
your employer any earlier, although it may be to
ADDITIONAL MATERNITY LEAVE (AML) your advantage, for example, you have special
health and safety protection during pregnancy and
● 26 weeks unpaid leave from the end of OML; the right to paid time off for antenatal care once
● for employees who have been in the same job your employer knows you are pregnant. The law
for at least 26 weeks by the 15th week before protects you from being dismissed or discriminated
their baby is due; against because of pregnancy.
● right to return to the same job, or if that is not
reasonably practicable, a suitable job on very
Giving notice for OML and AML
similar terms and conditions.
To give notice that you will be taking maternity leave,
What is it? you must tell your employer the following things in
AML is a further 26 weeks leave from work, usually or before the 15th week before your baby is due (if
unpaid, after OML. It starts on the day after the your employer asks you to, you must put the notice
end of OML. in writing:
Who gets it? ● that you are pregnant;
You can take AML if you have worked for the ● the expected week of childbirth;
same employer for at least 26 weeks by the 15th ● the date on which you intend to start your
week before the expected week of childbirth. ordinary maternity leave.
This is when you are about 26 weeks pregnant.
If you want to change the date you start your
In practice, this means you must have started your
maternity leave, you must give your employer notice of
job before you got pregnant in order to qualify
the new date at least 28 days before the new date or
for AML.
the old date, whichever is earliest. If there is a good
How do I work out the 15th week before my reason why that is not possible, tell your employer as
baby is due? soon as you reasonably can.
Find the Sunday before your baby is due (or the Note: you can choose when to start getting your SMP;
due date if it is a Sunday) and count back 15 the earliest you can start getting SMP is in the 11th
Sundays from there. That is the start of the 15th week before the week your baby is due.
week before your expected week of childbirth.
You should use the due date on the MAT B1 Once you have given notice, your employer must write
certificate that your midwife or GP will give you to you within 28 days and state the date you are
when you are about 20 weeks pregnant. expected to return from maternity leave.
140
Rights and benefits
Your contractual rights are your terms and If you want to return to work before the end of
conditions, for example, a company car or your maternity leave, you must give your employer
paid holidays. at least 28 days notice of the date you will be
During OML you may be entitled to SMP or returning. If you do not give this notice and just
MA (see Maternity Benefits). After that your leave turn up at work before the end of your maternity
will usually be unpaid. Some employers offer extra leave, your employer can send you away for up
(or contractual) maternity pay, so check your to 28 days or until the end of your leave,
contract or ask the human resources department whichever is earlier.
or your union representative.
You will continue to be an employee throughout Note: if you are entitled to AML but only
your AML, but the only contractual rights that will wish to take OML, you must give 28 days
continue automatically will be: notice of your return as you are in fact
returning early.
● the notice period in your contract of The law does not allow you to work for two
employment (if either you or your employer weeks after childbirth, and this period is known as
wish to terminate your employment); Compulsory Maternity Leave. You will not be
● any entitlement to redundancy pay (after two allowed to return to work during this time.
years’ service);
● disciplinary and grievance procedures; What happens when I go back?
● if your contract has a section which states that When you go back to work after OML, you have
you must not work for any another employer, the right to return to exactly the same job.
this will still apply during maternity leave; Unless you are entitled to additional maternity
● it might be possible to negotiate with your leave (see below), you can’t stay on maternity leave
employer for other contractual rights to after the end of your OML, unless this has been
continue. agreed with your employer. You should ask your
employer to confirm this agreement in writing.
During the whole of your maternity leave you When you go back to work after AML, you have
are still entitled to your statutory rights (i.e. rights the right to return to exactly the same job. But if
that apply by law to all employees in this country). your employer can show that this is not reasonably
For example, everyone has a legal right to 20 days practicable, for example, because the job no longer
paid annual leave whether they are on maternity exists, you have the right to be offered a suitable
leave or not. Also your employer must not alternative job on very similar terms and conditions.
discriminate against you by failing to consider you
for such opportunities as promotion. What if I work for a small firm?
If you are made redundant whilst on maternity If you work for a firm that employs five people or
leave, your employer must offer you any suitable less, you still have the right to AML. However, if
alternative work that is available. If there is none, your employer can show that it is not possible to
they must pay you any notice and redundancy pay keep your job open or to offer you a very similar
that you are entitled to. job, then you cannot automatically claim that you
have been unfairly dismissed if your job is not there
RETURNING TO WORK at the end of the AML. However, you may still be
able to claim ordinary unfair dismissal and sex
Do I have to give notice of my return? discrimination, and you may be entitled to
No, unless you want to return to work before the redundancy pay.
end of your maternity leave. You simply go to work
on the day that you are due back. What happens if I need more time off work?
You cannot stay off work after your maternity leave
● If you are entitled to take OML, you will be due has ended, as you will lose your right to return to
back to work on the day after the end of the 26 your job if you do not go back at the end of your
week period. OML or AML (if you are entitled to it). If you
● If you are entitled to AML, you will be due back need more time off you could:
to work on the day after the 52-week period.
141
Rights and benefits
● Ask your employer if you can take annual leave long as you meet the normal conditions. However,
immediately after your maternity leave. Note this will mean you will have to be receiving over
that paid holiday continues to accrue during £77 per week from your employer in
maternity leave so you may have some holiday approximately weeks 18–26 of your pregnancy
owing to you. when SMP entitlement is calculated.
● Ask your employer if they will agree to a further If you have already taken OML and AML (a year
period off work. You should ask your employer off) you will be entitled to a second period of OML
to confirm this agreement in writing and to and AML. However, if you go straight onto another
confirm that you will have the right to return to period of OML without physically returning to
the same job. work and decide to return to work after the second
● Take some parental leave at the end of your period of OML, you will not have the right to
maternity leave (see below). Note that you must return to exactly the same job as you normally
give 21 days notice to take parental leave, and it would at the end of OML. However, you will have
is usually unpaid unless your employer offers the same rights as you would have had at the end of
paid parental leave. AML, which is the right to return to the same job
● If you cannot return because you are ill, you can or, if that is not reasonably practicable, a suitable
take sick leave as long as you follow your alternative job on similar terms and conditions.
employer’s sickness procedures. If you return to work after the end of your first
What should I do if I don’t want to go back period of AML and before the start of your second
to work? period of OML – even if you only return for one
You should resign in the normal way, giving the day – your rights are not affected and you would
notice required by your contract or the notice have the right to return to exactly the same job
period that is normally given in your workplace. after OML (see Return to work section).
If you do not have a contract or nothing has been
said, you should give a week’s notice.
OTHER EMPLOYMENT
Note: You do not have to repay any of the RIGHTS
SMP you received (6 weeks at 90% and 20 These rights apply no matter how long you have
weeks at £100). been employed or how many hours you work
What happens if I say I want to return to per week.
work and I change my mind?
Many women find it impossible to know before the PAID TIME OFF FOR ANTENATAL CARE
birth how they will feel afterwards, so it is always a If you are an employee, you have the right to take
good idea to say you are coming back in order to reasonable time off for your antenatal appointments,
keep your options open. If you decide later not to including time needed to travel to your clinic or
return, you can resign from your job in the normal GP, without loss of pay.
way. Your notice period can run at the same time as You should let your employer know when you
your maternity leave. need time off. For appointments after the first one,
your employer can ask to see your appointment
Can I change my working hours?
card and a certificate stating that you are pregnant.
You have the right to ask for flexible hours and
Antenatal care can include parentcraft and
your employer has a duty seriously to consider your
relaxation classes. You may need a letter from your
request. Your employer must have a good business
GP or midwife to show your employer, saying that
reason for refusing. (See Return to work on child-
these classes are part of your antenatal care.
friendly working hours below.)
My maternity leave ends soon and I’m HEALTH AND SAFETY RIGHTS
pregnant again. What rights will I have? If you are pregnant, have recently given birth or are
Maternity leave does not break your continuity of breastfeeding, your employer must make sure that
employment, so your right to maternity leave for the kind of work you do and your working
this baby will be based on your total service with conditions will not put your health or your baby’s
your employer. You may also qualify for SMP as health at risk. To get the full benefit of this legal
142
Rights and benefits
protection you must notify your employer in ● have worked for the same employer for at least
writing that you are pregnant or have recently given 26 weeks by the 15th week before your baby
birth or are breastfeeding. Your employer must: is due.
● Carry out a risk assessment at your workplace When can my partner start paternity leave?
and do all that is reasonable to remove or reduce Your husband or partner can choose to start
the risks found. paternity leave either:
● If there are still risks, your employer must alter
● from the date of your baby’s birth, or
your working conditions or hours of work to ● from a chosen number of days or weeks after the
remove the risk.
date of the child’s birth (whether this is earlier or
● If this is not possible or would not avoid the risk,
later than expected), or
your employer must offer you a suitable ● from a chosen date.
alternative job.
● If this is not possible, your employer must Paternity leave must have been taken within 56
suspend you on full pay for as long as is days of your baby’s birth or, if your baby was born
necessary to avoid the risks. If you do night early, within the period from the actual date of birth
work and your doctor advises that you should up to 56 days after the expected week of birth.
stop for health and safety reasons, you have the Your partner will be able to return to the same
right to transfer to day work or, if that is not job after paternity leave.
possible, to be suspended on full pay. You must
What is Statutory Paternity Pay (SPP)?
provide a medical certificate.
SPP is paid by employers for up to 2 weeks at a
DISMISSAL OR UNFAIR TREATMENT rate of £100 per week or 90% of average earnings,
whichever is less.
It is against the law for your employer to treat you
unfairly, dismiss you or select you for redundancy Can my partner get SPP?
for any reason connected with pregnancy, childbirth Your partner can get SPP if he or she:
or maternity leave. ● is the baby’s father or your husband/partner
If you are dismissed while you are pregnant or and is responsible for the baby’s upbringing;
during your maternity leave, your employer must ● has worked for an employer for 26 weeks by the
give you a written statement of the reasons. You 15th week before the baby is due or, if the baby
may also have a claim for compensation for sex is born before then, would have worked for an
discrimination. If you are making a claim against employer for 26 weeks by the 15th week before
your employer, you must put your claim into the the baby is due;
Employment Tribunal within three months. ● is still employed by the same employer before
the birth;
OTHER TYPES OF LEAVE ● earns at least £77 per week on average (before
tax) in the eight weeks immediately before the
PATERNITY LEAVE week your baby is born.
What is it? Your partner must give their employer notice of
Since 6 April 2003 there has been a new statutory the date they want their SPP to start at least 28 days
right to paid paternity leave. Following the birth of before or as soon as reasonably practicable.
a child, eligible employees will be able to take one
or two weeks leave to care for the child or support PARENTAL LEAVE
the mother. They must give their employer the What is it?
correct notice. The leave must be taken within 56 Parental leave is designed to give parents more time
days of the birth. with their young children. It entitles you to take 13
weeks leave per parent per child, usually unpaid, up
Who gets it?
to your child’s fifth birthday. Parents of disabled
Your baby’s biological father, your husband or your
children will be entitled to 18 weeks leave. In the
partner, including a same sex partner, will be able to
case of a child on Disability Living Allowance
take paternity leave providing they:
(DLA), the leave must be taken before the child is
● expect to have responsibility for bringing up 18. It is also available for adoptive parents, in which
the child;
143
Rights and benefits
case you can take it either within five years of the THE RIGHT TO ASK FOR FLEXIBLE
placement for adoption or the child’s 18th birthday, WORKING ARRANGEMENTS
whichever is earlier.
What is it?
Who gets it? Since April 2003 parents have the right to ask their
● Parents of children born or adopted on or after employers for a change in their working patterns so
15 December 1999. that they can care for their children. The change
● Parents of children who were born or adopted requested could relate to the hours that you work,
between 15/12/94 and 14/12/99, in which case the days that you work or your place of work.
leave must be taken by 31/3/05. There is a clear procedure that you and your
● To qualify for parental leave you must be an employer must follow. Your employer must
employee, have been employed for a year (by the seriously consider your request and can only refuse
time you wish to take it) and be taking the leave for one of the business reasons set out in the
in order to care for your child. You must give legislation.
your employer 21 days notice of the dates you
Who does it apply to?
want to take your leave. Your employer can
You can ask for flexible work if:
postpone the leave, but only if their business
would be unduly disrupted. ● you are an employee;
● Fathers wanting to take time off at or around the ● you are the parent, adoptive parent, guardian or
birth of a baby can take parental leave, providing foster carer of a child under six or a disabled
they give their employers 21 days notice of the child under 18 (or you are married to, living
expected week of childbirth. An employer with or the partner of that person);
cannot postpone leave in these circumstances. ● you have worked for your employer for 26
weeks by the time you make your request;
TIME OFF FOR DEPENDANTS ● you have not made a request in the last
Every worker is also entitled to emergency unpaid 12 months.
leave to make arrangements for the care for a How do I ask to change my hours?
dependant who falls ill, gives birth or is injured. You will need to send a written request (your
This leave can be used if there is a sudden problem ‘application’) to your employer giving details of the
with care arrangements for the dependant (e.g. if new working pattern you want to work. There is a
your childminder falls ill). clear procedure that both you and your employer
must follow.
RETURN TO WORK Your application must include all of the following:
● State that this is an application for flexible work
ON CHILD-FRIENDLY and that you are applying as a parent or as
WORKING HOURS someone with parental responsibility.
● State the working pattern you are asking for and
If you need to change your working hours because
of childcare, you have the right to have your the date you want it to start.
● Explain how you think the new working pattern
request seriously considered under sex
discrimination law and, since April 2003, parents of may affect the employer and how you think it
young children have the right to ask for flexible could be dealt with.
● State whether you have asked before and, if so,
working arrangements.
It is not yet clear how the two rights will work when.
● Sign and date the application.
together. You should therefore carefully follow the
procedure for asking for flexible hours under the Your application can be by letter, fax or email
new right, and if your request is refused, you should and you should keep a copy. Some employers may
get advice about whether you have a claim for have a standard form for making an application, so
compensation under the new right and under sex you should check.
discrimination law.
144
Rights and benefits
What happens when my employer receives What can I do if I don’t think my employer
the application? had a good reason to refuse my request?
Your employer must follow the procedure stated in Under the new right to ask for flexible work you
the Regulations. They must: can make a claim in a tribunal if your employer
● Hold a meeting with you within 28 days of your does not follow the procedure or refuses for a
application. reason not stated in the rules or without an
● The meeting should discuss your application explanation.
and, if your employer does not think that would You must complete the appeal procedure and
work, any possible alternative compromise wait for the decision before you can make a
arrangements. tribunal application. The tribunal will not question
● Give you notice of their decision within 14 days whether your employer was justified in refusing
of the meeting and tell you about your right unless you can show that your employer got the
of appeal. facts wrong. The tribunal can only award a
● Give reasons for refusing, which must be one maximum of eight weeks pay (up to the statutory
of those allowed by the regulations, with an maximum of £260 per week) in compensation.
explanation as to why that reason applies in YOUR RIGHTS UNDER SEX
your case. DISCRIMINATION LAW
Can my employer refuse my request? What are my rights under sex
Your employer can only refuse your request for one discrimination law?
of the following business reasons: Although there isn’t an absolute legal right to change
● the burden of additional costs; your working pattern, if you need to change the way
● the detrimental effect on the ability to meet you work because of your childcare responsibilities,
customer demand; your employer must seriously consider your request
● an inability to reorganise the work among and look at how you can do your old job in a way
existing staff; that meets your childcare needs.
● an inability to recruit additional staff; Your employer can only refuse if they have a
● the detrimental effect on quality; good business reason. It may be indirect sex
● detrimental effect on performance; discrimination if an employer refuses a woman’s
● there is not enough work during the periods request to change her working pattern, and it may
the employee wants to work; be direct sex discrimination if an employer refuses
● planned structural changes. a man’s request when they allow a woman to
work differently.
Your employer must also explain why that reason Your employer will only know if they have a
applies in your circumstances. good reason for refusing your request by giving it
What can I do if my employer refuses? a lot of thought. For example, refusing even to
You have the right to appeal within 14 days of consider your request or having a policy of refusing
receiving notification of your employer’s refusal. part-time work would probably be seen as sex
To appeal, you must write to your employer stating discrimination by an employment tribunal. An
your reasons for appealing. You must sign and date employer must consider each individual request in
your letter. order to avoid discriminating against a woman or
Your employer must hold the appeal meeting man with childcare responsibilities.
within 14 days of receiving your notice of appeal. People often assume that a job has to be done
They must notify you of their decision in writing full-time or at certain fixed times of day, but if you
within 14 days of the appeal meeting, giving and your employer look carefully at your job, you
reasons for their decision. may be able to work out a more child-friendly
option – perhaps one that neither of you had
considered before.
145
Rights and benefits
Does this apply to me? old job in a way that meets your childcare needs
Yes, sex discrimination law applies to all employers and can only refuse if they have a good business
and all employed parents with childcare reason for refusing. Your employer will only know
responsibilities, but it only applies if you would be if they have a good reason for refusing your request
disadvantaged by not being allowed to work the by giving it a lot of thought. For example, refusing
child-friendly hours you need to. In other words, even to consider your request or having a policy of
you must have a good reason for asking to work refusing part-time work would probably be seen as
differently – just as an employer must have a good sex discrimination by an employment tribunal.
reason for refusing. A good reason might be:
How do I know if my employer had a good
● You can’t find or afford full-time childcare. reason to refuse my request?
● You can’t find or afford childcare outside It will largely depend on the circumstances of your
9–5 Monday–Friday. work. If your new working pattern will cause major
● You have to be there when your child or problems, then your employer may well be justified
children come home from school. in refusing. In the end it would be up to an
● Your parent or relative cannot look after your employment tribunal to decide whether your
child full time. employer did have a good reason to refuse if you
● You are suffering severe stress from working bring a claim for indirect sex discrimination.
long hours. There have been many tribunal cases under sex
● You are distressed or disadvantaged by having discrimination law in the last few years, and many
to work your old hours. of the reasons given by employers are not seen
When should I use my rights under sex as justifiable.
discrimination law instead of under the What can I do if I don’t think my employer
right to request flexible work? had a good reason to refuse my request?
The new statutory right to request flexible working You can get further advice on your employer’s
only applies to employees who are parents of reasons for refusing from your trade union
children under 6 (or under 18 if disabled), who representative or local Citizens Advice Bureau.
haven’t made an application within the last 12 If you want advice on whether you might have
months, and who have worked for their employer a good case, you should see a specialist
for 26 weeks at the time of making the application. employment lawyer.
Sex discrimination law may help you if you need Under sex discrimination law, you can make a
to change your working pattern in order to care for claim in an employment tribunal if your employer
your child but cannot use the statutory procedure, refuses without a good business reason. The
for example, because you have made a request tribunal will scrutinise your employer’s reasons and
under the procedure within the last 12 months or question your employer carefully about whether
have worked for your employer for less than they were justified in refusing. They can also award
26 weeks. unlimited compensation for loss of pay (if you had
Do I have to follow a procedure under sex to leave your job) and for injury to feelings.
discrimination law? You must make a tribunal claim within
No, there is no specific application procedure under three months of the refusal under the new right
sex discrimination law, so we suggest that, if you and under sex discrimination law.
can, you initially make your request under the
new right to ask for flexible work (see above).
Under sex discrimination law, once you have
asked your employer to work flexibly, your
employer must seriously consider your request.
Your employer must look at how you can do your
146
USEFUL ORGANISATIONS
Commission for Racial Institute for The Multiple Births
Some of these organisations are large. Many are Equality Complementary Medicine Foundation
small. Some offer advice or information face to St Dunstan’s House PO Box 194 Hamersmith House, Level 4
face or over the telephone. Others concentrate 201-211 Borough High London SE16 7QZ Queen Charlotte’s and
on providing useful leaflets or books (these are Street 020 7237 5165 Chelsea Hospital
marked *). Many have local branches or can put London SE1 1GZ www.icmedicine.co.uk Du Cane Road
you in touch with local groups or a local contact. 020 7939 0000 Charity providing information London W12 0HS
www.cre.gov.uk on complementary medicine 020 8383 3519
When you write for information it’s important to and referrals to qualified www.multiplebirths.org.uk
remember to enclose a large stamped addressed In Wales: practitioners or helpful For professional support of
envelope for a reply. CRE Wales organisations.* families with twins and multiple
3rd Floor births.*
Capital Tower La Lèche League
Greyfriars Road (Great Britain) National Childbirth Trust
SUPPORT AND Breastfeeding Network Cardiff CF1 3AG PO Box 29 (NCT)
INFORMATION 0870 900 8787 029 2072 9200 West Bridgeford Alexandra House
(breastfeeding supporter line, Encourages good relations Nottingham NG2 7NP Oldham Terrace
ACAS (Advisory, 9.30am-9.30pm every day) between people from different London W3 6NH
Conciliation and Arbitration 0845 120 2918 (24-hour
racial and ethnic backgrounds, helpline) 0870 770 3236 (admin)
Service) Caesarean Support the elimination of racial 0870 444 8707 (enquiry
Brandon House www.laleche.org.uk
Network discrimination and promotion Help and information for line)
180 Borough High Street 55 Cooil Drive of equal opportunities. 0870 444 8708 (breast
London SE1 1LW women who want to
Douglas breastfeed. Personal feeding)
020 7396 5100 Isle of Man IN2 2HF Community Relations www.nctpregnancyand
www.acas.org.uk counselling. Local groups.
01624 661 269 (Mon-Fri Council Write with SAE for details of babycare.com
Advice on time off for after 6pm and weekends) 6 Murray Street Information and support for
antenatal care and on your nearest
Offers emotional support and Belfast BT1 6DN counsellor/group.* mothers, including
maternity rights, parental leave practical advice to mothers 028 9022 7500 breastfeeding information,
and matters like unfair who have had or may need a www.community- antenatal classes, postnatal
dismissal. For your nearest Life
Caesarean delivery. Can put relations.org.uk Life House groups. Write for details of
office, look in the phone book you in touch with a local Provides advice and support your nearest branch and
or ask at your local library or Newbold Terrace
mother who has undergone a for those working in Northern Leamington Spa information pack.*
citizens advice bureau.* Caesarean and understands Ireland to develop a society Warwickshire CV32 4EA
the problems.* free from sectarianism. 01926 421587 NHS Direct Wales
Action on Pre-eclampsia 0845 4647
(APEC) 01926 311511 (helpline
Child Diabetes UK 9am-9pm) 24 hour nurse-led helpline
84-88 Pinner Road Charter House 10 Parkway providing health information
Harrow www.lifeuk.org
43 St Leonards Road London NW1 7AA Charity offering information and advice.
Middx HA1 4HZ Bexhill-on-Sea 020 7424 1000 (admin) www.nhsdirect.nhs.wales.uk
020 8863 3271 (admin) and advice pre- and after-birth
E. Sussex TN40 1JA 020 7424 1030 (careline) and after abortion. Accom-
020 8427 4217 (helpline 01424 732361 NSPCC (National Society
Mon-Fri 10am-1pm) 020 7424 1888 (text modation for homeless and
www.child.org.uk phone) for the Prevention of
www.apec.org.uk unsupported mothers.
Self-help organisation offering www.diabetes.org.uk Cruelty to Children)
National charity offering information and support to 42 Curtain Road
support and information about Local advice agencies
people coping with problems In Wales: There may be a number of London EC2A 3NH
pre-eclampsia via its helpline of infertility and childlessness. 020 7825 2500 (admin)
and newsletters. Provides a Diabetes UK Cymru helpful local advice agencies in
May be able to put you in Quebec House your district offering general 0808 800 5000 (24-hour
befriender service.* touch with a local contact national helpline)
Castlebridge advice on a range of topics, like
group.* Cowbridge Road East benefits, debts and consumer www.nspcc.org.uk
Active Birth Centre
25 Bickerton Road Cardiff CF11 9AB problems, or specialising in one
Child Poverty Action 029 2066 8276 area such as law or housing. To In Wales:
London N19 5JT Group NSPCC Cymru
020 7281 6760 Information and support for all find out what exists ask at your
94 White Lion Street people with diabetes.* library or town hall. Capitol Tower
www.activebirthcentre.com London N1 9PF Greyfriars Road
Promotes a holistic approach 020 7837 7979 Cardiff CF10 3AG
to active childbirth and Equal Opportunities Local health boards
www.cpag.org.uk Commission If you’re new to an area they 0808 100 2524 (helpline)
parenting. Antenatal and Campaigns on behalf of low-
postnatal classes (fee payable). Arndale House can give you a list of local 029 2026 7000
income families. Information Arndale Centre doctors including those with a Aims to prevent all forms of
Publishes list of UK active and advice for parents on
birth teachers.* Manchester M4 3EQ special interest in pregnancy child abuse. Look in the phone
benefits, housing, welfare 0845 601 5901 and childbirth. If you have book for the number of your
rights etc.* www.eoc.org.uk difficulty in finding a GP to nearest NSPCC office if you
Association of
Breastfeeding Mothers take you on contact the LHB. need help.*
Child Safe Wales In Wales: Look in the phone book under
PO Box 207 Llandough Hospital
Bridgewater Windsor House the name of your local health Patients’ Association
Penlan Road Windsor Lane board. PO Box 935
Somerset TA6 7YT Penarth CF64 2XX
0870 401 7711 (24-hour Cardiff CF10 3GE Harrow
029 2071 6933 029 2064 1079 Middx HA1 3YJ
voluntary helpline) www.capic.org.uk
www.home.clara.net/abm/ www.eoc.org.uk Maternity Alliance 020 8423 9111
Provides information on child Information and advice on 3rd Floor West 0845 608 4455 (helpline
Telephone advice service for safety.
breastfeeding mothers. Local issues of discrimination and 2-6 Northburgh Street Mon-Fri 10am-4pm)
support groups.* equal opportunities.* London EC1V 0AY www.patients-
Citizens Advice Bureaux 020 490 7639 (admin) association.com
National Association of Family Welfare 020 490 7638 (advice line) Advice service for patients
Association for Citizens Advice Bureaux
Improvements in the Association www.maternityalliance.org.uk who have problems relating
Myddleton House 501-505 Kingsland Road Information on all aspects of to health and health care.*
Maternity Services (AIMS) 115-123 Pentonville Road
5 Ann’s Court London E8 4AU maternity care and rights. Advice
London N1 9LZ 020 7254 6251 on benefits, maternity rights at Public libraries
Grove Road 020 7833 2181 (call for
Surbiton www.fwa.org work.* Useful starting points for
telephone number of your National charity providing free finding out addresses of
Surrey KT6 4BE local office) national and local organisations.
0870 765 1433 (helpline) social work services and Minority Ethnic
www.nacab.org.uk support for children and Community Health and
www.aims.org.uk Race Equality First
Voluntary pressure group families. Provides financial Social Wellbeing Project
Community Health support for families in need (NI) Friary Centre, The Friary
which aims for improvements Councils throughout the UK.* Cardiff CF10 3FA
in maternity services. Support Multi-Cultural Resource
The Association of Welsh Centre (MCRC) 029 2022 4097
and advice about parents’ Community Health Independent Midwives email:
rights, complaints procedures 12 Upper Crescent
Councils (AWCHC) Association Belfast BT7 1NT race.equality@enablis.co.uk
and choices within maternity Park House Now called Race Equality
care, including home birth.* 1 The Great Quarry 028 9024 4639
Greyfriars Road Guildford www.mcrc.co.uk Councils. They are concerned
Cardiff CF10 3AF Surrey GU1 3XN As part of MCRC, promotes with race and community
Benefits Agency: relations in their area and often
local offices 029 2023 5558 (24-hour 01483 821104 two-way communication
answering service) www.independentmidwives. between minority ethnic know of local minority ethnic
For general advice on all social organisations and support
security benefits, pensions and org.uk groups and health service
In Northern Ireland CHCs Free advice to women thinking providers. Provides translation groups.
National Insurance, including
maternity benefits and Income are called Health and Social about a home birth. Offers and interpreting services,
Support and Income-based Services Councils. For your maternity full care to women multilingual materials and a
Jobseeker’s Allowance, local CHC/HSSC, look in your who book with them for home reference library.
telephone, write or call in to phone book under the name births. Fees vary. Send an A5
your local social security of your district health SAE for information.*
office. The address will be in authority or local Health and
the phone book under Social Services Council.
‘Benefits Agency’. Hours are
usually 9.30am to 3.30pm. In
busy offices there may be a
very long wait if you call in.
147
RELATE (National National Drugs Helpline Wales Pre-school Rape and Sexual Abuse ILLNESS AND
Marriage Guidance) Freephone 0800 776600 Playgroups Association Line DISABILITY
(North Wales) (English and Welsh) Ladywell House In North Wales:
8 Rivieres Avenue Freephone 0800 917 6650 Newtown PO Box 4 The Association for the
Colwyn Bay (for other languages, e.g. Powys SY16 1JB 7-9 Abbey Road Welfare of Children in
LL29 7DP Bengali, Urdu, Hindi, 01686 624573 Bangor LL57 2EA Hospitals (AWCH Wales)
01492 533919920 Punjabi & Cantonese) www.walesppa.co.uk 01248 354 885 (helpline 31 Penyrheol Drive
www.relate.org.uk www.ndh.org.uk Help and advice on setting up Mon-Fri 6pm-9pm, Tue Sketty
and running parent and toddler 1pm-4pm, Wed 9am-12) Swansea SA2 9JT
(Mid and West Wales) In Northern Ireland see groups and playgroups. 01792 205 227
Tŷ Merthyr Dunlewey Substance Advice Contact with local playgroups. In South Wales: To promote equality health
Little Water Street Centre, Northlands and PO Box 338 care services for children in
Camarthen SA31 1ER NICAS under ‘Alcohol’ COPING ALONE Cardiff CF24 4XH hospital, at home and in the
01267 236737 029 2037 3181 community. Promotes
Confidential counselling on ALCOHOL Gingerbread awareness of the needs of
relationship problems of any 7 Sovereign Close Refuge children and their families in
kind. To find your local branch Alcohol Concern Sovereign Court 2/8 Maltravers Street the Health Service in Wales. To
look under RELATE or Waterbridge House London E1W 3HW London WC2R 3EE give information and support
Marriage Guidance in the 32-36 Loman Street 020 7488 9300 (admin) 0870 599 5443 (24-hour to parents and carers.*
phone book or contact the London SE1 0EE 0800 018 4318 (advice line helpline)
above addresses. 020 7928 7377 Mon-Fri 9am-5pm) Emergency accommodation BLISS
www.alcoholconcern.org.uk www.gingerbread.org.uk and advice for women and 68 South Lambeth Road
The Samaritans children experiencing domestic London SW8 1RL
08457 90 90 90 (helpline) Alcoholics Anonymous In Wales: violence in London. 0870 7700 337
www.shelter.org.uk (AA) Baltic House www.bliss.org.uk
24 hours a day, 7 days a week. AA General Service Office 4th Floor Welsh Women’s Aid Parent support network for
Confidential emotional PO Box 1 Mount Stuart Square 38-48 Crwys Road families of babies who need
support for anyone in crisis. Stonebow House Cardiff Bay Cardiff CF24 4NN intensive or special care. Local
Stonebow Cardiff CF10 5FH 029 2039 0874 branches.*
In Northern Ireland: York YO1 7NJ 029 2047 1900 (10am-3pm with out-of-
1850 60 90 90 01904 644026 Self-help association for one- hours message service) Contact a Family
0845 769 7555 (helpline) parent families. Local groups Information, support and refuge 209-211 City Road
Shelter www.alcoholics- offer support, friendship, for abused women and their London EC1V 1JN
88 Old Street anonymous.org.uk information, advice and children.* 020 7608 8700 (admin)
London EC1V 9HU practical help.* 0808 808 3555 (helpline
020 7505 4699 Drinkline FAMILY PLANNING Mon-Fri 10am-4pm)
0808 800 4444 (helpline) Alcohol Helpline Meet-a-Mum Association www.cafamily.org.uk
www.shelter.org.uk 0800 917 8282 (Mon-Fri (MAMA) Family Planning
9am-11pm, Sat, Sun 6pm- 376 Bideford Green Association In Wales:
In Wales: 11pm) Linslade D1 Rooms Trident Court
25 Walter Road Leighton Buzzard Canton House East Moors Road
Swansea SA1 5NN Welsh Substance Misuse Beds LU7 2TY 435-451 Cowbrige Rd. East Cardiff CF24 5TD
01792 469400 Intervention Branch 01525 217064 Cardiff CF5 1JH 029 2044 9569
www.sheltercymru.org.uk National Assembly for 020 8768 0123 (helpline 029 2064 4034 Links families of children with
Help for those who are Wales Mon-Fri 7pm-10pm) special needs through contact
homeless and advice on any Cathays Park www.mama.org.uk Sexual Health Helpline lines. All disabilities. Local
kind of housing problem.* Cardiff CF10 3NQ Support for mothers suffering 0800 567 123 parent support groups.*
029 2082 5111 from postnatal depression or
Twins and Multiple Births Provides a list of organisations who feel lonely and isolated Marie Stopes Clinic Council for Disabled
Association (TAMBA) offering help and advice.* looking after a child at home. Marie Stopes House Children
2 The Willows Will try to put you in touch 108 Whitfield Street 8 Wakley Street
Gardner Road CHILDCARE with another mother who has London W1P 6BE London EC1V 7QE
Guildford experienced similar problems, 020 7388 0662 020 7843 6061
Surrey GU1 4PG Daycare Trust or with a group of mothers 0845 300 8090 (booking & www.ncb.org.uk/cdc
0870 770 3305 (admin 21 St George’s Road locally. Write with SAE for appointment line) Information for parents and
Mon-Fri 9.30am-4pm) London SE1 6ES details of local groups.* www.mariestopes.org.uk details of organisations offering
(01732) 868 8000 (helpline 020 7840 3350 (helpline Registered charity providing help with particular
Mon-Fri 7pm-11pm, Sat, 10am-5pm Mon-Fri) National Council for One family planning, women’s health disabilities.*
Sun10am-11pm) www.daycaretrust.org.uk Parent Families check-ups, male and female
www.tamba.org.uk Campaigns for the provision of 255 Kentish Town Road sterilisation, pregnancy testing, Disability, Pregnancy and
Information and support for good childcare facilities. The London NW5 2LX advice on unplanned Parenthood International
parents of multiples. Network Daycare Trust gives 020 7428 5400 (admin) pregnancies and sexual (DPPi)
of local Twins Clubs.* information on all aspects of 0800 018 5026 (lone parent counselling for men and Unit F9
childcare.* helpline Mon-Fri 9am- women. You don’t need to be 89-93 Fonthill Road
Welsh Language Board 5pm) referred by your doctor, but London N4 3JH
Market Chambers Mudiad Ysgolion 0800 018 5126 you do need to book an 0800 018 4730 (freephone
5-7 St Mary Street Meithrin/The National (maintenance and money appointment. A charge is made Mon-Fri 9am-5pm )
Cardiff CF10 1AT Association of Welsh matters advice available to cover costs. 0800 018 9949 (text
029 2087 8000 Medium Nursery Schools Mon-Thu 11am-2pm, phone)
0845 607 6070 (enquiry and Playgroups Tue 3pm-6pm) HIV AND AIDS www.dppi.org.uk
line) 145 Albany Road www.oneparentfamilies.org.uk Information service on
www.bwrdd-yr-iaith.org.uk Roath Free information for one- Sexual Health Information parenting issues for disabled
Information on playgroups, Cardiff CF24 3NT parent families on financial, Line people and allied professionals.
Welsh education and 029 2043 6800 legal and housing problems.* 0800 567123
leaflets about the benefits www.mym.co.uk 0800 917 2227 (Other Disability Living Centres
of bilingualism. Help and advice on setting up Parentline languages 6pm-10pm, see Council
and running parent and toddler See Parentline Plus p.150 below) Redbank House
ADDICTIVE DRUGS groups and playgroups. 028 9024 9696 (helpline) For each of the languages 4 St Chad’s Street
Contact with local playgroups. listed below you can speak to Cheetham
Drugaid DOMESTIC VIOLENCE an operator between 6pm and Manchester M8 8QA
Drug and Alcohol Misuse National Childminding 10pm on the day shown. 0161 834 1044
Service Association NSPCC At all other times this is a 0161 839 0885 (textphone)
1a Bartlett Street 8 Masons Hill (See p. 147) multi-language line and you can www.dlcc.co.uk
Caerphilly CF83 1JS Bromley BR2 9EY hear messages in each Disabled Living Centres offer
029 2088 1000 020 8464 6164 Rape Crisis Federation language. information and advice on
Counselling and information www.ncma.org.uk Bengali Monday products, also the opportunity
to drug, alcohol and solvent Unit 7, Provident Works Urdu Tuesday to try them out and explore
misusers and the public. NIPPA–The Early Years Newdeligate Street Arabic Wednesday other solutions.*
Organisation Nottingham NG7 4FD Gujerati Thursday
Narcotics Anonymous (UK 6c Wildflower Way 0115 900 3560 Hindi Friday
service) Apollo Road (Mon-Fri 9am-5pm) Punjabi Saturday
202 City Road Belfast BT12 6TA www.rapecrisis.co.uk Cantonese Sunday
London ECIV 2PH 028 9066 2825 Acts as a referral service for
020 7251 4007 www.nippa.org women seeking advice and/or Positively Women
020 7730 0009 (helpline Information, advice and support around issues of rape 347-349 City Road
10am-10pm) training for early years staff and sexual abuse. London EC1V 1LR
www.ukna.org
and families with young 020 7713 0444 (admin)
Self-help organisations whose children.* 020 7713 1020 (helpline
members help each other to Mon-Fri 10am-4pm)
stay clear of drugs. Write or www.positivelywomen.org.uk
phone for information and the Support services for women,
address of your local group. children and families affected
Some groups have a crèche.* by HIV. Peer support, advice,
information and advocacy.
148
Disabled Living Foundation CRUSE Bereavement SPECIALISED MENCAP (Royal Society SCOPE
(DLF) Care ORGANISATIONS for Mentally Handicapped 6 Market Road
380-384 Harrow Road Ty Energlyn Children and Adults) London, N7 9PW
London W9 2HU Heol Las Association for Spina Bifida MENCAP National Centre 020 7619 7100
020 7289 6111 (admin) Caerphilly CF83 2WP and Hydrocephalus 123 Golden Lane 0808 800 3333 (helpline
0845 130 9177 (helpline 029 2088 6913 (admin) (ASBAH) Cymru London EC1Y 0RT Mon-Fri 9am-9pm,
Mon-Fri 10am-4pm ) 0870 167 1677 (all day 4 Llys Fedwen 020 7454 0454 Sat-Sun 2pm-6pm)
0870 603 9176 (text phone helpline) Parc Menai www.mencap.org.uk www.scope.org.uk
Mon-Fri 10am-4pm ) A nationwide service of Bangor
www.dlf.org.uk emotional support, counselling Gwynedd In Wales: In Wales:
Sources of information on daily and information to anyone LL57 4BL 31 Lambourne Crescent SCOPE Cwmpas Cymru
living and disability bereaved by death, regardless 01248 671345 Cardiff Business Park The Wharf
equipment.* of age, race or belief. Local Support for parents of children Llanishen Schooner Way
groups.* with spina bifida and/or Cardiff CF14 5GF Cardiff CF10 4EU
In Wales: hydrocephalus. Advice, practical 029 2074 7588 029 2046 1703
Disability Wales/Anabledd Foundation for the Study and financial help. Local Work with people with a
of Infant Deaths (Cot Offers advice and support
Cymru groups.* learning disability and their
Wernddu Court Death Research and to parents of children with
www.asbah.org families and carers. Local cerebral palsy. Local groups.*
Caerphilly Business Park Support)
Van Road Artillery House branches.*
Caerphilly CF83 3ED 11-19 Artillery Row Association of Parents of SENSE Cymru (National
029 2088 7325 London SW1P 1RT Vaccine Damaged Children Meningitis Research Deaf–Blind and Rubella
www.dwac.demon.co.uk 0870 787 0885 (admin) 78 Camden Road Foundation Association)
National association of 0870 787 0554 (24-hour Shipston-on-Stour Midland Way 5 Raleigh Walk
disability groups in Wales. helpline) Warwickshire CV36 4DH Thornbury Brigantine Place
Provide information and www.sids.org.uk 01608 661595 Bristol BS35 2BS Cardiff CF10 4LN
training.* Support and information for Advises parents on claiming 01454 281811 029 2045 7641
parents bereaved by a sudden vaccine damage payment. 080 8800 3344 (24-hour 029 2046 4125 (Minicom)
Genetic Interest Group infant death. Gives new parents national helpline) Advice and support for families
(GIG) advice on reducing risk of cot Cleft Lip and Palate www.meningitis.org of deaf–blind and rubella-
Unit 4D death.* Association (CLAPA) disabled children. Local
Leroy House 235-237 Finchley Road In Wales: groups.*
436 Essex Road Miscarriage Association London NW3 6LS Meningitis Cymru www.sense.org.uk
London N1 3QP c/o Clayton Hospital 020 7431 0033 149 Hawthorn Way
020 7704 3141 Northgate www.clapa.com Brackla Sickle Cell Society
www.gig.org.uk Wakefield Support for families of babies Bridgend CF31 2PG 54 Station Road
Umbrella body for support W. Yorks WF1 3JS born with cleft lip and/or 01656 646 414 (admin) Harlesden
groups working with those 01924 200799 (Mon-Fri 0800 652 9996 (helpline) London NW10 4UA
affected by specific genetic 9am-4pm) palate. Feeding equipment
available. Local groups.* www.meningitiscymru.co.uk 020 8961 7795/4006
disorders. www.miscarriageassociation. Education, support and www.sicklecellsociety.org
org.uk information about meningitis
Phab Information, advice and Cystic Fibrosis Trust
Summit House support for women who have 11 London Road for people in Wales. In Wales:
Wandle Road had, or who are having, a Bromley BR1 1BY Cardiff Sickle Cell and
Croydon CR0 1DF miscarriage. Local contacts and 020 8464 7211 Muscular Dystrophy Thalassaemia Centre
020 8667 9443 groups.* 0845 8591000 (helpine Campaign Butetown Health Centre
www.phabengland.org.uk Mon-Fri 9am-5pm) 7-11 Prescott Place Loundon Square Docks
Stillbirth and Neonatal www.cftrust.org.uk London SW4 6BS Cardiff CF10 5UZ
In Wales: Death Society (SANDS) 020 7720 8055 029 2047 1055
029 2075 0700 28 Portland Place Down’s Syndrome 020 7720 8055 (helpline Information, advice and
Ruthin 01824 705 859 London W1B 1LY Association Mon-Fri 9am-5pm) counselling for families affected
Newport 01633 263 015 020 7436 7940 (admin) 155 Mitcham Road www.muscular-dystrophy.org by sickle cell disease or trait.
www.phab.org.uk 020 7436 5881 (helpline London SW17 9PG Support and advice through Financial help when needed.
Promotes integration 10am-3pm, answerphone 020 8682 4001 local branches and a network Local groups.*
between disabled and non- after hours) www.downs-syndrome.org.uk of Family Care Officers.
disabled people through www.uk-sands.org Provides support for individuals In Wales:
social, leisure and educational Information and a national In Wales: and families affected by Sustainable Wales Real
activities. Local groups. network of support groups for neuromuscular conditions.
bereaved parents.* Suite 1 Nappy Campaign
LOSS AND 206 Whitchurch Road 0845 456 2447(advice line)
Cardiff CF14 3JL Nappy Laundry Service www.realnappies-
BEREAVEMENT WIDWODS 0121 693 4949
(See also ‘Child’ under c/o 60 Rocks Park 029 2052 2511 wales.org.uk
(Mon-Fri 9am-12.30pm) www.changeanappy.co.uk Provides information and
Support and information) Uckfield
Information, advice, counselling Details of local services. advice on choosing and using
East Sussex TN22 2AX
Antenatal Results and 01825 765084 (evenings) and support for parents of anppies and nappy laundering
Choices (ARC) Small support group of young The Pelvic Partnership
children with Down’s 26 Manor Green services in Wales.
73 Charlotte Street widows aiming to provide syndrome. Local groups.*
London W1T 4PN practical and emotional Harwell OX11 0DQ
www.downs-syndrome.org.uk 01235 820921 Tommy’s Campaign
020 7631 0280 (admin) support for those who 1 Kennington Road
020 7631 0285 (helpline experience the loss of a www.pelvicpartnership.org.uk
Haemophilia Society Provides information and advice London SE1 7RR
Mon-Fri 10am-5pm) partner. Please include a 08707 707070
stamped addressed envelope. Chesterfield House about the management of SPD.*
www.arc-uk.org 385 Euston Road 08707 773060 (info)
Support and information for London NW1 3AU www.tommys-campaign.org
parents throughout antenatal SMOKING Reach (The Association for
020 7380 0600 Children with Hand or Arm Information about problems in
testing, especially when a
serious abnormality has been Smokers Helpline 0800 0186068 (helpline Deficiency) pregnancy including
diagnosed and a choice has Wales (W) Mon-Fri 9am-5pm) Reach Head Office Toxoplasmosis, Pre-eclampsia,
to be made about the 0800 169 0 169 www.haemophilia.org.uk premature birth and
PO Box 54
termination of the pregnancy. Counsellors offer confidential Information, advice and Helston miscarriage. Also advice on a
Ongoing support given to help and advice. Open daily from practical help for families Cornwall TR13 8WD healthy pregnancy.*
parents who decide on 7a.m. - 11 p.m. affected by haemophilia and 0845 130 6225 (Mon 9.30-
termination. Local contacts.* other bleeding disorders. Some UK Hyperemesis
3.30pm, Tue and Wed
NHS Smoking Helplines local groups.* 9.30am-6pm, Thu 1pm- Gravidarum Awareness
Compassionate Friends NHS Pregnancy Smoking Group
53 North Street Helpline 6pm and 8pm-10pm,
Jennifer Trust for Spinal Fri 9.30am-6pm) 29 Windermere Avenue
Bristol BS3 1EN 0800 169 9 169 Muscular Atrophy
0117 966 5202 (admin) www.reach.org.uk Basingstoke RG22 5JH
Open daily from 12 noon-9pm Elta House 07020 969 728 (info)
0117 953 9639 (helpline Birmingham Road Information and support to
10am-10.30pm) parents of children with hand 07050 655094 (support)
NHS Asian Tobacco Stratford-upon-Avon
www.tcf.org.uk Helpline or arm problems. Local www.hyperemesis.org.uk
CV37 0AQ Support organisation run by
An organisation of and for 0800 169 0 881 (Urdu) 0870 774 3651 (admin) groups.*
bereaved parents and families. 0800 169 0 882 (Punjabi) volunteers.
Advice and support. Local 0800 975 3100 (helpline)
0800 169 0 883 (Hindi) www.jtsma.org.uk The Real Nappy
groups.* 0800 169 0 884 (Gujarati) Association The UK Thalassaemia
0800 169 0 885 (Bengali) Self-help group offering Society
PO Box 3704
Website: information and support to London SE26 4RX 19 The Broadway
www.givingupsmoking.co.uk parents of children with the 020 8299 4519 Southgate Circus
disease. Can put you in touch www.realnappy.com London N14 6PH
with other parents. Equipment For a FREE information pack 020 8882 0011
on loan.* send SAE (two stamps). 0800 731 1109 (24-hour
Or contact the Women’s information line)
Environmental Network on 020 www.ukts.org
7481 9004. Information, and advice for
families affected by
thalassaemia.*
149
SUPPORT FOR STRESS
AND DEPRESSION
(See also Parents Advice
Centre in the Coping Alone
Section)
CRY-SIS
BM Cry-sis
London WCIN 3XX
020 7404 5011 (8am-
11pm)
www.our-space.co.uk/
serene.htm
Self-help and support for
families with excessively crying,
sleepless and demanding
children. Send SAE for details.*
MIND (National
Association for Mental
Health)
Granta House
15-19 Broadway
London E15 4BQ
020 8519 2122 (admin)
0845 766 0163 (Mind info
line)
www.mind.org.uk
In Wales:
3rd Floor
Quebec House
Castle Bridge
Cowbridge Road East
Cardiff CF11 9AB
029 2039 5123
Help for people experiencing
mental distress. Mind info line
offers confidential help. Local
associations.*
Parentline Plus
520 Highgate Studios
53-57 Highgate Road
London NW5 1TL
0808 800 2222 (helpline,
Mon-Fri 8am-10pm,
Sat 9.30am-5.0pm,
Sun 10am-3pm)
0800 783 6783 (text
phone)
www.parentlineplus.org.uk
Free confidential helpline
to anyone parenting a child.
Runs parenting classes and
produces a range of leaflets
and publications.*
150
INDEX clothes
for the baby 88
while you’re pregnant 8–12
foot exercises 17 Listeria 11
sex
after the birth 117
for the mother 89 forceps delivery 101 liver 12 in pregnancy 42, 47
A colostrum 69 fore milk 69 long-term medication 129 sexual organs (man’s) 21
abnormalities combined pill 117 free milk and vitamins 69, losing a baby 106 sexual organs (woman’s)
tests to detect 57–59 community midwife 62 73, 133 21, 22
worrying about 41 conception 21–23 fruit and vegetables 8, 9 M sexually transmitted
acupuncture 93 best time to get pregnant massage (for pain relief) infections (STIs) 17–18,
alcohol 14, 71, 128 25 G 93 54, 129
allergy, peanut 12 condoms 117 ‘gas and air’ (in mastitis 72 shape (after the birth) 109
alpha-fetoprotein (AFP) constipation 78, 108 labour) 91 maternity allowance 136 ‘show’ 84, 90
test 57 contraception 109, 117 general practitioners Maternity Benefits sickle cell disease 19, 54–55
alternative methods of contractions 90, 93, 94–101 (GPs) 62 133–136 signs of pregnancy 26
pain relief 93 cot death 121–122 genes 24 maternity leave 139–142 single parent 45
amniocentesis 58–59 sleeping position 121 German measles (see medicines skin and hair changes 81
amniotic fluid 31 temperature 121 rubella) before getting pregnant 129 sleeping (baby) 86, 120–121
amniotic sac 30 cot mattresses 122 going home with the baby during pregnancy 14 what you need 86
anaemia 10, 53 cot safety 86 114 midwife 62 sleeplessness (mother) 82
animals, coming into cots and cribs 86 GP/midwife unit 35 minerals 10 slow-growing babies 83
contact with during Council Tax Benefit 133 miscarriage 84, 104–105 smoking 13, 49, 121, 122,
pregnancy 19 cramp 78 H morning sickness 26, 80 128
antenatal care 51 crying 119–120 haemophilia 19 monthly cycle 25 giving up 13
antenatal classes 64–65 cystic fibrosis 19, 33 hair (changes during soft cheese 11
antenatal notes 60 pregnancy) 81 N special care (for babies)
aromatherapy 93 D headaches 79 nappies 122 112
‘D and C’ 105 health and safety rights changing nappies 123 spina bifida 10
B dairy products 9, 10, 11, 12 139 disposable 85, 123 tests for 57, 58, 59
babies with disabilities 113 death washable cloth 85, 123 starchy foods 9
babies born late 101 health visitor 63
of child 106 heartburn 79 what you need 85 Statutory Maternity Pay
babies’ stools 124 of partner 46 nappy rash 123–124 137–138
‘baby blues’ 117 hepatitis B 53
deep vein heredity 24 nausea 80 stillbirth 106
baby milk (formula) 73 thrombosis (DVT) 84 navel 110 stitches 108, 118
backache 77 herpes 18, 55
delivery high blood pressure 84 neonatal unit (NNU) 112 street drugs 14
bathing the baby 86, 125 at home 33, 34, 35, 94 nipples stretch marks 82
bilingualism 65, 127 hind milk 69
in hospital 33, 34, 35, 94 HIV and AIDS 18 cracked 72 sunshine 127
birth (see Labour) delivery rooms 95 flat 68 swollen ankles, feet and
birthmarks 111 and breastfeeding 18, 66,
development of the baby 129 sore 72 fingers 82
birth plan 37–38 28–32 nose bleeds 80
birthing pools 95 HIV positive mothers 129
diabetes 52, 129 HIV test 54 T
blood pressure 52, 61 difficulty in conceiving 128 home birth 33, 34, 35 O team midwifery 34, 35, 36
bottle feeding 73–76 disabilities (baby) 113 obstetric cholestasis 84 tear 98, 99
cleaning and sterilising 76 hormonal changes
dismissal because of after pregnancy 117 obstetrician 62 teeth and gums 82
equipment 74, 88 pregnancy 143 oedema 61 teenagers 27
making up the feed 74 during pregnancy 39, 79, 80,
domestic violence 46 81, 82 ovaries 22, 23, 24 temperature 121–122
microwaves 74, 76 Domino delivery 34 ovulation 23, 25 TENS 91–92
preparing a feed 75 hormones 24
‘double’ test (see ‘triple Housing Benefit 133 termination 105–106
bras (nursing) 67, 88 plus’ test) P thalassaemia 19, 54–55
Braxton Hicks’ hygiene during pregnancy paediatrician 63
Down’s syndrome (tests 12 thrush 83
contractions 42, 90 for) 57, 58 pain relief in labour 91–93
hyperemesis gravidarum partner (see Fathers) tiredness 83
breast pads 69, 88 duvets 86 toxoplasmosis 19
breastfeeding 37, 100, 109, 80 passing water often 80–81
E hypnosis 93 paté 12 ‘triple plus’ test 58
112 twins 25, 103
advantages for the baby 67 ectopic pregnancy 33, 104 pelvic floor exercise 16
advantages for the mother eggs 11 I pelvis 22
67 embryo 28, 29 illness pethidine 92 U
after the birth 107 engagement (of the baby’s baby 122, 126 phototherapy 113 ultrasound scan 29, 30, 33,
and contraception 117 head) 32, 61 meningococal septicaemia physical activity during 56, 57, 58, 59
and drinking 71 engorged breasts 71–72 126 pregnancy 15–16 umbilical cord 30
going back to work 68 Entonox 91 mother 77 physiotherapist (obstetric) uterus (womb) 22
help with 69 epidural 92–93 immunisation 101, 109, 118 63
how to 70 epilepsy 129 Incapacity Benefit 135 piles 81, 108–109 V
problems 71–72 episiotomy 99, 100 Income-based Jobseeker’s placenta 30, 99 vacuum extraction (or
starting off 69 exercises Allowance 131 postnatal check 118 Ventouse) 101
breasts after the birth 109, 115 Income Support 131 postnatal depression 117 vagina 22, 23, 96, 97, 98
babies’ 111 during pregnancy 15–17 incontinence 81 postnatal exercises 109, vaginal bleeding 84, 109
changes in during pregnancy expressing milk 72 incubators 113 115 vaginal discharge 83
26 indigestion 79 prams and carrycots 87 varicose veins 83
cracked nipples 72 F induction 101 pre-eclampsia 84 VDUs (using during
engorged breasts 71–72 faintness 78 inherited conditions 19 pregnancy tests 26 pregnancy) 20
lumpy, tender breasts 72 fallopian tubes 22, 23 injections (in labour) 92, premature babies 112 Ventouse extraction 101
mastitis 72 families and friends 43 100 and breastfeeding 68 vernix 32, 99
preparing for breastfeeding fathers internal examination 55, 95 presentation (of the baby) vitamin K 110
68 becoming a father 50, 128 itching 79, 84 61 vitamin supplements 10
breech birth 102–103 feelings 47, 48, 50 IUD (intrauterine device) progestogen-only pill 117 vitamins 10, 69, 73
bumps and bruises (baby) helping during labour 103 117 pushchairs 87
110 involvement 114
physical symptoms 48 J R W
practical support 49 jaundice 111, 113 reflexology 93 washing the baby 86, 125
C understanding your partner registering the birth 119 waters breaking 30, 90,
Caesarean section 101–102 48 L relationships 116 94, 97
caffeine 9 feeling hot 79 labour rest weight gain in pregnancy
cap (diaphragm) 117 feelings 27, 39–40 signs of labour 90 after the birth 115 11, 52
car safety fetal heart monitoring first stage 96–97 during pregnancy 20 wind 72
during pregnancy 20 96–97 second stage 98–99 restricted diet 11 work
with the baby 88 fetus (development of) third stage 99 rhesus negative mothers and pregnancy 20, 44
cats 19 28, 30 afterwards 100 53, 110 hazards 20, 129
cervical smear 55 fits (baby) 126 pain relief 91–93 rubella (German measles) parental leave 143
cervix 22, 23 flat nipples 68 speeding up labour 97 17, 53, 109, 129 paternity leave 49
dilation of in labour 96 folic acid 10, 128–129 starting too early 100 time off for antenatal care
chicken pox 18 fontanelle 110 labour partner 103 S 142
Child Benefit 130–131 food lanugo 31, 32 safety restraint in the car Working Families’
childcare arrangements 44 after the birth 108, 116 let-down reflex 69 88 Tax Credit 131–132
chorionic villus sampling preparing for next baby 128 Salmonella food poisoning worrying
(CVS) 59 when you’re breastfeeding 11 about abnormality 41
chromosomes 24 71, 116 serum screening 58 about the birth 40
The Department of Health would like to thank all the mothers and fathers who took
part in research for the earlier editions of this book, and all those people whose helpful
comments continue to shape its development.
USEFUL NUMBERS
The Department of Health would also like to thank all those organisations and
individuals who contributed to the making of this book and, in particular:
Community Practitioners and Health Visitors Association Doctor:
Maternity Alliance
National Childbirth Trust
Royal College of General Practitioners
Royal College of Midwives
Royal College of Obstetricians and Gynaecologists
Royal College of Paediatrics and Child Health
St John Ambulance
Midwife:
Dr Petra Clarke, Christine Gowdridge, Professor David Harvey, Dr Sheila Macphail,
Ros Meek, Jeanne Langford, Dr Lindsay Smith, Dr David Sowden, Ros Steele and
Glenys Sykes.
The photographs have been reproduced with the permission of the following:
Angela Hampton, pages 91 middle and bottom, 98 middle, 107 and 119. Bubbles,
pages 4 middle and right, 6 top, middle and right, 6, bottom left and right, 8 top, 16,
19, 20 top and bottom, 33 top and bottom, 35, 37, 42, 45, 47 and cover, 50, 56 Hospital:
bottom, 65 bottom, 66 top, 70 top, 71, 77, 79 and cover, 80, 85 bottom, 87 and cover,
88 top, 94 bottom, 95, 96, 98 top left, 99 bottom right, 100 top and bottom, 102 top
and bottom, 103, 104, 110 top and bottom, 111, 113, 114 top, 115, 116 bottom, 120,
124, 125 bottom, 128 top, 130. Collections, pages 70 bottom, 73, 86 bottom, 91 top
left, 92, 98 bottom, 99 top left, 110 2nd down, 122 and cover, 125 top, 127 left and
right. Cow & Gate, page 74. Format, pages 6 top left, 34, 48, 49 top, 51, 54, 85 top,
86 top, 89, 93, 94 top, 108 top, 121, 128 bottom. The Foundation for the Study of
Infant Deaths (photographer: Sandra Lousada) page 86 bottom right. Health
Hospital ref no:
Promotion England, pages iii, 4 left, 5 top right, 7, 8 foot, 10, 12, 15 bottom right,
17, 39, 52, 56, 63, 66 bottom, 67, 68, 83, 88 right, 116 top. Images, front cover.
National Meningitis Trust, page 126. Sally and Richard Greenhill, pages 5 bottom
left and right, 9 top, 15 left and top right, 44, 49 left, 53, 55, 62 top and bottom, 65
top, 72, 81, 84, 97 top right, 99 top right, 100 left middle, 108 bottom, 110 3rd down,
112, 114 bottom, 118. Science Photo Library, pages ii, 5 top left, 21, 24 top and
bottom, 28, 29, 30 top and bottom, 31 top and bottom, 57, 58, 59, 97 left. Health visitor:
Ilustrations
Rachel Busch, pages 8, 11, 13, 26, 37, 39, 40, 41, 43, 48, 64, 69, 78, 87, 90, 111, 115,
117, 120, 124 and 128.
Annabel Milne, pages 16, 17, 21, 22, 23, 28, 29, 30, 31, 32, 55, 61, 70, 75, 76, 82 and
123.
Original text: Nancy Kohner
Revised text: Sally Burningham, Karen Ford, Angela Phillips NHS Direct 0845 4647
This edition: Dr Virginia Beckett, Sue Latchem
24 hour nurse-led helpline providing health
Cover design: Persona Grata information and advice.
First published by Health Education Authority, 1999
Revised edition published by Health Promotion England, 2001
This revised edition published by the Office of The Chief Medical Officer, Welsh
Assembly Government, based on the original version produced by The Department of NHS Pregnancy Smoking Helpline
Health, 2004
0800 169 9 169
ISBN 0 7504 3687 5
Open daily from 12 noon to 9 pm.
© Crown copyright January 2005