Maternity Services

Booking with your Midwife

Many women put off seeing their doctor and miss out on free health checks and valuable service.

If you think you are pregnant, contact your midwife as soon as you find out you are pregnant. In Derbyshire and Derby, an appointment can be made direct with your midwife via the GP receptionist in your local GP surgery.

Your midwife will be able to:

Give up to date advice and information about looking after yourself and your baby during your pregnancy
Help you plan and make decisions about the rest of your pregnancy
Help you plan where you want to give birth to your baby
Provide information on financial benefits and allowances
Inform you if you entitled to Healthy Start vitamins and vouchers
Provide information on and arrange check ups, screening tests and scans. For more information on screening go to the following sites:

National screening committee website:

http://www.screening.nhs.uk/public

An independent charitable Trust site explaining principles of screening to public:

http://www.senseaboutscience.org.uk/index.php/site/project/415/

The first 12 weeks of your pregnancy are the most important time for your baby’s development. The earlier you are seen by a midwife or doctor the sooner they can check that everything is alright with both of you.

It is even more important if you have a medical condition such as epilepsy or if you had any complications in your last pregnancy or birth. If you have pre-existing diabetes it is important to contact your local antenatal clinic as soon as you have a positive pregnancy test.

Your midwife or GP will talk confidentially with you about your pregnancy and give you a check up. They will then discuss your choices for screening and pregnancy care and make sure you are referred to the right people and organisations.

You should receive your first antenatal appointment within two weeks of informing your GP or midwife that you are pregnant. If you have not been contacted by this time, please make sure you phone your GP or midwife.

Choosing where to have your baby

You may give birth at home, in a unit run by midwives (either in the community or within a hospital) or in a unit in hospital run by a maternity team.

Your choice about where to have your baby will depend on the facilities you want for your labour and the kinds of pain relief you think you will need.

For women with some medical conditions it is safest to give birth in hospital because specialists are available if you need extra help during labour.

Sometimes the maternity unit you choose may not be available if many women are in labour at the same time and the unit is full. Ask your midwife what you should expect if this happens to you.

In Derbyshire, you have the following choices:

Home
Midwifery-led units in hospital
Maternity care team in hospital. This includes midwives, anaesthetists and consultant obstetricians. For some women this is the safest option.

For more information on the hospitals in your area, click here

Feeding your baby

Breastfeeding

One of the most important decisions of all is how you will feed your baby as this may affect its life-long health. Whichever way you choose, the health professionals you meet will support you in your decision.
The World Health Organisation and the Department of Health recommend that babies are exclusively breast-fed for their first six months and that after weaning, they continue to be breast-fed for their first year and beyond.

What are the benefits of breastfeeding for the baby?

Breast milk is the natural baby food. It has the perfect combination of proteins, fats, carbohydrates and fluids that new-born babies require. .

Breastfeeding reduces the risk of babies developing infection

On average, breastfed babies have fewer infections in their early life. In particular, they have less diarrhoea and vomiting, chest infections and ear infections compared to babies who are not breastfed. The main reason for this is that antibodies and other proteins are passed in the breast milk from mother to baby. These help to fight against infection compared to babies who are not breast fed. These help to fight against infection.
Breastfeeding reduces the risk of cot death -there is good evidence that sudden infant death syndrome (cot death) is less common in breastfed babies. This is not fully explained, although the fact that breastfed babies have fewer infections is possibly a contributing factor.

How will this affect the health of my baby when he/she is older?

Many studies have looked at the long-term health benefits of breastfeeding. There is now good evidence that, on average, the following health problems in later life are less common in those who had been breastfed compared to those who had not:

Obesity and overweight
High blood pressure
High cholesterol level
Eczema
Diabetes
Leukaemia
Asthma

As mentioned, exclusive breastfeeding for the first 6 months of life provides maximum benefit.

Are there any health benefits to the mother?

Various studies have looked at the possible health benefits to women who have breastfed. There is now good evidence that, on average, the following health problems are less common in women who have breastfed one or more babies compared to those who have never breastfed:

Breast cancer
Ovarian cancer
Type 2 diabetes
Postnatal depression

What other benefits are there?

From a mother’s point of view, breast milk is there when needed and at just the right temperature, it costs you nothing in time or money, unlike formula milks, which need to be bought and made up.

Another health benefit for mothers is that the action of breast-feeding will also help the womb return to its normal size after the birth and it is easier to lose weight after giving birth if you are breastfeeding.

What local services are there to support me to breastfeed once I am home from hospital?

Midwives, midwifery support workers, peer supporters and health visitors are available to support you through the early days and weeks breastfeeding your new baby. You can either ask your midwife for advice or contact one of the following organisations. They are all working together to provide you with the support you need.

Please click here to access a full list of support groups and services available in Derbyshire.

Other organisations which offer support on breastfeeding:

www.babyfriendly.org.uk - The Baby Friendly Initiative is a worldwide programme of the World Health Organization and UNICEF. It was established in 1992 to encourage maternity hospitals to implement the Ten Steps to Successful Breastfeeding and to practise in accordance with the International Code of Marketing of Breastmilk Substitutes.
www.breastfeeding.nhs.uk - Breastfeeding is natural and normal and gives your baby the best start. The Department of Health recommends exclusive breastfeeding for the first 6 months of life and can continue to benefit your baby along with solid foods for many months after. Every day you breast feed makes a difference to your baby's health now and in the future.
www.abm.me.uk Association of breast-feeding mothers – Information and advice on breast-feeding and support for breast-feeding mothers. Tel: 08704 017711- 24 hour helpline.
www.lli.org La Leche League – information on breast-feeding and support for breast-feeding mothers. Tel: 08451 202918
www.breastfeedingnetwork.org.uk The Breastfeeding Network (BfN) aims to be an independent source of support and information for breastfeeding women and others. If you need help with breastfeeding or have a specific question that would like to discuss with a Breastfeeding Supporter you can phone the supporter line on: Tel:0300 100 0210
www.nctpregnancyandbabycare.com The National Childbirth Trust work to fulfil their mission and vision of enabling all parents in the UK to have an enriching experience of pregnancy, birth and early parenthood. Their purpose is to provide support and evidence-based information in pregnancy, birth and the early days of parenthood. Tel: 0300 3300771

Formula feeding

As mentioned above, the World Health Organisation and the Department of Health recommend that babies are exclusively breast-fed for their first six months and that after weaning, they continue to be breast-fed for their first year and beyond. However, if you decide to use formula to feed your baby, here is some important advice from the Department of Health:

The Department of Health (2005) advise that a bottle should be made when it is needed, not made in batches and stored in the fridge. This is because milk which has not been heated to a high enough temperature may contain bacteria which may cause vomiting and/ or diarrhoea in babies.
Pour water which has just boiled into a sterilised bottle to the level needed.
Add level scoops of powder as directed on the milk container. Screw on the teat and cap and shake the bottle to mix the water and powder.
Rapidly cool the bottle under a running tap or in a bowl of cold water until the milk is just warm when a drop is on your wrist.
Once a bottle has been started, it should be used within an hour.
At night time or if you are going out, you can put boiled hot water into a thermos flask to make up a feed or better still use ready prepared feeds for nighttimes and when you are out and about

Maternity Services Liaison Committees

Maternity Services Liaison Committees are set up to inform the development and improvement of local maternity services.

The Maternity Services Liaison Committee (MSLC) is made up of:

Parents (mothers and fathers)
Voluntary Groups (e.g. NCT (National Childbirth Trust))
Doctors
Midwives & Health Visitors
Children’s Centre Workers
Primary Care Trust representatives

We all work together to monitor and improve the Maternity Services in Derbyshire.

If you care would like to help shape and improve the maternity services in your area, we would welcome you to join the Committee. Here is what you need to know:

The groups meet 4 or 5 times a year and each meeting lasts about 2 hours.
Childcare can be provided or if you wish to use your own registered childminder, the cost can be reimbursed.
Travel expenses will be paid
You do not need experience of working in the NHS. It’s just about hearing your views as a parent and making sure service users’ suggestions are taken into account.
We want to hear about your views on all areas of maternity care from before you had your baby (antenatal care) to when you went into labour right through to how you found the services after you had your baby (postnatal care).

If you want to make any general comments about local Maternity Services or are interested in joining the committee or would like some more information, either phone Helen Butler on 01246 514026 or email: Helen.Butler@derbyshirecountypct.nhs.uk

Safe sleeping for babies

Cots should have a new firm mattress, with a washable covering, that fits well into the cot and there should be no pillow or toys in the cot.

Baby should be placed on his/her back to sleep – placing your baby "feet to foot” with baby’s feet to the bottom of the cot and the covers up to shoulder high. Use loose sheets and blankets, tucked in tightly, rather than duvets which may make baby too hot.

Babies need to be warm but not hot. If baby feels hot or is sweating then it is too warm. You may need to reduce the room temperature or remove some of the clothes or covers.

If you are concerned that baby has a temperature due to being unwell then always seek medical advice.

Sleeping all night in bed with your baby increases the risk of cot death and you should NEVER sleep with baby by choice or accidentally on a sofa, chair or water bed. Placing your baby to sleep in a car seat also increases the risk.

Never bring your baby into bed with you if you or your partner smoke, take drugs or prescribed medication, have been drinking alcohol or are unwell.

Never bring your baby into bed with you if they are less than 3 months, were premature or low birth weight.

Breast feeding helps to reduce cot death. Some research suggests that the use of a Dummy when the baby falls to sleep can also reduce the risk, although you should wait two weeks until the baby is established with Breast feeding first.

Safe Sleep Assessment – Your midwife or health visitor will assess your baby’s sleeping arrangements when they visit you at home after the birth. This assessment will include seeing where baby sleeps.

Protecting Baby’s Head - A Baby’s head is big and heavy compared to the rest of its body. Unless, supported, the head flops around because the neck muscles aren’t strong enough to hold it still. Always support your baby’s head with your hand and arm in the cradling position.

Never shake your baby because this can cause brain damage or death. The major reason that babies are shaken is due to a build up of frustration by a parent or caregiver in response to a crying baby.

Crying is one way a baby can tell us how they are feel or what they want. They may be uncomfortable, hungry, upset, unwell or lonely. Step back, stop and think what baby may need and try: changing the nappy, feeding, have a cuddle, go for a walk round the house or outside in the fresh air, gently rub or massage your baby or try a dummy if you use one. If all else fails and you are getting upset or angry wrap baby in a thin soft sheet and place baby in a safe and quiet place and leave the room checking your baby at least every 10 minutes. This will allow you to calm down and crying for a while will not harm your baby.

If you are worried about baby crying then you should talk to your GP, Health Visitor or Midwife.

Talking in a happy way and Singing to your Baby whilst looking into your baby’s eyes is good for you and baby. This process helps to develop the relation between baby, mother, father and caregiver. It helps to make baby feel happy, safe and secure and promotes healthy brain development.

Things you should cut down on or avoid

Stop smoking. The health and growth of your baby can be affected if you smoke- you are strongly advised to stop completely and to maintain this once the baby is born. For FREE help and advice, contact the Stop smoking service on 0800 085 2299

Avoid drinking alcohol. If you need FREE, confidential advice please contact:
Derbyshire Alcohol Advice Service
Tel: 0845 3084010

www.alcoholadvice.webeden.co.uk

Addiction Dependency Solutions (ADS)
Tel: 0800 0515 85

Stop taking illicit drugs and legal highs. All drugs can harm your baby. For help and advice to stop taking drugs please contact:
FRANK/UK National drugs helpline: Tel (free): 0800 77 6600

Unity Derbyshire (adult drug treatment service covering Derbyshire County)
Tel: 01246 277388

Phoenix Futures (open access, information and advice, key working, harm reduction and needle exchange- Derby City)
Tel: 01332 294410

Don’t have too much caffeine. Drinks like tea, coffee, high-energy drinks and coca cola all contain caffeine. Altogether have no more than 200mg of caffeine per day. This is about two cups of brewed coffee (or two -three cups of instant coffee), or four cups of tea per day.

Avoid eating raw or undercooked meat, eggs or fish, unpasteurised dairy products, soft cheeses such as brie or camembert or patés. All these can cause listeriosis.

Don’t eat too much tuna (no more than four medium-sized cans (about 140g per can) of tuna a week. This is about six rounds of tuna sandwiches. Avoid eating shark, marlin and swordfish as they contain mercury.

Reduce your vitamin A intake. Avoid eating liver and don’t take cod liver oil or vitamin A tablets

Don't handle animal droppings - these carry infections which can harm your baby

There are a number of things you can do to make sure you and your baby have the best start in pregnancy.

Take Folic Acid
Folic acid is an important vitamin for your health and the health of your baby. If you take folic acid supplements, it reduces the risk of having a baby born with a defect of their spinal cord, such as spina bifida. Ideally you should take folic acid supplements as soon as contraception is stopped. If you are not already taking folic acid, you should start taking this now. You should take 400 mcg every day and continue to take the supplements for the first 12 weeks (3 months) of pregnancy.

Eat plenty of fruit and vegetables – eat at least 5 portions a day. Green vegetables are also a good source of folic acid.

Eat pulses, red meat, dried fruit, green vegetables and fortified cereals; these are great sources of iron

Eat some dairy products such as milk, cheese and yoghurt to help maintain your calcium

Drink water to keep yourself hydrated. It will also help with your kidney and bowel functions.

Take gentle physical activity such as swimming or walking. Exercise during pregnancy is proven to increase energy levels, reduce constipation and help you sleep better. If you are in doubt about what you can do, please contact your midwife.

If taking medication or supplements do not stop taking them without discussion with your GP, midwife or consultant unless previously advised to do so.

Eat little and often as this can help prevent you from feeling sick early in your pregnancy

Wash your hands, especially after gardening, handling raw meats, cats or kittens. Wear gloves when gardening or handling animal droppings, which can carry harmful bacteria

What about peanuts?
If you would like to eat peanuts or foods containing peanuts during pregnancy or whilst breastfeeding, you can choose to do so as part of a healthy balanced diet, unless you are allergic to them or your health professional advises you not to. Visit: www.dh.gov.uk for further information.

Think about breastfeeding your baby. Ask your midwife for more information or go to www.breastfeeding.nhs.uk

Think about getting a flu vaccination. Women who are pregnant over the winter period are advised to have the seasonal flu vaccination. For further information either speak to your midwife, GP or practice nurse or visit the NHS choices website: www.nhs.uk

Unhappy to be pregnant?

Not everyone will be happy to be pregnant. For some women, it is a very difficult time.

If you are concerned about continuing with your pregnancy and need more advice deciding what is right for you, then you should discuss it with your GP or contact one of the organisations below as soon as you discover you are pregnant. They will support you in whatever you decide.

Organisations offering confidential advice on pregnancy choices:

Contraceptive and Sexual Health Service

Chesterfield:
Wheatbridge Surgery – 01246 235792
Derby City:
0115 9509151

Family Planning Association Helpline - 0845 122 8690

British Pregnancy Advisory Service – 0845 730 4030

Marie Stopes - 0845 300 8090

Brook Clinic (under 25 yrs old) Tel (Free):0808 802 1234

Useful numbers, links & documents

Pregnancy advice
NHS guide to pregnancy www.nhs.uk/pregnancy
National Childbirth Trust Tel: 0300 330 0772 or www.nct.org.uk

Leaflet on things you should know and do when you find out you are pregnant:
Please click here for the "Happy to be pregnant?” leaflet

Sexual Health

GUM
Chesterfield 01246 512121 or 01246 513500
Derby 01332 254 681

Domestic Abuse/Violence/Rape
National Domestic Violence 24-hour helpline Tel:0808 2000 247

Derbyshire Women’s Aid (Domestic Abuse Helpline) Tel (Free): 08000 198668

Derbyshire Rape Crisis- covers Derby City, Chesterfield and the High Peak and Dales: Tel: 01332 372545

Email: info@drconline.org.uk
Web: http://www.drconline.org.uk

Information on benefits, debts, housing problems etc

Citizen Advice Bureau www.citizenadvice.org.uk

Most GP practices in Derbyshire have a Citizens Advice Bureau service. Appointments are available through your practice.

Stress and depression

MIND Tel:0845 766 0163

Teenage parents

Connexions is a service for all 13-19 year olds offering information, advice and guidance. As part of this Connexions support is available to Teenage Parents/Pregnant Teenagers.

For further information please contact:

North of the Derbyshire county- Lynne Eldred – 01246 201581 or email lynne.eldred@connexions-derbyshire.org

South of the Derbyshire county- Rachel Edwards- 01773 746174 or email rachel.edwards@connexions-derbyshire.org

www.connexions-derbyshire.org

General
Samaritans Te: 0845 90 90 90

Other useful website links

www.nhs.uk – This is also known as the NHS Choices website. This site provides information from the National Health Service on conditions, treatments, local services and healthy living. It includes lots of useful information about pregnancy and birth including a pregnancy planner.

www.nct.org.uk - National Childbirth Trust, helping over a million mums and dads each year through pregnancy, birth and early days of parenthood. This site offers antenatal and postnatal courses, local support and reliable information to help all parents.

www.mums.net - this site is currently under reconstruction, but it's a useful one for new mums to put in their 'Favourites'.

www.dad.info – this site provides a range of information specially aimed at dads

www.bestbeginnings.info - Focusing on the window of opportunity between conception and two years of age, where foundations for a healthy life can be laid. Best Beginnings has developed a range of interventions, resources and health-based information to reach parents and parents-to-be to help them safeguard their children's health, avoid preventable illnesses and death.

www.nhs.uk/Start4Life - Start4Life provides up-to-date advice on breastfeeding, introducing solid food and active play, and tips on how to use them to give your baby a better start in life.

www.derbyshire.gov.uk/childrenscentres
- Sure Start Children’s Centres bring all the different organisations together to offer a range of services to meet you and your child’s needs, all in one place. They’re somewhere your child can make friends and learn as they play. You can get professional advice on health and family matters, learn about training and job opportunities or just socialise with other people.

Useful documents

Maternity matters

Derbyshire Report