Your Pregnancy Guide

Widnes and Runcorn

Contents

Choosing where to have your baby 4 Healthy eating and drinking 7 Healthy lifestyle 11 Common ailments in pregnancy 16 BMI in pregnancy 19 Risk of getting an infection 22 Midwifery supervision 24

3 Choosing where to have your baby

The most important reason in making your decision is the safety of you and your baby.

4 Homebirth Choosing where to To book for a home birth it is essential you are healthy, well and have your baby have a normal pregnancy. Occasionally women develop There are two main ways for complications in pregnancy or women to refer to our service: labour which may exclude them self-referral or via the GP. You from this choice. If you have had a will be asked where you would previous normal pregnancy, labour like to have your baby. This is and birth you are less likely to a difficult decision to make require transfer to a hospital. if you are not aware of the services that are available. Only in exceptional circumstances will it be necessary to transfer you Many women make their and your baby to hospital. decision based on previous birthing experiences or on the recommendation of family Hospital birth and friends. Pregnant women in Halton have The most important reason in four hospital choices that provide making your decision is the maternity care: safety of you and your baby. Countess of Chester Hospital Current research suggests Liverpool Women’s Hospital that in normal, uncomplicated pregnancies for women not Warrington Hospital having their first baby, there is Whiston Hospital no safety difference between Most women will make their choice having your baby at home or based on: in hospital. previous experience Wherever you choose to give birth, being as relaxed recommendation of family as possible when you are in and friends labour is more likely to result locality and easy access. in your labour progressing Information on each hospital is well and you achieving a available on the hospital website. normal birth.

If you require further information, your midwife will be happy to help you.

5 Who can have a home birth? Is it safe? Any woman can request to have a Evidence suggests that a planned home birth. However there are some home birth for a woman without instances when a home birth may be complications is safe. Many women unwise and your midwife can discuss also report a feeling of higher these with you. satisfaction with their birth experience when compared with those women who Why have a home birth? have had their birth in hospital. Women have their own personal What types of pain relief reasons for choosing a home birth such as: can I use? it feels right for them Women who labour and deliver at the need to feel safe, secure and in home report needing fewer drugs for control pain relief. a previous bad experience in hospital Women labouring at home tend to be or a fear of hospitals more relaxed, feel in control and are the need to avoid unnecessary able to cope with their contractions. intervention and focus on normal However, you will have access to childbirth entonox (gas and air). Cylinders will be to assist in the establishment of delivered to your home when you are breast feeding 37 weeks pregnant. less disruption to family life, You may also wish to consider other particularly to other children. types of pain relief such as TENS, aromatherapy and water. If you wish to have a home water birth, please ask Who will be there? your midwife for information about how to loan a pool from our service. A midwife will attend any woman choosing to have a home birth. Midwives are experts in normal Will I have to go into hospital? pregnancy, birth and care of you and your baby following birth. A second If there are any complications you will midwife will attend your home as be asked to transfer to hospital. your labour advances to ensure two How do I arrange midwives are there for the birth. The midwife may also be accompanied a home birth? by a student midwife. Speak to your midwife who will be able to discuss home birth in more detail with you, answer your questions and make the necessary arrangements. You can also ask to speak to a supervisor of midwives.

6 Healthy eating and drinking

It is important for you and your baby’s health that you eat a balanced diet when you are pregnant. A balanced diet is one that includes different fresh foods that should be eaten every day.

7 Fruit and vegetables

Try to eat at least five portions a day Fresh orange juice counts as one of the five, but drinking more than one glass will still only count as one portion.

Meat, fish and alternatives Bread, cereals, Eat daily portions of protein, pasta, rice and such as lean meat, fish, potatoes beans and lentils Choose lean cuts of meat Make starchy foods the Avoid liver and pâté. basis of all your meals Wholemeal foods contain more fibre and help prevent constipation Eat fortified cereals (e.g. cornflakes) daily, as they contain many of the vitamins that you will need during pregnancy.

Milk and dairy Fat and sugar products

Eat daily portions of dairy Eat small amounts foods, such as milk, yoghurt Do not attempt to diet and cheese during your pregnancy. You Choose lower fat portions will lose any excess weight once you have had your Avoid mould ripened soft baby if you continue to eat a cheeses and blue veined balanced diet. cheeses.

8 Folic acid Iron

Folic acid helps to prevent abnormalities Anaemia is common during pregnancy. in the baby, e.g. spina bifida. The You will be offered blood tests to monitor recommended dose is 0.4mg per day for your iron levels, and if necessary, a at least 8 weeks before pregnancy and up course of iron supplements will be to 12 weeks into the pregnancy. prescribed. However it is known that a balanced and varied diet is effective in If you are taking anti-epileptic drugs preventing anaemia. or have a family history of fetal abnormalities, the recommended dose is 5mg per day. A folic acid prescription can be obtained from your GP. Alternatively it Good sources of iron rich food are: can be obtained from any pharmacy. Meat: particularly red meats, Vitamin A corned beef and black pudding Fish: sardines, tuna (in small High levels of vitamin A can cause amounts) and pilchards abnormalities in unborn babies. You Eggs: hard boiled should avoid taking vitamin supplements Pulses: beans, lentils and peas containing vitamin A while you are pregnant. You should also avoid eating Dried fruit: apricots, raisins and liver or anything made from liver, peaches such as pâté. Green vegetables Others: breakfast cereals, bread, Caffeine cocoa, chocolate, marmite, bovril, oxo and treacle. Caffeine is a stimulant that is contained in tea, coffee and cola drinks. Some cold and flu remedies also contain caffeine. Too much caffeine should be avoided Drinking caffeine-based drinks such as (200mg per day - see below) as it is coffee, tea and cola is known to reduce passed through the placenta and may iron absorption. It is advisable to avoid affect your baby. Too much caffeine can these drinks for thirty minutes before also cause miscarriage. and after a meal. Vitamin D To aid absorption take your iron tablet with a drink rich in vitamin C, for example All women will need vitamin D fresh orange juice. supplements as a matter of routine care during pregnancy to help with healthy development of the baby. Your midwife will advise you. One mug of One mug of One mug of One can of Instant coffee Filter coffee Tea Cola

Caffeine content 100 140 40 mgs mgs 75 mgs measurements mgs

9 Foods to avoid

Mould ripened soft Peanuts. If you would cheese may contain like to eat peanuts listeria, e.g. Camembert or food containing or Brie, blue veined cheese, Chevre peanuts during pregnancy you (a type of goat’s cheese) and any can choose to do so as part of other with a similar rind. There a healthy balanced diet, unless is no risk with hard cheese such you are allergic to them or your as cheddar or with cottage or health professional advises you processed cheese. Always read the not to. The latest research shows label if you are unsure. that there is no clear evidence that eating peanuts in pregnancy affects the chances of your baby developing a peanut allergy. All types of pâté (including vegetarian) may contain listeria. Unpasteurised milk and dairy products (Goats, sheep and some cows milk). Raw/Undercooked Ensure milk is labelled as meat. Cook all meat pasteurised. Natural yoghurt is and poultry thoroughly not pasteurised. Always read the so that there is no trace of pink or label to see if it is pasteurised. blood. It is fine to eat whole cuts of beef and lamb such as steaks, cutlets and joints (but not rolled joints) rare, as long as the outside Raw or soft boiled eggs may contain salmonella. has been properly cooked. It is best to avoid dishes that contain raw eggs, such as home made mayonnaise. During pregnancy, eggs are best eaten Sushi. It is fine to eat when they are thoroughly cooked. sushi and other dishes made from raw fish as long as the fish has been frozen Types of fish. first. Some raw fish used to make Do not eat shark, sushi such as smoked salmon marlin or sword fish and no more does not need to be frozen first than 2 tuna steaks a week (140g as the smoking kills any worms cooked, 170g raw) or 4 medium that may be in the fish. cans of tuna a week.

10 Healthy lifestyle

Making healthy choices during pregnancy is more likely to result in a healthy mother and baby.

11 Alcohol Exercise Avoid alcohol in pregnancy. If you Regular exercise is essential to good choose to drink alcohol, no more health throughout life. You can start than 1-2 units (see below) per week is moderate exercise before or during advised by the Department of Health. your pregnancy. Getting drunk and binge drinking is not advisable as too much alcohol Some activities: contact sports, increases the risk of miscarriage (NICE horse riding, skiing, cycling, 2008). Drinking alcohol in pregnancy gymnastics should be avoided. may lead to fetal alcohol syndrome. Ask your midwife about exercise Drugs classes such as aquanatal and yoga. Brisk walking for 10 minutes per day Taking non-medical drugs during is beneficial during pregnancy if other pregnancy is not recommended as it forms of exercise do not appeal. It may seriously harm you and your baby. is important to seek advice before A specialist midwife is available for help starting any new form of exercise. and support if needed. Sexual activity Smoking Sex is safe unless your midwife advises The effects on your baby of smoking you otherwise. If you have any vaginal in pregnancy include a higher risk of bleeding contact your midwife. miscarriage, nausea, haemorrhage and stillbirth and long term risks of cancer, coronary heart disease and Relationships lung diseases. Smoking may cause in Some women find pregnancy a time your baby: of increased stress and physical low birth weight discomfort. It can greatly affect your premature labour emotional state, your body image and relationships with others. If you feel breathing problems anxious or worried about anything asthma you can discuss your problems in glue ear confidence with your midwife. increased risk of cot death and meningitis. Second hand smoke can also affect your baby. 1/2 pint of ordinary 1 shot of 1 small glass of strength beer or lager spirit (25ml) wine (125ml)

1½ Alcoholic unit measurements 1 1

12 Avoiding infections Food hygiene It is important that you and your unborn baby stay healthy. Make sure Only use pasteurised or you avoid infections from food and UHT milk. animals during your pregnancy by Wash your hands before you taking simple precautions. Although handle food and after handling the possibility of contracting an meats and vegetables. infection in pregnancy is very rare, it is important that you are aware of Ensure food has not gone past the risks associated with some foods its use by date. and activities. Wash utensils thoroughly before re-using. Listeria and salmonella Avoid eating uncooked ready Listeria bacteria can be found in prepared meals. some cheeses and milk products. When re-heating foods ensure It causes flu like symptoms and they are thoroughly heated can cause miscarriage in pregnant right through, do not eat it if it women, stillbirth, or severe illness is luke-warm or cold. Bacteria in newborn babies. Salmonella can is killed by heat so thorough be picked up from food and harm cooking minimises the risk of your unborn baby. It is also advisable infection. to avoid high-risk foods when Use opened food straight away breastfeeding your baby. or store correctly until needed. Avoid raw or partially cooked Infections from animals meat, especially poultry. Cook Bacteria like campylobacter and all meats until pinkness has salmonella can be present in the gone and the juices run clear. excreta of cats and other animals. Use separate cutting boards Bacteria such as these are common for meats and poultry to those forms of food poisoning. Symptoms used for vegetables and other are abdominal pain, diarrhoea and foods. sickness. These infections are not known to cause any effects to an Ensure all surfaces are unborn baby but the symptoms thoroughly washed and are unpleasant and they are best cleaned after preparing foods. avoided. Putting the bacteria in Store raw meats separate your mouth causes infection of the to other foods to avoid stomach, so always wash your hands contamination. thoroughly before handling food Wash all fruit and vegetables and after handling animals. including ready prepared salads.

13 Chlamydiosis Toxoplasmosis Ovine Chlamydiosis is a very rare Toxoplasmosis is an infection that disease that can affect sheep. It may does not usually cause symptoms in cause miscarriage in pregnant women healthy women. Very occasionally it can if they come into close contact with cause problems for the unborn baby sheep and newborn lambs. It can of an infected mother. You can get it also be passed onto women through from eating undercooked or uncooked contaminated clothing and boots. Be meat, from the faeces of infected cats, aware when you are in the countryside contaminated soil or water. or visiting farms.

Pigs To avoid this during pregnancy it is advisable to: Research is ongoing to see if pigs are a source of hepatitis E infection. Wear gloves and wash your Avoid contact with pigs and pig’s hands thoroughly after faeces as this infection is dangerous in gardening or handling soil. pregnancy. There is no risk from eating Avoid contact with cat faeces cooked pork products. (in cat litter, or in soil). It is best to get someone else to empty and clean any litter trays. Ensure all meats are thoroughly cooked before you eat them.

14 Parent education Where abuse already exists it has been shown that it may worsen Prospective mums and dads may feel during pregnancy and after the birth. they have a lot to learn about labour Domestic abuse can lead to serious and birth. Parent education assists in complications, which affect your baby. this preparation enabling you both to You can speak in confidence to your make informed choices regarding your midwife or a specialist midwife who care during labour, life after birth and can offer help and support or you may caring for your newborn. Your midwife prefer to contact a support agency will arrange these classes for you such as Women’s Aid. during your pregnancy. Travel Work and benefits To protect you and your baby, always Contact your local DSS office or wear a seatbelt with the diagonal strap midwife for a booklet on the across your body between your breasts Governments’ latest provision on and the lap belt over your upper thighs. Maternity Rights and Benefits and The strap then lies above and below discuss your options with your your ‘bump’, not over it. personnel office or employer early in pregnancy; ensure everything is in Also make sure all baby / child seats writing. Up to date information can are fitted correctly according to British also be found on the Department Safety Standards. for Work and Pensions website www.dwp.gov.uk. If you are planning to travel abroad An FW8 certificate will be issued in you should seek advice from your early pregnancy entitling you to free midwife or GP. Short haul air travel prescriptions and dental treatment. is generally permitted up to 34 Your midwife will also supply you with weeks of pregnancy and long haul a maternity certificate after 20 weeks air travel up to 28 weeks. of pregnancy called a Mat B1 to claim your entitlement. However, you will need to confirm this Domestic abuse with the airline. Long haul air travel is associated with an increased risk 1 in 4 women experience domestic of deep venous thrombosis. Wearing abuse at some time in their lives and correctly fitted compression stockings, many cases start during pregnancy. drinking more fluids, mobilising when It can take many forms, including possible and performing leg exercises physical, sexual, mental or are effective at reducing the risk. emotional abuse. It is advisable to confirm that you can receive medical insurance cover as some companies have greater restrictions than others.

15 Common ailments in pregnancy

Pregnancy brings a variety of physical and emotional changes. Many of these changes are normal, although some of them may cause you discomfort. If you want to discuss these problems contact your midwife.

16 Nausea and sickness Thrush

You may feel sick or experience vomiting If you have vaginal thrush, a yeast in the early part of your pregnancy. This infection known as candida, contact usually stops around your 16th to 20th your GP for treatment. Your doctor will week. Women use different ways to prescribe you cream and / pessaries. cope with morning sickness or reduce its During pregnancy you should avoid effect, such as: taking any treatment for thrush that needs to be swallowed. Ginger nut or arrowroot biscuits Eating breakfast in bed Eating small amounts more often Itching in pregnancy Avoiding cooking smells Mild itching in pregnancy is common and Using wrist acupressure is caused by an increased blood supply to Although the common name for nausea the skin. In late pregnancy stretching skin and sickness in pregnancy is called may also cause itchiness. ‘morning sickness’ it can occur at any time. If you begin to vomit even when you drink, particularly if you have not eaten Seek advice if: for more than 24 hours, contact your GP The itching becomes severe, or midwife. particularly on hands and feet. If you develop jaundice Headaches (yellowing of skin and eyes) If you also have a rash. The hormonal changes and demands the growing baby makes on a woman’s body often results in tiredness and occasionally Teeth and gums feelings of exhaustion. This is normal in the early and late stages of pregnancy. Bleeding gums are caused by a build-up During these periods many women suffer of plaque (bacteria) on the teeth. from headaches which should resolve During pregnancy, hormonal changes in with rest or simple analgesia, such as your body can cause the plaque to make paracetamol. If you suffer from your gums more swollen and bleed persistent headaches, especially in the more easily. later stages of pregnancy, you should consult your midwife. Go to the dentist for a check-up. It is free while you are pregnant and for one year Heartburn after your baby’s birth. Heartburn in pregnancy is normal, Backache particularly as your baby grows bigger and your stomach is pushed upwards. Backache is common in pregnancy. Drinking iced milk can relieve heartburn You may find that massage therapy, symptoms. If your heartburn persists your exercising in water, yoga or going to GP can prescribe an antacid to relieve group or individual back care classes may the symptoms. help to relieve the pain.

17 Constipation Varicose veins

Many women suffer from constipation Although varicose veins are common, during pregnancy due to the hormonal they are not harmful during pregnancy. changes. If you suffer from constipation Compression stockings may relieve the while you are pregnant your midwife or symptoms (such as swelling of your legs) GP can offer advice in changing your diet although they will not stop the veins to a high fibre one and increasing your from appearing. intake as this often relieves the problem. If you have severe problems that are not Vaginal discharge alleviated by diet your GP can prescribe you a gentle laxative. You may have more vaginal discharge than usual while you are pregnant. This Haemorrhoids is normally nothing to worry about. However, if the discharge becomes itchy, If you suffer from haemorrhoids (piles) sore, smells unpleasant, or you have pain your midwife can give you advice in on passing urine, tell your midwife or GP changing your diet. If your symptoms as you may need treatment. continue to be troublesome your GP can prescribe a cream to help relieve Water infections the problem. Urinary tract infections (water infections) Abdominal and pelvic pain are common in pregnancy. Between antenatal appointments if you experience You may feel aches and pains as your any burning, stinging or discomfort when body changes with your growing passing urine you need to contact your baby, using simple analgesia, such as midwife or GP. paracetamol should ease any discomfort. If you are concerned about any symptoms If any pelvic or abdominal discomfort or discomfort you are experiencing becomes painful and does not ease with during your pregnancy or you need help rest it is important that you consult your or advice, your midwife or GP will be GP or midwife. happy to discuss it with you.

18 Raised BMI in pregnancy

Women who are overweight are at increased risk of developing pregnancy complications.

19 What is BMI?

Body mass index (BMI) is a tool for indicating weight “status” in adults. It is possible for 2 people to have the same BMI but be very different in terms of fitness and build. BMI ranges are based on the effect body weight has on health. As BMI increases so does the risk of disease. This is the same for pregnant women.

BMI Weight status Recommended weight gain

Below 18.5 Underweight 12.5 – 18 kg (28 – 40lb)

18.5 – 24.9 Normal 11.5 – 16 kg (25 -35lb)

25.0 – 29.9 Overweight 7 -11.5 kg (15 – 25lb)

30.0 – 34.9 Obese 6+ kg (15+lb)

35.0 and over Morbidly obese 6+ kg (15+lb)

National Institute for Health and Clinical Excellence. (2010) Dietary interventions and physical activity interventions for weight management before, during and after pregnancy.

Why is BMI used What are the risks of a in pregnancy? raised BMI?

BMI is now calculated for all women Antenatal period at their booking appointment. The Women who are overweight are at Confidential Enquiry into Maternal increased risk of developing pregnancy Deaths (CEMD, 2002) highlighted the complications. You are more likely to need for midwives to use this tool for have a miscarriage, become diabetic, all women at booking as part of the develop high blood pressure and risk assessment. This report suggests have blood clots. Scans to check for that women with a BMI greater than 30 abnormalities of the baby are not as have increased risks in pregnancy. accurate in larger ladies. It is also The National Institute of Excellence more difficult to feel and check how (NICE, 2007) have suggested that using big the baby is and to see which way it a BMI of 35 as the level when risks is lying. are increased. Within Halton, we have Birth agreed that if a woman has a BMI Women with a raised BMI (greater than level of less than 18 or greater than 35 35) may have problems moving about we would advise a delivery in a hospital in labour and it can be more difficult unit rather than at home. to hear the baby’s heart beat during labour.

20 Your baby may be bigger than average This is best achieved by dietary and which may make your delivery more healthy lifestyle advice including: difficult. This increases the chance Adopt a healthier eating style by of you having to have help with the eating regular meals, cutting down on delivery therefore the chances of fatty or sugary foods. Avoid alcohol. having an instrumental delivery or a casearean section are higher. This may Aim for 5 portions of fruits, be difficult to perform and therefore vegetables and salads per day. riskier for you. Dairy foods like milk, cheese and yoghurt are important for calcium. Epidurals and spinal blocks are more difficult to site in larger women and Become more active – take part general anesthetics are riskier. After in regular exercise e.g. swimming/ the birth you are at an increased risk of aquanatal/yoga. getting blood clots in your legs and if Further advice can be found on you have had a caesarean birth you are NHS Direct www.nhsdirect.nhs.uk or more likely to have complications with NHS Choices www.nhs.uk. your wound. Long term your child can develop problems with obesity. A scan to date the pregnancy will be offered, as will a detailed fetal anomaly Breast feeding is recommended as scan. Scans to check the baby’s growth there is less likelihood of your baby and position in later pregnancy will also becoming obese and therefore be arranged. developing diabetes and other illnesses later in life. Monitoring your blood pressure

What can be done to help? Your blood pressure (BP) will be monitored regularly and a larger Pre-pregnancy care BP cuff will be used to check the Weight loss before you get pregnant measurements as it is more accurate. is the ideal aim. Whilst this may not A test for diabetes will be offered be possible during the pregnancy it is at 28 weeks (glucose tolerance test something you should seriously think (GTT)) and you will be given a leaflet about before trying to get pregnant. explaining this procedure. Pregnancy care for a woman with a The anesthetic department of the BMI of 35 and above hospital unit where you wish to deliver Women with a BMI of 35 or above will will be advised of any pregnant be recommended to give birth in a woman with a BMI of 40 or above. The hospital unit. anesthetist will discuss a plan for pain You will be advised not to put on relief in labour and anesthesia for a excessive amounts of weight during caesarean if this becomes necessary. pregnancy – ideally you should try to At all times you will be treated with maintain your current weight. (You may dignity and respect and will be involved also be referred to a dietician). in discussions about your care and the risks associated with your pregnancy.

21 How to reduce the risk of getting an infection after having your baby

After you have had a baby you are at increased risk of getting an infection.

22 Infection after having a baby

Infection may occur at the site of the Even if you have not had stitches there afterbirth (placenta) inside your is still a chance of infection because womb or in the area where you have you may have some small grazes that had stitches internally (vagina) or did not need to be stitched. externally (perineum).

There are things you can do to reduce the risk of getting an infection after you have had your baby:

Washing your hands is the most Change your sanitary pads important thing you can do to regularly, each time you go to prevent infection. However, the toilet. At least four times a not only should you wash your day for the first few days. hands after going to the toilet, it is very important that you wash your hands before going to the toilet as well as before changing If possible use a towel to dry your sanitary pads. This is your hands that is not used by particularly the case if you have the rest of the family. a sore throat, a cough, a cold or have young children.

If you start to feel unwell in any Your midwife will discuss with way — for example: you the best way to clean your hands. It is easy for some germs if you have a high temperature on your hands (even if they look increased bleeding clean) to cause an infection in increased pain or new pain or around your stitches or inside develop a cough, cold or your womb (uterus). sore throat. notice an offensive smell pain when passing urine If you are somewhere where you are unable to use soap and water passing urine more often than then you should use an alcohol usual and passing smaller based hand gel. amounts or generally feel unwell. You need to see your Make sure you drink midwife or GP plenty of fluids.

23 References

British Nutrition Foundation. 2003. Martinez, L. 2002. World Health Diet through Life: Pregnancy. Organization. Special groups. [online] Available at: http://www. International Travel and Health. nutrition.org.uk [Accessed: March Geneva: World Health Organization. 2006]. National Institute for Clinical Broen, N., Kulier, R. and Excellence, 2007. Intrapartum care: Gulmezeoglu, AM. 2003. A Care of healthy women and babies supplementation during pregnancy. during childbirth. Guideline 55. Cochrane Database of Systematic [online]. London. Available at www. Reviews, 1 pp. 1-21. nice.org.uk

Camporesi, E. 1996. Diving National Institute for Clinical and pregnancy. Seminars in Excellence, 2008. Antenatal Care Perinataology, 20 pp. 292 - 302. [online]. London. Available at www. nice.org.uk Food Standards Agency, 2011. Eating while you are pregnant. National Institute for Clinical [online]. London. Available at Excellence, 2010. Dietary http://multimedia.food.gov.uk/ interventions and physical multimedia/pdfs/publication/ activity interventions for weight eatingwhilepregnant1209.pdf management before, during and after pregnancy. [online]. London. Greenwood, C. and Statinon, M. Available at www.nice.org.uk 2001. Back pain / discomfort in pregnancy: invisible and forgotten. NHS Choices, 2011. The Pregnancy Journal of Perinatal Education, 10 Care Planner. [online] Available at: pp. 1-12. http://www.nhs.uk

Jewell, D. and Young, G. 2001. NHS Choices, 2012. Why Interventions for treating breastfeed? Pregnancy and constipation in pregnancy. Cochrane baby guide [online]. Available Database of Systematic Reviews, 1. at: http://www.nhs.uk/ Planners/ breastfeeding/Pages/ Jewell, D. and Young, G. 2001. breastfeedingbenefits.aspx. Interventions for nausea and vomiting in early pregnancy. Royal College of Obstetricians and Cochrane Database of Systematic Gynaecologist. Why Mother’s Die Reviews, 2. 1997 – 1999. 2002. Confidential Enquiries into Maternal Deaths.

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Widnes and Runcorn

Delivering care

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If you have any questions about your pregnancy then call us today on: 0151 495 5079 www.bridgewater.nhs.uk