Advice for a safer pregnancy

Stop smoking

Smoking cigarettes in pregnancy is associated with higher rates of stillbirth. If you smoke while you are pregnant your baby's growth and development are affected, and problems with your baby's health and wellbeing are much more likely. If you smoke you should stop – ideally before your pregnancy but even part way through your pregnancy it is still worth giving up smoking.

You can get advice on stopping smoking from your GP.  You can also call the NHS Pregnancy Smoking Helpline on 0800 169 9 169 or visit NHS choices.

Avoid alcohol and drugs during pregnancy

Drinking alcohol and taking drugs during pregnancy can seriously affect your baby’s development, as well as increase your risk of miscarriage and stillbirth.

For more information on alcohol and drugs during pregnancy visit NHS choices.

Ensure you are a healthy weight

Obesity is a risk factor for stillbirth.  The best way to protect your health and your baby’s wellbeing is to lose weight before you become pregnant. By reaching a healthy weight, you cut your risk of all the problems associated with obesity in pregnancy. Your GP can give you advice about how to lose weight.

If you're obese when you become pregnant, your midwife or GP can give you advice about improving your health while pregnant.  Eating healthily and activities such as walking and swimming are good for all pregnant women. If you were not active before becoming pregnant, you should consult your midwife or doctor before starting a new exercise programme while you're pregnant.

Protect yourself against infection

Around 10% of stillbirths are caused by infection. Infections such as listeria, salmonella, and toxoplasmosis increase the risk of stillbirth for instance. Eating certain foods such as some types of fish or cheese can increase your risk of being exposed to such infections. Ask for information from your midwife about what foods and activities to avoid during pregnancy.

For more information on pregnancy infections visit NHS choices.

It is important to remember that the majority of pregnancies and births are free from problems but it is good to be informed and if you have any concerns speak to your midwife.

Go to all your antenatal appointments

It is important to keep in regular contact with your midwives and doctor and go to all your antenatal check-ups. They will monitor the progress of your pregnancy and if there are problems they can make sure you get the care you need.

Urine and blood tests, along with regular blood pressure monitoring and ultrasound scans can pick up early signs of medical conditions that might affect your baby.

Regular measurement of your baby's growth can tell your midwife (and you) about your baby's progress. Poor growth can indicate problems and it is important this is picked up. A baby not growing well is at risk of stillbirth.
 

A change in baby's movements

Feeling your baby move is a sign that they are well.

There is no set number of normal movements. Every baby is different. From 16–24 weeks on you should feel your baby move more and more up until 32 weeks. From then, movements should stay roughly the same until you give birth and during labour too.

Call your maternity unit and go to get checked straight away if:

• your baby is moving less than normal
• movements feel weaker than normal
• movements have stopped

Do not wait until the next day to get checked. The maternity unit is open 24 hours a day 7 days a week. You can call and get checked any time of the day or night.

If you are away from home, you can contact any maternity unit.

Do not do anything to try and make your baby move.

Do not use home dopplers, hand held monitors or phone apps to check your baby’s heartbeat. Even if you hear a heartbeat, this does not mean your baby is well.

Why are my baby’s movements important?

Sometimes, a baby who moves less is not getting enough oxygen. A small number of babies who move less are stillborn. This means they die before they are born. So it is important to get checked straight away even if your pregnancy has been straightforward or you have not had any problems before.

What if my baby is moving less after I have been checked?

Contact your maternity unit straight away. Do this even if you have been seen earlier the same day or were recently told your baby was well. Always get checked, no matter how many times this happens.

I am not sure about movements, but I just feel that something is wrong. What should I do?

You know your body and your pregnancy best. If you feel that something is wrong, contact your maternity unit and tell them you are coming in. You should do this even if you can’t explain exactly why you feel that something is wrong. 

The Royal College of Obstetrics and Gynaecology has information about baby's movements. 

Download

The charity Tommy's and NHS England have produced information about baby's movements. Download

Download the 'Feeling your baby move is a sign that they are well' leaflet from Tommy's and NHS England   Download

Report any abdominal pain or bleeding

If you have pain or tenderness in your abdominal area you should contact your doctor or midwife. Acute pain, high fever or vaginal bleeding should be reported immediately. It is better to report any pain that worries you sooner rather than later. 

Most pregnancies and births are problem free but every baby is to some degree at risk and stillbirths are more frequent among the following groups:

• Twin or multiple pregnancies
• Older mothers i.e. aged 35 years+
• Teenage mothers
• Women with specific medical conditions, especially diabetes, hypertension and thrombophilia
• Women with a past obstetric history of complications
• Women who smoke
• Women who are obese i.e. a body mass index (BMI) over 30
• Women living in areas of social deprivation
• Women from some ethnic minority groups

Your midwife can give you information about your personal circumstance. The vast majority of women in these groups still give birth to a healthy baby

“As a pregnant woman, how can I contribute to the management of my own care if I don’t know the risks?” Mum

Although most pregnancies are free of problems, some babies do die before or soon after birth.

Parents who have experienced this loss often say they had no idea that babies sometimes die and wish they had known it was a possibility. They might have acted differently if they had known there was any risk.

Many people think stillbirth is a thing of the past. That increases the risk of missing warning signs that something is wrong.

At Sands we think mothers should have access to information about stillbirth and the possible warning signs if something is not right.

What do we mean by poor growth?

Midwives check the growth and well-being of your baby at every antenatal appointment. They use a tape measure to work out the distance from the pubic bone to the top of the womb. They should plot your baby’s growth on a chart to ensure he or she is continuing to grow.

Every baby is different and should grow to a size that’s normal for him or her. Some babies are naturally small, usually because their mothers are small. But all babies should continue to grow steadily throughout the pregnancy.

If a baby seems to be smaller than he or she should be, or the growth pattern tails off as the pregnancy continues, this is described as ‘growth restriction’, being ‘small for gestational age’ or not reaching his or her ‘growth potential’.

If a baby does not reach his or her growth potential in the womb this may be because the placenta is not working properly. This increases the risk of stillbirth.

Problems with a baby’s growth should be picked up during antenatal appointments.

It’s important also to be aware of your baby’s movements. Being aware of the patterns of movements may help in spotting any problems as early as possible.