Your maternity journey

The first 1,001 days are a critical time in the development of your baby and child’s life. You can find support during your pregnancy and up to your child's second birthday. 

Start for Life is part of our family hubs for children, young people and families across Croydon.  

https://www.croydon.gov.uk/croydon-start-life

 

Screening tests are offered during pregnancy to assess the chance of certain genetic, chromosomal and infectious conditions. Screening does not give a diagnosis. It helps determine whether further diagnostic testing should be offered.

Screening for Down’s syndrome, Edwards’ syndrome and Patau’s syndrome

Screening for chromosomal conditions is offered to all pregnant women.

What conditions are screened for?

• Down’s syndrome (Trisomy 21) – caused by an extra copy of chromosome 21.
• Edwards’ syndrome (Trisomy 18).
• Patau’s syndrome (Trisomy 13).

Down’s syndrome affects learning ability and may be associated with health conditions such as congenital heart defects. Edwards’ and Patau’s syndromes are more serious conditions often associated with significant medical complications and shortened life expectancy.

Combined screening test (11–14 weeks)

The combined test includes a blood test and an ultrasound measurement (nuchal translucency) taken at the 12-week scan.

The result provides a chance figure (e.g., 1 in 150). If the chance is higher than a set threshold (usually 1 in 150), you will be offered further testing.

Combined screening (NHS)

Quadruple test (14–20 weeks)

If combined screening is not possible, a quadruple blood test may be offered. This estimates the chance of Down’s syndrome only.

Non-invasive prenatal testing (NIPT)

If screening shows a higher chance result, you may be offered NIPT. This blood test analyses small fragments of fetal DNA in maternal blood. It is more accurate than combined screening but is still not diagnostic.

Diagnostic testing

If screening indicates a higher chance, you may be offered:

• Chorionic villus sampling (CVS) – performed between 11–14 weeks.
• Amniocentesis – usually performed after 15 weeks.

Both tests carry a small risk of miscarriage (approximately 0.1–0.5%).

Screening for infectious diseases

Blood tests at your booking appointment screen for:

• HIV
• Hepatitis B
• Syphilis

Early identification allows treatment to significantly reduce the risk of transmission to your baby.

Screening for HIV, hepatitis B and syphilis (NHS)

Screening for sickle cell disease and thalassaemia

A blood test is offered early in pregnancy to identify whether you carry genes for sickle cell disease or thalassaemia. If you are a carrier, your partner will be offered testing.

If both parents are carriers, there is a 1 in 4 chance the baby could inherit the condition.

Sickle cell and thalassaemia screening (NHS)

Screening for gestational diabetes

You may be offered an oral glucose tolerance test (OGTT) between 24–28 weeks if you have risk factors such as raised BMI, family history of diabetes, previous large baby, or previous gestational diabetes.

Gestational diabetes screening (NHS)

Antenatal care with twins or multiples

If you are expecting twins or more, you will usually have more frequent scans and appointments. Care depends on whether twins share a placenta (monochorionic) or have separate placentas (dichorionic).

Further reading:

Pregnant with twins (NHS)

If screening tests find something

If a screening test indicates a higher chance of a condition, you will be referred to a specialist fetal medicine team. You will be supported to understand your results and discuss available options.

If antenatal screening tests find something (NHS)

 

If you had a health condition before becoming pregnant, you may need additional monitoring or adjustments to your care. Many people with long-term conditions have healthy pregnancies, especially when care is planned and personalised.

Why pre-existing conditions matter

Pregnancy places additional demands on your body. Some existing conditions may increase the risk of complications for you or your baby. Early review and personalised care planning help reduce risk.

Common conditions requiring additional care

You may be offered specialist input if you have:

• Diabetes (Type 1, Type 2 or previous gestational diabetes).
• High blood pressure (chronic hypertension).
• Heart disease (including congenital heart disease).
• Epilepsy.
• Thyroid disorders.
• Autoimmune conditions (e.g., lupus).
• Asthma.
• Mental health conditions.
• Obesity (BMI ≥30).

You may be referred to a consultant-led clinic alongside your midwifery care.

Medication review

Some medicines are safe in pregnancy, while others may need adjustment. Do not stop prescribed medication without medical advice.

Monitoring during pregnancy

Depending on your condition, you may have additional scans, blood tests or appointments. This helps monitor your health and your baby’s growth.

What this means for you

Having a long-term condition does not mean you cannot have a healthy pregnancy. Care plans are tailored to your needs. You are entitled to clear explanations and shared decision-making.

Trauma-informed care

If previous healthcare experiences have been difficult, please tell your care team. We can adapt communication, appointment planning and support to help you feel safe and heard.

Health inequalities and personalised care

National data shows higher complication rates for some communities and individuals with multiple risk factors. You are entitled to additional monitoring and advocacy where appropriate.

When to contact maternity triage urgently

Seek urgent review if you experience:

• Severe headache or visual disturbance.
• Reduced baby movements.
• Severe shortness of breath.
• Chest pain.
• Severe abdominal pain.
• Heavy vaginal bleeding.

Local support in Croydon

• Croydon Maternity Triage – 24-hour urgent advice.
• Consultant-led antenatal clinics.
• Diabetes specialist midwife service.
• Hypertension and fetal growth surveillance clinics.
• South London and Maudsley mental health services.

 

Medicines in pregnancy

Not all medicines are safe in pregnancy. Always check with your GP, midwife or pharmacist before taking prescription, over-the-counter or herbal medicines.

Do not stop prescribed medication without medical advice, particularly for conditions such as epilepsy, diabetes, asthma or mental health disorders.

Medicines in pregnancy (NHS)

Healthy eating in pregnancy

A balanced diet should include fruit and vegetables, wholegrains, protein sources, and dairy or fortified alternatives.

Foods to avoid include:

• Unpasteurised milk and soft cheeses with mould rind.
• Raw or undercooked meat.
• Liver and liver products (high vitamin A).
• Certain fish high in mercury.
• Raw shellfish.

Foods to avoid in pregnancy (NHS)

Vitamins and supplements

It is recommended to take 400 micrograms of folic acid daily until 12 weeks of pregnancy. Higher doses (5mg) may be recommended for certain risk groups.

Vitamin D supplementation (10 micrograms daily) is recommended throughout pregnancy.

Vitamins and supplements (NHS)

Alcohol, smoking and drugs

There is no safe level of alcohol in pregnancy. Alcohol can pass through the placenta and affect fetal development.

Smoking increases the risk of miscarriage, stillbirth, premature birth and low birth weight. Stopping smoking at any stage reduces risk.

Recreational drugs may harm your baby. Speak confidentially to your midwife if you need support.

Drinking alcohol while pregnant (NHS)

Smoking Cessation in Pregnancy – Detailed Guidance

Smoking during pregnancy increases the risk of miscarriage, stillbirth, premature birth, low birth weight, placental problems and sudden infant death syndrome (SIDS). Carbon monoxide from cigarette smoke reduces the oxygen supply to your baby.

Stopping smoking at any stage in pregnancy reduces these risks. The earlier you stop, the greater the health benefit for both you and your baby.

Support to stop smoking

You do not need to stop alone. Ask your midwife to refer you to the Stop Smoking Service. These specialist services provide free, confidential support tailored to pregnancy.

Support may include:

• One-to-one behavioural support.
• Carbon monoxide (CO) monitoring.
• Nicotine replacement therapy (NRT) if appropriate.
• Ongoing follow-up to reduce relapse risk.

Nicotine replacement therapy is safer than continuing to smoke, as it does not expose your baby to carbon monoxide or other harmful chemicals found in cigarettes.

If your partner or other household members smoke, they should also be encouraged to seek support, as second-hand smoke increases risks during pregnancy and after birth.

Stop smoking in pregnancy (NHS)

Exercise in Pregnancy – Detailed Guidance

Regular physical activity during pregnancy is safe for most pregnant people and provides significant health benefits for both you and your baby. If you were active before pregnancy, you can usually continue exercising with appropriate adjustments. If you were not previously active, it is safe to start gentle exercise.

Benefits of exercise in pregnancy

Regular exercise can:

• Improve cardiovascular fitness.
• Reduce back pain and pelvic discomfort.
• Improve posture and muscle tone.
• Reduce the risk of gestational diabetes.
• Support healthy weight gain.
• Improve sleep.
• Reduce anxiety and low mood.
• Help prepare your body for labour and birth.

How much exercise is recommended?

The NHS recommends aiming for at least 150 minutes of moderate-intensity activity per week. This can be broken into 30 minutes on most days.

Moderate intensity means you should still be able to hold a conversation while exercising.

Exercise in pregnancy (NHS)

Suitable activities during pregnancy

Examples include:

• Walking.
• Swimming or aqua-natal classes.
• Pregnancy yoga or Pilates.
• Low-impact aerobics.
• Stationary cycling.

Pelvic floor exercises are particularly important during pregnancy to reduce the risk of urinary incontinence.

Activities to avoid

Avoid activities that carry a high risk of falling or abdominal trauma, including:

• Contact sports (e.g. martial arts, football).
• Horse riding.
• Downhill skiing.
• Scuba diving (risk of decompression sickness).

After 16 weeks of pregnancy, avoid exercises that require lying flat on your back for prolonged periods, as this can reduce blood flow to your baby.

When to stop exercising and seek advice

Stop exercising and contact maternity services if you experience:

• Vaginal bleeding.
• Dizziness or faintness.
• Chest pain.
• Severe shortness of breath.
• Regular painful contractions.
• Fluid leaking from the vagina.
• Reduced baby movements (after 24 weeks).

When to seek individual advice before exercising

Speak to your midwife or doctor before starting or continuing exercise if you have:

• Heart or lung conditions.
• Severe anaemia.
• Cervical weakness.
• Placenta praevia after 26 weeks.
• Pre-eclampsia.
• History of preterm birth.
• Multiple pregnancy with complications.

Your baby’s movements

You should start to feel your baby move between 16 and 24 weeks. Once movements are established, contact maternity services immediately if you notice reduced or changed movements.

Your baby’s movements (NHS)

Vaccinations in pregnancy

Vaccines protect you and your baby. The flu vaccine and whooping cough vaccine are routinely recommended during pregnancy.

Vaccinations in pregnancy

Infections in pregnancy

Certain infections can affect your baby, including toxoplasmosis, CMV, parvovirus B19 and listeriosis. Good hygiene, food safety and avoiding contact with cat litter reduce risk.

Infections that may affect your baby (NHS)

Weight gain and BMI

Weight gain varies between individuals. Women with raised BMI may be offered additional monitoring. Healthy weight gain supports optimal outcomes.

Weight gain in pregnancy (NHS)

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