The resources below provide general advice for pregnancy. Please discuss your condition with your healthcare team to ensure the advice is right for you and your pregnancy.
Pregnancy
What do I do once I am pregnant?
As soon as you find out you are pregnant, contact your GP or midwife and you will be offered an appointment with a midwife. If you have a health condition and have been advised to let the team who normally looks after you know, then please contact them.
I have a health condition. Who will care for me during my pregnancy?
The community midwife will provide much of the care you need during pregnancy. They will ask detailed questions about any previous pregnancies and your physical and mental health. Any additional appointments will depend on your individual needs and circumstances.
You may be referred to a specialist antenatal clinic in your local hospital. Most hospitals run a variety of specialist antenatal clinics, for example clinics for women with diabetes in pregnancy, with doctors and midwives who are experts in diabetes. Most women who need hospital appointments will be able to attend their local hospital for these. Some women may be asked to travel to hospitals with specialised services, for example clinics for women with heart or kidney problems. These clinics are run by teams who are experts in these areas.
I have been referred to the South West Maternal Medicine Network (SWMMN). What does this mean?
If you have a medical condition, your doctor may refer you to the SWMMN. You may be offered an appointment at a specialist clinic, or a plan made for your pregnancy at a specialist multidisciplinary team meeting (MDT). The SWMMN aims for the care of women to be close to home, where possible.
What is an MDT?
The SWMMN has monthly MDTs where women with cardiac and general obstetric medicine issues are discussed, and fortnightly meetings where women with kidney or blood disorders are discussed.
The team meetings are usually made up of:
- specialists for the health conditions – for example a nephrologist (kidney specialist) or a cardiologist (heart doctor)
- specialist obstetricians who are experts in looking after women with health conditions during pregnancy
- specialist midwives
- an obstetric physician – a specialist in looking after medical conditions around the time of pregnancy
- obstetric anaesthetists
As a group they will look at your specific details, your wishes and preferences as represented by your obstetrician, and the expertise of your local hospital. Based on this information they will make recommendations for your care during pregnancy, around the time of birth and after birth.
This will either include:
- ongoing care at your local hospital
- being seen at another hospital
The recommendations are guided by what the group of experts believe to be the safest for you and your baby, with the aim for you to have as much care close to home as possible.
Your obstetric team will explain the recommendations from the MDT to you. You will have the opportunity to ask questions and discuss the plan.
What happens during an antenatal clinic visit in hospital?
Team members will discuss your health conditions, how they might impact your pregnancy and how pregnancy may affect your conditions. The doctors may advise additional tests, depending on your condition.
They will also usually discuss your medications. Please bring a list of these with you. For most medications the benefit of taking them is greater than the risk of not taking them. It is generally not advisable to stop taking your medication without talking to a healthcare professional about this first.
The obstetric team will discuss and agree a pregnancy plan with you. This may involve extra monitoring, for example additional scans. They may suggest additional treatments such as aspirin, aiming to reduce the chance of developing pre eclampsia Pre-eclampsia – NHS (www.nhs.uk).
You will have the opportunity to explain your concerns and wishes and to ask questions. It is often a good idea to write these down before you attend so that you remember to ask them all.
The maternity team will record the clinic visit and agreed plans in your pregnancy notes. They will also sometimes communicate with other healthcare professionals involved in your care, for instance your GP or other specialists.
Who do I call for help between any appointments?
The team looking after you will explain to you where and how to seek advice and help. This will likely differ for different questions or problems and may commonly include:
- Your community midwife
- The hospital’s maternity advice line
- Your specialist midwife
- Your specialist nurse
- Your GP
- Your consultants
- Emergency Department
- 111
