{"id":4337,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/pregnancy\/"},"modified":"2026-03-25T14:14:55","modified_gmt":"2026-03-25T14:14:55","slug":"pregnancy","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/pregnancy\/","title":{"rendered":"Pregnancy &amp; Post Natal Care"},"content":{"rendered":"\n<p>There is a centralised call centre and 1st antenatal appointment system for pregnant women who wish to continue their pregnancy. <\/p>\n\n\n\n<p>The aims of this approach are to :<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>allow women to self refer to a midwife in line with the national \ncampaign and the national objectives set out in the Scottish Government&nbsp;\n Health Department initiative &#8216;Keeping Childbirth Natural and Dynamic&#8217;. <\/li>\n\n\n\n<li>facilitate earlier referral and booking in line with new antenatal screening requirements. <\/li>\n\n\n\n<li>improve the sharing of important information about the pregnant \nwoman between GP and midwife in advance of the first maternity \nappointment. <\/li>\n\n\n\n<li>promote SCI gateway as the common portal for GP obstetric referral. <\/li>\n\n\n\n<li>improve the provision of interpreters for non English speaking women at appointments. <\/li>\n\n\n\n<li>improve appointment management&nbsp; and birth planning arrangements across Lothian. <\/li>\n\n\n\n<li>reduce the time spent by community midwives doing administrative \nwork e.g. creating records, sending in referrals and arranging scanning \nappointments. <\/li>\n\n\n\n<li>provide a co-ordinated approach for dealing with maternity referrals and appointments management across Lothian.\u200b<\/li>\n<\/ul>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">How to refer:<\/h4>\n\n\n\n<p>Women can access maternity care in 3 ways following a positive pregnancy test and where she wishes to continue with the pregnancy :<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>A&nbsp;woman can contact the maternity 1<sup>st<\/sup>&nbsp;appointment centre on the direct line&nbsp;<strong><strong>0300 7900 628<\/strong><\/strong>.&nbsp; During the call she will be given the time, date and venue of her 1<sup>st<\/sup>&nbsp;appointment with her community midwifery team together with a scan appointment.&nbsp;&nbsp; Details of these appointments will also be sent to the woman&#8217;s GP&nbsp;<strong>together with an e-mail request to the practice&#8217;s clinical e-mail box<\/strong>&nbsp;requesting that the GP&nbsp;<strong>complete&nbsp; and forward&nbsp; a SCI Gateway Obstetric referral<\/strong>.<br>&#8216;I<em>nformation only from GP&#8217;&nbsp;<\/em>should be selected in the &#8216;Referral Source&#8217; box in this protocol.<br>High risk referrals will be triaged by a Senior Midwife who will re-direct these to the appropriate high risk clinics or discuss with a Consultant Obstetrician.<\/li>\n\n\n\n<li>If the woman chooses to see her GP the GP should refer the woman via SCI gateway using the Obstetric referral template. In this case &#8216;<em>Referral from GP&#8217;<\/em>&nbsp;should be chosen in the &#8216;referral source&#8217; box.<\/li>\n\n\n\n<li>If the woman contacts a community midwife directly the community midwife should complete a pro-forma and forward this in the usual way.<\/li>\n<\/ol>\n\n\n\n<ul class=\"wp-block-list\">\n<li><em>GP&#8217;s can refer or &nbsp;send information back to either St John&#8217;s or RIE as&nbsp;it will be received at a single destination i<strong>.e<\/strong><strong>&nbsp;it does not imply that is the hospital the women is choosing to deliver the baby in.<\/strong><\/em><\/li>\n\n\n\n<li><em>When GPs are asked&nbsp;to send information back via SCI Gateway&nbsp; they are&nbsp;<strong>only expected to complete the protocol sections&nbsp;with information they hold in their clinical records.<\/strong>&nbsp;If they don&#8217;t know or can&#8217;t find this information readily then they should leave the relevant sections blank.<\/em><\/li>\n\n\n\n<li><em>The maternity 1<sup>st<\/sup>&nbsp;appointment centre will use call queuing and monitoring technology. All calls will be r&nbsp;ecorded and performance will be audited.<\/em><\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<ul class=\"wp-block-list\">\n<li><strong>What about folic acid?<\/strong><br>Women can&#8217;t currently get folic acid free WITHOUT A PRESCIPTION. It isn&#8217;t covered by the minor ailments service. It is, however, very cheap . Alternatively pregnant women should request a prescription from their GP.<br><\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Who will triage high risk referrals including those for St Johns?<\/strong><br>All referrals to the Maternity 1<sup>st<\/sup>&nbsp;appointment centre will be triaged&nbsp; by a senior midwife including those women who wish to deliver at St John Hospital. A list of consultant antenatal clinics and consultant contact details will be maintained in the centre to ensure good communication between the triaging midwife and consultant obstetrician.&nbsp;&nbsp; In addition all community midwives undertake a risk assessment as part of the maternal history taking process&nbsp; and will make appropriate referrals as recommended by the Lothian Antenatal Referral Guidelines.&nbsp;&nbsp; Any concerns regarding the referral of a high risk woman should be escalated to the&nbsp; Community Midwifery Manager, Women&#8217;s Services, Lothian<br><\/li>\n\n\n\n<li>The GP referral\/information sharing protocol will ensure that important information relevant to the management of the pregnant woman is available&nbsp; in advance of the 1<sup>st<\/sup>&nbsp;antenatal appointment and will inform the triaging process.<br><\/li>\n\n\n\n<li><strong>How can appointments be changed?<\/strong><br>Women wishing to change their 1<sup>st<\/sup>&nbsp;appointment or scanning arrangements should do this by contacting the Maternity 1<sup>st<\/sup>&nbsp;appointment centre.&nbsp;&nbsp; If midwives are changing appointments then they should do this directly with the woman.<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><a href=\"http:\/\/intranet.lothian.scot.nhs.uk\/Directory\/ReproductiveMedicine\/PoliciesAndGuidelines\/Documents\/Maternity%20Pan%20Lothian\/Antenatal\/Antenatal%20Referral%20Guidance.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">NHS Lothian Full Antenatal&nbsp;Referral Guidance&nbsp;link&nbsp;on Intranet here<\/a><\/p>\n\n\n\n<p>2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the&nbsp;Postpartum&nbsp;&nbsp;<a href=\"https:\/\/www.liebertpub.com\/doi\/pdfplus\/10.1089\/thy.2016.0457\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.liebertpub.com\/doi\/pdfplus\/10.1089\/thy.2016.0457<\/a><\/p>\n\n\n\n<p><a href=\"\/files\/sites\/2\/Thyroid-Function-Testing-in-Pregnancy-Guidance-june-2021.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Thyroid Function Testing in Pregnancy Guidance june 2021.pdf<\/a>&nbsp;&nbsp;&nbsp;<\/p>\n\n\n\n<p><a rel=\"noreferrer noopener\" href=\"http:\/\/www.readysteadybaby.org.uk\/index.aspx\" target=\"_blank\">Ready Steady Baby website<\/a>This site has&nbsp;links to a other useful sites and documents.<\/p>\n\n\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>There is a centralised call centre and 1st antenatal appointment system for pregnant women who wish to continue their pregnancy. The aims of this approach are to :<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":3664,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[570],"class_list":["post-4337","page","type-page","status-publish","hentry","category-pregnancy"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/pregnancy\/\" rel=\"tag\">Pregnancy<\/a>","rttpg_excerpt":"There is a centralised call centre and 1st antenatal appointment system for pregnant women who wish to continue their pregnancy. The aims of this approach are to :","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4337","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4337"}],"version-history":[{"count":10,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4337\/revisions"}],"predecessor-version":[{"id":27389,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4337\/revisions\/27389"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3664"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=4337"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4337"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}