Firstly, you need to decide which option of care is right for you (see the options of care section under maternity care). You should then telephone the appropriate department as soon as possible to arrange your first antenatal visit. The staff will record your name, date of birth, address and phone number and allocate you a hospital number. You will be offered an appointment date and time for your ‘booking visit’ when you are 12-14 weeks pregnant. If you have any problems in the meantime such as abdominal pain or vaginal bleeding you should contact your GP or telephone the assessment and emergency unit of the hospital.

Please bring your PPS number and your medical card, GNIB card or details of your private health insurance as applicable with you, along with a GP letter if you have one. If you are on any medication please bring it with you. Please register with the reception staff who will take your details and show you to a waiting area. You should not arrive more than 15 minutes before your appointment time.

The general advice is to avoid contact with most chemicals in early pregnancy but there is no current data linking hair dye with pregnancy complications.

This appointment is referred to as your ‘booking visit’. On this visit the midwife will review your history in detail along with your partner. Depending on the care option you have chosen, you may also see a doctor. You will have a physical examination, blood tests and an ultrasound scan to confirm your expected date of delivery and that all is well with your pregnancy. There is no need to fast, but you will need a full bladder for the scan. The blood tests will determine your blood group, your haemoglobin (blood iron) level and what infections you have either had or been vaccinated against. Please allow 2 – 3 hours for this visit. Please see the ‘first antenatal visit’ section under antenatal care for more detailed information.

It is quite common to have more vaginal discharge in pregnancy because of the increased oestrogen hormone and greater blood flow to the vaginal area. Healthy vaginal discharge should be clear and white and should not smell unpleasant. If the vaginal discharge is coloured or smells strange or you feel itchy or sore you may have a vaginal infection such as thrush which requires treatment. In this case please attend your GP for review.

A woman who is expecting her first baby will usually start to feel the baby move between the 18th and 20th week of pregnancy. These movements will initially feel like flutters and later in pregnancy they will become more pronounced and become definite ‘kicks’. On subsequent pregnancies a woman will usually start to feel her baby moving around 16 to 18 weeks. It is very important to be aware of your baby’s movements and you should feel at least 10 movements in 12 hours. You should monitor your baby’s movements from 28 weeks onwards and you can record these on a ‘kick chart’ available from the hospital. If you have concerns that your baby is not moving as much as normal you should go immediately to the assessment and emergency unit in the hospital.

Dental problems are more common in pregnancy. Tell your dentist that you are pregnant and they will assess whether it is appropriate to treat you during pregnancy or not. It is generally advised to avoid amalgam fillings in pregnancy due to the mercury content but your dentist could offer you an alternative. Local anaesthetic to perform dental treatment is used with caution in pregnancy particularly during the first twelve weeks. However, it is very important to visit your dentist at least once during pregnancy.

The ‘show’ is a plug of mucous which seals the neck of the womb (cervix) in pregnancy. It comes away when the cervix is starting to soften and open up. The show can be heavily bloodstained, pinky streaked or dark brown stained mucous. There is no need to come to the hospital with a ‘show’ alone but it can indicate that labour is starting. A show is never vaginal bleeding. If you are bleeding come directly to the assessment and emergency unit in the hospital.

Please check in at the main reception desk in the hospital and give the staff your details. They will let the midwife in the assessment and emergency unit know that you are here for review. You will then be examined by a midwife and have a tracing done on baby’s heart beat. If you are in established labour we will bring you to the delivery suite. If you are in the early stages of labour we may admit you to the prenatal ward where we can monitor you and your baby until you are in active labour.

Over-the-counter cough or cold remedies may contain alcohol or other ingredients that should be avoided during pregnancy. You should drink plenty of water and other fluids. If you have a fever (high temperature) that isn’t settling a low dose of paracetamol (500 mg to 1 gram) can be taken to reduce the temperature. Please talk to your pharmacist or GP before taking any medication.

In uncomplicated pregnancies we recommend that your antenatal care is shared between the hospital staff and your GP. This is known as ‘combined care’. Your first visit in the hospital is generally followed by a visit to your GP at around 20 weeks and a return visit to the hospital staff around 28 weeks. You will be seen more frequently from 28 weeks onwards and weekly by either the hospital staff or your GP as you approach your due date. You will also have additional appointments for your ultrasound scan and where applicable parent education antenatal classes. It is important to attend all your appointments and please contact the hospital if you need to change an appointment.

You should contact the assessment and emergency unit in the hospital by phone for advice. If the bleeding is light or there is vaginal spotting only you may be given an appointment to attend the early pregnancy unit in the hospital where you will be examined and have an ultrasound scan. If the vaginal bleeding is heavy or you have worsening abdominal pains you should attend the assessment and emergency unit in the hospital.

Regular painful contractions are the only definite sign that labour has started. These contractions occur when the muscles of the uterus contract and then relax resulting in dilatation of the cervix. Contractions develop into a pattern that increases in strength, intensity and duration over time. You should come into the assessment and emergency unit in the hospital when you are having regular contractions approximately 5 minutes apart lasting 45 – 50 seconds. However, if you are in a lot of pain, live a significant distance from the hospital, have a history of fast labours or need pain relief you are advised to come to the hospital sooner for assessment. In the case of an emergency where urgent medical attention is needed you may need to ring an ambulance.

This occurs when the bag of fluid (liquor) surrounding your baby either starts to leak or breaks with a gush. You may feel a slow trickle or have a sudden gush that you cannot control. You should note the time this happens and the colour of the fluid, which is usually clear, slightly straw coloured or it may have a vague tinge of pink. If you think your waters have broken you should phone the assessment and emergency unit in the hospital for advice. If the fluid is green or green/brown in colour or heavily blood stained, you should come into the assessment and emergency unit immediately.

If you are not able to drink some fluids without vomiting and are unable to eat for 24 hours you should go to your GP and have your urine checked to see if you are becoming dehydrated. If you are showing signs of dehydration your doctor may refer you to the hospital for treatment.

Bleeding in early pregnancy is treated as a threatened miscarriage. Implantation bleeding can occur as the fertilised egg is implanted in the lining of the womb (uterus). Typically implantation bleeding will happen between a week and a few days before your expected period. If you have bright red blood loss or heavy bleeding or worsening abdominal pain we advise you to contact your GP or telephone the assessment and emergency unit in the hospital for advice.

You may have had chickenpox as a child and were unaware of it or have forgotten. It is important that you get your blood checked because if you have not had chickenpox you are at risk of contracting it as you do not have any immunity. You need to contact the assessment and emergency unit in the hospital. If you had a previous pregnancy, we may be able to confirm if you have immunity or not. If not, we will arrange for you to have a blood test taken to check for chickenpox antibodies. If you do not have the antibodies you will be offered the varicella (chickenpox) vaccine to protect you and your baby against the disease. Chickenpox is infectious and children who have chickenpox can transmit the infection from before the spots appear until the spots have crusted over. For this reason we ask you to avoid close contact (being in the same room) with a child or the family of a child who has chickenpox where possible.

The vomiting and diarrhoea caused by a tummy bug will usually pass within 24 – 48 hours so try to take plenty of fluids and rest. However, if you are unable to tolerate fluids and the vomiting or diarrhoea lasts for more than 24 – 48 hours you should contact the assessment and emergency unit in the hospital, by phone. Please do not attend that hospital without prior arrangement as the bug is likely to be highly contagious and can spread very easily to other people.

If you smoke and would like to quit while you are pregnant, we would be delighted to help you. We have a smoking cessation support midwife who will provide you with practical support to help you stop smoking. There are proven benefits to your baby if you stop smoking at any stage during pregnancy. Unfortunately nicotine replacement patches are not considered safe in pregnancy as it is the nicotine that can damage the placenta which is the baby’s life support.