Tummy2Mummy Baby Scans and Private Midwife Services, Hinckley, Leicestershire, Midlands

While you are on maternity leave, you may be entitled to maternity pay either under your contract of employment or by law through Statutory Maternity Pay or Maternity Allowance, which can be paid for up to 39 weeks. The rules about maternity pay depend on how long you’ve worked for your employer, how much you earn and what your contract says.

For more information about maternity pay, click here.

‘Yes! When you go into labour, if your midwife hasn’t met you before, your birth plan allows her to get to know your preferences. Try to have your plan ready by about 36 weeks, and go through it with your midwife. She’ll be able to advise you on whether it’s realistic in terms of the services provided – for example, whether there’s likely to be a birthing pool available.’

There is no set cure for morning sickness. You can try to find out what brings on the sickness though. It may be the time of the day – such as morning or early evening. It might help to rest or eat a small snack to boost your blood sugar level before these times (have some snacks by the bed to eat before you get out of bed for example).

1. You may find that some smells set off your nausea, so avoid these particular smells if you can.
2. Wear travel sickness wristbands (elasticated bracelets that have a plastic button that presses on a particular place on your wrist).
3. Try nibbling ginger biscuits or sipping ginger tea, particularly first thing in the morning in bed.
4. Avoid large meals, but eat smaller more frequent meals and snacks.
5. If you are often sick, rinse your mouth afterwards with plain water to prevent the acid in your vomit attacking your teeth.
6. If the nausea is accompanied by severe vomiting to the extent you cannot keep food or drink down, you need to contact your GP or midwife as soon as possible.

There are some foods that could pose a risk to pregnant women, these include:


• liver and liver products


• soft mould ripened cheeses, such as Camembert, Brie and blue-veined cheese


• pâté (including vegetable pâté)


• uncooked or undercooked ready-prepared meals


• uncooked or rare meat (meat should be cooked so there’s no pink or bloody meat)

• cured meat, such as salami or Parma ham 


• raw shellfish, such as oysters


• fish containing relatively high levels of mercury, such as shark, swordfish and marlin


• unpasteurised milk or dairy products made from unpasteurised milk
• raw or undercooked eggs or products containing them such as fresh mayonnaise


• alcohol – it is safest to avoid alcohol altogether


• food beyond it’s use by date. 


It is recommended that the intake of certain other foods be limited, such as:


• tuna – no more than four medium size cans or two fresh tuna steaks per week


• Oily fish – no more than two portions a week


• No more than two portions a week of sea bream, sea bass, turbot, halibut, rock salmon (also known as dogfish, flake, huss, rigg or rock eel), brown crabmeat


• caffeine – no more than 200 milligrams a day. Caffeine is present in coffee, tea, colas, energy drinks and chocolate

Prior to formal induction of labour, when women are 41 plus weeks pregnant, it is recommended that all women be offered a membrane sweep to assess the readiness of the cervix (neck of womb) for labour*. It may also help stimulate labour as it has been shown to increase the possibility of labour occurring naturally within the following 48 hours*.

A membrane sweep involves an internal vaginal examination by your Midwife or Doctor. They will place a finger just inside your cervix and, making a circular sweeping movement, will attempt to separate the membranes from the cervix*. This will stimulate the release of hormones that may start contractions. It will be uncomfortable but should not cause actual pain; you may also experience a mucus/bloodstained ‘show’ like a discharge, following this, which is quite normal.

*NICE guidelines (National Institute for Clinical Excellence). Induction of labour. June 2001.

Group B Streptococcus (GBS) is a normal bacterium which colonises up to 30% of adults in the UK, without symptoms or side-effects. GBS can cause infection, most commonly in newborn babies before, during or shortly after birth. GBS can more rarely cause infection in adults (typically women during pregnancy or after birth, the elderly and people with serious underlying medical conditions which impair their immune system).

GBS is not a sexually transmitted disease and treatment of the woman and of her partner does not prevent re-colonisation. 

In newborn babies, there are two types of GBS disease: early and late-onset. Roughly 80% of GBS disease is early-onset, occurring in the first 6 days of life and usually apparent at birth. Early-onset GBS disease is normally characterised by the rapid development of breathing problems, associated with blood poisoning. Late-onset disease - which usually presents as GBS meningitis - occurs after the baby is 6 days old and, normally, by age 1 month but, rarely, up to age 3 months. After age 3 months, GBS infection in babies is extremely rare.

GBS is also a recognised cause of preterm delivery, maternal infections, stillbirths and late miscarriages. GBS infections are rare in adults, especially so for men and women who are not pregnant.

Overall, without preventative medicine, GBS infections affect an estimated 1 in every 1,000 babies born in the UK. Each year, based on 700,000 babies born annually in the UK, approximately:

• 230,000 babies are born to mothers who carry GBS; 88,000 babies (1 in 8) become colonised with GBS; 700 babies develop GBS infections, usually within 24 hours of birth; and
• 75 babies (11% of infected babies) die.

Of the survivors of GBS meningitis, up to one half suffer long-term mental and/or physical problems, from mild to severe learning disabilities, loss of sight, loss of hearing and lung damage (in around 12% of the survivors, the disabilities may be severe). The great majority of survivors of early-onset disease do so with no long-term damage.

At GBSS we believe all low-risk women should be offered the opportunity to have a sensitive test to detect GBS carriage late in pregnancy.

Whatever the result, it is good news. If you test and find you’re not a carrier that is great. If you test and find you are a carrier that is also good news – although it means your baby is at a raised risk of developing GBS infection, it also means you know about it so you can decide whether to put into place simple straightforward steps which have been proven to be hugely effective at minimising that risk.

There are three types of tests for GBS carriage:

Standard High Vaginal Swab (HVS) method
Enriched Culture Medium (ECM) method
Polymerase Chain Reaction ( PCR) method

Standard (HVS)
This is the method the NHS usually offers, when testing is offered at all. Usually only a vaginal (and often a high vaginal) swab is taken. In the laboratory, the cells from the swab are transferred onto a dish or ‘plate’ containing agar and after 24 and 48 hours incubation, the plate is examined to see if GBS has grown.

A positive result using this test method is highly reliable – there are very few falsely positive results. But it is not a particularly sensitive test and gives a high proportion of falsely negative results – i t will only pick up GBS in around 50% of cases where it is there .

Many health professionals and most pregnant women are unaware of just how high the false-negative rate is for these tests.

Enriched Culture Medium (ECM)

This method usually requires both a low vaginal and rectal swab (ideally using two separate swabs, but sometimes one combined vaginal then rectal swab is used) and is offered at a small number of enlightened NHS hospitals (we have heard of three offering it). This is also the method used by two private laboratories, each of which offers a postal service – The Doctors Laboratory and Mullhaven Medical Laboratory.

In the laboratory, the cells from the swab are incubated in an enriched culture medium specifically designed to encourage the growth of GBS and so enhance its detection. After incubation, the specimen is sub-cultured onto an agar plate. The bacteria have to grow into a sizeable colony before they can be identified, so getting a result takes a minimum of 24 hours, and more usually 48-72 hours to establish whether GBS has grown.

The national standard method for testing for GBS carriage (Bacteriological Standard Operating Procedure 58) describes this method in more detail and the document is available from the Health Protection Agency Evaluation & Standards Laboratory (e-mail .(JavaScript must be enabled to view this email address) or you can download a PDF copy at http://www.hpa-standardmethods.org.uk/documents/bsop/pdf/bsop58.pdf).
The ECM test, sometimes referred to as the ‘gold standard’ is highly reliable. Research has showed that, when the ECM test was performed within 5 weeks of delivery, a negative result was 96% predictive of not carrying GBS at delivery (4% of women acquired carriage between the test and giving birth) and a positive result was 87% predictive of carrying GBS at delivery (13% of women lost carriage between performing the test and giving birth). The test can be done earlier, but then isn’t as reliable at predicting colonisation status at delivery. It can be done later, but the chance of the baby arriving before the result increases.

Although only available in the UK since May 2003, ECM tests have been used for many years in many countries and have been validated during more than a decade of use.

PCR (Polymerase Chain Reaction)

These tests require a low vaginal swab PLUS a rectal swab (ideally using two separate swabs, but sometimes one combined vaginal/rectal swab is used).

The swab(s) are sent to the laboratory, where they use special equipment, which uses a rapid test to detect special molecules found only in GBS. This method is approved by the Federal Drug Administration (FDA) in the USA and Health Canada, and bears the CE Mark for the detection of GBS (having the CE mark means that the test is approved for use in any European country). However, this test method has not been validated for use in the UK.

This test method is at least as sensitive than the ECM test and can produce results much more quickly.

Any test result positive for GBS during pregnancy means that the pregnant woman should be offered intravenous antibiotics from the onset of labour or waters breaking and then 4-hourly until delivery.

A negative ECM or PCR test result means that the pregnant woman does not need to be offered intravenous antibiotics from the onset of labour or waters breaking against GBS infection in her baby.

Where no ECM test result is available OR the less reliable NHS test has returned a negative result, the pregnant woman should be offered intravenous antibiotics during labour against GBS infection in her baby if one or more risk factors is present.

The ECM test has only been available in the UK since 1st May 2003 so many health professionals may not yet be aware of its availability. You can find more information about this test which you can give to your health professional from The Doctors Laboratory and from Mullhaven Laboratory.


If a test finds you are carrying GBS, this is perfectly natural and normal – you just may wish to have precautionary IV antibiotics during labour and delivery.

Any test result positive for GBS during pregnancy means that the pregnant woman should be offered intravenous antibiotics from the start of labour or waters breaking and then usually 4-hourly until delivery. Your health professionals should discuss this with you.



The reliability of a negative GBS test result varies depending upon which test it is:



High Vaginal Swab (HVS)

Whilst a positive HVS result is highly reliable, a negative one is not. Only around 50% of women who are carrying GBS when the swabs are taken will correctly be told they carry GBS – the other half will be incorrectly told they don’t. So trust a positive HVS result, but be wary of a negative one!

Enriched Culture Method (ECM)

This test is recognised as optimal for detecting GBS carriage by both the Royal College of Obstetricians & Gynaecologists and by the Health Protection Agency, it is not available routinely on the NHS. This test is highly sensitive and has been specifically designed for the isolation of GBS.

Research shows that, if the ECM test is performed within 5 weeks of delivery, a negative result is 96% predictive of not carrying GBS at delivery (so in that trial 4% of women acquired carriage between the test and giving birth) and a positive result is 87% predictive of carrying GBS at delivery (so 13% of women lost carriage between performing the test and giving birth).

A negative ECM test result means that the pregnant woman would not need to be offered intravenous antibiotics from the onset of labour or waters breaking against GBS infection in her baby.

Testing low-risk pregnant women for GBS at 35-37 weeks of pregnancy - using reliable enriched culture method (ECM) tests - and offering intravenous antibiotics in labour to women whose babies are at higher risk of developing GBS infection*, will prevent more GBS infection in newborn babies than using the current prevention method of offering intravenous antibiotics in labour to women with recognised risk factors.

Without testing low-risk women for GBS carriage, many of those whose babies will be at risk of GBS infection simply won’t be identified and so no preventative medicine can be given. 
The result of an ECM GBS test is always good news. If it’s negative, then it’s hugely unlikely your baby will develop GBS infection. If it’s positive, although it does mean that your baby is at a raised risk of developing GBS infection, it also means that you can consider taking simple straightforward steps that have been proven to be extremely effective at minimising that risk.


*Pregnant women whose babies are at higher risk of developing GBS infection are those where GBS has been found during the current pregnancy from a urine culture or a vaginal or rectal swab; those delivering prematurely; those who have previously had a baby with GBS infection; and those with other recognised risk factors.