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Antenatal care Q&As

Published by Bupa's health information team, May 2009.

Answers to questions about routine care during pregnancy

This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.

 

Which health professionals will I see during pregnancy?

During your pregnancy, you will see many different health professionals. You are most likely to see your GP and a midwife for your antenatal check-ups. In some hospitals, you may also routinely see an obstetrician (a doctor specialising in the care of women during pregnancy and the birth). However, in other hospitals, you will only be referred to the obstetrician if there is a problem.

Explanation

According to National Institute for Health and Clinical Excellence (NICE) guidelines on antenatal care, your care during pregnancy should be provided by a small group of healthcare professionals. You should feel comfortable with all the people looking after you, and you are entitled to be treated by specialist staff if you experience any problems.

Your GP should be your first port of call once you realise you are pregnant. You will receive essential pregnancy advice, checks that you are well, and your antenatal care plans. In some areas, your GP may provide all your antenatal care, but usually it will be the local midwifery service. Your GP may be involved in the birth if you have your baby at home, but not if you have your baby in the hospital.

Midwives are specially trained to take care of you and your baby during your pregnancy, labour and after the birth. You may see the midwife at home, at a medical centre or at a local hospital. A hospital midwife will look after you at the hospital antenatal clinic and when you go into labour and will deliver your baby. However, you may not see the same hospital midwife each time. A community midwife will look after you during pregnancy and in the early days after the birth. You should know the name of the midwife who is responsible for your care and should be able to contact her if you have any problems.

If you are having a hospital birth, you will be under the care of a consultant obstetrician - a doctor specialising in the care of women during pregnancy, labour and soon after the birth. In many hospitals, you will see the obstetrician only if you have a particular problem, such as complications the last time you were pregnant (eg high blood pressure) or a chronic illness like diabetes. The consultant, or a member of his or her team, will deliver your baby if you have a caesarean section. If the pregnancy is going well, and you are having a vaginal delivery with no complications, you won't see the consultant and a midwife will deliver your baby instead.

A paediatrician is a doctor specialising in the care of babies and children. If you are having a difficult labour or problems with the baby have been identified during the pregnancy, a paediatrician will be present for the birth. A paediatrician will also check your baby after the birth to make sure that your baby is well.

A health visitor is a specially trained nurse who can look after the health of your whole family. You may meet your health visitor before the birth or, more usually, once your baby is 10 days old. The health visitor can advise you on all matters relating to babies and young children under five years.

You may also meet various other health professionals while you are pregnant or during the birth, for example, dieticians, or the physiotherapists at certain antenatal classes.

Further information

Sources

  • The Pregnancy Book. Department of Health, 2007. www.dh.gov.uk
  • Antenatal care: routine care for the healthy pregnant woman. National Institute for Health and Clinical Excellence (NICE), 2008. www.nice.org.uk
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Why is my blood sugar being checked?

As part of your antenatal care, your midwife or GP will check your urine for the presence of a type of sugar called glucose. If the levels of glucose in your urine are high, you will be asked to have a further test to check the glucose levels in your blood. High blood glucose levels indicate that you have gestational diabetes (diabetes associated with pregnancy) and will need to be monitored carefully.

Explanation

At your first antenatal appointment, or "booking" appointment, your midwife or GP will ask you specific questions to see whether you are likely to develop diabetes during your pregnancy (called gestational diabetes). For example, you will be asked whether anyone in your family has diabetes. You will be more likely to develop gestational diabetes if you:

  • are very overweight or obese (your body mass index, BMI, is above 30)
  • had a very large baby in a previous pregnancy, weighing 4.5kg or above
  • have had gestational diabetes before
  • have a family history of diabetes
  • have a family origin with a high prevalence of diabetes (eg South Asian, Afro-Caribbean or Middle Eastern).

According to National Institute for Health and Clinical Excellence (NICE) clinical guidelines, all women with any one of the above risk factors should be offered a blood test for gestational diabetes. You should also be offered blood glucose testing if you have a high level of glucose in your urine at a routine antenatal appointment with your GP or midwife.

Gestational diabetes is a type of diabetes that develops only during pregnancy, usually during the second or third trimester. Gestational diabetes usually has no symptoms, which is why routine testing is important.

The diabetes usually develops once your baby's major organs have grown. Therefore, the risk to your baby is fairly low, although this depends on how high your glucose levels are and how long they have been high. If the diabetes isn't detected and controlled, it can increase your risk of having a larger baby, which increases the likelihood of problems during labour and birth.

The blood glucose test is called an oral glucose tolerance test. It involves having a blood test before breakfast and then two hours after a glucose drink. If your insulin levels are normal, your blood sugar level should rise and then quickly return to normal.

If the results of the test indicate that you have diabetes, your doctors will advise you on how to control your blood sugar levels. This usually involves regularly testing your own blood sugar levels at home with a special blood testing kit. You will also be monitored closely during pregnancy and labour, and will be given advice on eating a healthy diet, maintaining your weight and taking regular exercise. In most women, gestational diabetes improves with changes in their diet or more regular exercise, although some women (between one and two in 10) will need to take some medication to keep their blood glucose levels stable.

Gestational diabetes usually disappears once your baby is born. Your blood will be tested after the birth to make sure your glucose levels have returned to normal. You should also have a fasting blood test six weeks after the birth and then once a year, to make sure the diabetes doesn't return. Women who develop gestational diabetes have a three in 10 risk of developing type-2 diabetes during their lifetime. You are also more likely to develop gestational diabetes in future pregnancies.

Further information

Sources

  • Diabetes in pregnancy. National Institute for Health and Clinical Excellence (NICE), 2008. www.nice.org.uk
  • Gestational diabetes. Diabetes UK. www.diabetes.org.uk, accessed 29 June 2008
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What will I learn at antenatal classes?

Antenatal classes can help to prepare you both physically and emotionally for labour, the birth and early parenthood. They can give you confidence, as well as information, and the opportunity to discuss any worries or plans. At antenatal classes, you will also get the chance to meet other new parents in your local area.

Explanation

Antenatal classes usually start eight to 10 weeks before your baby is due, although some courses are provided early on in pregnancy. The classes are normally held once a week during the day. The topics covered include health in pregnancy, labour and birth, pain relief, exercises for pregnancy and birth, relaxation and caring for your baby (especially feeding).

Some classes are for pregnant women only, while others cater for partners as well. In some parts of the country, there are classes specifically for single mothers, teenagers or women whose first language isn't English. While most classes are for first-time parents, refresher classes are also available.

NHS antenatal classes (NHS Parentcraft) are usually free. They may be run by your local hospital, midwives or health visitors or by your GP or health centre. They tend to focus on pain relief, the hospital system and feeding and caring for your baby, although the exact format varies. You will often meet the health professionals involved in your care and may be given the opportunity to look around the labour and postnatal wards to prepare you for the birth. If you are interested in attending NHS classes, it's important to inform your midwife.

The National Childbirth Trust (NCT) also runs antenatal classes, but these are usually in the evenings or weekends for a pregnant woman and her birth partner (which could be the baby's father or another supporting person such as your mother, sister or friend). The trainers are not usually midwives, but have been through a three-year NCT training course, leading to a diploma in Higher Education. The classes tend to be informal and may be held in the trainer's own home or a public venue. Most courses cover a wide range of topics, including coping with labour, exercises, how to care for a newborn, your feelings about pregnancy, birth and beyond, relaxation techniques. The cost varies, and you need to book the classes in advance.

It's important to consider other classes in your local area, but you should make sure that any trainers have been properly trained by asking about their qualifications. Active birth with yoga classes, for example use yoga to strengthen your body in preparation for the birth. At these classes, you can learn how to use breathing and relaxation exercises to improve your posture. To find a specialist antenatal yoga class, ask your midwife if there are any in your area.

If there isn't a specialist antenatal yoga class in your area, you may be able to find a qualified general yoga teacher through the British Wheel of Yoga, the governing body for yoga in Great Britain. Make sure you tell the yoga teacher that you are pregnant and by how many weeks, so that the classes can be tailored to your specific needs.

Further information

Sources

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Related topics

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This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: May 2009

Antenatal care health factsheet

 

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