Your pregnancy. Your body. Your decisions.Getting familiar with your rights during pregnancy can completely change how you approach your maternity care. You are not a passenger in this process- you are an active participant in the decisions being made about you and your baby.One of the most important things to understand is informed consent. This means being given enough information to understand what is being offered, why it’s being offered, the potential benefits and risks, your alternatives, and what may happen if you choose not to proceed. You should have the opportunity to ask questions and make your decision without pressure.It should feel like a conversation, not a conveyor belt.Have a browse through the resources below to understand more about your rights, informed consent and shared decision-making, because knowing your rights means you can be an active decision-maker in your care. NHS: Where to give birth- the options Birthrights: Can I choose where to give birth Birthrights: Your 'Rights' in Maternity CareBirthrights: Understanding 'Informed Consent' NHS: Consenting to TreatmentBirthrights: Your right to see your maternity records / notes Birthrights: Your right to choose / change your midwife Birth Partners - Understanding your rights NICE Guidance: Understanding Shared Decision Making

There’s a general schedule of antenatal appointments throughout pregnancy, but what this looks like, and how often you’re seen can vary depending on your individual care pathway. This NICE (National Institution for Health & Care Excellence)  guidance gives you a helpful overview of what is routinely offered, and what to expect along the way.As always, these are only ‘offers’ of care- you can ask questions, accept or decline, and make informed choices about what feels right for you.NICE: Schedule of Maternity Appointments Your Antenatal care pathwayNICE Guidance: Overview of Standard Maternity Care. What to Expect

There are quite a few tests and screening options offered during pregnancy, and it can sometimes feel like a lot to take in. This section breaks down what’s offered, what each test is looking for, and what the results can (and can’t) tell you, so you can make an informed decision about what feels right for you.As always, these are ‘offers’ of care, and you can accept, decline, or ask questions before deciding.Dr Sara Wickham: Screening and the consequences of knowledgeNHS: Screening tests in pregnancy RCOG- Group B Streptococcus (GBS)Dr Sara Wickham: GBS Screening- What the evidence says RCOG – Gestational DiabetesNICE: Diabetes in Pregnancy Evidence Based Birth: Diagnosing Gestational Diabetes Cochrane Review: Screening women for GDDiabetes UK: Glucose Tolerance TestEvidence Based Birth: Diagnosing Gestational Diabetes

Blood comes up quite a lot during pregnancy: (blood group, rhesus status, antibodies, Anti-D and, sometimes-blood transfusion). It can sound like a lot of medical jargon, so this section is here to break down what’s being checked, why it matters, and what your options are, with links to evidence-based information if you want to dig a little deeper.As always, these are ‘offers’ of care, and you can ask questions, accept, decline and make informed choices about what feels right for you.Blood transfusions in Pregnancy / Post-Birth RCOG: The Management of Women with Red Cell Antibodies during PregnancyNICE: Routine antenatal anti-D prophylaxis for women who are rhesus D negativeRCOG: Haemolytic Disease of the Fetus and NewbornRhesus factor and anti-D – NHS patient informationBlood Groups and Red Cell AntibodiesAntibody Screening

12 Week scan: Your dating scan is usually offered during the first trimester and is used to estimate how far along your pregnancy is, check your baby's development and establish your estimated due date. Your dating scan can include measurement of the nuchal translucency (NT) if you choose to have screening for Down's syndrome, Edwards' syndrome and Patau's syndrome. The NT measurement looks at the amount of fluid at the back of your baby's neck. It is combined with information from your maternal blood test and other factors to calculate a chance of your baby having one of the three chromosomal conditions. NHS: Your 12 week scan GOV.UK: Dating Scan ScreeningNHS: NT Screening RCOG: Supporting families through NT Screening If you're offered a NIPT or CVSIf your combined test indicates a higher chance of Down syndrome, Edwards syndrome or Patau syndrome, a NIPT can be offered as a more accurate screening test before you decide whether to accept an invasive diagnostic test, and is generally reported as either a ‘lower’ or ‘higher’ chance result. NIPT is generally more accurate than the combined test for these three trisomies. However, a higher-chance NIPT result still needs to be confirmed if a definite diagnosis is wanted. If you do receive a ‘higher chance’ screening result, you will be offered the invasive diagnostic test. (CVS). Useful distinction to make an informed choice: NIPT is a screening test, whereas CVS and amniocentesis are diagnostic tests. NIPT estimates the chance of certain chromosome conditions. If NIPT or another screening test indicates a higher chance, CVS or amniocentesis may be offered to obtain a sample for diagnostic testing. These invasive tests can provide much more definitive information, but it’s important to note that they do carry a small risk of miscarriage. RCOG's current guidance states that the additional miscarriage risk following CVS or amniocentesis performed by a skilled operator is likely to be below 0.5%RCOG: NIPT for Chromosomal AbnormalityRCOG: Impact of the NIPT NHS: CVS Screening RGOG: Amniocentesis for Prenatal DiagnosisRCOG: CVS SamplingBMJ: NIPT Cohort Study PubMed: Non-Invasive Chromosomal Evaluation StudyPubMed: Procedure-related risk of miscarriage following CVS and amniocentesis study20 Week Scan:Your second routine scan is usually offered between 18 and 21 weeks. It is commonly called the 20-week scan, anomaly scan or mid-pregnancy scan. This is a much more detailed examination of the baby's anatomy, and can also assess your placenta and its position. GOV.UK: 20 Week Screening  NHS: Your 20 week scan

The ‘Big Baby’ saga…Growth scans are often offered to give your clinician an ‘estimate’ of how your baby is growing. The problem is that ultrasound is not a very accurate way of predicting a baby's actual weight. There is a recognised margin of error, and the results can lead to a label of “big baby” or “small baby” that turns out not to be correct. In the 2025 ‘UK Big Baby Trial’ around half of babies who were thought to be large on ultrasound were not actually large at birth. And once you put that label on a pregnancy, it can create a whole lot of anxiety and sometimes lead to discussions about induction or caesarean that wouldn't otherwise have happened. The Big Baby Trial found no statistically significant reduction in shoulder dystocia in its main analysis when induction was offered for suspected large babies. So, while growth scans absolutely have a place when there is a genuine clinical reason to monitor growth, it’s unhelpful to pretend that a scan can tell us exactly how big your baby is or predict how your birth will go. As Sara Wickham puts it, the ultrasound “weight guess” is just that - a guess. The below articles on the evidence behind suspected big babies and the Big Baby Trial are well worth a read if you want to dig a little deeper.Sara Wickham: Induction for big baby: what's the evidenceSara Wickham: The Big Baby TrialThe Big Baby Trial: Original Lancet StudyCochrane Review: Induction for suspected large babiesThe ‘Small Baby’ saga…A baby being estimated as “small” on a scan doesn't automatically mean that something is wrong. Small for gestational age (SGA) generally means a baby is below a particular size/weight centile, whereas fetal growth restriction (FGR) is about a baby not reaching its growth potential and can be associated with problems with the placenta and an increased risk of complications. Some babies are simply small and completely healthy. RCOG makes this distinction very clearly. Ultrasound can be useful when there is a genuine concern about growth, but it isn't a crystal ball. A 2024 systematic review found that a third-trimester ultrasound estimated fetal weight below the 10th centile detected only around 36% of babies who were ultimately born SGA at 32 weeks, rising to around 48% at 36 weeks. In other words, plenty of genuinely small babies won't be picked up by a scan- and being labelled “small” doesn't automatically mean a baby is growth restricted.RCOG: Small BabyPub Med: FGR Systematic Review NICE: Guidance around NOT routinely scanning for uncomplicated pregnancies

These are two of those very routine checks that can easily feel like another box being ticked at your appointment- but there is a reason they’re offered. Blood pressure is checked to look for raised blood pressure, while the urine is checked for protein, which can be a sign of pre-eclampsia. Pre-eclampsia can sometimes develop without you feeling unwell, so these checks are a way of picking up changes that you might not otherwise know about. That doesn't mean a slightly raised BP or a bit of protein automatically means something is wrong. These results are clues- not diagnoses, and if something is picked up, further assessment may be needed to understand what is actually going on. NICE recommends BP and urine checks as part of routine antenatal care for this reason. I've included some links below if you'd like to explore the evidence and guidance further. As always, it's important to make an informed choice, and you can choose to ‘accept’ or ‘decline’ this routine offering.RCOG: Pre-eclampsiaNHS: Signs of Pre-eclampsia WHO: Pre-eclampsia Factsheet

There are currently three vaccinations routinely offered during pregnancy in the UK:flu, whooping cough (pertussis) and RSV. They’re offered to help protect you and, importantly, your baby, including through antibodies that cross the placenta. It’s completely valid to want to understand more before deciding. There is a substantial body of research looking at both the safety and effectiveness of vaccination in pregnancy, including studies looking specifically at outcomes for babies. But ultimately, it’s your decision. You can ask questions, look at the evidence, talk it through with your midwife or GP, and then decide whether you want to accept or decline each vaccination.NHS: Vaccination schedule GOV.UK How to protect you and your babyVaccines in Pregnancy UKRCOG: Vaccinations in pregnancy Review of Vaccination in pregnancy to prevent pertussis in early infancy

Sometimes pregnancy comes with a few unexpected plot twists- an elevated blood pressure reading, low iron, pelvic pain, a baby who’s decided to sit in a rather unconventional position… and suddenly you’ve got a whole load of new terminology thrown at you.Knowledge is power, especially when something feels unfamiliar.Everything in the drop down sections below is here to help you understand some of the physical health considerations that may come up during pregnancy, what the terminology actually means, and what questions you might want to take to your maternity team.No doom-scrolling. No Dr Google. Just trusted information to help you feel informed, prepared and less overwhelmed.

If you've been told you have a “high BMI”, you may suddenly find yourself hearing a lot more about risk, additional monitoring and what you can or can't do.But BMI is a number- it doesn’t tell the whole story about your health, your pregnancy or how you're going to give birth.Yes, a higher BMI is associated with an increased chance of some pregnancy complications. But the picture is far more nuanced than simply labelling someone “high risk” because of their size. Most women with a higher BMI have straightforward pregnancies and healthy babies.What matters is that your care is based on you as an individual, not simply a number on a chart. You deserve respectful, individualised care, and your choices shouldn't be restricted without a proper assessment of your individual circumstances.Let's dive in.Dr Sara Wickham: 6 things you need to know if you're 'plus size' and pregnant Dr Sara Wickham: Plus Size Pregnancy Resources Weight Inclusive Maternity care Evidence Based Birth: Respectful Maternity CareRCOG: What the clinical guidance says NHS: Guidelines on higher BMI in pregnancy🎧 Want to dive a little deeper?This one is well worth a listen- Dr Sara Wickham joins ‘The Midwives’ Cauldron’ to talk about plus-size pregnancy, BMI and birth, including what the evidence actually tells us about increased BMI, why it can lead to additional monitoring and restrictions, and the impact of weight bias within maternity care. It’s a really interesting conversation if you’ve been told your BMI means you’re automatically “high risk”, or you’ve found yourself with more questions than answers about what your BMI actually means for your pregnancy and birth.Grab yourself a cuppa, have a listen, and make up your own mind.Plus Size Pregnancy - an interview with Dr Sara Wickham

A high blood pressure reading in pregnancy can feel like a bit of a bombshell- especially when suddenly you’re hearing words like ‘hypertension’, ‘pre-eclampsia,’ ‘extra monitoring’ and ‘possible medication’.This section breaks down what gestational hypertension actually means, why it matters, what you might be offered and what questions you might want to ask.You may be offered medication to lower your blood pressure, including labetalol, (a beta blocker), alongside additional monitoring. But what does the evidence say about treatment, and why might one medication be recommended over another? Read the research. Understand your options. Ask the questions. Make your own informed decision.NICE Guidance: Evidence review for monitoring Gestational Hypertension RCOG: Hypertension in pregnancyNHS: Gestational Hypertension (High BP)Cochrane Review: Early birth for high blood pressure pregnanciesCHAP Trial: Treatment for mild chronic Hypertension during pregnancyNHS: BP TestNHS: Recommendations for BP monitoring

It’s real- and as it doesn’t automatically mean there’s a problem- it’s worth bearing in mind.Lots of women feel more anxious or on edge having their blood pressure taken in a clinical setting, and that can temporarily push the reading up. So, if you get a higher reading in clinic, it can be really helpful to repeat it at home, in your own environment and when you’re relaxed, rather than making a judgement based on one number. Looking at readings over time helps build a much better picture of what your blood pressure is actually doing. Have a look at the links below for more info on this subject. PubMed Study: Monitoring of 'White Coat' Hypertension PubMed Study: Development of Pre-eclampsia with 'White Coat' Hypertension

That lovely little pregnancy plot twist nobody asked for… PGP. Pelvic girdle pain is pain around the joints of your pelvis, which can show up in your lower back, hips, groin, pubic bone or thighs. It can make everyday things like walking, getting dressed, turning over in bed or getting in and out of the car surprisingly bloody difficult. It’s common in pregnancy and it’s not because your pelvis is out of alignment or because you’re doing something wrong. Pregnancy-related physical changes and your baby’s position massively play a part.The good news is that PGP can usually be managed. Below are some trusted resources to help you understand what’s going on, what may help, and when it’s worth getting some extra support.Have a read, explore your options and find what works for you.RCOG: Pelvic Girdle Pain and PregnancyNHS: Pelvic pain in PregnancyCUH: Pregnancy Pelvic Pain Management Pelvic Partnership: Managing Pelvic Pain

Are you feeling absolutely bloody exhausted in pregnancy? Sometimes it’s more than just “I’m growing a human.”Iron deficiency is common in pregnancy because your body needs more iron to make the extra red blood cells needed for you and your baby. If your iron stores become too low, you can develop iron-deficiency anaemia, which can leave you feeling exhausted, breathless, weak or generally pretty rubbish. If your blood tests show anaemia or low iron, you may be offered iron supplements, usually tablets. If these aren't suitable or aren't working well enough, other options such as intravenous (IV) iron may sometimes be discussed. This section is here to help you understand what your results actually mean, why iron matters, what you might be offered and what questions you can ask your maternity team.Read the evidence, understand your options and make your own informed decisions about your care…NHS: Iron Deficiency RCOG: Blood transfusion in Pregnancy Cochrane Review: Daily oral iron supplementation during pregnancyCochrane: Treatments for anaemia in pregnancy thought to be due to iron deficiency

Let’s clear something up: HG is not just really bad morning sickness.Hyperemesis gravidarum is the severe end of pregnancy sickness, where nausea and vomiting can become so intense that eating, drinking and functioning normally become incredibly difficult, and it’s no friggin joke! It can lead to dehydration, weight loss and sometimes hospital treatment. And if you’re experiencing it, you do not need to simply suffer through it because you’re pregnant. There are treatment options, including anti-sickness medication and, when needed, fluids and other support. This section is here to help you understand what HG actually is, when to ask for help, what you might be offered and where to find proper support.Because sometimes you don't need another person telling you to “try some ginger biscuits”. You need to be heard, taken seriously and supported.HER FOUNDATION: HG Support RCOG: HG in Pregnancy RCOG: Green top guideline- management of HGPregnancy Sickness Support NCT: Morning sickness and HGBUMPS: Medication in Pregnancy Cochrane Review Interventions for treating severe nausea and vomiting during pregnancy (Hyperemesis Gravidarum)

Your baby doesn’t come with an instruction manual, and there’s no magic number of kicks you should be counting every day. What matters is getting to know your baby’s usual pattern of movements.Sometimes babies have quieter periods, they might be having a little nap, or you may simply have been busy and not noticed their movements as much.Before you panic, take a moment to stop, sit somewhere quiet, have something cold/sugary to drink or something to eat, and tune in to your baby. Give yourself some time to notice what’s happening.But if you’re still concerned, your baby’s movements are less than usual, have stopped, or their normal pattern has changed, contact your midwife or maternity unit for advice. You’re not wasting anyone’s time, and you don’t need to feel silly for getting checked.Know your baby. Trust your instincts. And don’t panic-  but don’t ignore a change either.Tommys: Baby's movements in PregnancyTommys's: Movement - a sign that baby is well Science Direct Study: Midwife and OB experiences with fetal movement SANDS: Improving how we talk about fetal movements RCOG: Baby's movements in Pregnancy

First things first: breech is a variation of normal, and you should absolutely be supported to explore all of your options INCLUDING a vaginal delivery, if you wish. Babies move around a lot during pregnancy, and If your baby remains breech, you’ll likely be offered an ECV (external cephalic version) to try to turn them head-down, alongside discussions about your options for birth. And yes- a planned caesarean will very likely be discussed too.But depending on your individual circumstances, a planned vaginal breech birth may also be an option. So… what can you try?If you’re hoping to encourage your baby to turn, there are plenty of things you’ll find suggested online, some with more evidence behind them than others.You might come across:Swimming and spending time moving freely in the waterThe Breech Tilt / Breech ProtocolSpecific positioning or pelvic-tilt exercisesIce or something cold placed at the top of your bumpMusic or sound played towards the bottom of your bumpAcupunctureMoxibustionChiropractic care, including the ‘Webster’ TechniqueSome of these are based largely on anecdotes or theory, while others have been studied. For example, And then there’s ECV (external cephalic version)- a medical procedure where a trained clinician attempts to turn your baby from the outside. So, by all means, explore your options, try to understand what the evidence actually says, and don't let anyone convince you that there's a guaranteed trick for turning your baby - babies are very wise and will always settle in the safest position for them. Breech without borders: Information and Advocacy Breech Birth Network Spinning Babies: Flip a Breech ROCG: Breech Baby RCOG: Breech green top guidelineNHS: Patient Information LeafletSpinning Babies: Breech TiltBMJ: Should Moxibustion be offered Evidence Based Birth: The Evidence on Breech Version Cochrane Review: MoxibustionCochrane Review: Ways to turn a Breech babyCochrane Review: ECV for Breech presentation Cochrane Review: Planned Caesarean for Breech Baby

Finding out at your 20-week scan that your placenta is low-lying can send you straight into the “OH SHIT, WHAT DOES THIS MEAN?!” spiral. I get it. Placenta praevia is where the placenta sits low in the uterus and, in some cases, covers the cervix, essentially sitting in the way of your baby's exit route.But here's the reassuring bit: in the vast majority of cases, a low-lying placenta found at the 20-week scan won't still be low later in pregnancy. As your uterus grows, the placenta usually ends up further away from the cervix. Around 9 out of 10 women with a low-lying placenta at 20 weeks will find that it has moved out of the way by their follow-up scan.So yes, you might spend the next few months worrying about it, googling it at 2am and wondering whether your birth plans have just gone out the window… only to get to that follow-up scan and find it's no longer an issue. Hurrah!If it does remain covering or very close to the cervix later in pregnancy, a vaginal birth may not be considered safe because the placenta can obstruct the baby's route out. In that situation, you'll usually be advised that a caesarean birth is the safest option.So, if you've been told your placenta is low at 20 weeks, try not to jump straight to the worst-case scenario. There's a very good chance this isn't the final picture.Tommy's: Low Lying Placenta RCOG: Placenta Previa - Patient Information PubMed Study: Risks of preterm Birth with PP