The pattern of antenatal care depends on individual circumstances. For low risk pregnancies, all care will be given in the community. For higher risk pregnancies, care will be shared between hospital and community, as needed.
Each consultation involves a physical and mental health assessment of the woman and physical wellbeing of the fetus.
Women should bring their hand-held notes and a urine sample to every clinic.
- 4-12 weeks - Early access to Community Midwife at GP surgery or Children’s Centre
- 12-14 weeks - Booking-in interview at the hospital. An NT scan and blood test for Down Syndrome and Spina Bifida can usually be done at this visit, if desired. Other Blood Tests are taken.
- 15-17 weeks - QUAD screening for Down Syndrome and Spina Bifida, in the community clinic. See Blood Tests
- 20 weeks – Detailed scan at venue of choice, Only your partner and children can go into the room with you but sometimes we ask them to wait outside while measurements are taken of the baby. Photographs of your baby can be purchased in the clinic. If your pregnancy is high risk, you will see the consultant.
- 25 weeks - 1st pregnancies – community midwife
- 28 weeks - Blood tests taken with consent
Anti-D given to Rhesus negative women
MatB1 form and Health Grant forms signed by midwife
For further financial information, visit the UK Government website:
Parent's Guide to Money
Parentcraft classes booked
Labour in Motion (Pregnancy Support Classes) session booked
- 31 weeks - 1st pregnancies – community midwife clinic
- 34 weeks – Discussion of labour (Birth Plan) discussed and drawn up. Home Births are planned and equipment ordered.
Details of MLU and Delivery Suite given. Tour of the unit arranged.
Details of What to pack for the big day
- 36 weeks – Blood tests with consent
- 37 weeks - External Cephalic Version is offered by the consultant if baby is in a breech position
- 38 weeks - Community midwife clinic
- 41 weeks – Cervical assessment is offered and an appointment made for
Induction of Labour at 42 weeks
Journey through Childbirth
Confirmation of Pregnancy
Once pregnancy has been confirmed, your GP will send a referral letter to the maternity unit or give you a reference number which will enable you to access the Choose and Book system. Further information is available at www.chooseandbook.nhs.uk or by calling the Wirral Booking Office on 0151 604 7501. When calling the Wirral Booking Office, please have your reference number and password available.
Currently, there are three places to book-in:
- Antenatal Clinic at the Women and Children’s Hospital, Arrowe Park, Upton
- Victoria Central Health Centre, Wallasey
- St. Catherine’s Health Centre, Birkenhead
Women usually attend at 12-14 weeks from the last menstrual period.
Should any complications occur before this time, women will be seen at the Early Pregnancy Unit.
Booking-in can take up to an hour and a half and involves the following:
- Ultrasound scan to confirm the pregnancy and gestational age, giving the expected date of delivery.
- A named Community Midwife will be allocated to each woman for her care throughout
- Detailed medical and pregnancy history is obtained and entered onto the computer system
- Blood samples taken with consent, for analysis.
- Screening options discussed.
- Risk assessment by midwife:
- Women with low risk pregnancies will be offered midwife-led care within the community and delivery at home or in the Midwife-Led Unit (MLU)
- Women with potential medical or obstetric difficulties will be offered Consultant-led care, professional support from High Risk Midwives and Delivery Suite births
- Specialist Midwives may become involved, if indicated
- Public Health advice, supporting literature and contact numbers will be given
- Choice of Place of Birth will be offered to all women. Home births are actively encouraged for low risk women
- Weight and height recorded. Women with a raised Body Mass Index (BMI) will be advised and referred for a GTT (sugar level test), later in the pregnancy
- Plan of Antenatal care given to each woman and follow-up appointment made for 20 week scan
- Individual hand-held notes will be given to each woman
- Mental Health assessment made
For Further information, please see related links to the left had side of this page.
The Maternity ward
Some women need care in hospital during the antenatal period. Care is provided on the Maternity Ward on the first floor of the Wirral Women and Children’s hospital.
There are 26 individual rooms for newly delivered mothers and pregnant women, each with en-suite bathrooms. Your partner may be able to stay on the ward with you. Please speak to the midwife caring for you.
There is a six bedded Post Operative Care Bay (pictured) where higher dependency care can be delivered around the clock.
The Midwifery-led Unit (MLU)
The MLU has five home-from-home rooms and two poolrooms for water births. Women with low risk pregnancies are encouraged to labour here if they do not want to give birth at home. This area is totally staffed by midwives and is a centre for normality in childbirth.
There are two designated Maternity Theatres directly linked to the Delivery Suite and MLU which are staffed 24 hours per day for elective and emergency surgery.
The Postnatal ward also has four “Transitional Care” rooms that are used when babies require additional support that can be provided outside the Neonatal Unit.
The antenatal clinic is situated on the ground floor of Wirral Women and Children’s Hospital.
The following services are provided:
- Obstetric consultant led clinics for women who have medical problems prior to and complications during pregnancy
- Young Women’s Antenatal clinic
- Perinatal Mental Health Clinic
- Pre-operative Assessment Clinic
- Anaesthetic Clinic
- Medical Disorders Clinic
- Obstetric Ultrasound Scanning
- Substance Misuse Clinic
Induction of Labour
There are 2 methods of induction used at Wirral Women and Children’s Hospital, depending on clinical examination and cervical assessment
Prostaglandin Vaginal Pessaries/Tampons
If the Bishop’s score is below 8 points, prostaglandin pessaries are the induction method of choice. Individual condition determines which is more suitable.
- Prostin tampon is inserted and left for up to 24 hours or until labour begins or
- Pessary is placed behind the cervix, at the top of the vagina where it dissolves
- Hormones in the pessary cause the cervix to soften and the uterus to contract
- If labour has not begun 6 hours later, the process is repeated
- A 3rd pessary is sometimes given the following day, if indicated
Artificial Rupture of Membranes and Syntocinon
If the Bishop’s score is 8 or above, artificial rupture of membranes (ARM) can be performed. This should be no more uncomfortable than any other vaginal examination.
- Small, slim instrument is used to nick the bag of membranes, releasing some of the water.
- Often this is sufficient stimulation for the uterus to start contracting and labour begins
- An intravenous infusion of a hormone called syntocinon can be used to stimulate the uterus to begin contracting.
People who are Rhesus positive (Rh pos) have a substance known as 'D antigen' on their red blood cells, whereas Rhesus negative (Rh neg) people do not.
If an Rh neg woman carries an Rh pos baby, there is a slight risk that a small amount of the baby’s blood could enter the mother’s bloodstream.
This could cause an immune response to the D antigen and her body will produce antibodies against it, which stay in her blood forever.
This doesn’t usually affect the existing pregnancy but can cause difficulties in subsequent pregnancies.
The antibodies in the mother’s blood can cross the placenta and attach to the D antigen on the baby’s red blood cells. This can harm the baby and cause anaemia and jaundice.
Anti-D Immunoglobulin - Wirral Women and Children’s Hospital advises all Rhesus negative women to accept a prophylactic Anti-D injection at certain times:
- Should there be any bleeding during the pregnancy
- Following miscarriage and amniocentesis
- Routinely at 28 weeks gestation
- Following birth, if the baby is Rhesus positive
- For further information, visit www.nice.org.uk/TA156.
Routine blood tests taken at booking include:
- Blood group and Rhesus factor
- Full Blood Count test for anaemia and Thalassaemia
- Virology tests for Hepatitis B, Syphilis, HIV and Rubella (German Measles)
The results of these are filed in your notes at the 20-week scan visit.
Should any need to be repeated, the community midwife will do this at a clinic.
- At 15-16 weeks the Quadruple screen for Down’s and Spina Bifida risk, is offered and is entirely optional.
- At 28 weeks the Full Blood Count and Rhesus factor tests are repeated
- At 36 weeks the Full Blood Count is repeated, to detect and treat possible anaemia prior to delivery
- After delivery, a Kleihaur test offered to all Rhesus Negative women and a Full Blood Count may be indicated
All pregnant women in Wirral have a named Community Midwife to provide individualised professional and supportive antenatal and postnatal care, regardless of the intended place of birth. Seeing the same midwife regularly, as planned, provides continuity of care and the formation of trust between mother and midwife.
Community Midwives are rotationally on-call 24 hours a day, 365 days of the year for women giving birth at home.
Community Midwives liaise and work closely with the hospital-based midwives and Obstetricians, local GPs, Health Visitors, Social Workers, Physiotherapists and other allied professionals to try to ensure needs are met and families are fully supported.
Each locality has a specialist Neonatal Midwife whose role is to examine and assess any babies born at home or who are taken home from hospital within the first 24 hours after birth.
Community Midwives conduct Parentcraft and birth preparation classes throughout Wirral, including Labour in Motion and Aquanatal sessions.
Community Midwifery care in Wirral is divided into three localities - see documents below for downloadable pdfs.
Mums and Midwives Shop
Mums and Midwives shop is situated at 12 Milton Pavement Grange Shopping Centre Birkenhead.
The shop is open between:
- Monday: 9am-4pm for pre-arranged booking appointments only.
- Tuesday- Friday: 10am-3pm, Drop-in no appointment necessary.
- Saturday: 10am-1pm, Drop-in no appointment necessary.
The shop offers a drop in service with no appointment necessary so you can access midwifery care at a time that's convenient to you.
The shop is run by very experienced Community Midwives who can give you support and reassurance throughout your pregnancy and for a month after you have had your baby as well.
You can call in for a chat or come for a full ante natal check up. Advice is given to you on a wide range of issues to help allay any concerns and help you make the right choices for you and your baby. When you have had your baby you can call in and feed your baby in a welcoming and friendly environment. You can also find out how you can donate your breast milk to the Milk Bank to help premature babies.
Expectant mums in Wirral now have access to a new team of midwives dedicated to women choosing to have their babies at home or in the birth unit at Seacombe Children’s Centre.
The Highfield Birth Team consists of six experienced community midwives who will provide a 24 hour service, 7 days a week giving women access to a known midwife throughout their pregnancy, birth and after their baby is born. The team is the latest addition to Wirral University Teaching Hospital’s community midwifery service, which cares for thousands of women during and after pregnancy.
Named after the former maternity facility on the site of Victoria Central Hospital, the Highfield Birth Team is one of the first of its kind to be up and running in Cheshire and Merseyside. The specialised service makes it easier for mums-to-be to develop relationships with just one or two named midwives over the course of their pregnancy, achieving more continuity and one to one care determined by individual needs and circumstances.
Women under the care of the Highfield Birth Team, are also able to choose from a range of suitable locations for the majority of their antenatal appointments, whether that be a local clinic, at home or even at their place of work where appropriate.
If you are thinking about a home birth or would like to know more about having your baby at the new ‘pop up’ birthing centre opening in Seacombe, please ask your community midwife to refer you to the Highfield Birth Team.
You can also contact the team directly by emailing email@example.com or by calling 0151 666 3131 during day time hours. Alternatively, please leave a message on 0151 604 7682 and the team will be in touch as soon as possible.