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Women's Health

By Dr Tamara Karni Cohen & Dr Chiara Hunt

Pregnancy and birth can be overwhelming, especially for first time parents. At Sloane Street Surgery we are here to guide you through the minefield of choices and provide continuity of care for you and your baby throughout your pregnancy, in the postnatal period and as your child grows.

We offer guidance and support in all areas of pregnancy, from fertility testing, during those anxious first few weeks, right up to when your baby is born, and of course we look after both mother and baby after delivery. As a practice we provide a holistic approach towards prenatal, antenatal and post-natal care and tailor our support to each individual and couple.

Antenatal care provided by general practitioners (GPs), alongside obstetricians and midwives, plays a crucial role in ensuring the health and well-being of both the mother and the unborn child during pregnancy. Here’s a general overview of what pregnancy and postpartum care in our GP setting typically involves.

When should I visit to discuss a future pregnancy?

We recommend a prenatal consultation for anyone considering pregnancy, ideally a few months before trying to conceive. This allows you the chance to discuss optimising your health before pregnancy and making amendments to your lifestyle in order to give you the best chance of conception. You will have the opportunity to discuss managing any health conditions during pregnancy. If you have concerns about fertility we are happy to discuss topics such as assisted conception and egg freezing. A physical examination would usually be done as well as blood tests if necessary to assess your current health.

What does antenatal care consist of?

Once you have a positive home pregnancy test, the journey then begins with an initial consultation where your GP confirms the pregnancy, discusses medical history, assesses any risk factors, and helps you plan your care during pregnancy. Questions to think about are:

  • Do you want private or NHS care for your pregnancy? If you chose to be looked after in the NHS, what private additions are available, such as extra scans, swabs and more detailed tests to assess risks of chromosomal disorders (non-invasive prenatal testing – NIPT)?
  • If you chose private pregnancy care, do you want Midwife led care or Obstetrician led care? Which hospital would you prefer to deliver in? What are the cost implications to all these options?
  • If you chose private obstetrician led care, who might be the best match for you?

Once you have chosen the option that works best for you, you can continue to see your GP, alongside your Obstetrician or midwife, throughout the pregnancy. We act as the central point of contact and are here for any unanswered questions, as well as ensuring regular pregnancy monitoring, and helping you navigate through the system, which can often be overwhelming, especially for first time parents.

When should I book in with an obstetrician or midwife?

Whatever type of pregnancy care you chose, you need to book in with the Obstetrician, private midwives or NHS team, around weeks 8-11 of the pregnancy. Remember, pregnancy dates are calculated from the first day of your last period so by the time you find out, you are usually already 4 weeks pregnant.

What scans should I have during pregnancy?

In the UK the NHS offers two routine scans during pregnancy, at 12 weeks and 20 weeks. Privately, you would have scans more frequently. As a minimum we would suggest having an additional early scan at 6 weeks to check the viability of the pregnancy as well as an additional late scan at 35 weeks to check the position of the baby and the condition of the placenta. Many of our patients chose to have reassurance / pregnancy welfare scans more frequently during the pregnancy. The scans use ultrasound and are not in any way harmful to your baby. We are here to help you coordinate appropriate screening tests and assessments for your pregnancy.

How often will I see an obstetrician or midwife?

A woman would usually be seeing her obstetrician or midwife on average once a month during the pregnancy, and more frequently towards the end.

What other tests can I expect to have during my pregnancy?

You will have various tests to monitor the mother and baby throughout pregnancy.  These may include blood tests, urine tests, ultrasound scans, genetic screening, and screening for conditions such as gestational diabetes and preeclampsia. Most of these tests happen with your obstetrician and/or midwife, but we are happy to discuss any new or ongoing concerns and provide extra support for any parental concerns regarding results.

We will also often test and treat for conditions such as such as morning sickness, (which can often be all day sickness), pelvic girdle pain, carpal tunnel syndrome, pelvic floor dysfunction and infections, for instance UTIs and thrush, which are all common in pregnancy. Later on in pregnancy you will have a test for gestational diabetes which needs close monitoring if it develops.

What if I have a pre-existing health condition?

We of course also monitor pre-existing health conditions such as diabetes, hypertension, or thyroid disorders and adjust treatment plans as necessary to ensure optimal management during pregnancy.  We liaise with any specialist colleagues to make sure you are receiving the best care for your condition during your pregnancy.

How do I keep healthy during my pregnancy?

Physically

Maintaining a healthy diet during pregnancy is key. During your initial consultations we would discuss recommendations for essential nutrients, vitamins, and supplements necessary for both the mother and baby’s health.  We would also discuss healthy lifestyle and signpost which exercises to perform or avoid during pregnancy.

Emotionally

An important aspect of antenatal care also involves providing emotional support and counselling to address any anxieties, fears, or emotional challenges the expectant parent may be experiencing. We also work with a wide range of psychologists and psychiatrists who specialise in perinatal mental health to support expectant and new mothers.

In the community

There is plenty of additional support for pregnant and post-partum women. These include antenatal classes such as Dr Chiara Hunt’s “The Bump Class”, women’s health physiotherapy to help maintain a healthy pelvic floor and abdominal core during and after pregnancy, pregnancy exercise groups and also specialist breastfeeding support.

When should I come in after giving birth?

Most mothers with their newborns stay in hospital for between one and three nights, depending on the birth. Parents and their babies can come see their GP any time after giving birth or request a home visit. For the baby these visits allow an opportunity not only to perform physical examinations but also for the parents to ask any questions that may have built up since the last visit. For the mother we provide postnatal check-ups, contraception counselling, postnatal depletion screening, breastfeeding support, and monitoring for any complications of birth.   This includes screening for postnatal depression or baby blues and providing mental health support.

We would normally do the following check-ups for baby and mother in our practice:

Baby:

2–4-week newborn check

6-week formal baby check

2-month vaccinations and check-up

3-month vaccinations and check-up

4-month vaccinations and check-up

5–6-month development review and weaning consultation

9-month development check

12-month development check and vaccinations

13-month vaccinations

18-month development review

From 2 years old we usually do annual health checks for our paediatric patients.

Mother:

6-week postnatal check

3–4-month health review including blood tests to check for postpartum depletion.

One-year postnatal check and follow up.

 

At Sloane Street Surgery we provide a complete, holistic and tailored prenatal and postnatal service to our patients which aims to promote the health and well-being of both the mother and baby throughout pregnancy; offering comprehensive medical support, guidance, and reassurance.

If you would like an appointment with one of our experienced GPs, please book online here or call 0207 245 9333.

References:

https://www.nice.org.uk/guidance/ng201

https://patient.info/doctor/antenatal-care

https://podcasts.apple.com/gb/podcast/the-parent-hood/id1296197387

https://www.thebumpclass.com/

 

 

 

 

 

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