**Temporary Changes to Antenatal and Postnatal Classes**
Although group antenatal education classes are currently not available in all Trusts, you don’t have to miss out. We can provide you with antenatal and postnatal education classes online. These virtual classes cover the same topics your face to face antenatal classes and are an excellent source of help and support in the postnatal period.
Our maternity service provides maternity care for nearly 5000 women and their babies each year, during pregnancy, labour, birth and up until one month after birth.
Whether you are pregnant and thinking about where to have your baby or someone thinking about joining our team, we are delighted that you have chosen to visit this site.
During pregnancy, we offer both midwifery-led care (in hospital and in the community) and consultant-led care (provided by our expert multi-disciplinary team based at our hospitals). In some cases your care will be shared by a number of professionals including your GP, Midwife and Consultant Obstetrician.
Our midwives look after women at the hospital antenatal clinic, midwifery led units, at local GP surgeries and in your own home whilst our medical staff are available for consultations if problems arise.
For your labour and birth, we provide midwifery led services as well as hospital-based care and a home birth service. For reasons of medical safety, the place of birth is dependent on individual assessment.
Our philosophy of care is based on respect for pregnancy as a state of health and childbirth as a normal, healthy, physiological process.
Pregnancy and birth are very significant events in a womans life and that of her family. The care we provide will aim to respect the diversity of womans needs and the variety of personal and cultural values that women, families and communities bring to these events. Care will be continuous, personal and responsive to a womans health, social and emotional needs.
We aim to keep women informed at all times of the progress of their pregnancy and likewise any issues that arise during their care. We will encourage decision-making as a shared responsibility between the woman, her family and her care givers. To facilitate this, care provision must include evidence based information, education and counselling support to enable the woman to make informed choices.
Currently we provide services in three main sites boasting state-of-the-art facilities:
Are you planning for a baby?
Research shows that before conception we can not only influence the health of our newborn baby, but also his/her health in adult life.
Couples planning to become pregnant can take a number of steps to give their baby the best possible start in life. Lifestyle changes should ideally start at least three months prior to the planned pregnancy as women’s eggs and men’s sperm may be adversely affected by inadequate diet as well as social and environmental factors.
For more information, click here.
As soon as you have a positive pregnancy test, you can now refer yourself directly for maternity care Hospital within the South Eastern HSC Trust.
Please complete the form below and email it to the relivant address. Upon receipt, midwives will arrange the first booking appointment for you, and also notify your GP of your pregnancy.
If you have any queries regarding this form or if you have not received an appointment by the 12th week of your pregnancy please phone:
Ulster Maternity: (028) 9056 1364
Lagan Valley Midwifery Led Unit: (028) 9263 3534
Downe Midwifery Led Unit: (028) 4461 6995
Please return via email your completed form to:
Antenatal Care (before your baby is born)
Most antenatal care is carried out in the community by your GP or Community Midwife. However, if you have any underlying medical condition or develop complications with your pregnancy, you care will be then be carried out by a hospital Obstetrician.
You first appointment is known as your booking appointment. This can either take place in the community or in the hospital. Those women booking in the community will also need a short hospital appointment for a scan to confirm the pregnancy and to have investigative bloods taken. Those women booking in the hospital will have a two hour allocated appointment to accommodate all the necessary information required.
At all bookings, the Midwife will need to ask you some questions to help plan your future care. This will include your medical history, your family history and any previous pregnancies.
At your booking appointment you will be given a set of hand-held maternity notes. These notes will be given to you and must be brought with you to all visits and appointments.
Types of Antenatal Clinics
Consultant Hospital Clinics – For those women who require specialist care
GP/Community Midwife Clinics – For low risk women
Hospital Midwifery Led Clinic – For low risk women
If you have particular medical needs you may be seen at Specialist Clinics:
- Diabetic clinic
- Fetal wellbeing and assessment
- Perinatal Mental Health
- Young mums (for those aged 19 an under)
You should receive a leaflet with your booking appointment explaining your first visit. Please read this prior to the appointment, you will be able to ask any questions you may have.
Screening (Blood Tests)
At booking, you will be asked to consent to some blood tests. These blood tests check for particular medical conditions:
- Haemoglobin levels
- Blood group and antibodies
- We also offer a blood test called the TRIPLE TEST that will give you a probability ratio for Down’s Syndrome. A doctor will discuss this with you.
This scan usually takes place between 20 and 23 weeks. The purpose of the scan is to check that structures and growth of the baby are normal. It is carried out by a specialist qualified radiographer.
It’s good to have some information on feeding your baby before your baby arrives, why not check out our resource page here.
Types of Care
This is care carried out by the obstetric team led by your Consultant and generally is most suitable for those women who have more complicated pregnancies or have underlying health concerns themselves. All your appointments will be at the hospital and this antenatal service is available at the Ulster, Lagan Valley and the Downe. Women receiving Consultant care are booked for delivery in the Ulster Hospital.
In this case, your antenatal care is shared between your Community Midwife and the medical staff at the hospital. Dependent on risk factors, women having this type of care can give birth in the Midwifery Led Unit.
Midwifery Led Care
This type of care is offered to women with low risk pregnancies. Care can be provided in either the Midwifery Led Unit or in the community setting. The Midwives have full support of the medical team and discussion and/or referral for advice can happen at any stage should concerns be raised.
Recent research has demonstrated that there are many benefits for mothers and babies associated with Midwifery Led Care with no identified adverse effects as long as the women are healthy and have straight forward pregnancies.
This is also the type of care we provide if you choose to have your baby at home.
Benefits of Midwifery Led Care include:
- An increased feeling of being in control
- Giving birth in a homely, unrushed setting
- Ability to be mobile during labour
- Less use of drugs during labour
- Reduced use of assisted births
- Positive birth experience
- Increased breast feeding rates
- Service close to home
Onset of Labour
Many women experience contractions before the onset of labour; these may be painful and may even be regular for a time, causing women to think that labour has started. The two features of true labour that are missing are effacement (shortening) and dilation of the Cervix. This can only be assessed by vaginal examination.
In late pregnancy, vaginal secretions are increased but should not be blood stained. A ‘Show’ in early labour or prior to the onset of labour is quite common. It is usually a pink or blood-stained jelly-like loss. During pregnancy your Cervix (the opening of the womb) is closed and plugged with mucous, this is to prevent any ascending infections coming in contact with the baby. Your Cervix is about 2cms long and firm. During labour your Cervix has to open to allow baby to be born. First it has to soften and shorten. These changes may start in late pregnancy before labour has even begun. Hours or even days before labour starts your Cervix may start to open a little causing the mucous plug to come away.
Braxton Hicks contractions are more noticeable in late pregnancy and some women experience them as painful. They are usually irregular or their regularity is not maintained for long periods of time. In true labour, contractions exhibit a pattern of rhythm and regularity, usually increasing in length, strength and frequency as time goes on.
Spontaneous Rupture of Membranes
It is often difficult to be sure whether or not the membranes have ruptured spontaneously prior to labour or in early labour. Some women may be experiencing a degree of stress incontinence (involuntary passing urine) so may be unsure if it is fluid or urine she is passing. If in doubt, contact your Midwife who may decide to pass a speculum and look for amniotic fluid in the vagina.
Rupture of membranes can be a slow trickle or a large gush but the water should always be clear. If your water is clear you will be sent home with instructions and to return in 24hours for admission. If your water is coloured you will not be sent home.
Smoking and Pregnancy
15% of women in Northern Ireland smoke throughout pregnancy.
The shock figure reflects the general increase in the number of young women who smoke, and is causing concern about the health of new born babies. Smoke Free Wombs is an exciting initiative by midwives in the South Eastern HSC Trust to encourage mums-to-be to stop smoking. Currently, 15.4% of pregnant women who book with this Trust are smokers. Smoke Free Wombs uses Facebook, a powerful DVD and cartoon images to try and get the message across that smoking harms the unborn child.
Midwives are asking mums to be to sign a pledge to work in partnership with them to give up. Mums to be will receive a letter outlining how smoking can harm babies in the womb, and offering the opportunity to meet with the Health Improvement Midwife. The woman will then be offered intensive support to use the excellent smoking cessation services. It’s too early to formally assess impact of this innovative approach, but since this initiative began, our midwives’ data suggest a 52% increase in referral to no smoking programmes and that the “quit” rate has trebled.
New mum Michelle Walsh, from Lisburn, appears on the DVD on Facebook. The DVD also features Consultant Obstetrician Dr NiamhMcCabe who says: “We do see nicotine withdrawal sysmtoms in babies. It makes them jittery.” Health Improvement Midwife, Cathy Bell says: “Research has shown that smoking during pregnancy increases the risk of complications for the baby. These include premature delivery, low birthweight and cot death. NICE guidance found that women may receive mixed messages about smoking in pregnancy, and to aid behavioural change consistent advice should be given to any woman who is smoking and pregnant.”
The new Smoking Cessation Initiative in the South Eastern HSCT, ‘Smokefree Wombs’ provides women booking for their pregnancy with the opportunity to pledge to stop smoking during pregnancy. Women are provided with consistent information through face to face contact, phone support, text message and Facebook.
Pregnant women who smoke form a priority group on the Department of Health’s 10 year Tobacco Control Strategy for N.Ireland. There is never anything negative about stopping smoking and the benefits for mums and babies begin as soon as the first cigarette is stubbed out. This initiative encourages women to feel empowered and committed to quitting smoking through friendly consistent support to choose the best start for their baby—a Smoke Free Womb.”
Why is it harmful to smoke during pregnancy?
A baby in the womb gets everything from its mother. Nutrients and oxygen come via the placenta and umbilical cord. Smoking not only exposes the fetus to toxins from the tobacco but it also damages the placenta therefore enabling it to function properly. Oxygen flow that is essential for your baby’s growth and development is restricted.
Babies born to mothers who smoke during pregnancy are on average, significantly smaller than those born to women who don’t smoke. Low birth weight is one of the main causes of illness and disability in babies, and also increases the risk of your baby being stillborn. The further into your pregnancy you smoke the greater you risk of complications.
It is never too late to stop smoking. Every cigarette you decide not to smoke will help your baby’s health. Carbon monoxide and chemicals will soon clear from your body and oxygen levels will return to normal.
If you stop smoking:
- You are more likely to have a healthier pregnancy and a healthier baby
- Your baby will cope better with the birth and any birth complications
- Your baby is less likely to be born too early and have to face additional breathing, feeding and health problems that are associated with being born premature
- Your baby is less likely to be underweight
- You will reduce the risk of stillbirth
- You will reduce the risk of cot death
- Stopping smoking will also benefit your baby in later life. Children of parents who smoke are more likely to suffer from illnesses such as asthma and frequent ear and chest infections.Children of parents who smoke are also more likely to become smokers themselves compared to children of non-smokers
Within the Trust we have specialist health professionals to help you stop smoking, so please speak to your Midwife or GP.
Stages of Labour
What happens in the stages of labour?
During early labour your Cervix starts to open and widen. You may not notice this starting, as your Uterus may be contracting very gently. It may feel like period type cramps or dull backache. You may even be a few centimetres dilated before you realise you are in labour. Every ones labour is different so you will have your own pace and rhythm. As a rough guide contractions are usually more than 5-10 minutes apart and can be as short as 30 seconds. At this stage you should still be able to walk through them and carry on with your normal routine. Sometimes this stage can stop and start before continuing on to active labour.
As labour progresses your contractions usually becomes longer, stronger and closer together. This is known as the active stage of labour. Contractions are more powerful and will come as a wave gradually reaching a peak and then fading away. In this active stage contractions are usually every 2-3 minutes and lasting about a minute. Contractions are very intense but you should still have relief between each one. This can still take up to 8-12 hours.
The transitional stage of labour is when you move from the first stage towards the pushing stage. This can happen from about 8cms the contractions may be less frequent but more intense and may come as a double wave, contractions reaching a peak then starting to fade but then increasing in intensity again. At this stage women react in different ways. Some find it overwhelming and may find it difficult to cope with the intensity of the contractions, taking it out on their partner by shouting or even lashing out at them. You may also feel sick and may possibly vomit; equally you may feel none of this at all. Transition means that you are nearly there and with support for your partner and Midwife you will get through it.
The second stage is when you push your baby down through the vagina. The same muscles that make you go to the toilet push your baby out so it is an uncontrollable urge. So listen to your body and push when you have the urge. Sometimes this urge may happen before you are fully dilated but the Midwife will help you breathe through the contraction until the Cervix has disappeared altogether.
With every push your baby will move through the pelvis a little at a time. It is like two steps forward and one step back. When the baby is well down in the pelvis and the perineum is stretching you will probably feel a hot stinging sensation.
Whenever the baby’s head does not slip back after the contraction, the Midwife will guide you through the next contractions asking you not to push but either pant or breathe slowly. This enables her to control the delivery of the head to prevent or minimise any trauma to you perineum. With a first baby this stage can take up to an hour but with subsequent babies it should be considerably shorter.
The delivery of the placenta is generally known as the third stage of labour. Contractions may start up again but will be much weaker. These allow your uterus to contract making the placenta separate and peel away from the uterine wall. You will be offered an injection to help with this process. Following the delivery of the placenta the midwife will check it to make sure that is has separated intact.
Post Natal Care
Caring for yourself and your baby
It is important to look after yourself after you have had your baby and to understand what is happening to your body. After the birth of your baby, you will stay in the labour ward for a short time before transfer to the ward. Those mothers delivering in the Midwifery Led Units will remain there. Your length of stay in hospital will be dictated by delivery type and on you and your baby’s health.
As soon as possible after birth, skin to skin contact with your baby will help them feel safe and secure. It will help you to get to know your baby and they will feel comforted by your voice and touch. Your baby should be encouraged to feed within one to two hours after birth. Skin contact should be maintained until your baby is showing readiness to feed. If you choose to breastfeed, skin contact will also help increase your milk supply.
Help and support when you go home
A Community Midwife will call the next day following discharge, and she will arrange to call to see you again and will leave a contact number.
A Health Visitor will also make contact with you to make arrangements to call when baby is approx two weeks old.
Contact your GP/Out of Hours if you have any concerns about your baby’s health.
Feeding your baby
We have a new Breastfeeding Peer Support Service (BFF) to help and support you with Breastfeeding.
BFF is available to all breastfeeding women; all you have to do is ask your Midwife to make a referral before you are discharged home from the maternity unit. Your Community Midwife or Health Visitor can also make a referral if you weren’t referred before going home with your baby.
Breastfeeding Peer Support is mother to mother support given by women who have breastfed (or are still breastfeeding) and would like to support other mothers in their breastfeeding journey. It is a texting and/or phone call support service.
All our volunteers have completed a training course and are registered with the South Eastern HSC Trust Volunteer Service.
For more information about Breastfeeding and formula feeding please see our resource page here.
Perinatal Mental Health
zPregnancy is a time of great excitement and change and for most women the mixed emotions experienced are natural and short-lived. However for some women pregnancy will either provoke new, or exacerbate old problems with their mental health.
Everyone is unique and individual needs will vary but talking through thoughts and concerns can help. The midwifery listening service is a voluntary clinic run by midwives who have a special interest in mental health and well-being. It is provided for women who have mental health concerns and provides a safe, non-judgemental environment in which you can freely explore your thoughts and feelings. It is not a counselling or diagnostic service. We do not prescribe or adjust medication. However we can act on your behalf and liaise with other health care professionals in the role of advocate.
If you are interested in availing of this service click here to download the self-referral form. Please complete and either post to the address listed or email to the Perinatal Mental Health Midwifery Co-ordinator at Elaine.Erwin@setrust.hscni.net
Hypnobirthing enables pregnant women and their birthing partners to be calm, confident and in control during childbirth. By using breathing, relaxation and hypnosis techniques hypnobirthing helps the process of birth to be natural and easy. Learning to be free of fear and tension means hypnobirthing women allow their birthing bodies to do what they are perfectly designed to do – birth gently.
In the South Eastern Trust we offer hypnobirthing over three sites in Downe, Lagan Valley and the Ulster Hospital, places are limited and filling out the expression of interest does not guarantee a place. Classes are held over 3 evenings and birth partners are actively encouraged to attend along with the birthing mother.
What is the User Group?
The groups are available in all three sites in the Trust, it is a dedicated Committee who makes sure that providers take account of the views and experiences of women and their families who use local maternity services.
What does the User Group do?
The User Groups monitor the maternity services provided in their local area, recommends changes and improvements, and acts as a voice for those who use the services.
The members are made up of:
Senior Midwives from all local maternity services
What does the Maternity Services Liaison Committee not do?
We are very interested in hearing comments and suggestions from women and their partners who are using, or have recently used, local maternity services. However, we are unable to deal with queries from individuals about their care or deal with complaints.
If you have questions or concerns about your maternity care, or if you would like to discuss your birth experience in confidence, you can speak to your Midwife, or if you have a complaint, contact the Trust’s Complaints Department
If you would like to know more about the role of the User Group, or would like to participate, contact any of the Midwives who will be able to help.
Bereavement Support Midwife
The Bereavement Support Midwife offers support to parents when a pregnancy has not gone as planned.
The Bereavement Support Midwife specialises in supporting parents whose babies have died, are ill or for parents who have had an experience which they have found difficult. Everyone has individual needs following bereavement or loss. You may not wish to talk to anyone for weeks or months.
If you would like support please contact Jacqueline Dorrian, Bereavement Support Midwife: Telephone: (028) 9056 4717.
Forget-Me-Not’ Bereaved Parent Liaison Group
The ‘Forget Me Not’ group welcomes all parents who have been bereaved in the Ulster Hospital. The user-focused group provides a forum for parents who have been bereaved through miscarriage, stillbirth or the death of their child.
The forum provides an opportunity for parents to discuss the care provided and to help us in our commitment to provide a service that is of the highest possible standard.
The aim of the focus group is to identify what we are doing well and also identify areas of our service that could be improved.
The ‘Forget-Me-Not’ focus group has raised funds to provide bereaved parents cared for within the Maternity Unit with a digital camera, photo printer, memory boxes and baby blankets. If staff or bereaved parents would like to attend this group, please contact Hilary Patterson, Bereavement Support Midwife, Telephone: (028) 9056 4717.
To view a copy of the ‘Forget Me Not’ leaflet please click here.
It is now widely recognised that pregnancy can be a stressful time. This can sometimes have a huge impact on relationships, and in some cases may result in physical, sexual or emotional violence. The effect of this on the pregnancy, the relationship and the family can be traumatic and so we have support which we can offer in these circumstances. If you disclose that there is a problem, this will be taken seriously and will be dealt with the utmost sensitivity and confidence.
There are help lines and groups which you can be put in touch with. These can give you access to specially trained people who can give you practical advice, help and support. Please refer to the support groups below for further details:
There are two locations within the South Eastern Trust area where Women’s Aid run “One Sop Shops”. No appointment is necessary.
They are held from 10am to 12 noon on Friday mornings at two locations:
Belfast & Lisburn Women’s Aid Support and Research Centre
30, Adelaide Park
40 Killough Road
Links, Leaflets, Publications & Videos
- Advice & Exercises During Pregnancy
- Being Overweight & Pregnant: Achieving a Healthy Pregnancy & Safe Birth
- Birth Options – VBAC- Vaginal Birth After Caesarean
- Birth to Five
- Breast Awareness: Looking Out for Changes
- Breastfeeding: Off to A Good Start
- Breastfeeding: Out & About
- Caring for Your Perineum & Pelvic Floor After a 3rd or 4th Degree Tear
- Cervical Screening: It’s Best To Take The Test
- Getting to Know Your Baby
- Grandparents Guide to Supporting Breastfeeding
- Group B Strep- A Mothers Guide
- Home from Home Unit
- Infant Feeding Guidelines
- Post-Natal Depression
- Post-natal Exercises
- Remifentanil Patient Controlled Analgesia – Ulster Hospital Maternity Unit
- The Pregnancy Book
- Vitamin K for Newborn Babies
- What Dad’s Should Know About Breastfeeding
- What is tongue-tie?
- What You Need to Know Before Offering Your Breastfed Baby a Formula Feed
- Wound Care Advice for Women Following Abdominal Surgery
- Your Baby’s Hearing Screen
- Your Baby’s Hearing Screen (Neonatal Unit)