The Information - Pregnancy

This title looks at approaches to observing and recording your baby's well-being during labour through the monitoring of their heart rate. The methods of listening to, and observing the rate and pattern of your baby's heart rate in labour range from 'listening in', usually with a midwife's stethoscope (called a 'Pinard stethoscope') to the use of more complex electronic devices that use sound (sonic) waves. These can vary from a small hand-held ultrasound machine called a 'Doppler' or sonic aid, to a cardiotocograph (CTG) machine that can measure and print out the baby's heart rate pattern and record the frequency of your contractions.

Having an ultrasound scan in early pregnancy can be exciting as it means you may be able to 'see' your baby for the very first time. Doctors and midwives use ultrasound to help assess the progress of your pregnancy and to identify whether there are any possible problems. If you have a scan and a potential problem is found you may have to make some difficult decisions. In order to make an informed choice about whether or not to have a scan, it's essential to understand their purpose and limitations. This title explains why scans are used in early pregnancy and what midwives and doctors can do with the information obtained from them. It also explains the advantages and disadvantages of having an ultrasound for you and your baby.

There is concern over the effects of alcohol during pregnancy, which is why it is advised that pregnant women should not drink excessively. Current UK guidance recommends that not drinking during pregnancy is the safest option; however, the issue is confusing as official advice also says that drinking up to 4 units a week is unlikely to be harmful. There is also ongoing debate about how much is too much, which can be confusing when you're trying to decide what's best for your baby and your health during pregnancy. In order to help you decide, the information in this title will give you the current research evidence and facts that are known about drinking alcohol while you are pregnant.

Between 2-3% of babies that are born in England and Wales are found to have a major problem with their development - these defects are called `congenital abnormalities`. They may take the form of a problem with the development of a certain part of the baby`s body or an organ, for example, the heart, which results in a problem in its structure that then affects the way it works. However, other congenital abnormalities may be caused by problems or defects in the genetic make-up of your baby that are passed on through family members (called hereditary disease). Abnormalities may also be caused by problems that occur in the very early stages of pregnancy when the egg (ovum) has been fertilised and errors occur in the development and structure of the rapidly dividing cells. These are called chromosomal abnormalities and they may or may not be hereditary. Some of these conditions cannot be treated and their effects are life-long. For these reasons, nearly every pregnant woman is offered screening tests in pregnancy. This title explains what these tests are able to check for as well as those conditions they are not able to detect. Choosing whether or not to have screening tests in pregnancy is an important decision for you and your family. The information in this title will help you to make your decision and to think about what the results might mean for you, your pregnancy and your baby.

Most babies move into a 'head down' position during the last few months of pregnancy. Where this isn't the case, and the baby's position is 'bottom down', it is called a 'breech presentation'. The information in this title will help you to understand what this means for you and your baby and what options you have for your baby's birth.

Although you may have a date that has been estimated for the birth of your baby, it is perfectly normal for pregnancies to go beyond this date. In fact, only four out of every 100 babies are born on their estimated due date and anything between 38 weeks and 42 weeks is considered to be a normal length for pregnancy. However, when you go overdue it is understandable to feel impatient about when your baby is finally going to arrive. You may also find yourself faced with a choice between waiting and continuing to let nature take its course or making plans to have your labour induced. This title explores what happens in terms of health, well-being and induction of labour, when your pregnancy goes beyond 42 weeks.

Eating a healthy, balanced diet is an important part of a healthy lifestyle. However, it is even more important before you become pregnant (conceive) and during the first three months of pregnancy when your baby`s major body organs are developing and your baby will benefit the most from the food you eat. This title looks at the research evidence around diet and nutrition in pregnancy, as well as the general principles of a healthy diet and how this can lead to a healthier pregnancy for you and your baby. It also considers how eating certain nutrients may have an impact on your pregnancy and on longer-term health. There is also guidance on general food safety; this should be read in conjunction with the Informed Choice title Infections in pregnancy - prevention, detection and treatment.

Vitamin K is a substance that is naturally present in the body. It plays an important part in helping blood to clot; for example, if you cut yourself, vitamin K helps the blood to form a clot, which stops the bleeding and allows the skin to start healing. At birth, a baby is born with very low stores of this vitamin and these are then quickly used up over the first few days of life. Once milk feeds are established the baby then gradually builds up its own stores. The initial low levels just after birth can leave a baby vulnerable to severe bleeding (haemorrhage) because they are less able to form blood clots. They can also develop a condition referred to as vitamin K deficiency bleeding (VKDB) which is a rare but very serious condition that affects 1 in 10,000 babies. Therefore, the current advice is that levels of vitamin K should be increased for the first few weeks of life to offer protection until a baby starts to produce its own vitamin K stores, which will then minimise the risk of this condition. This title looks at the current evidence around vitamin K and how it can be given to your baby.

There are four main blood groups: A, B, AB and O and alongside your blood group is the Rhesus factor (Rh), with the D antigen (a substance that stimulates your immune system to produce antibodies) being the most important. If you have this factor (your midwife/doctor will tell you after a routine blood test) you are described as being RhD positive, and if you do not have it you are RhD negative. This title gives information about being Rhesus negative and its relevance to your pregnancy, your baby's well-being and what options you have for your baby's birth.

'Haemoglobinopathies' is a term that is used to describe disorders in the production of the globin chains of haemoglobin (haemoglobin is the oxygen carrying pigments which are present inside the red blood cells of the human body). The most common haemoglobinopathies are sickle cell disease and the thalassaemias. These disorders are inherited through your genes, and, if you are affected by one of them, this will be from birth. You are more likely to suffer from one of these disorders if your family, even several generations ago, originally came from Africa, Asia, the Caribbean, the Middle East, or the Mediterranean. How the disorder is passed on from generation to generation is quite complicated. Some people are not actually affected by the disorder itself but they can be a carrier of the affected gene. However, where both parents are carriers of the disorder, this will mean it is highly likely that their children will be affected by it. The advice in this title can only be an overview of the issues around this topic. If you have concerns about anything raised in this title, you should seek advice for your specific individual needs with your doctor, midwife or health visitor.

Pregnancy is a time when you will find yourself receiving a lot of new information and health advice, and will need to make a number of choices and decisions. It is a time when you also need to continue to look after, and protect, your own sexual health. This is about enjoying sexual relationships without causing harm to you, your partner, or your unborn baby. Being pregnant does not affect your risk of acquiring a sexually transmitted infection (STI); you are just as vulnerable as those sexually-active friends and colleagues who are not pregnant. Catching a sexually transmitted infection can harm the pregnancy and damage both you and your baby's longer-term health. Your pregnancy is also a good time to think about the future and begin planning ahead; this includes thinking about your contraceptive needs. You may already know quite a lot about the various methods of contraception that are available, but bodily changes related to recovering from pregnancy and the birth, as well as breastfeeding your baby, may mean that you need to consider methods that differ from those you might have previously used.

This title gives you information about a condition called iron deficiency anaemia. This is where the amount of iron present in the body's red blood cells is lower than it should be. This can lead to health problems for the mother and/or her unborn baby. Iron deficiency anaemia is the most common cause of anaemia in the United Kingdom (UK). There are other causes of anaemia but these are usually as a result of loss of blood or as the result of pre-existing medical conditions, for example, sickle cell anaemia and thalassaemia. You can find more information about these conditions in the title, Sickle cell and thalassaemia disorders: screening offered to mothres and babies.

We are all susceptible to different infections, diseases and health problems throughout our lifetime. Most pregnant women are generally fit and healthy, which may mean they are not always aware they have caught an infection until they experience symptoms or health problems. In some cases, these only develop in the later stages of the infection or disease. Some infectious diseases can be fairly minor causing a few short-lived, bothersome symptoms, however others can lead to serious health complications for the mother during pregnancy and after the birth, as well as for her developing and/or newborn baby. This title has been developed to help you recognise the importance of any signs of infection in pregnancy, so that you can seek care and advice as soon as possible. This is a huge topic, so we have focused on the most important aspects of information and have included details of a large number of websites and information resources for additional information.

Thinking about your health before you decide to become pregnant may involve the need to make some changes to your lifestyle. Health advice around planning a pregnancy or during the very early stages of pregnancy is important because a number of factors are known to adversely affect this process. These have the potential to cause defects or abnormalities in the organs, limbs and bone structures of the developing baby. However, with advice and support many of these factors can be avoided, which in turn, can reduce the risks of harm, ill health and longer-term disability for your baby. The information in this title is about planning a pregnancy as well as care in the early weeks of pregnancy, with a focus on the current guidance being offered in the United Kingdom (UK). It therefore looks at the choices, decisions and responsibilities of parents as individuals, as well as health services in the UK that are available to help, advise and support. These services have an important role to play where you might need to make specific changes to your health and lifestyle.