Supporting your birthing decisions

Birth options clinic

This specialist clinic is run by a consultant obstetrician for women who require more personalised care. It may be that you have had a difficult previous delivery and therefore want to plan for a birth that is more comfortable. Here you can discuss all birthing options and concerns.

Vaginal birth after caesarean ( VBAC) clinic

This is a clinic for women who have had at least one previous caesarean section. The reasons for the previous caesarean section(s) will be reviewed and discussed with each woman, together with the birth options for the current pregnancy which can be a trial of vaginal delivery or a caesarean section. The clinic is a place for discussion about how best to avoid complications and have good health outcomes, both short and long term for mother and baby.

Birth reflections clinic

If during your pregnancy, delivery or after giving birth you had a complication and want to talk through it in detail with a consultant, you can be seen in this specialist birth reflections clinic. You can bring your husband, partner family member or friend to talk through what happened with a consultant obstetrician.

Our specialist clinics

Each pregnancy is different, our specialist services are there to support you from pregnancy through to birth.

Care for women with diabetes in pregnancy

Our diabetes service specialises in the management of diabetes in pregnancy, where we see women who have Type 1, Type 2 or Gestational Diabetes.  The clinic is run by a multidisciplinary team (MDT) which includes obstetric doctors, diabetes doctors, diabetes midwives and a dietician who support women to control their blood sugar levels during pregnancy.

The maternity dietitian

Our maternity dietitian will help you to plan and manage your diet during pregnancy.

The maternity dietitian sees women with a variety of conditions including diabetes, under or overweight, poor weight gain or appetite, food allergies, extreme sickness (hyperemesis), medical (metabolic) conditions or digestion conditions.  If you have any of these conditions you will be referred for an appointment.

Obstetric medicine

If you have a known medical condition or a medical problem has been identified during your pregnancy you will be seen in a specialist obstetric medicine clinic. These are special clinics that are jointly run with a consultant obstetrician and consultant medical doctor. They may include:

  • Renal clinic: for women who have had kidney transplants in the past or have known kidney problems. You may also be seen here if you have developed a kidney problem during your pregnancy.
  • Hypertension clinic: if you suffer with high blood pressure, either before or since becoming pregnant, you may be asked to attend this clinic.
  • Maternal cardiac clinic: for women with known heart problems or have developed a heart problem during pregnancy.
  • Neurology clinic: for women who have neurological problems including Epilepsy, migraines and spine/brain problems.

In all of these clinics you will have a joint review by an obstetrician and specialist renal or cardiac or neurology consultant, where a plan of treatment and care will be agreed for your pregnancy, delivery and post-natal period.

Fetal medicine unit

In most pregnancies, there will be no complications, however, sometimes a mother or her unborn baby needs extra care.

Our fetal medicine team is a specialised department that offers women and their families support through pregnancy and antenatal screening when a congenital or genetic condition might be suspected or diagnosed. The team also provides specialist scans and support for women with complex pregnancies such as with twins or triplet pregnancies.

We can support you by offering the following:

  • advice and/or counselling to help decision making
  • working closely with our clinical genetics team to ensure that you and your partner receive all the information you require to help make a decision
  • helping you through diagnostic procedures such as amniocentesis or chorionic villus sampling which can be performed to make a genetic diagnosis
  • provide other resources of advice and support
  • making referrals to other hospitals that specialise in specific conditions for further assessment

Urgent cases are seen within 72 hours from the time of referral.

Fetal echocardiography clinic

Our combined fetal echocardiography clinic is for women with congenital heart conditions, a family history of congenital heart conditions or where the baby is found to have a heart condition. This is a detailed scan of the heart which can only be performed at specialist centres.

Maternal fetal assessment unit

The Maternal Fetal Assessment Unit (MFAU) is a clinic for pregnant women seen by appointment from 17 weeks of pregnancy. You may been seen here if you have a pregnancy problem that needs follow up, such as high blood pressure and low iron levels. The clinic is run by midwives and is open Monday to Friday, from 9am to 5pm on the 8th floor next to the antenatal clinic.

If you need to see a consultant in MFAU you will be given an appointment for either Monday (11am – 1pm) or Thursday (2pm – 5pm).

Breech clinic

If at 35-36 weeks into your pregnancy your baby is not facing with its head down in the pelvis you will be referred to this specialist breech clinic.

 You will see a consultant and discuss options which may include trying to turn the baby around (named external cephalic version; ECV), having a vaginal breech delivery or undergoing a caesarean section. You will be supported throughout with whatever decision you make.

Pre-term birth clinic

This is a clinic run by a consultant obstetrician for women who have a history of delivering their babies early or prematurely. You may require an ultrasound scan to measure the length of the cervix (neck of the womb) to make sure that the cervix is long. If the cervix is short who will be offered further management to reduce the chance of you going into early labour.

An individualised plan of care will be made and midwives and obstetricians are assigned to monitor each pregnancy

The anti D clinic for rhesus negative women

If your blood type is rhesus negative you can be pregnant with a rhesus positive baby if the baby's father is rhesus positive. If any of the baby’s blood enters your bloodstream, your immune system can develop antibodies against the rhesus antigens. This is known as sensitisation. You will need to have blood tests in pregnancy and may need an injection.

The blood test clinic runs every Tuesday from 9.20am – 3.20pm.  Anti D Injection Clinic (usually at 28 weeks of pregnancy) runs every Wednesday from 9.20am - 3.20pm.

Virology clinic

This clinic is to ensure women are contacted and receive their screening results within 10 days from being tested. A referral is then made to a virology specialist for the patient to receive treatment. This clinic is run by the antenatal new born screening team.

Pregnant women who receive positive results for Hepatitis B and Syphilis may be seen at this clinic.

Supporting you before birth

Antenatal clinic

At our antenatal clinics you can discuss your birthing options and hear more about our midwifery-led clinics. You will receive tailored antenatal care from the appropriate members of our multidisciplinary team.

Clinic hours

Clinics take place on Ward 8E of The Royal London Hospital on the following dates and times;

  • Monday to Friday, 8.40am to 5pm (except Bank Holidays)
  • Phone lines, 9am to 5pm Mon-Fri (except Bank Holidays)

Booking clinic

Booking clinics take place from Monday – Friday between 8.40am – 2.40pm. This is an important first meeting with the midwife and usually takes between one or two hours. At the booking clinic you will discuss your health, have your blood tests, ultrasound and you’ll be introduced to your midwifery team.

If you wish to have a screening test consent for this will be gained during this clinic.

Your antenatal appointment schedule is located inside the front cover of your maternity notes. You will be given your maternity notes at the booking appointment which you must bring with you to each appointment.

Screening

You will be offered screening tests during pregnancy to identify any health problems that could affect you or your baby. The tests can help you make informed decisions about your pregnancy, tests or care.

We are here to help you and your midwife will discuss the screening options with you. Please read the ‘screening tests for you and your baby’ booklet before meeting with your midwife.

Midwives follow up clinic

This clinic takes place every Monday, Tuesday and Thursday from 9am – 12pm and 1.40pm – 4pm and is for out-of-borough women with the city midwife. Women are seen in this clinic for their follow-up appointments and antenatal care.

Extra support for you

Pregnancy can be a vulnerable time and we recognise that there are some women who may require additional support because of this. This could be due to a number of reasons, for example, being a young mother to be, mental health difficulties, domestic abuse or other social circumstances. We have a team of specialist midwives who are able to provide enhanced maternity care and support.

We encourage you to let your midwife know if you feel that you would benefit from this type of care. You will then receive the right support at the right time.