Early pregnancy, maternity and neonatal care: Attending and visiting our services

Updated Monday 27 February 2023

Visiting our maternity services safely:

• If you are Covid-19 positive and coming for an appointment, please inform your midwife and sonographer. This will not affect your care.
• Birth partners and visitors are asked to not come to the hospital if they feel unwell. This includes symptoms of Covid-19, sickness, diarrhoea, fever, sore throat or flu.
• Mask wearing is optional in our hospitals for patients and visitors. There may be some circumstances where face masks are required, such as when visiting patients with a suspected or confirmed Covid or flu infection, which you may be informed of prior to attending our hospitals or on arrival in ward areas.
• Face masks are available for patients and visitors who choose to wear them.

Early Pregnancy Assessment Centre

• One birth partner can be present with you at all appointments

Antenatal clinics (Southmead Hospital and the community)

• One birth partner can be present with you at all antenatal appointments

Ultrasound appointments

• One birth partner can be present with you at all Ultrasound appointments
• Unfortunately we are unable to permit children to the ultrasound appointments 

Antenatal Assessment Unit (AAU)

• One birth partner can be present with you at all antenatal appointments

Antenatal inpatient care

• Antenatal care is provided on Quantock ward, this includes inpatient care and induction of labour. Visiting times in this area will be from 10am – 9pm for one birth partner and one visitor.
• Some mothers that are admitted for induction of labour will be cared for in the induction of labour suite situated on delivery suite.
• On the Quantock assessment unit, one person can be present with you in the unit day and night and stay with you as required.

 Induction

You can be supported by one birth partner throughout induction, early labour and birth. Please note we do not have bed facilities for partners.

Once you are in established labour and have been transferred to our Central Delivery Suite, a second birth partner can also attend.

 Labour and birth

• Two birth partners can support you once you are in established labour on Central Delivery Suite and Mendip Birth Centre at Southmead Hospital and at Cossham Birth Centre.
• To minimise movement around our birth units we ask birth partners to remain in the birth room at all times.  Please bring food to keep yourself fed (we will supply tea and coffee).  All our birth rooms have en-suite facilities which birth partners are able to use.
• We encourage pregnant women and their birth partners to get vaccinated against Covid-19 as soon as possible. You can be vaccinated at any point in pregnancy and this will help to keep you, your baby and our team safe. Guidance on vaccination in pregnancy is available from the Royal College of Obstetricians and Gynaecologists.

Postnatal inpatient care

There may be times when exceptions are needed to this guidance - please speak to the Midwife/Nurse in charge to discuss these exceptions.

• Once you have had your baby you may be ready to go home quickly, in which case you will be discharged. If you need to stay in for a few more hours or days you will be transferred to either Percy Phillips Ward or Transitional Care on Mendip Ward.
• Visiting times in this area will be from 10am – 9pm for one birth partner and one named visitor per day. Siblings are welcome between 2 – 6pm. If visiting Percy Phillips ward, we encourage the use of the family room for the duration of the child's visit. 
• One birth partner may stay overnight for support.
• There may be times when our staff ask for a visit to be limited, especially if everyone in a bay has a visitor at the same time.  If we ask your visitors to leave and return at a later time, it will be for your safety and for the safety of those around you.

Neonatal care

• Parents/carers can both have unrestricted access throughout your baby’s stay in the neonatal unit and we are now able to support visiting for extended family members, including siblings.
• Due to the constraints of space within the unit, at times we may need to politely ask parents/carers to leave their baby’s room if there is a need for more medical and nursing staff to be in that room for emergencies or procedures.

Transitional care

• Visiting times on Mendip Transitional care ward will be from 10am – 9pm for one birth partner and one named visitor per day. Siblings are welcome between 2 – 6pm.

Neonatal Intensive Care Unit

• Read our Neonatal Intensive Care Unit visitor policy.

Covid-19 testing for women

• If you do test positive for Covid-19, please follow the instructions in the testing kit, and contact your community midwife.

 Covid-19 testing for partners

• Birth partners must not have any symptoms of Covid-19 - we will ask everyone on arrival whether they have any symptoms – we are sorry but if you have symptoms of Covid-19 you will not be able to come into the hospital in order to protect patients and staff.  In this situation, an alternative birth partner could come in to support but they would need to be free of any symptoms.

Site map

Entry and exit from any other route is not permitted without speaking to a member of staff. We appreciate your co-operation.

If you have any questions, please speak to your midwife or a member of the security team.

Role of the abdominal muscles and changes during pregnancy

The abdominal muscles keep your internal organs in place as well as supporting your spine. In pregnancy they also support your growing baby and uterus. The abdominal muscles and ligaments stretch throughout pregnancy under the influence of the hormones Progesterone and Relaxin.

The Rectus Abdominus muscles pass from the ribs and breastbone to the pubic bones. They are the most superficial of the abdominal muscles. Below them are the Oblique muscles and Transverus Abdominus. A ligamentous band called the Linea Alba holds the Recti together. This band softens and stretches as the abdomen enlarges during pregnancy and allows the Recti to move apart. This separation is called a Divarication of the Recti or a Diastasis Recti. It will be checked postnatally by your midwife or physiotherapist and you will be offered outpatient treatment if the separation does not resolve itself quickly and is found to be 3cms or more.

Treatment

After the birth of your baby, your abdominal muscles will feel weak and stretched. As Relaxin and Progesterone start reducing, your muscles and ligaments will gradually become toned.

In the first six weeks avoid movements which may prevent the separation recovering such a, sitting straight up when getting out of the bath or bed and/or heavy lifting.

There are two gentle exercises we suggest to strengthen the deep stabilising muscles whilst the Linea Alba recovers. These can be done in lying, sitting or standing position.

Pelvic floor exercises

The pelvic floor is like a hammock/sling of muscles suspended from inside the front of your pelvis to the coccyx (tailbone). They work with the deep abdominal muscles (Transversus Abdominus) so when you work your pelvic floor the Transversus Abdominus muscles also work.

Try to exercise your pelvic floor at least three times a day in sitting, standing or lying position.

The action is to squeeze and lift the pelvic floor muscles by squeezing and drawing up the back and front passages as though you are trying to control wind and the flow of urine.

There are two ways to work them:

1. Hold for several seconds and repeat several times. Aiming to build up to a 10 second hold 10 times.
2. Squeeze and lift then let go quickly. Aim to repeat up to 10 times.

Each time you exercise, the muscles become stronger and more supportive. You should also get into the habit of contracting your pelvic floor muscles before lifting, coughing, sneezing or bending.

Transversus Abdominus exercise

Take a breath in, and then as you breathe out gently draw in your abdominal muscles below your tummy button (imagine you are taking in a notch in a low sung belt). Hold this for 5-10 seconds whilst breathing normally. Repeat 5-10 times resting between each pull-in. Try to do this exercise several times a day in sitting, side-lying or standing. They work with the pelvic floor muscles so you could do them together. It is also important to use these muscles functionally so when you are going to pick up your baby remember to gently pull them in.

Your physiotherapist will check your progress and monitor the gap between the muscles before giving you other abdominal exercises to practice. The physiotherapist may also fit you with some elasticated abdominal support in order to encourage Linea Alba to recover if it is felt needed.

The Bribery Act 2010 came into force on 1 July 2011 with the aim of tackling bribery and corruption in both the private and public sectors. Bribery is defined as the giving or receiving of a financial or other advantage in exchange for improperly performing a relevant function or activity.

North Bristol NHS Trust is committed to applying the highest standards of ethical conduct, following good NHS business practice and having robust controls in place to prevent bribery. However, as an organisation we cannot afford to be complacent and under no circumstances is the giving, offering, receiving or soliciting of a bribe acceptable and the trust will not tolerate this in any form.

The Trust’s zero tolerance approach to bribery and corruption is set out in further detail within the Counter Fraud Policy and the Declarations of Interests Policy, and across a range of other trust policies and procedural documentation. This applies to all staff and non-executives, together with contractors and agents working or acting on behalf of the trust.

All are responsible for gaining an understanding of the requirements, the standard of conduct expected of them and ensuring that they comply at all times with all of our policies and procedures. This includes those in relation to procurement, hospitality and the acceptance of gifts.

Bribery and corruption under the act are punishable for individuals as a criminal offence by up to 10 years imprisonment and if the trust is found to have taken part in the corruption the trust could face an unlimited fine and face incalculable damage to our reputation. The trust therefore takes its legal responsibilities very seriously.

Any act of bribery undertaken by a member or an employee of the trust will result in disciplinary action and will be treated with a similar level of importance by the Trust’s Board. If you are in any doubt as to whether any conduct could amount to bribery, or if you have any concerns or suspicions regarding bribery being committed, please contact the Trust’s compliance officer Glyn Howells, Chief Finance Officer, email Glyn.Howells@nbt.nhs.uk. 

The success of the organisation’s anti-bribery measures depends on all employees, and those acting for the organisation, playing their part in helping to detect and eradicate bribery. Therefore, all employees and others acting for, or on the behalf of the organisation are encouraged to report any suspected bribery in accordance with the procedures set out in the Counter Fraud Policy and the Declarations of Interests Policy, which incorporates anti-bribery and corruption policy. 

We are producing a series of care pathways and patient information leaflets to help explain what you can expect from our care.

Duodopa

• Duodopa Integrated Care Pathway at bristolhealthpartners.org.uk/uploads/documents/2019-01-24/1548344498-final-duodopa-pathway.pdf

A pressure injury, also referred to as a pressure ulcer or bed sore, is an area of damaged skin or underlying tissue that develops when constant pressure on a part of the body shuts down the blood vessels feeding that area.

Pressure injuries usually develop on bony prominences and on anyone who sits or lies down for prolonged periods of time. Shearing from slipping or sliding down the bed/chair can contribute to pressure injuries.

How can you help avoid pressure injuries?

• Change your position regularly, every few hours and check your skin for any redness or broken areas and report immediately to the nursing/medical staff.
• If you are able have short walks up and down the ward to increase your blood flow to your skin and increase tone in your muscles.
• If you wear Compression/Thromboembolism-deterrent stockings, do not allow them to roll down as this can cause pressure and skin damage.
• If you have problems with continence please speak to a member of the nursing team for advice on skin care. 
• Try to have a minimum of 8-10 cups of fluid daily unless on a restriction as advised by your doctor. 
• Eat a well-balanced diet to give your skin the right nutrients for repair and growth. If you are finding it difficult to eat and drink properly, talk to your nurse who will refer you to a dietician.

What are the symptoms of a pressure injury?

A Pressure injury may initially appear as a red area of skin that does not disappear when  pressed gently.  Look for changes in skin condition including pain or tenderness, heat and swelling. The area may become painful and purple in colour. Continued pressure and poor circulation can cause the skin and tissue to break down. Please inform your health care provider if you experience any of these symptoms.

Thank you for registering to attend the Annual General Meeting 2019.

Confirmation has emailed to you. 

We look forward to welcoming you on the 25 July. 

We have introduced vCreate an NHS trusted secure video messaging service for parents, to provide you, our NICU parents, with a better experience.

This safe and secure video messaging service allows our clinical teams to send you video updates during the times you’re unable to be with your child. You can then access the videos, on any device, providing you reassurance of your child’s wellbeing and minimise any separation anxiety.

Parents will need to register for a vCreate account, which is then approved by our NICU team. Once approved our NICU team record short video updates and assign the videos to the appropriate parent account. You can then login at any time to watch your child’s videos and are alerted when new videos are available. As more short videos are added, a secure video diary builds up over time.

Our NICU staff record videos when they are able; they do not have a prescribed rate and the videos will never contain any sensitive clinical information.

If your child is transferred to a new NICU, the account and videos move with them.

When your child leaves and goes home, you are able to download the videos to keep. At this point we will thendelete the videos and remove your account.

We offer parents the opportunity of signing up for having fingerprint access to our Neonatal Intensive Care Unit (NICU).

Being the first Trust in the South West to introduce this biometric technology, the fingerprint access will enable you to come and see your baby whenever you wish without needing to wait for the door to the unit to be opened by a member of our staff, allowing you unrestricted access to your baby.

The fingerprint access is an electronic device which scans and captures a digital image of your fingerprint patterns. When your finger is put on the scanning area, a digital image of fingerprint patterns is read by the sensor. A biometric template is generated which is then stored in a database.

The image of the fingerprint taken by the biometric system is only recognisable by the system itself and would only be able to generate information such as check-in times. It is very near impossible to recreate a fingerprint and no risk to their identity if there were a data breach.

We do kindly ask all parents to ensure they do not let anyone else onto the unit. All our members of staff wear badges and will not be offended if you ask to see it.

To sign up to NICU fingerprint access control, please speak to a member of the NICU team.

The complication rates for weight loss surgery are low. Approximately 1 in 100 may have a problem after gastric band surgery, and 1 in 1000 may not survive the operation. Following gastric bypass and sleeve gastrectomy operations the risk of complications are approximately 3 in 100, and 1 in 500 may not survive the operation. These are historical figures and may in fact be much lower. Patients at higher risk are those who are heavier, older, those with other significant health problems or if they have had previous operations in that area.

The risks of gastric band surgery are low, but the band can occasionally slip, become infected or erode into the stomach. The oesophagus (gullet) can also stretch above the band if you overeat. If these complications occur, generally the band will need to be removed.

Gastric bypass and sleeve gastrectomy operations involve cutting the stomach, so leaks can occur. Should this happen then further surgery is usually required to deal with the leak. Bleeding from the staple lines can also happen and may require a blood transfusion. Internal twisting of the bowel can happen at a later stage following gastric bypass.

One of the major risks of this type of surgery is of blood clots within the legs (DVT), which can occasionally dislodge and get stuck in the lung (PE). We cannot completely get rid of this risk, but we can try to reduce it by giving you compression stockings to wear during and after the operation, giving blood thinning injections during your stay and getting you up and about as soon as possible after surgery. The risk of clots doesn’t go away for a few weeks, so it is important to keep wearing the stockings at home and being as active as possible.

Before being discharged from hospital you will be given information as to what to look out for when you get home, as well as what to do and who to contact  if you are worried.

What is rehabilitation?

The World Health Organisation has defined rehabilitation as:

“A process aimed at enabling people to reach and maintain their optimal physical, sensory, intellectual, psychological and social functional levels. Rehabilitation provides people with the tools they need to attain independence and self-determination.”
Access to rehabilitation is a human right.

The Bristol M.E. Service aims to support people living with M.E./CFS in developing optimal self-management and rehabilitation. However, surveys carried out by patient charities have found that some rehabilitation approaches have been problematic for some people living with M.E./CFS. We wanted to learn more about this, so that these problems could be avoided. We therefore worked with the national charity Action for ME on their detailed survey of patient experiences of rehabilitation which was carried out in 2010. A detailed analysis of the responses to the ‘free text’ sections of the survey was carried out which encouraged respondents to write about their experiences of these therapies. We published the findings from this research in a peer-reviewed journal [1] as we think that it is important to share knowledge about what works well, and what the problems can be, especially as these problems can be avoided.

We found that key issues for a number of survey participants included:

• difficulties setting a sustainable baseline for exercise or activity (see below)
• the importance of good quality therapist-patient communication and collaboration.

Based on our clinical experience and the feedback analysed in Action for M.E.’s patient survey, we devised the following checklist to help people living with M.E./CFS to ensure that they receive the best advice and support from their rehabilitation therapist.

Rehabilitation checklist

1. Have you been fully assessed?

2. Do you have significant "ups and downs" in your symptoms and ability from day to day?

3. Have you spent time with your therapist discussing your baselines for activities?

4. Are you able to work to your baselines in practice?

5. Have you discussed strategies to increase your exercise or activity level with your therapist?

6. Do you understand that you may experience a mild, acceptable increase in symptoms following your increase in exercise?

7. Have you discussed a setback plan with your therapist?

8. Is your rehabilitation focused on your personal goals?

9. Do you understand that not everyone makes progress with rehabilitation?

10. Are you seeing a therapist who has had success with rehabilitation for people with CFS/ME?