Inform yourself fully before you make any decisions on this one.
Interestingly, blaming your partner may be legitimate at this point: Danish research published in the British Medical Journal, November 2003, suggests that a father’s genes play a major part in deciding the timing of the birth, and your chance of having a ‘prolonged pregnancy’.
Where to go for help:
For fetal development in more detail try Your Pregnancy Week by Week by Dr Glade B. Curtis and Judith Schuler (Da Capo Press, US, 2004)
Antenatal checks and tests
How many visits?
The National Institute of Clinical Excellence (NICE) guidelines say low risk pregnant women should have an antenatal appointment (with the midwife) at about ten weeks (to be booked in), then at 16 weeks, then 19–21 weeks (for a scan), then every three weeks until you are 36 weeks pregnant, then every two weeks until you are 40 weeks pregnant, then weekly until you deliver.
At each visit your urine will be tested for protein (sign of pre-eclampsia) and sugar (diabetes). Your blood is pressure taken. The midwife will feel and measure your uterus (from the outside!) and check the baby’s heartbeat. Use these visits to get to know the midwife, and talk over your worries/concerns/options generally.
Initial ‘booking’ visit
At about ten weeks: Your medical history and general health: weight, height, heart, lungs. Test for sugar and protein in urine. Blood pressure. First blood test (see below).
Ultrasound scans
These are the most common scans, though they are not offered by every hospital:
Dating: 8–12 weeks. To assess when baby due.
Nuchal fold: 11–13 weeks. Looks at thickness at back of baby’s neck. Gives a ‘risk’ of Down’s syndrome, from which you can decide if you want to take further tests (see below). About 80 per cent of Down’s babies are detected in this way.
Anomaly scan: 19–21 weeks. To assess baby’s overall development. Looks specifically at the development of the palate, brain, spine, bladder, kidneys and stomach.
Blood tests
First blood test: taken at booking-in visit at around 8 weeks. Determines your blood group and whether you are rhesus negative or positive (can affect your body’s response to your baby). Also checks for: anaemia (supplements may be needed), immunity to rubella (German measles – can damage the baby if you catch it in pregnancy), syphilis, hepatitis B, HIV and genetic conditions such as sickle cell and thalassaemia. These are inherited blood disorders. In Britain, sickle cell disorders are found mainly in those of African/Caribbean descent and thalassaemia is most common in people from Mediterranean, Asian and Middle Eastern ancestry.
‘Triple screen’: about 16–18 weeks. Screens principally for Down’s syndrome and also for spina bifida. Only 65 per cent of these conditions are detected. Do not panic if you get a ‘high risk’ result (see below).
Anaemia: usually at around 28 and sometimes at 36 weeks too.
Invasive diagnostic tests
These are usually offered, with a local anaesthetic, if other tests show you are at a slightly higher-than-average risk of having a baby with chromosomal abnormalities or neural tube defects.
Chorion Villus Sampling (CVS): | done after 11 weeks. Needle inserted through your abdomen takes a sample of placenta. One to two per cent risk of miscarriage.
Amniocentesis: | done after 15 weeks. Very fine needle inserted through your abdomen takes a sample of amniotic fluid. One per cent risk of miscarriage.
Decoding Results
Many of these tests, with their talk of statistics and probabilities, put the fear of God in you and many hospitals don’t offer adequate counselling. Most women who have ‘high risk’ results go on to have perfectly healthy babies. Do not let these tests panic you. If you are at all unclear or confused by any test result ask the hospital if there is anyone who can sit with you and talk over the results. And/or call: Antenatal Results and Choices (ARC) 020 7631 0285 www.arc-uk.org.
Where to go for help:
Sickle Cell Society 54 Station Road London NW10 4UA. 020 8961 7795 [email protected] www.sicklecellsociety.org.
UK Thalassaemia Society 19 The Broadway, Southgate Circus, London, N14 6PH. Freephone advice line: 0800 7311109 www.ukts.org.
Association for Spina Bifida and Hydrocephalus (ASBAH) ASBAH House, 42 Park Road, Peterborough PE1 2UQ. 01733 555988 (9am–5pm) www.asbah.org
Down’s Syndrome Association Two babies with Down’s syndrome are born every day in the UK. Around one in every 1,000 babies born will have Down’s syndrome. Many (but not all) parents will know this, in advance, from screening tests done in pregnancy. Langdon Down Centre, 2a Langdon Park, Teddington TW11 9PS. 0845 230 0372 www.downs-syndrome.org.uk
HIV: Positively Women 347–349 City Road, London EC1V 1LR. Administration tel: 020 7713 0444 (9:30am–5pm Monday to Friday) Helpline staffed by HIV positive women: 020 7713 0222 (10am–4pm Monday to Friday) www.positivelywomen.org.uk.
FIND OUT MORE
Resources
Maternity shopping from your desk
FOUR PLACES TO BUY BASICS
Next www.next.co.uk
Mothercare www.mothercare.co.uk
JoJo MamanBebe www.jojomamanbebe.com
Blooming Marvellous www.bloomingmarvellous.co.uk
FOUR PLACES TO FIND A SPECIAL OUTFIT
Isabella Oliver small collection of stylish basics 0870 240 7612 www.isabellaoliver.com
Seraphine designer-y range www.seraphine.com
Small but trendy range of genuinely nice clothes www.serendipity-online.com
Formes expensive but fantastically cut French clothes www.formes.com
MATERNITY BRAS
This website has a great rundown of what to look for, and bras tested. It’s a great place to start: www.midwivesonline.com/centreofexcellence_breastfeedingbras.htm
