Care during your pregnancy (antenatal or prenatal care)

Alternatively, you can arrange your first appointment as below

If you’re unsure which area you’re in

Please call your GP surgery and they’ll be able to help you.

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

ePHR is a web-based solution that allows people under our care to view their maternity notes online.

At the Royal Cornwall Hospitals Trust, we use Euroking, a secure maternity IT software, to record the majority of your maternity care. After you’ve had an appointment or spoken to us, your midwife or maternity support worker will record the data and you’ll be able to see it in your ePHR.

What will you see in your ePHR?

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 to the community midwife team after you’ve given birth
• Postnatal contacts with the midwifery team
• Information about when we discharge you from the service
• You will not be able to see any sensitive information such as social concerns, or disclosures about domestic issues.

How can I get access?

You can only access your ePHR for your current pregnancy. Please either complete this form or call the Maternity IT team on 07557 172389.

If you call, we’ll check your details and add your email address to the ePHR system (this has to be your personal email, we don’t allow work or general email addresses to make sure your personal healthcare data stays secure).

After we’ve got your form or you’ve spoken to us, we’ll authorise your account. You’ll then get an email from cwlmaternity.phrreg@nhs.net asking you to verify your email address and create a password for your ePHR. You must verify your details within 72 hours. If this expires then please call us and we can resend the verification email.

If you get stuck setting it up, please call 07557 172389.

Remember to keep your password secure and your personal data safe.

• Your pregnancy and baby guide – week-by-week guides, videos, health advice and information about your NHS pregnancy journey
• Common pregnancy symptoms – A guide from the NHS on common pregnancy symptoms and how to manage them
• Screening tests for you and your baby – A leaflet from the NHS on the screening you will be offered during and after your pregnancy.
• Pregnant? There are many ways to help protect you and your baby – leaflet about the vaccinations you’ll be offered during pregnancy and for your baby after their birth.
• Stop smoking in pregnancy – information from Healthy Cornwall.
• Eating well for a healthy pregnancy – a practical guide from the First Steps Nutrition Trust.
• Information on alcohol in pregnancy – Guide from Royal Cornwall Hospitals on alcohol in pregnancy.

Mental wellbeing

The most common complication of pregnancy and birth is related to mental health.

If you or your partner are struggling with mixed emotions, sadness, irritability and exhaustion, you are not alone. You may also experience a lack of interest or pleasure in the things that you usually enjoy or in looking after your baby. For most women and their partners these emotions are relieved by spending time with family and friends, and with adequate support to allow you to rest and sleep. For around one in five women symptoms are more persistent and need additional support and treatment.

The most important thing is to talk with the people around you and with your midwife, health visitor or GP about how you feel. Your midwife is there to support you with your mental health as much as with your physical health.

We also offer a number of specialist services to support your mental health during and after pregnancy. These include:

• The perinatal mental health team – you can contact them through your midwife or directly by sending an email to rcht.pmhmidwives@nhs.net.
• The birth reflections service – they can offer you support and a debrief if you experienced trauma during a previous birth. You can contact the birth reflections midwives at rcht.birthreflections@nhs.net.

Further resources on mental wellbeing

Maternal Mental Health in Cornwall – a Facebook page run by Midwives alongside the Maternity Voices Partnership that provides pregnancy and postnatal mental health support during the Covid pandemic

Outlook Southwest – offer psychological therapy services for people in Cornwall and the Isles

Tommy’s Pregnancy and Post-birth Wellbeing Plan – a two-page plan that helps you start thinking about how you feel emotionally and what support you might need in your pregnancy and after the birth. It’s also helpful in working out how to start a conversation with your partner, friend, midwife, health visitor or GP.

The midwife will:

• ask some questions to find out what care you’ll need.
• ask if they can carry out some screening tests. This might include your height and weight, blood and urine tests, and blood pressure.
• give you information about your pregnancy, birth and breastfeeding, staying healthy, what care you’ll be offered and further support.

If you’re more than 10 weeks pregnant and haven’t seen a GP or midwife, contact a GP or midwife as soon as possible.

Find out more about what happens at the booking appointment on the NHS website: Your first midwife appointment.

• Ask about your physical and emotional wellbeing
• Ask about your living situation and relationships
• Take blood
• Ask for a urine sample
• Record your heart rate, blood pressure, height or weight
• Check the baby’s position
• Check the baby’s heart rate
• Ask if baby is moving normally for you
• Measure your baby to make sure they are growing well
• Make a referral to specialist midwives or other health professionals
• Discuss any results from earlier appointments
• Discuss your birth choices
• Discuss how to know you are in labour and who to call
• Discuss pain relief in labour
• Discuss postnatal care

The appointments are also time for you to ask questions and discuss any issues and concerns with your midwife. If there’s anything worrying you do, please do make sure you mention it, it’s important so that we can provide you with the best possible care.

Specialist midwives

We may refer you to a specialist midwife during your pregnancy. A specialist midwife is someone who has done specialist training in a particular field. Our team includes midwives who specialise in:

• diabetes
• screening
• birth trauma
• bereavement
• infant feeding
• touch massage and aromatherapy
• mental health

12-week pregnancy dating scan

Takes place between 8 and 14 weeks and checks how far along in your pregnancy you are, and your baby’s development.

If you’ve agreed to have screening for Down’s syndrome, Edwards’ syndrome and Patau’s syndrome, and your scan takes place between 11 and 14 weeks, the sonographer (person doing the scan) will also do the screening.

Your dating scan will usually take place at the Fetal Medicine Unit at the Royal Cornwall Hospital in Truro.

Find out more about what happens at your 12-week scan on the NHS website.

20-week scan

This detailed ultrasound scan, sometimes called the mid-pregnancy or anomaly scan, is usually carried out when you’re between 18 and 21 weeks pregnant.

The scan looks in detail at the baby’s bones, heart, brain, spinal cord, face, kidneys and abdomen. It allows the sonographer to look for 11 rare conditions. The scan only looks for these conditions, and cannot find everything that might be wrong.

Find out more about what happens at your 20-week scan on the NHS website.

Other scans

You may also be offered other scans during your pregnancy to check how the baby is doing, for example if we want to check on the baby’s growth or if the baby’s activity levels have changed.

*If you have concerns about your baby’s wellbeing, including if you think their movement patterns have changed, slowed down or stopped, it’s important that you call us straight away. If you’re less than 28 weeks pregnant, call your community midwife. If you’re more than 28 weeks pregnant, please call the maternity triage team on 01872 258000. You can find out more about why your baby’s movements are important on the Kicks Count website.

• Raised blood pressure, in case you need medication or tests for pre-eclampsia
• Reduced fetal movements, which could result in electronic monitoring (CTG) or induction of labour
• Acute abdominal pain
• Vaginal bleeding during pregnancy
• Low fetal weight identified on an ultrasound, which may need reviewing by a clinician and further ultrasound scans
• Taking blood samples
• An iron infusion if you have anaemia
• For administration of intramuscular steroids
• Induction of labour (IOL). This might be for various reasons, most commonly if you are past your estimated due date.
• Or if you need to see a consultant, which could be for a number of reasons including hyperemesis, spontaneous rupture of membranes (your waters have broken) or a pre-assessment before an elective caesarean section.

You can find information about the different wards and units you may come to here:

• Maternity Day Assessment Unit – where we look after women who are experiencing complications with their pregnancy, but who don’t need to stay in hospital.
• Wheal Rose – our specialist inpatient ward for pregnant women before they’ve had their babies
• Delivery Suite – where women come to give birth.
• Wheal Fortune – where we look after women after they have had their babies but who need to stay in hospital for monitoring or treatment.

• Our labour and birth page – tells you about birth choices, including where you can give birth.
• Our Infant Feeding Team page – for support on how to feed your baby.
• Dadpad – A guide to babies developed especially for dads in conjunction with the NHS.