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Antenatal care

 

Type of antenatal care available:

  • Midwifery-led care (Integrated midwifery model)
    You will be seen by a member of the midwifery team throughout your pregnancy in your local community providing your pregnancy is uncomplicated.

  • Shared care
    Your care will be shared between your midwife and GP in the community, and doctors and midwives in hospital providing your pregnancy is uncomplicated.

  • Consultant care
    For women with maternal or pregnancy-related complications that require full hospital care by the obstetric team. This is usually recommended if you have medical problems, had problems in a previous pregnancy or develop problems in your current pregnancy.

Please click on the below links for more information on the following antenatal care services:


Your first appointment  
Your first appointment is called a 'booking appointment' and will be with a midwife who will ask you about your medical, obstetric and social history.  The midwife will discuss the type of care and place of birth that you would like, and give you advice, guidance and information about your pregnancy and birth. It is a good opportunity for you to ask any questions. You can find more information on NHS Choices here.

The midwife will also arrange further appointments for you, including ultrasound scans, screening tests and follow up appointment.

Routine blood screening tests
We will ask your permission to take a blood sample for routine screening. This is to identify your blood group and check your haemoglobin level for any signs of anaemia. We also check for any other forms of anaemia (sickle cell disorder or thalassaemia) and test for any viral infections, including German measles (rubella), sexually transmitted diseases, HIV and hepatitis. If you have a family history of, or are known to have, sickle cell disease or thalassaemia, you can contact the specialist midwife regarding early referral to a specialist centre for antenatal diagnosis on 020 8453 2050 or on 020 8453 2052.

We advise all women to have a antenatal HIV test as part of your routine blood test, your midwife will discuss this with you at the first appointment.  

Follow up appointments
These regular check-ups are important and will take less time. At each antenatal appointment you will have your urine and blood pressure checked and your abdomen examined. Routine blood tests are also taken at 28 and 34 weeks to check your blood group and haemoglobin levels for anaemia.

Follow up appointments are held in antenatal clinics at Central Middlesex Hospital in Park Royal and Northwick Park Hospital in Harrow, and health and children's centres across Brent and Harrow. The care you receive during pregnancy will depend on you and your baby’s health.  Most healthy women will receive care throughout pregnancy from a midwife or GP.  If you have a more complex medical history your antenatal care will be planned by a consultant obstetrician, but you will still see a midwife from time to time.

You may choose to see your GP alongside your hospital/midwife appointments. This type of care is called 'shared care'. Regardless of the care you have chosen it is important that you are seen regularly throughout your pregnancy. Information on the plan of care is in your antenatal handheld (yellow) notes.  Please make sure you know when you should to be seen and make appointments accordingly.

Tests and scans
During your booking appointment you will be offered the following tests and services.

Screening for Down’s syndrome
Down’s syndrome is a chromosomal abnormality (T21). The aim of the screening programme is to identify whether you are at an increased risk of having a baby with Down’s syndrome. Screening tests do not give a definite answer but they do tell us if a baby has an increased risk. Further diagnostic tests will be offered if you are found to be at an increased risk. The combined screening test is available between 11 weeks and 14 weeks and 1 day. This test is a combination of the nuchal translucency ultrasound scan which measures the amount of fluid under the skin at the back of the baby’s neck, and a blood sample taken from the mother to calculate the risk factor.

The Quadruple test is offered between 14 weeks+2days and 20 weeks. This is a blood screening sample taken from you that screens for Down’s syndrome and open neural tube defects such as spina bifida. Your midwife will discuss these tests with you in detail at your booking appointment. Any further questions you may have can be answered by your midwife to help you make a decision regarding your screening tests. You can find out more on screening tests at  www.screening.nhs.uk

Your ultrasound scan
Women who do not wish to have Down’s syndrome screening will be offered a dating scan to calculate an accurate estimated due date (EDD). This accurately dates the pregnancy and you can see the baby's heartbeat. It is painless and considered safe for you and your baby. Dating scans are performed between 8 and 18 weeks of pregnancy. You can purchase a picture of your baby in the womb.

Detailed ultrasound scan
Anomaly scans are offered between 19 and 22 weeks of pregnancy. This scan checks for possible physical problems with your baby. It is offered to all women but not everyone chooses to have it.  Please read the information provided before deciding. The scan does not pick up all problems. You can expect this scan to take 20 minutes. You can buy an ultrasound picture of your baby the cost is displayed in the waiting area.

The Ultrasound department operate an appointment system. Please try to arrive on time for your scan appointments. If you are unable to make the appointment please phone the Ultrasound department:

Northwick Park
Tel.  020 8869 3885

Central Middlesex
Tel.  020 8963 8833 

Antenatal Classes
To support you and your growing family we offer antenatal classes and workshops to prepare you for the birth of your baby and beyond.  We suggest that you arrange your antenatal classes early - from 26 weeks of pregnancy - as they are very popular and get booked up fast.  

Please book online: http://www.lnwh.nhs.uk/antenatal-classes   If you need to change your appointment please send a text to 07747 865 640.  

You may also choose to attend privately run classes in the area contact the Natural Childbirth Trust (NCT).

Infant Feeding and Relationship Building

We offer infant feeding and relationship building workshops on the 1st and 3rd Saturday of every month (excluding Bank Holiday weekends). It is held in the Parent Education Room on Level 4, Maternity Reception from 10am - 12noon.  It is a drop-in workshop so there is no need to book in advance. You are welcome to attend.

Some useful information:

 

Specialist antenatal clinics
Most women experience a normal natural pregnancy and will only need midwife/GP care.  For those women who have a more complex obstetric history we offer specialist clinics.  Appointments will be arranged by your midwife based on the information you give at the booking appointment.

  • Joint endocrine antenatal clinics - these clinics see patients with diabetes, thyroid diseases, pituitary diseases etc. There is a clinic at Central Middlesex Hospital and Northwick Park Hospital.  Each clinic is supported by a consultant obstetrician, consultant endocrinologist, specialist registrars, diabetic specialist nurse, diabetic specialist midwives and dieticians

  • Maternal medicine clinics - these clinics offer pre-pregnancy counselling and support for women with complex medical history, including hypertension, epilepsy, cardiac diseases, diseases of the bowel, renal diseases, diseases of the musculo-skeletal system, and diseases of immune origins such as systemic lupus erythamatosis. There are two clinics held at Northwick Park Hospital

  • Joint obstetric haematology clinic - this clinic is for pregnant women with haematological conditions like blood clotting disorders (Thrombophilia, Deep Vein Thrombois, Idiopathic Thrombocytopenia etc), severe anaemia and other related conditions. This clinic is supported by an obstetric consultant, consultant haematologist and specialist registrars

  • Bereavement clinic - this clinic is for couples who have had pregnancy loss and supported by an obstetric consultant and a specialist midwife

  • African Well Women’s Clinic - This clinic sees pregnant women of African origin who have special needs and is held on Friday mornings.  It is run by specialist midwives who will refer women on to a consultant if necessary

  • VBAC clinic (vaginal birth after caesarean) - this clinic is for women who have had a caesarean section in the past and would like to discuss the option of having a vaginal birth in this pregnancy.  This clinic is run by specialist senior midwives.