The National Health Service provides a wide and comprehensive range of professional people and services to give you adequate help before, during and after your pregnancy. A great deal of careful thought and planning has gone into the provision of the necessary services and expert help is available not only for everything to do with your pregnancy but also for the care of your new-born baby. These facilities fall into one of three main categories. Firstly your general practitioner, secondly your local authority, and thirdly the hospital service.
Your General Practitioner
Consult your general practitioner as soon as you either believe or know that you are pregnant. He may or may not deliver babies, or even look after women during their pregnancies, but these facts do not matter. Whether it is your first or your tenth baby the prime consideration is the early diagnosis of your pregnancy and a discussion with your doctor so that a decision can be reached, after due consultation, on which particular aspects of the National Health Service facilities are most suitable for the management of your own particular pregnancy.
You and your doctor may decide that he will look after you or, if he does not personally look after maternity patients, one of his general practitioner colleagues will do so. Should you decide to have your baby at home, you will be under your doctor’s supervision and direction throughout your pregnancy, labour and puerperium. Many general practitioners, especially those with group practices, organize an antenatal clinic at their own surgery where your care and supervision will be shared with your domiciliary midwife.
General practitioner maternity units. One of these units may be situated in your area and if you are to have your baby in that unit your doctor will supervise your antenatal care and your confinement. These units are nearly always attached to a large hospital maternity unit and every facility, together with consultant advice, is readily available should it be required.
Shared care. If you are going to have your baby in hospital it may be decided that your antenatal care should be shared between your doctor and the hospital. When your doctor has diagnosed your pregnancy, you will visit the hospital booking clinic and arrange a date previously agreed between your doctor and the hospital to return there. Your doctor will look after you until that time. If you are having ‘shared care’ you will be given a maternity co-operation card to be filled in by both general practitioner and hospital doctors as a record. Always keep it with you.
Local Authority Services
The domiciliary midwife works in close co-operation with your doctor and if you are going to have your baby at home she will share with him responsibility for your management throughout your pregnancy, delivery and for ten days after your delivery. In some areas she will be responsible for your care if you are to be delivered in a general practitioner maternity unit, or even if you are to have your baby in a consultant maternity unit.
Local authority clinics. Your local authority runs a clinic which is attended by your domiciliary midwife and a local authority medical officer, or perhaps your own general practitioner. You may be asked to attend this clinic for your antenatal visits if you arc going to have your baby in hospital or if your own doctor does not undertake maternity care. It also provides extensive facilities for advice after your baby has been delivered and you should have no hesitation in visiting the clinic if you have any cause for worry or anxiety.
The health visitor is a trained nurse, employed by the local authority, who has undertaken specialist training in the care and development of young children. If you have your baby in hospital the health visitor will call and see you shortly after your return home. Many people do not seem to realize the lengths to which the Health Service goes in order to provide a complete and comprehensive service for its patients. Whether you have your baby at home or in hospital, your delivery is specially recorded and a form of notification is sent to the local Medical Officer of Health, who in turn notifies the appropriate health visitor on his staff. In due course she will call to see you and enquire if there is any help or advice she can possibly give. She will also provide information concerning the local authority clinic where you will find her and other experts in the management and care of new-born and growing babies. If she is attached to your general practioner’s health team she will tell you when to attend his clinics and how to get help and advice whenever you need it.
The Hospital Service
The hospital maternity service provides for your delivery in hospital. You may attend the antenatal clinics at the hospital throughout your pregnancy or your antenatal care may be shared either by your own doctor or your local authority clinic. Following delivery you normally remain in hospital for approximately eight days or, if everything is satisfactory and appropriate arrangements have been made, you may return home earlier under a system known as ‘planned early discharge’. If you wish to go home shortly after your delivery you must discuss this with your domiciliary midwife and the hospital because early discharge is only possible if your domiciliary midwife can look after you at home when you have left the hospital.
Obstetric emergency service. This is a special service provided by maternity hospitals which may be used in an emergency. It consists of a team of doctors and midwives who travel in an ambulance from a maternity unit to visit women at home if complications suddenly occur. They are ‘on call’ for 24 hours every day.
Use the services that are available to you. If you need help or advice, ask for it. The majority of the complications of pregnancy are preventable but they can be diagnosed earlier and prevented more easily if you co-operate fully.