A pregnancy can be the best or the worst thing to happen to you, depending on whether it is planned or not. And unplanned can become wanted, as well as the other way round.
This section is going to take you through planning a pregnancy, confirming a pregnancy, seeking help if the pregnancy is wanted , unwanted or if you are unsure, and how to seek help if you suspect you may be having a miscarriage or ectopic pregnancy.
Planning a pregnancy gives the opportunity to ensure you are in best possible health and your baby gets the best possible start in life.
Get fit; eat a well balanced diet, exercise sensibly and take folic acid vitamin supplements (400 microgrammes a day) for at least 3 months to reduce the risk of an abnormality in your baby called spina bifida. If you are a smoker, stop if you can. Everyone should avoid smoky atmospheres…chemicals from tobacco have been found in the fluid surrounding the eggs in women's ovaries…that is how toxic they are.
Cut back on alcohol, during pregnancy the recommendation is only 2 units a week, and avoid illegal drugs. What you cannot stop, cut back as much as you can. For help with stopping smoking, alcohol or drug problems etc please see the links to the right.
Check with your GP if you are unsure if you have been immunised against german measles (‘rubella’) because you can have this done if not and if you are in the age category for cervical smear tests, make sure they are up to date. If you take prescribed medication or have a medical condition, check with your GP or specialist if there are any particular precautions you have to take during pregnancy/ any change in medication that may risk causing an abnormality in the baby.
We recommend NHS Choices Pregnancy Careplanner as a website for information on being healthy at such an important time in your life.
The Centre for Maternal and Child Enquiries (CMACE) has released it's report 'Maternal obesity in the UK: Findings from a national project', for information on this please click here.
Years ago, before modern technology provided us with blood tests and ultrasound scans, it was believed pregnancies lasted 9 months. With technology, we now know a normal pregnancy lasts from 37 to 42 weeks, 40 weeks on average. Also, the duration of a pregnancy for generations has been calculated from the first day of the last menstrual pregnancy before pregnancy occurs. This is often written as a woman’s LMP. However, this makes some assumptions. These are that all women have a 28 day cycle (28 days from day one of one period til day one of the next) and that conception occurred 14 days from the LMP. (Conception must not be confused with intercourse….sperm can live up to seven days and the egg for 36 hours so the day you had sex does not necessarily tie in with the day you got pregnant.) Of course, not all women have exactly 28 day cycles ever, certainly not every month, and many women are not exactly sure when either their last period was or what their normal cycle is, which is why now, all pregnancies are dated from ultrasound scans. When you book in for pregnancy care, your carer will arrange a scan to confirm exactly how far along your pregnancy is.
This is done by a urine pregnancy test which detects a hormone produced in pregnancy called human chorionic gonadotrophin (HCG). You can buy a kit to do the test at home, or it can be done for you by your GP, Family Planning Clinic and by some outreach workers and school nurses. The test is best done on the first urine sample of the morning (as the concentration of hormone will be highest then) and usually will not read positive until you are 2 weeks pregnant. If there is any doubt about the result, repeat the test in a week. If there is still doubt due to symptoms or a urine test that is difficult to interpret, your GP or clinic may recommend a blood test. For further information see NHS Choices.
For the routine care that all healthy women can expect to receive during their pregnancy we recommend you read the NICE Guideline Routine Antenatal Care for Healthy Pregnant Women.
It tells you what to expect at each appointment, what advice you will be given to stay healthy and what tests you will be offered and how your baby’s progress will be checked.
You should book your first appointment for care as soon as you know you are pregnant. In Hull and the East Riding, you do this by contacting your GP.
Specific information on some pregnancy related topics are available on the Royal College of Obstetricians and Gynaecologists (the medical specialists for women’s health care ).
If the pregnancy is unplanned and you don’t know what to do, sometimes it helps to speak to someone independent, outside your family and friends. The local Pregnancy Advisory Service employs specialist counsellors specifically to support women in decision-making at this very difficult time. They can be accessed through your GP or any Family Planning or Sexual Health clinic and are based in Wilberforce Health Centre in Hull.
Here is an extract from their leaflet:
"The Counselling Service offers short-term counselling to support women before, during and following the termination. Your counsellor will listen to you with respect and without judging you. They will not offer you instructions or solutions. They will offer you time, space and use their professional skills to help you explore your thoughts and feelings so that you can deal with the problems you are facing now. Counselling may help you through a difficult time and enable you to manage again."
Early miscarriage is the loss of a pregnancy under 12 weeks advanced and happens to about 1 in 5 of all pregnancies conceived. It is unusual to miscarry after this stage. About 1 in a hundred pregnancies (2 in a hundred locally) do not develop in the womb but elsewhere in the woman’s reproductive tract, usually the fallopian tube, and are lost as a consequence…these are called ectopic pregnancies. A good review of early miscarriage with information on what happens and choices of management, with links to information sheets on bleeding and pain in early pregnancy and recurrent miscarriage are in the Royal College of Obstetricians and Gynaecologists website Patient Information section. Another good website is the Miscarriage Association website.
If there are signs of losing a pregnancy…bleeding or pain… then you must contact your GP straight away for assessment and advice because the early symptoms of miscarriage and ectopic are the same and whereas a miscarriage is terribly sad an ectopic is also very dangerous to the women’s health.
The further on you are in pregnancy, the less chance there is of a miscarriage. Locally, women who have the symptoms of miscarriage, or at risk of miscarriage, up to 12 weeks of pregnancy are assessed in the Early Pregnancy Assessment Units based at Castle Hill and Hull Royal Infirmary Women and Children’s Hospital unless your doctor assesses you need to be admitted as an emergency. There, a scan and blood tests are offered to assess the pregnancy. A scan will tell little before 6 to 7 weeks because it is so early on in the pregnancy.
For further information on ectopic pregnancy, we recommend NHS Choices.
For information about recovery from surgical management of a miscarriage please click here.