At your first visit, your midwife will help you plan your care before the birth (antenatal or prenatal care) and refer you for either your 12­ week (first trimester) scan, or a scan to find out how far through your pregnancy you are (also known as a dating scan).

We run midwifery antenatal appointments and classes in a number of settings and locations across the county, including Health Centres, GP Practices, Children’s Centres and Penrice Birth Centre. Obstetric clinics are held in one of Cornwall’s community hospitals.

The Fetal Medicine Unit

You’ll most likely come to the Fetal Medicine Unit at the Royal Cornwall Hospital for your prenatal screening. We also provide comprehensive care for complex pregnancies.

You’ll visit the Fetal Medicine Unit for:

• Your 12 week dating scan
• Combined testing at 11-14 weeks for Down’s, Edwards’ and Patau’s Syndrome or Quadruple testing at 16-20 weeks for Down’s Syndrome
• Your mid-pregnancy anomoly scan (usually between 18 and 21 weeks)
• An ultrasound assessment and management of fetal abnormalities identified at your mid-pregnancy scan
• Fetal echocardiography in conjunction with paediatric cardiology colleagues in Bristol via a telemedicine link
• Diagnostic services including chorionic villus sampling and amniocentesis
• Therapeutic procedures including amniodrainage, pleural, bladder and cyst aspiration, septostomy
• Assessment of fetal wellbeing: growth, behaviour, amniotic fluid, Doppler and anaemia screening
• Maternal ultrasound assessment: uterine artery Doppler and cervical length

You may be invited to the Maternity Day Assessment Unit (DAU) for assessment and monitoring if you have any pregnancy complications such as hypertension, bleeding, reduced movements, anaemia and ruptured membranes. We also provide individualised care to women who have experienced previous pregnancy loss at the Maternity DAU.

At home

If you choose to give birth at home, you’ll be supported by the community midwife team. You call the on­call midwife when you go into labour and they will come to your home for the delivery. Most home births go as planned, and our consultants are always on hand to support and advise your midwife throughout the birth, but there is a chance you may need to come into hospital if you or your baby need additional support.

Birth Centres in Cornwall

We have three specialist midwife-led birth centres in Cornwall; Penrice in St Austell, Helston and at the Royal Cornwall Hospital in Truro.

The Penrice birth centre is run by a small team of midwives and maternity support workers; it is manned throughout a 24 hour period and has beds if you and your baby need to stay in overnight.

The birth centre at Helston is only available for labour and birth, we don’t have facilities at Helston for you stay overnight after you have given birth. Helston is not manned 24 hours, you simply call the on­-call midwife when you are in labour and they will meet you at the centre.

The Isles of Scilly

Women on the Isles of Scilly can either have a home birth if they are on St Mary’s or if they live on one of the off islands then you can use the birthing room at St Mary’s Hospital.

Consultant­-led unit

The Delivery Suite is at the Royal Cornwall Hospital in Treliske in Truro. The unit looks after women with medical, pregnancy or labour complications, women who are planning to have an epidural for pain relief, as well as women who deliver without complications.

If you live in the far north of Cornwall, you are also able to access the consultant­-led units in Devon. Your midwife can advise you on this.

If a complication develops with you or your baby during a home birth or at one of our birth centres, we will need you to transfer to the consultant-led unit at the Royal Cornwall Hospital in Truro. This transfer rate for women having their first baby is roughly 50%.

If you are likely to give birth before 26 weeks gestation, you will be transferred to Derriford Hospital in Plymouth, either accompanied by a midwife before giving birth, or with a specialist transport team after you have given birth.

What is the maternity Electronic Personal Health Record (ePHR)?

ePHR is a web-based solution that allows women to securely login to view their maternity notes on any device such as a mobile phone, tablet or PC. The Royal Cornwall Hospitals Trust use Euroking (maternity IT software) to record the majority of your maternity care. After a visit (contact) with your midwife or maternity support worker, the data recorded from your appointment will become visible to you when you log in to your ePHR.

What will I see?

You will be able to see summaries of the following:

• Antenatal appointments with your community midwife
• Antenatal visits to the Delivery Suite at the Royal Cornwall Hospital
• Antenatal visits to the Day Assessment Unit at the Royal Cornwall Hospital
• A summary of your labour and delivery notes including caesarean section
• Birth information about your baby(s)
• Information about your discharge following the birth to the community midwife team
• Postnatal contacts with the midwifery team
• Information about your final postnatal discharge

You will not be able to see any sensitive information in your ePHR regarding social concerns, domestic issues disclosure etc.

How can I get access?

For access to your ePHR please call 07557 172389. Laura Wilkins or Kim Hewlett will take your call. Kim or Laura will verify your identity and then ensure your personal details recorded on the patient administration system are correct and then add your email address into the system. This must be your own personal email address.

After you have been authorised you will receive an email from cwlmaternity.phrreg@nhs.net asking you to verify your email address and create a password in order to have access to your ePHR. You must verify your details within 72 hours. If this expires then you can contact Laura or Kim on the same number and be re-authorised.

Remember to keep your password secure and your personal data safe

If you have your baby in the consultant­-led unit or birth centre, you can usually go home a few hours after the birth. If you have had a caesarean, you will normally stay with us for 48 hours, but all care is based on the individual needs of each woman.

If your baby needs specialist care, they will be transferred to the Neonatal Unit at Royal Cornwall Hospital. Babies with complex health problems will receive intensive care.

Postnatal Care at home

For the majority of women and their babies, postnatal care is carried out at home. Your midwife will visit you the day after birth or discharge from hospital, on day five for the newborn blood spot screening and then to discharge you around 10 days after birth.