Maternity Services: Your Pregnancy

When you first find out you are pregnant you should contact a Midwife through your local hospital’s Maternity Team for your first appointment.

An anonymous Text Service (0776 993 2189) is offered for anyone who has any pregnancy issues, even before meeting their Midwife. If required, a discreet meeting can be arranged out with hospital premises before the first appointment.

If you are unsure about continuing your pregnancy, information and support is offered from the local Maternity services on 01851 708300 or using the anonymous test service (0776 993 2189) and also from the Western Isles Pregnancy Crisis Support Service, tel. 07901 966 101. 

If you are sure about terminating your pregnancy, this service can be accessed through a health professional by phoning 01851 708300 or your GP, using the anonymous text service (0776 993 2189), or directly through the Social Gynaecology Service at Inverness, tel. 01463 704431 (available on Tuesday and Wednesdays). 

Usually medical terminations can be provided at home, if less than 10 weeks or in Western Isles hospital.  Once a termination is requested a review will carried out to determine gestation and circumstances. A pick up point for medications will be arranged and patients will be fully supported through the process by a trained member of staff.

Additional information can be viewed via NHS Inform's Abortion: Tests and Treatment or the Pregnancy Advisory Service.

Safe Access Zones

Safe Access Zones are in place everywhere that abortion services are provided in Scotland from 24th September 2024. Within a Safe Access Zone, it's illegal to try to influence, harass, or prevent anyone from accessing or providing abortion services.

There are 30 safe access zones across Scotland – to view these please click here. For more information visit www.gov.scot/safe-access-zones

Ready Steady Baby! offers a comprehensive guide to pregnancy, labour and birth and early parenthood up to 8 weeks. 

View online at Ready Steady Baby! (nhsinform.scot)

Best Start Foods

Best Start Foods helps eligible pregnant women and families with children under the age of 3 to buy healthy foods and milk. The payments are loaded onto a pre-paid card that works like a regular bank card.

You can apply for Best Start Foods as soon as you know you are pregnant.

You may be able to get Best Start Foods if:

• you’re under 18,
• you’re aged 18 or 19 and someone is getting benefits for you,
• you look after someone who is under 20 and pregnant, or
• you or your partner are getting certain benefits.

For more information and to apply go to: www.mygov.scot/best-start-grant-best-start-foods or call Social Security Scotland free on 0800 182 2222

Best Start Grant

The Best Start Grant is made up of three possible payments. It provides parents or carers who get certain benefits or tax credits with financial support during the key early years of a child's life. The three possible payments are given in these stages:

• Pregnancy and Baby Payment
• Early Learning Payment
• School Age Payment

For more information and to apply go to: www.mygov.scot/best-start-grant-best-start-foods or call Social Security Scotland free on 0800 182 2222,

From your booking appointment your midwife will be able to tell you if you are a low risk pregnancy or a high risk pregnancy based on what you have told us. She will explain the reasoning to you.

Schedule of appointments in routine antenatal care

You will be offered screening tests for you and your baby. This is in accordance with the UK National Screening Committee guidelines.

It is important that you read the booklet and inform your midwife of any relevant conditions that may occur in you, your partner or your immediate families.

More Information about screening tests:

Ultrasounds Scans

You will be routinely offered two scans during your pregnancy. The first scan is offered between 11+0 and 13+6 weeks of the pregnancy and the purpose of this scan is to:

• Measure the length of your baby, to check that it correlates with your dates and
  estimate an expected due date
• Check your baby’s heart rate
• Check if there are multiple pregnancies – twins or more
• Check for abnormalities
• Offer you screening for Down's syndrome

The second scan offered is between 18+0 – 20+6 weeks of the pregnancy and the purpose of this scan is to:

• Look at all the major organs and limbs to detect any structural abnormality with
  the baby
• Determine where the placenta has embedded
• Determine the amount of amniotic fluid

In some pregnancies your Obstetrician will recommened additional scans.

Blood Tests

You will be offered a number of blood tests at your booking appointment, which we encourage you to have.  Blood tests are a vital way of checking your and your baby’s health and we can provide the correct treatment for you and your baby if any of the results were to show you or your baby were at risk, or affected.

• Screen for haemoglobinopathies (blood disease) – to see if you are a carrier
  of Sickle cell or Beta Thalassemia
• Screen for infectious diseases – Hepatitis B, HIV, Syphilis and whether you
  are immune to Rubella or not
• Determine your blood group and rhesus factor

Screening for Down's Syndrome

You will be offered screening for Down's Syndrome following your first scan. The screening test is able to provide specific information about your chance of having a baby affected with Down's Syndrome. The ‘Combined test' (CUBS) is offered to all women under 14+1 weeks of pregnancy and involves measuring three markers in relation to the pregnancy. The markers are:

• Measurement of fluid under the skin at the back of the baby's neck, known as the nuchal translucency (NT).
• Measurement of two serum markers found in the mother's blood from the pregnancy.

The results from all of these markers are processed by a very specific computer programme to generate a ‘risk' or your chance of having a baby with Down's Syndrome. Any number that is below 1 in 150 means that there is a higher chance of the baby having Down's Syndrome and you will be offered further testing, if you wish. Numbers that are above 1 in 150, means that there is a lower chance of the baby having Down's Syndrome. However, it has to be remembered that a screening test cannot diagnose Down's Syndrome. If the result is ‘high' the screening midwives will contact you to discuss the implications of the result and your options.

We offer classes in the maternity unit from when you are around 28-32 weeks pregnant. An invitation letter will be sent to you.

Why go to classes?

Parentcraft classes can help you to prepare for your baby's birth and learn to look after and feed your baby. You can learn about the different arrangements for labour and birth, and the choices available to you. This can help you to make your own birth plan.

Knowing the health benefits of breastfeeding can help you make an informed choice in how you decide to feed your baby. At classes you can gain information and practical skills that will help you be successful in your chosen method of feeding.

You will be able to discuss your plans and any worries with a midwife and with other parents. Classes are also a good way to make friends with other parents who are expecting babies around the same time as you. These friendships often help parents through the first few months with a baby. If you have any questions about this then please ask your midwife at your next appointment.

Women who require close observation during their pregnancy, or require inpatient induction of their labour are admitted to this area in the Western Isles Hospital. Women in Uist and Barra will sometimes need cared for here also and this plan of care would be arranged accordingly between midwifery teams.

A team of midwives and an obstetrician will care for you and ensure you have an individualised plan for your stay.

Facilities

• 2 single rooms
• 2 bays with 3 beds and en-suite

Visiting times:

• Open visiting for partners only
• 14:30 – 16:30 all other visitors
• 18:30-20:30

Meals are available for mothers and special dietary requirements can be accommodated. Self service breakfast, lunch 12.30pm, dinner 5:30pm.

Alcohol in Pregnancy

It is best to avoid alcohol completely during pregnancy, as any alcohol you drink while pregnant will reach your baby and may cause harm. Women who are trying to conceive should also avoid drinking alcohol. There is no ‘safe' time for drinking alcohol during your pregnancy and there is no ‘safe' limit. We do know that the risk of damage increases the more you drink, but there is no cut-off level at which damage is known to occur. Drinking no alcohol during your pregnancy is the best and safest choice. Everyone has a role to play in supporting pregnant women to avoid alcohol, and pregnancy is an ideal time for partners to cut down on their drinking too.

Fetal Alcohol Spectrum Disorders

Regularly drinking and binge drinking in pregnancy can lead to an increased risk of a wide range of development issues and physical disabilities including Fetal Alcohol Spectrum Disorders (FASD). Although children with FASD look healthy, the effects can include physical, mental, behavioural and learning disabilities.

One particular disorder in FASD is Fetal Alcohol Syndrome (FAS). Children with FAS have restricted growth, distinctive facial features including small eyes and a flat area between the nose and upper lip, and lifelong learning and behavioural problems.

If you have any concerns, your midwife, GP or other healthcare staff will be happy to discuss these with you.

Smoking and the unborn baby

Protecting your baby from tobacco smoke is one of the best things you can do to give your child a healthy start in life. It's never too late to stop smoking. Every cigarette you smoke contains over 4,000 chemicals, so smoking when you are pregnant harms your unborn baby. Cigarettes can restrict the essential oxygen supply to your baby, so their heart has to beat harder every time you smoke.

Benefits of stopping smoking in pregnancy

Stopping smoking will benefit both you and your baby immediately. Harmful gases like carbon monoxide and other damaging chemicals will clear from your body. When you stop smoking:

• you will have fewer complications in pregnancy
• you are more likely to have a healthier pregnancy and a healthier baby
• you will reduce the risk of stillbirth
• you will cope better with the birth
• your baby is less likely to be born too early and have to face the additional breathing, feeding and health problems that often go with being premature
• your baby is less likely to be born underweight: babies of women who smoke are, on average, 200g (about 8oz) lighter than other babies, which can cause problems during and after labour, for example they are more likely to have a problem keeping warm and are more prone to infection
• you will reduce the risk of cot death, also called sudden infant death.

Stopping smoking will also benefit your baby later in life. Children whose parents smoke are more likely to suffer from asthma and other more serious illnesses that may need hospital treatment.

The sooner you stop smoking, the better. But even if you stop in the last few weeks of your pregnancy this will benefit you and your baby.

Second-hand (passive) smoke harms your baby

If your partner or anyone else who lives with you smokes, their smoke can affect you and the baby both before and after birth. You may also find it more difficult to stop if someone around you smokes.

Second-hand smoke can also reduce birth weight and increase the risk of cot death. Babies whose parents smoke are more likely to be admitted to hospital for bronchitis and pneumonia during the first year of life. http://www.maternal-and-early-years.org.uk/second-hand-smoke

Nicotine replacement therapy (NRT)

You can use NRT during pregnancy if it will help you stop smoking, and you're unable to so without it. It's not recommended that you take stop smoking tablets such as Champix or Zyban during pregnancy.

NRT is available as:

• patches
• gum
• an inhalator
• nasal spray
• mouth spray
• lozenges
• microtabs

Before using any of these products, speak to your midwife, GP, a pharmacist or a specialist stop smoking adviser for more detailed information and support.

Quit Your Way Hebrides

To find out more about quitting and to get support, you or your partner can contact the Quit Your Way Hebrides, your local stop smoking support service in the Western Isles. Or, if you prefer, ask your midwife or doctor to refer you.  View the Quit Your Way Hebrides leaflet here.

Quit Your Way Hebrides offers a team of highly trained support workers who will be delighted to support you in your quit attempt.

You can contact them for free, friendly, confidential support on:

Quit Your Way Hebrides – Western Isles

Email: wi.hebridesquityourway@nhs.scot