Early pregnancy advice
From the time you stop using contraception and for the first 12 weeks of pregnancy, it’s recommended that you take a supplement of 400mcg of folic acid each day (available from any chemist and some supermarkets) as well as eating plenty of folate-rich foods such as green leafy vegetables, pulses and fortified breakfast cereals. This is to help prevent neural tube defects such as spina bifida. Current national guidelines recommend if you have a higher chance of neural tube defects that you take a higher level of 5mg of folic acid. You should take a higher dose if:
- you or the baby's biological father have a neural tube defect
- you or the baby's biological father have a family history of neural tube defects
- you have had a previous pregnancy affected by a neural tube defect
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you have diabetes
- you take anti-epilepsy medicine
- you take anti-retroviral medicine for HIV
Contact your GP to inform them you are planning to become pregnant if any of the above criteria apply to you so that you can be prescribed the correct does of Folic Acid.
It is important to report any bleeding to your Midwife or GP, as bleeding in pregnancy requires a medical review. In early pregnancy it could be a sign of miscarriage, although many women who do bleed go on to have successful pregnancies. If you experience any bleeding in early pregnancy, contact your GP who may refer you to the Early Pregnancy Assessment Unit.
Using the Tommy's pregnancy planner tool can help you to identify whether there is anything you need to do to optimise the wellbeing of you and your baby.www.
The NHS Pregnancy page includes all you need to know about trying for a baby, pregnancy, labour and birth.
In early pregnancy your body is going through many changes and you may notice different signs and symptoms Usually there is no need to be worried, but if you want to check if your symptoms are normal and how to manage them, visit the NHS common health problems in pregnancy page.
Lifestyle advice during pregnancy
Cheshire East: One You Cheshire East offer residents friendly local sup
port with a number of programmes to help you have as healthy a pregnancy as possible. They can help you to lose weight, move more, and be smoke free. New services include stand strong and healthy baby & you. To sign up for for any of their programmes, visit the One You Cheshire East sign up page.
Cheshire West and Chester: Brio Leisure now run an integrated wellness c
ontract known as Cheshire Change Hub, offering free health and wellbeing services to residents of Cheshire West and Chester. Visit the Cheshire Change Hub website to find out more.
Alcohol and drugs can have a potentially serious effect on your unborn baby. It is important to be honest with your Midwife if you are drinking alcohol or taking drugs during pregnancy, to enable you to receive the help and support you require. The NHS Illegal drugs in pregnancy and Drinking alcohol while pregnant pages include more information as well as the Drymester website.
If a blood test shows that you are anaemic during your pregnancy, you may be prescribed iron tablets, but you can also make changes to your diet to increase your iron levels. More information can be found on the NHS Iron deficiency anaemia page.
For information on keeping healthy in pregnancy see the nhs webpage: Have a healthy diet in pregnancy [NHS]
Dieting in pregnancy is not recommended but healthy eating is advocated. National Institute for Health and Care Excellence (NICE) state that there is only a need for an extra 200 calories per day in the last three months of pregnancy, therefore pregnant women should be advised against “eating for two”.
The Royal College of Midwives (RCM) has teamed up with Slimming World to provide information, advice and support with healthy eating during pregnancy. We encourage you to eat healthily and to keep active during pregnancy as evidence indicates this helps to prevent and limits the complications associated with excessive weight gain during pregnancy. This benefits both mother and baby and will also help you after you have had your baby.
For more information, please see the Slimming World website: Working together to help you manage your weight before, during and after pregnancy
It is important that you remain as active as possible throughout your pregnancy. This will help your body to cope better with pregnancy and labour. The NHS Exercise in pregnancy page includes general exercise tips, pelvic floor exercises and exercises to avoid.
It is important for you to let your GP and Midwife know if you are using any type of medication whether it is prescribed, purchased from a pharmacy or recreational throughout your pregnancy and during breastfeeding. Some medications are not safe to take during pregnancy, and may cause side effects to you or harm to your baby.
To reduce your risk of excessive perineal tearing and long term problems with your pelvic floor, we advise that you do regular pelvic floor exercises throughout your pregnancy. More information can be found in the links below:
During your antenatal appointments the Midwife will regularly check your carbon monoxide levels.
Carbon monoxide is a poisonous gas which you can’t see or smell but is dangerous to you and your baby. Exposure can prevent oxygen reaching your baby, slow its growth and development, and can result in miscarriage, stillbirth and sudden infant death. For more information about how this test is carried out, see the Test Your Breath leaflet.
One reason your carbon monoxide levels may be raised, is if you or a household member smokes. If you would like help to stop smoking there are a number of support services available to you: www.
This short video eplains the effects of smoking on you and your baby.
Cheshire East residents www.
Cheshire West residents cheshirechangehub.org/
You can refer yourself to these services, or your Midwife will arrange a referral for you. You will be offered behavioural support as well as Nicotine Replacement Therapy (NRT) to help reduce your cravings and help you to quit smoking.
Research has shown that in the third trimester of pregnancy (from 28 weeks) going to sleep on your side has been shown to help prevent stillbirth. Further information can be found on the Tommy’s website about sleep positions in pregnancy.
There are a number of ways we can help you and your household members to stop smoking. This following website has been created to help mums-to-be in the Cheshire and Merseyside area to experience a smokefree pregnancy, and by doing so give their child a healthier start to life. If you want any more information or support, please speak to your Midwife.
www.
Quitting is tough, but so am I Facebook page.
I am tough Instagram account.
You will be offered:
Whooping Cough vaccination, it can be given from 16 weeks of pregnancy. For more information: Whooping cough vaccination in pregnancy guide (UK Health Security Agency).
Respiratory Syncytial Virus (RSV) from 28 weeks of pregnancy. For more information: RSV vaccine - NHS
Influenza (flu) vaccination, usually within the autumn/winter period (September to March). For more information: Flu vaccine (NHS).
If you want to read more about all these vaccinations, visit the British Society for Immunology and download their Guide to vaccinations during pregnancy.
There is currently differing advice about taking Vitamin D during pregnancy. You should base your decision on your dietary intake and personal circumstances.
Saving Babies Lives Care Bundle v3 published April 2025 states that all women should take Vitamin D 10 micrograms daily throughout their pregnancy. However current NICE / NHS guidance says:
You need 10 micrograms of vitamin D each day. It's recommended pregnant and breastfeeding women take a daily supplement containing this amount between September and March.
Vitamin D regulates the amount of calcium and phosphate in the body, which are needed to keep bones, teeth and muscles healthy. Our bodies make vitamin D when our skin is exposed to summer sunlight (from late March/early April to the end of September)
Between the months of September and March the body cannot make sufficient vitamin D from sunlight alone, which is why a supplement is recommended.
Vitamin D is also in some foods, including:
- oily fish (such as salmon, mackerel, herring and sardines) – during pregnancy, you should eat no more than 2 portions of oily fish a week
- egg yolks
- red meat
- fortified foods – such as some fat spreads and breakfast cereals
- liver – but avoid eating liver during pregnancy
Because vitamin D is only found in a small number of foods, whether naturally occurring or added, it is difficult to get enough from foods alone.
Do not take more than 100 micrograms (4,000 IU) of vitamin D a day as it could be harmful.
You can get vitamin supplements containing vitamin D free of charge if you're pregnant or breastfeeding and qualify for the Healthy Start scheme.
Information:
There have been some reports about vitamin D reducing the risk of coronavirus (COVID-19). But there is currently not enough evidence to support taking vitamin D solely to prevent or treat COVID-19.
If you have dark skin or cover your skin a lot
You may be at particular risk of not having enough vitamin D if:
- you have dark skin (for example, if you're of African, African Caribbean or south Asian origin)
- you cover your skin when outside or spend lots of time indoors
You may need to consider taking a daily supplement of vitamin D all year. Talk to a midwife or doctor for advice.
