Pre-conception and early pregnancy care

At the Southern Trust, we recognise that families come in many different shapes and sizes, and the route to becoming parents can be varied and sometimes challenging.

If you are planning to have a baby, it is an ideal time to think about your health and that of your partner. Allow plenty of time for preconception planning and care before you start to try for a baby.

On this page, we hope to show you some steps you can follow to improve your health before starting or continuing your family.

Tommy’s Planning for pregnancy toolkit, as linked below, will help you understand how to improve your health and lifestyle ahead of pregnancy:

https://www.tommys.org/pregnancy-information/planning-pregnancy/planning-for-pregnancy-tool

• Healthy Start Scheme

  The Healthy Start Scheme enables eligible pregnant women and families with children under the age of four who meet the qualifying criteria to claim pre-loaded Healthy Start cards that can be used to purchase milk, fruit and vegetables or infant formula milk. In addition to the pre-paid card, those entitled to the Scheme may also avail of free vitamins.

  Please see link for more information:

  Healthy Start scheme | Department of Health (health-ni.gov.uk)

• Keep to a healthy weight

  You will increase your chances of getting pregnant if both you and your partner are in good health.

  If you are overweight, you may have problems getting pregnant and fertility treatment is less likely to work. Before you get pregnant, you can use the BMI healthy weight calculator to find out your BMI.

  Being overweight (having a BMI over 25) or obese (having a BMI over 30) also raises the risk of some pregnancy problems, such as high blood pressure, deep vein thrombosis, miscarriage and gestational diabetes.

  Having a healthy diet and doing moderate exercise are advised in pregnancy, and it is important not to gain too much weight. You can keep to a healthy weight by having a balanced diet and doing regular exercise.

  Find out about foods to avoid when you’re pregnant.

• Take a folic acid supplement

  Prior to becoming pregnant, and for the first 12 weeks of your pregnancy, we recommend that you take a 400 microgram (mcg) supplement of folic acid every day. Taking Folic acid reduces the risk of your baby having a neural tube defect, such as spina bifida.

  You may need to take a higher dose supplement of 5mg folic acid if:

  • you or the baby’s biological father have a neural tube defect
  • you previously had a pregnancy affected by a neural tube defect
  • you or the baby’s biological father have a family history of neural tube defects
  • you have a BMI >30
  • you take anti-epilepsy medicine
  • you have thalassaemia
  • you have diabetes
  • you have coeliac disease

  Please talk to your GP if you require a higher dose supplement, as they can prescribe it.

• Vitamin D

  During pregnancy and breastfeeding, a 10 microgram (mcg) supplement of vitamin D per day is recommended by the Public Health Agency.

  However, in the summer months, most people will usually get enough vitamin D from sunlight, so you may choose not to take a supplement over the summer months (late March/April to the end of September).

  People who cover their skin for cultural reasons, those confined indoors or with dark skin should take a daily supplement of vitamin D throughout the year.

• Diabetes Pre-Pregnancy clinic

  The SHSCT Diabetes Pre-Pregnancy clinic is for women with diabetes or previous gestational diabetes.

  Why should you attend?

  • To help to reduce the risks to both you and your baby and help improve your diabetes control.
  • Review medications suitable for pregnancy and ensure correct dose of folic acid e.g. 5 mg once daily.
  • Up to date retinal screening for pregnancy.
  • Review of key dietary nutrients for pregnancy.

  Who will I see?

  • Diabetes Specialist Nurse & Diabetes Specialist Dietitian.

  Clinic structure

  • All appointments are on Tuesdays via Microsoft Teams or telephone. Face to face appointments may also be arranged.
  • Your first and second appointments will last approximately 60 minutes each and will be with either Nurse or Dietitian.
  • Your review appointments will last 30-45 minutes and will be joint with both the Nurse and Dietitian.
  • Appointments will be offered over a period of up to 12 months.

  What I need to do before my appointments?

  • You should have your blood and urine tests completed before your first appointment.
  • You should have your HbA1c blood test repeated before each review appointment.

  What else do I need to know?

  • Attending this clinic does not replace attending your Consultant or GP Diabetes clinics.
  • To cancel an appointment please do so via email or telephone as early as possible.
  • If you no longer wish to attend, you can request to be removed from the waiting list.
  • You can self-refer at another time if required.
  • If you do not respond to appointment letters or attend an appointment without contacting the team, you will be discharged and your GP will be informed.

  Diabetes UK as linked below, will provide you with some information prior to attending the SHSCT diabetes pre-pregnancy clinics –

  Pregnancy and diabetes | Diabetes UK

  Diabetes Pre-Pregnancy Clinic contact information

  Telephone: 02837563336

  E-mail:  diabetes.prepregnancycare@southerntrust.hscni.net

   

• Stop smoking

  Research has found that protecting your baby from tobacco smoke is one of the best things you can do to give your child a healthy start in life. Smoke from other people’s cigarettes can damage your health and that of your unborn baby, so ask your partner, friends and family not to smoke near you.

   

  Smoking during pregnancy has been linked to a variety of health problems, including:

  • miscarriage
  • sudden infant death syndrome (SIDS), also known as cot death
  • premature birth
  • low birth weight
  • breathing problems or wheezing in the first 6 months of life

   

  It can be difficult to stop smoking, but it is never too late to quit and there is support for you and your family. Within Southern Trust, you can avail of Stop Smoking Service at your local pharmacy or via your G.P. When you are pregnant, your midwife can also refer you to this service, so please ask at your first appointment.

  Additionally, NHS Smokefree offers free help, support and advice on stopping smoking, including when you are pregnant. Their helpline (0300 123 1044) is open 9am to 8pm Monday to Friday, and 11am to 4pm at weekends.

• Cut out alcohol

  The Chief Medical Officers recommend that the safest approach is not to drink alcohol at all.

  Do not drink alcohol if you are pregnant or trying to get pregnant, as alcohol can be passed to your unborn baby.

  The risk of damage to your baby’s physical and mental development increases the more you drink which is why binge drinking is especially harmful. This risk relates to a range of conditions including Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Spectrum Disorder (FASD).

  Find out about alcohol and pregnancy, alcohol units and tips for cutting down.

• Talk to a doctor if you have a long-term condition

  If you have a long-term condition, such as epilepsy or diabetes, it could affect the decisions you make about your pregnancy – for example, where you might want to give birth.

  Before you get pregnant, we encourage you to have a discussion with your specialist or a GP about getting pregnant and medicines you are currently taking.

  From the NHS website, please find out more about:

  • asthma and pregnancy
  • diabetes and pregnancy
  • epilepsy and pregnancy
  • heart diseaseor congenital heart defect
  • pre-existing high blood pressure and pregnancy
  • mental health problems and pregnancy
  • being overweight and pregnancy
• Know which medicines you can take

  Not all medicines are safe to take when you are pregnant or planning a pregnancy, whether they are on prescription or medicines you can buy in a pharmacy or shop.

  If you take prescribed medicine and you are planning to get pregnant, talk to a doctor.

  Do not stop taking your medicine without talking to a doctor.

  Find out about medicines in pregnancy.

• Getting pregnant if you have a mental health condition

  Everyone’s mental health journey is different, but whatever happens, you will have a team of people supporting you. This may include midwives, GPs and mental health specialists.

  It would be beneficial to discuss your plans for pregnancy with your GP if you have a mental health condition, or did in the past, such as anxiety, depression, psychosis, schizophrenia or bipolar disorder.

  Do not stop taking medicine for your mental health condition without speaking to a GP or mental health practitioner. If you continue any medicines while you are pregnant, your doctor will explain how this may affect your baby. Try not to worry – you will be offered the safest medicine at the lowest dose that will still work.

• Vaccinations and infections

  Some infections, such as rubella (German measles), can harm your baby if you catch them during pregnancy.

  Most people in the UK are immune to rubella, thanks to the uptake of the measles, mumps and rubella (MMR) vaccination. If you have not had 2 doses of the MMR vaccine, or you’re not sure if you have, ask your GP surgery to check your vaccination history. If you have not had both doses or there is no record available, you can have the vaccinations at your GP surgery.

  You should avoid getting pregnant for 1 month after having the MMR vaccination, which means you will need a reliable method of contraception

  Find out about other infections during pregnancy that can harmful and what you can do to reduce your risk of getting them, including cytomegalovirus (CMV), parvovirus (slapped cheek syndrome) and toxoplasmosis.

• Testing for sickle cell and thalassaemia

  Sickle cell disease (SCD) and thalassaemia are inherited blood disorders that mainly affect people whose ancestors come from Africa, the Caribbean, the Mediterranean, India, Pakistan, south and Southeast Asia, and the Middle East.

  If you or your partner are concerned you may be a carrier for one of these disorders, perhaps because someone in your family has a blood disorder or is a carrier, it’s a good idea to get tested before starting a family. You can ask for a free blood test from either a GP or a local sickle cell and thalassaemia centre.

  Find out more about screening for sickle cell and thalassaemia in pregnancy

• Ways to become a parent if you are LGBT+

  There are several ways you could become a parent, all these options can be explored by anyone, including single people and same sex couples.

  Possible ways to become a parent include:

  • donor insemination
  • IUI (intrauterine insemination)
  • surrogacy
  • adoption or fostering
  • co-parenting

  There are also several ways that could help people with fertility problems have a baby, including IVF (in vitro fertilisation).

  IUI and IVF can sometimes be done on the NHS. This depends on things like your age. Check with a GP to find out about what might be available to you.

  Surrogacy is not available on the NHS.

• Reduced movement