Air Travel

If your pregnancy is straightforward, there is no evidence that the changes in air pressure and/or the decrease in humidity have a harmful effect on you or your baby.

Make sure you are up-to-date with your vaccinations and have travel insurance.

If you do not have electronic access to your pregnancy notes, it's a good idea to take a copy of them with you, so that, should it be required, health professionals can see your relevant information; you can ask your midwife to print a copy of your information.


Make sure your travel insurance covers you for any eventuality, such as pregnancy-related medical care during labour, premature birth and the cost of changing the date of your return trip if you go into labour.


There is no evidence that flying will cause miscarriage, early labour or your waters to break. Anyone who flies is exposed to a slight increase in radiation.

Check with your airline whether they have specific rules relating to pregnancy.

Air travel and pregnancy

Air travel and pregnancy

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Alcohol

The Department of Health recommends that women who think they may become pregnant should not drink alcohol at all, this is to keep risks to the baby to a minimum.


When you drink, alcohol passes from your blood through the placenta and to your baby. There is no known safe level for drinking during pregnancy, so the safest approach is not to drink at all while you're expecting.

Drinking alcohol at any stage during pregnancy can cause harm to your baby and the more you drink, the greater the risk. This is why the alcohol unit guideline advice to pregnant women is that the safest approach is to not drink alcohol at all during pregnancy.


Drinking in pregnancy can lead to long-term harm to the baby and the more you drink, the greater the risk.

Getting drunk and/or drinking every day are especially dangerous.

But please be aware if you're already pregnant and drank only small amounts of alcohol in the early stages of pregnancy, the risk of harm to the baby is low. However if you are worried, you should talk to your GP or midwife.

 

Drinking alcohol in pregnancy - Tommy's information

Drinking alcohol in pregnancy - Tommy's information

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Royal College of Obstetricians and Gynaecologists

Royal College of Obstetricians and Gynaecologists

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Useful links

Free helpline for advice on Fetal Alcohol Syndrome
Weekdays 9am to 8pm

Weekends 11am to 4pm

Phone: 03001231110

Free national alcohol helpline

Phone: 02084585951

Call Talk to Frank

Phone: 03001236600

Addaction is a UK-wide treatment agency that helps individuals, families and communities manage the effects of alcohol and drug misuse.


Alcoholics Anonymous (AA) is a free self-help group. Its "12-step" programme involves getting sober with the help of regular support groups.


Change 4 life - choose less booze

Choose less booze is one of a number of sections on this site to help make positive lifestyle changes.

It has a range of easy to use tools to help you do this including:

  • A drinks checker tool to see how much alcohol you are drinking
  • Free drink tracker app to download
  • Easy drink swaps advice
  • Advice on units

Drinkaware.co.uk


NHS Choices


National Organisation on Fetal Alcohol Syndrome UK
More information and advice on Fetal Alcohol Syndrome (FAS).

Exercise in Pregnancy

If your pregnancy is uncomplicated it is actually much healthier for you and your baby to exercise while pregnant. The more active and fit you are during pregnancy, the easier it will be for you to adapt to your changing shape and weight gain. It will also help you to cope with labour and get back into shape after the birth.

Keep up your normal daily physical activity or exercise (sport, running, yoga, dancing, or even walking to the shops and back) for as long as you feel comfortable.


Exercise is not dangerous for your baby - there is some evidence that active women are less likely to experience problems in later pregnancy and labour.

Exercise in water (Aquanatal)

Exercising in water is proven to be effective in helping to reduce lower back and pelvic pain in pregnancy.

Yoga

A study looking at the effect of yoga on pregnancies with high risk complications has indicated that yoga can have a positive effect on the pregnancy and health of your baby.

More information from the Tommy's website can be obtained here:

Yoga during pregnancy

Is it safe to exercise in pregnancy?

Is it safe to exercise in pregnancy?

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Tips for exercise in pregnancy

Tips for exercise in pregnancy

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Easy office exercises to do when you are pregnant

Easy office exercises to do when you are pregnant

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Making a plan for exercising in pregnancy

Making a plan for exercising in pregnancy

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Useful links

Fit for Pregnancy

Fit for Pregnancy

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Fit and Safe

Exercise advice for mothers-to-be and new mothers

Fit and Safe

Exercise advice for mothers-to-be and new mothers

 
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Physical activity for pregnant women

Physical activity for pregnant women

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Exercise and activity in pregnancy

Tommy's: Exercise and activity in pregnancy

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Healthy Diet

Everything you eat or drink during pregnancy reaches your baby in some way and influences the baby's health both before and after he or she is born.

You don't need a special diet, but you need to eat a balanced diet.

You are not eating for two and doing so will probably result in excessive weight gain, which is not good for you or the baby. In general you do not need extra calories for the first two-thirds of pregnancy and it is only in the last12 weeks that women need an extra 200 calories a day.

It is important to eat well during pregnancy. It is recommended that you have a low fat, low sugar and high fibre diet. Make sure you drink plenty of water too. Try and eat five portions of fruit or vegetables each day, including vitamin C and iron rich foods. Your midwife will be able to advise you further.


We will weigh you during pregnancy if your BMI is above 30 at booking. There are no formal UK guidelines defining appropriate weight gain during pregnancy, however, research suggests if your:

  • BMI is 25 to 30, then a healthy weight gain in pregnancy is about 7 to 11 kg (15 to 25 pounds).
  • BMI is over 30 at the start of pregnancy, then it is not healthy to gain more than 5-9 kg (11-20 pounds).

It is important for all women to stay physically active during pregnancy. From regular walks to aqua natal classes there are many different options for exercise. Please discuss this further with your midwife.

Body mass index (weight)

At the earliest opportunity your midwife will calculate your BMI. This is calculated using your height and weight measurements.

Your health team will use your BMI to know whether you are a healthy weight for your height.

Generally, people involved in your health care will describe your BMI as follows:

  • 18.5 or lower = underweight
  • Between 18.5 and 24.9 = healthy weight
  • Between 25 and 29.9 = overweight
  • 30 or higher = obese.

Your BMI (using your pre-pregnancy weight) may highlight a need for some extra care and support during your pregnancy.

Raised BMI/ Obesity
Please refer to the 'Raised BMI/ Obseity' section for further information.

Useful links

NHS - Have a Healthy Diet

NHS - Have a Healthy Diet

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Tommy's - Healthy Diet in Pregnancy

Tommy's - Healthy Diet in Pregnancy

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Tommy's - Guide to a Healthy Diet in Pregnancy

Tommy's - Guide to a Healthy Diet in Pregnancy

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Illegal or Recreational Drugs

If you use illegal or recreational drugs it is important for you to know how they can affect you, your pregnancy and your baby. Depending on what drugs you use the effects can include growth restriction, increased miscarriage, birth defects and a chance that your baby will have to withdraw after birth.

If you take any illegal or recreational drugs it can be very hard to stop and in some cases may even be harmful to stop suddenly. There is support available for you so please talk to your midwife or GP.

Tommy's

Illegal or recreational drugs in pregnancy

Tommy's

Illegal or recreational drugs in pregnancy

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IMPACT

IMPACT Swindon & Wiltshire Active Recovery Service is a free drug and alcohol service run by Turning Point.

IMPACT

IMPACT Swindon & Wiltshire Active Recovery Service is a free drug and alcohol service run by Turning Point.

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Anyone living in Bath & North East Somerset can get free and confidential help if they are struggling with drugs or alcohol.

Smoking in Pregnancy

When you smoke a cigarette, over 4000 poisons are passed through the placenta directly into your baby's body.

The best thing you can do for your baby is to quit smoking.

We know that your health, and the health of your baby is the most important thing in the world to you. Quitting smoking should be done as early as possible because smoking increases the chance of complications during pregnancy and afterwards.

It can also lead to premature births and even stillbirth.


If you are a smoker or have recently given up smoking you will be offered a referral to a  Smoking in Pregnancy specialist midwife who will support you to stop and stay stopped.

For information on services in the Bath & North East Somerset area, Wiltshire and also Somerset, click here:

Service information


Positive Image, Motivation and Support (PIMS) (salisbury.nhs.uk)


Smoking in Pregnancy Service | Great Western Hospital (gwh.nhs.uk)


Why carbon monoxide screening matters

Why should I quit?

Cutting down is not enough, you and your baby are still at risk.

Harm to you

Smoking increases the risk of complications during pregnancy including the risk of:

  • Infection to your baby
  • Your waters breaking early
  • Baby being born prematurely
  • Miscarriage
  • Bleeding
  • High blood pressure
  • Stillbirth

Harm to your baby

Smoking can harm your baby's growth and development.

Chemicals in cigarette smoke causes changes in blood vessels and carbon monoxide replaces oxygen in your bloodstream. Your baby's heart has to beat faster to make up for getting less oxygen, and they will not grow as well as they should. This increases the risk of them not growing to their full potential (known as "small for gestational age") and of premature birth.

Cigarette smoke contains toxins that can damage the placenta. This increases your own risk of dangerous complications such as placental abruption (a serious condition where the placenta starts to come away from the womb wall) and also affects the growth and development of your baby, putting them in greater danger of miscarriage, stillbirth, low birth weight and prematurity.


Smoking can damage your baby's:

  • Airways, making them smaller and putting them at higher risk of cot death as well as respiratory infections and asthma
  • Ears, increasing the chances that they will have ear infections and middle ear inflammation in childhood
  • Brain development, making them more susceptible to learning disorders and behavioural problems in the future.

 

Smoking in Pregnancy Information

Why are smoke free homes really important?

Children breathing in other people's smoke results in thousands of G.P visits and hospital admissions each year. Over 80% of cigarette smoke is invisible. If anyone smokes near you, you will be exposed to second hand smoke. This is dangerous because the chemicals are inhaled by you and your baby.

Babies born to mothers who smoke or who grow up in a smoky atmosphere have a much higher chance of SIDS (sudden Infant Death Syndrome).

Smoking even a few cigarettes a day in pregnancy can increase the chance of SIDS by up to 4 times.

Smoking 20 a day increases the chance by up to 9 times.

All birth centres are smoke-free sites: what support will I be given before I come into hospital?

This means that neither you or your partner or birth supporter will be able to smoke anywhere on site .

If you are one the small number of women who are still smoking towards the end of your pregnancy, we suggest you make a plan for how you will manage your cravings whilst you are staying in hospital. Talk to you your midwife; s/he can refer you to one of the Stop Smoking teams for information on the best Nicotine Replacement Therapy (NRT) for you during your hospital stay.


If you haven't made prior arrangements by the time you come in, you can ask for NRT when you arrive at the Bath & Swindon Birth Centres; NRT is not available in Chippenham or Frome Birth Centres, as there are no doctors there to prescribe this for you.

Remind your partner or birth support person that they will need NRT or a Vape too whilst they are supporting you in labour

Vaccinations: Covid-19, Flu & Whooping Cough

Some vaccines, such as the inactivated seasonal flu vaccine and the whooping cough vaccine, are recommended during pregnancy to protect the health of you and your baby. (An inactivated vaccine doesn't contain a live version of the virus it is protecting against).

It is recommended that you have these vaccinations.

Why do pregnant women need to be vaccinated against Covid-19, flu and whooping cough?

During pregnancy, your immune system (the body's natural defence system) is naturally weakened to protect the pregnancy. This can mean you're less able to fight off infections. As the baby grows, you can't breathe as deeply, increasing the risk of infections such as pneumonia.

These changes can raise the risk from Covid-19 & flu - pregnant women are more likely to get flu complications than women who are not pregnant, and are more likely to be admitted to hospital. Theses complications include bronchitis, chest infection and pneumonia.

Having the Covid-19 vaccine reduces your chance of being severely affected by Covid-19.

Having the flu vaccine means you're less likely to get flu.


Whooping cough is a very serious infection, and young babies are most at risk. Most babies with whooping cough will be admitted to hospital.

When you have the whooping cough vaccination in pregnancy, your body produces antibodies to protect against whooping cough. These antibodies pass to your baby and this offers them some protection until they are old enough to have their whooping cough vaccination at eight weeks old. You should have the vaccination, even if you have been vaccinated before.

Your midwife will offer and discuss the vaccinations with you.

Covid-19 vaccination

The Covid-19 vaccine is recommended in pregnancy. Vaccination is the best way to protect against the known risks of Covid-19 in pregnancy for both women and babies, including admission to intensive care and premature birth.

Covid-19 Vaccine in Pregnancy and Breastfeeding

Flu vaccination

The vaccine is available from September/October to February/March and is free while you are pregnant. You can have the vaccination at any stage of pregnancy.

You can get the vaccination from your GP or at the antenatal clinic during your visit

Flu Vaccination in Pregnancy Information

Whooping Cough vaccination

You can get a vaccination to protect your unborn baby from 16-32 weeks. If you have it after this it may be less effective. You need to make an appointment with your GP for this vaccination.

Whooping Cough Vaccination Information

If you require leaflets regarding vaccinations in pregnancy in an alternative language, please use the link below. If the language required is not available, please get in touch with your community midwifery team or the maternity and neonatal voices partnership.

https://padlet.com/charlotteeaston1/multilingual-maternity-resources-45-different-languages-from-3d17xn80xsdaurup

https://www.bswmaternityvoices.org.uk/resources/

Contact - Bath North East Somerset, Swindon and Wiltshire Maternity Voices Partnership Plus (bswmaternityvoices.org.uk)

Vitamins and Supplements

Eating a healthy, varied diet in pregnancy will help you to get most of the vitamins and minerals you need.

Some women choose to take a once a day multivitamin and mineral that is specifically designed for preconception and pregnancy.

You should avoid taking 'regular' vitamins as these may contain vitamin A and too much vitamin A should be avoided in pregnancy.

Those on a low income may be entitled to Healthy Start, free vitamins and vouchers for milk, fruit and vegetables speak to your midwife who will be able to provide you with an application form.

It is recommended that you take the two following supplements:

Folic Acid

Folic acid is a vitamin that helps to build your baby's nervous system.

Lack of folic acid can cause spina bifida, where the baby's spine does not close up properly.

If you're pregnant or planning to have a baby, start taking a folic acid supplement every day.


It is really important you take folic acid before pregnancy and for at least the first 12 weeks of pregnancy.

Tommy's information on the benefits of Folic Acid

Tommy's information on the benefits of Folic Acid

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In what foods is folic acid found?

Good sources include:

  • broccoli
  • Brussels sprouts
  • asparagus
  • peas
  • chickpeas
  • brown rice
  • lentils.
  • dried beans
  • nuts
  • avocado

Other useful sources of folic acid include fortified breakfast cereals, some bread and some fruit (such as oranges and bananas).

How much folic acid should I take?

Take folic acid prior to pregnancy and for at least the first 12 weeks of pregnancy.


You are advised to take 400mcg.

For certain groups of women an increased 5mg dose is recommended as they may have a higher risk of having a baby with spina bifida or other Neural Tube Defects (NTD). You will need to ask your GP for a higher dose of 5mg, which is only available on prescription.

  • Those who have a NTD or a family history of NTD
  • Those whose partner has a NTD or a family history of NTD
  • Those with diabetes
  • Those with coeliac disease
  • Those taking anti-epilepsy medication
  • a BMI above 30

Most pregnancy multivitamins contain folic acid. Only take a multivitamin that's made specifically for pregnancy, and check the label to see how much folic acid it contains. Ask your pharmacist, midwife or doctor if you're not sure which one is suitable.

You can get vitamin supplements containing vitamin D free of charge if you are pregnant or breastfeeding and qualify for the Healthy Start scheme.

Can I take too much?

Folic acid is a water soluble vitamin which is not stored in the body and therefore any ingested folic acid which is not needed is simply excreted out of the body. Prolonged intake of large doses of folic acid can make a particular type of anaemia more difficult to diagnose but this is very uncommon in women of child-bearing age.

Folic Acid Information

Vitamin D

The Department of Health also advises you take a vitamin D supplement.

  • 10 micrograms (10 mcgs) of vitamin D a day during pregnancy

Most pregnancy multivitamins contain vitamin D. or you may prefer to take a single vitamin D supplement. Only take a multivitamin that's made specifically for pregnancy, and check the label to see how much vitamin D it contains. Ask your pharmacist, midwife or doctor if you're not sure which one is suitable.

You can get vitamin supplements containing vitamin D free of charge if you are pregnant or breastfeeding and qualify for the Healthy Start scheme.


Some women need more vitamin D

You are advised to take 25 mcgs of vitamin D a day if you:

  • always cover your skin
  • use high-factor sun block
  • have dark skin
  • have a BMI above 30

You will need to ask your GP for a prescription.

What does vitamin D do?

Vitamin D regulates the amount of calcium and phosphate in the body, which are needed to keep bones, teeth and muscles healthy. Not having enough vitamin D when you are pregnant or breastfeeding may prevent your baby from getting enough calcium and phosphate. This can cause him to develop weak teeth and bones, and in rare cases, develop rickets.

Our bodies make vitamin D when our skin is exposed to summer sunlight (from late March/early April to the end of September). It's not known exactly how much time is needed in the sun to make enough vitamin D to meet the body's needs, but if you are out in the sun take care to cover up or protect your skin with sunscreen before you start to turn red or burn.

In what foods is vitamin D found?

Vitamin D is in some foods, including:

  • oily fish (such as salmon, mackerel, herring and sardines)
  • eggs
  • red meat

As vitamin D is found only in a small number of foods, whether naturally or added, it might be difficult to get enough from foods alone.

Vitamin D is added to all infant formula milk, as well as some breakfast cereals, fat spreads and non-dairy milk alternatives. The amounts added to these products can vary and might only be small.

Vitamin D Information

You might be eligible for free Healthy Start vitamins

Who can get a Healthy Start card?
Why you should get your free Healthy Start vitamins

Useful links

Healthy Start scheme

The government's Healthy Start scheme helps low-income and young, pregnant women, as well as new mums. If you are eligible for the scheme, supplements that contain vitamin D are free of charge.

Healthy Start scheme

The government's Healthy Start scheme helps low-income and young, pregnant women, as well as new mums. If you are eligible for the scheme, supplements that contain vitamin D are free of charge.

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NHS - Vitamins, minerals, and supplements in pregnancy

NHS - Vitamins, minerals, and supplements in pregnancy

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DoH Advice on supplements for at-risk groups

DoH Advice on supplements for at-risk groups

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Looking after your teeth and gums in pregnancy

You're entitled to free NHS dental treatment if you're pregnant when you start your treatment and for 12 months after your baby is born.

To get free NHS dental treatment, you must have a valid maternity exemption certificate (MatEx) issued by your midwife or GP.

There is currently a national shortage of NHS dentists, if you are not registered with a dentist and need to be seen by a dentist please call Wiltshire/Swindon dental helpline 0345 758 1926 (Monday-Friday, 8:30-17:00) or NHS 111 out of hours.

For further information please see:

Bleeding gums in pregnancy

Some women get swollen and sore gums, which may bleed, during pregnancy. Bleeding gums are caused by a build-up of plaque on the teeth.

Hormonal changes during pregnancy can make your gums more vulnerable to plaque, leading to inflammation and bleeding. This is also called pregnancy gingivitis or gum disease.

Symptoms include:

  • your gums bleeding when you brush your teeth, floss or eat hard foods such as apples
  • your gums becoming swollen, red and sore

Gum Disease can lead to:

  • bad breath and a bad taste in the mouth
  • your gums shrinking
  • your teeth becoming loose or falling out

You can take steps to prevent gum disease, such as:

  • brushing your teeth with fluoride toothpaste at least twice a day – spit after brushing, do not rinse
  • clean in between your teeth every day using floss or interdental brushes
  • replace your toothbrush every 1 to 3 months
  • see a dentist and dental hygienist for regular check-ups, especially if you're pregnant or have type 2 diabetes
  • Avoid using mouthwash straight after brushing

Treatment for gum disease can include:

  • Advice about keeping your teeth clean
  • Use of products to help your gums, i.e mouthwash recommended by your dentist
  • Stopping smoking, if you smoke
  • Having your teeth cleaned by a dental hygienist

If your gum disease if serious, you may:

  • Require antibiotics
  • Need to have deep cleaning under the gums
  • Have teeth removed
  • Have gum surgery

Your dental/midwifery team will be able to support you with any questions that you may have