Specific Services:
Starting a family
Preconceptual Counselling
When you wish to start a family, it is a good idea to
start preparing 3 - 6 months before if possible. This applies to men as well as women, so if you want advice, you may like to come and see one of our nurses or doctors together or check this . You should both give up smoking of course and any other illicit drugs, ideally stop alcohol, reduce caffeine, get fit and eat a healthy diet and reduce stress. You should avoid taking any over the counter medication including ‘natural remedies’ and supplements. Men should avoid hot baths and tight underpants and women need to start taking Folic Acid 0.4mg and maybe vitamin D and reduce weight if overweight. Working out the most fertile time for sex is also helpful!

Women should ensure they are immune to Rubella (German Measles). It is worth having a blood test even if you are sure you had the immunisation. It is a good idea to make sure you are up to date with your cervical smear.

It can takes up to 18 months to get pregnant but if it has been 12 months, or earlier if you are approaching 40yrs or have had previous gynaecological problems, then come and see your doctor.

Antenatal Care
pregnant

Once you have become pregnant it is a good idea to see your doctor as soon as possible to ‘book’ your pregnancy, usually from week 6-10. Just request a normal appointment with the doctor whom you know best (Note, Dr Selwyn does not normally provide antenatal care). You can also refer yourself directly to the hospital of your choice.
Provided you have confirmed your pregnancy with a pregnancy test (obtainable from the chemist or supermarket), there is no need to do another.

Most of our patients have their babies at Northwick Park Hospital, though there is occasionally the choice of Barnet, Royal Free, St Mary’s, Watford or The Hammersmith (Queen Charlotte's) depending on demand. For ‘low-risk’ pregnancies, there is also the choice of the Midwife-led Birth Centre at Edgware Community Hospital.

We have not had community midwife services at the surgery for some years so all the antenatal care is now delivered by midwives in the community clinics. You will be seen by a midwife at the hospital for booking and have an examination and blood tests and an ultrasound scan arranged (you have this between 16-20 weeks). You will be given an antenatal folder containing all the information pertaining to your pregnancy. Please remember to take it to any appointments you attend. Typically you might have an antenatal appointment every four weeks after 12 weeks, and then every two weeks from about 32 weeks, and for the last three or four weeks have weekly appointments. This is variable depending on circumstances.

At most appointments you will have your blood pressure checked, your urine tested, an examination of your abdomen including listening to your baby’s heartbeat and a check for swelling of your legs.

For further details of pregnancy and antenatal care try:
NHS Choices pregnancy pages National Childbirth Trust , BBC Health , and Emma's Diary which is very good though supported by a lot of advertising.

Postnatal Care
A community midwife will visit you at home after delivery. You will be under her care for the first 2 weeks. After this your health visitor will help you with advice on caring for your baby, yourself and the rest of your family.

You will receive an appointment for a Postnatal Check at the surgery for around 8 weeks after delivery. This will be a chance to sort out any health concerns or other worries with the GP who looked after you antenatally and ensure you are well on the way to becoming a normal human being again! Contraception will become important again!

The GP will find out how you are adapting to life with your new baby and will check such things as your blood pressure, breasts, abdomen, may carry out a smear test, if due and will ask about contraception. The appointment will also include your baby’s 8 week developmental check and first immunisations.

It is very common, probably even usual, to feel 'down' for a period after the arrival of your baby. This is partly hormonal and related also to the huge change in your role and personal position as well as the tiredness and stress of having a demanding infant. A more serious illness, postnatal depression can creep on insidiously and can be serious. Make sure you talk to your midwife, health visitor or GP about how you feel. There the Perinatal Outreach Team who can help and if things get too bad there's Coombe Wood Mother-Baby unit where you can stay for a while and receive help and care.