Consultant-led care

Women who have complex maternity needs will be referred to consultant-led care. Consultant-led clinics involve different specialties, so your appointment will take longer.

Consultant-led clinics in the Midwife-Led Unit include:

  • Social Wellbeing and Antenatal Complexities (SWAN)

Consultant-led clinics in the Maternity Hospital are listed below.


  • Endocrinology / diabetes

    Pre-pregnancy care

    This service is based in the Diabetic Education Centre at the Royal Victoria Hospital. It is for women with type 1, type 2 or previous gestational diabetes.

    You can be referred by your GP, the hospital, or you can self-refer by emailing: diabetesnurses@belfasttrust.hscni.net

    Diabetes in pregnancy clinic

    The joint endocrinology / obstetric clinic takes place every Tuesday afternoon in the Maternity Hospital antenatal clinic between 1.30pm and 5.30pm.

    This clinic is primarily for women with a diagnosis of diabetes. However, women with other endocrine conditions also attend this clinic. Your care will be tailored to your type of diabetes or other endocrine condition.

    We encourage all women to attend antenatal education or Getting Ready for Baby sessions. However, birth preferences can be discussed with the diabetic midwife coordinators.

    Gestational diabetes

    If you have gestational diabetes, your care will be managed at the gestational diabetic clinic. This takes place every Monday afternoon in the Maternity Hospital antenatal clinic between 1.30pm and 5.30pm.

    There is an oral glucose tolerance test (OGTT) clinic in the Maternity Hospital from Monday to Friday between 8am and 12pm.

    Further information

    Gestational diabetes

    Royal College of Obstetricians and Gynaecologists – Information for you

    Diabetes UK – What is gestational diabetes?

    Queen’s University Belfast – Women with diabetes

    Diabetes and pregnancy

    Diabetes UK – Planning for a pregnancy when you have diabetes

    NHS – Diabetes and pregnancy

    NICE – Diabetes in pregnancy: management from preconception to the postnatal period

     

  • Birth choices clinics

    Birth choices clinics provide an opportunity for women who have previously had a caesarean section or traumatic birth to explore their birth choices for the current pregnancy.

    We recommend that all women who have had one previous straightforward caesarean section and are currently having an uncomplicated pregnancy should plan to have a vaginal birth after caesarean (VBAC).

    The birth choices clinics at the Maternity Hospital are led by consultant obstetricians and midwives. They will go over your previous birth records with you and talk you through the progression and management of your previous labour and birth. They will then develop a management plan with you for giving birth.

    The risks and benefits of both vaginal birth after caesarean and repeat caesarean will be discussed with you. Download our Birth after caesarean leaflet.

    If you request a caesarean section birth for non-medical reasons or are worried about specific aspects of childbirth, you may also be referred to this clinic.

  • Breech clinic

    The breech clinic takes place every Tuesday in C ward between 1pm and 5pm.

    You will be referred to this clinic by your midwife or doctor if they believe your baby is lying in the breech position when you are 35 weeks or more into your pregnancy.

    Your baby is breech if it is positioned bottom down instead of head down.

    You will be seen in the breech clinic by a consultant obstetrician and midwife. The appointment may take about two hours.

    • You will find out if the baby is still breech.
    • If the baby is still breech, you will have an ultrasound scan.
    • We will discuss the best plan with you. You will have the opportunity to ask questions and discuss any concerns.
    • We will try to turn your baby around by external cephalic version (ECV). This is a simple and safe technique. We will monitor your baby’s heart rate before and after the procedure.
  • Joint cardiology / obstetric clinic

    The joint cardiology / obstetric clinic takes place every other Tuesday in the antenatal clinic between 1.30pm and 5.30pm.

    This clinic is mainly for women with a diagnosis of existing cardiac disease, such as congenital heart disease or cardiac arrhythmia, or a history of ischaemic heart disease.

    • At this clinic you have the opportunity to be seen by a specialist team that includes a cardiologist and an obstetrician.
    • The number of hospital visits you need will depend on your cardiac condition. Many women only need to be reviewed once each trimester. This means most of your antenatal care will be shared with your community midwife and GP.
    • Some women only attend for cardiac review and aim to deliver in a hospital closer to home.
    • We want to help all patients attending this clinic have a normal vaginal delivery unless there is a cardiology / obstetric reason not to do so. We therefore encourage all patients to attend antenatal education classes as usual.
  • Haematology

    The haematology clinic takes place every other Tuesday in the Maternity Hospital between 9am and 12pm.

    The haematology clinic provides care for women who have been diagnosed with, or need treatment for, blood disorders. The clinic receives referrals for women with current or previous pregnancy complications such as:

    • pre-eclampsia
    • stillbirth
    • fetal growth restriction

     

    The clinic also treats women with other medical conditions such as:

    • maternal hypertensive disease
    • hepatobiliary disease
    • gastrointestinal disorders
    • renal disorders
  • Joint epilepsy obstetric clinic (neurology clinic)

    The joint epilepsy obstetric clinic takes place every other Thursday in the antenatal clinic between 9am and 12pm.

    This clinic is mainly for women with a diagnosis of epilepsy. However, if you have another diagnosed neurological condition such as multiple sclerosis, you will also be reviewed.

    • At this clinic you have the opportunity to be seen by a specialist team that includes an obstetrician, consultant neurologist and epilepsy specialist nurse / midwife.
    • Depending on your epilepsy type and control, you can expect to see these staff at each hospital visit. Your antenatal care will be shared between the hospital and your GP or community midwife.
    • If your epilepsy control is good, you can access the neurology team at different stages during your pregnancy. At least once in each trimester is recommended.
    • At certain points during your pregnancy it may be necessary to provide a blood sample to monitor your anti-epileptic drug level.
    • For those patients attending with other neurological conditions, you can access the neurology team as required.
    • We want to help all patients attending this clinic have a normal vaginal delivery unless there is an obstetric / neurological reason not to do so. We therefore encourage all patients to attend antenatal education classes as usual.
  • Multiple pregnancy clinic

    The multiple pregnancy clinic takes place every Wednesday afternoon between 1.30pm and 5pm.

    Multiple pregnancies are exciting for both parents and doctors. However, they may also present more risks so the care we provide is led by consultants and involves senior medical and midwifery staff.

    The National Institute for Health and Care Excellence (NICE) guidelines are followed to ensure you receive the best possible care.

    When your multiple pregnancy is confirmed, you will automatically be referred to the clinic by your midwife. We aim to see all multiple pregnancies for the first hospital appointment between 11 and 14 weeks. Your schedule of care will be decided after your booking scan.

  • Pre-term surveillance birth clinic

    This service provides care for women at risk of pre-term (premature) birth. Pregnant women who have previously experienced a premature birth (before 34 weeks) or a late miscarriage (after 14 weeks) are referred to the clinic after their dating scan.

    You will also be referred to the clinic if:

    • you had treatment to your cervix after an abnormal smear test
    • you have an abnormally shaped womb

     

    An obstetric and midwifery team provide a unique package of care including:

    • infection screening
    • ultrasound assessment of cervical length
    • fetal fibronectin testing
    • cervical cerclage (cervical stitch)
    • progesterone therapy

     

    Support is offered to women during the critical middle stage of pregnancy when their anxiety levels may be high.

  • Anaesthetic clinic

    The anaesthetic clinic takes place every Tuesday and Thursday afternoon in the Centre for Fetal Medicine on the second floor of the Maternity Hospital.

    Referrals to this clinic are made by the obstetric team.

    If you have an underlying medical problem or wish to discuss your anaesthetic or epidural, you can attend the outpatient clinic.

    The Labour Pains website set up by the Obstetric Anaesthetists’ Association has more information on the options for pain relief in labour.

  • Fetal medicine
    Day Obstetric Unit

    The Day Obstetric Unit (DOU) is on the second floor of the Maternity Hospital, along with the Centre for Fetal Medicine. Referrals are made by the obstetric teams.

    The following services are provided in the Day Obstetric Unit:

    • management of morning sickness requiring intravenous fluids
    • monitoring and follow-up of high blood pressure, preterm prelabour rupture of membranes (PPROM), obstetric cholestasis
    • tracing of fetal heart rate (cardiotocograph, CTG)
    • intravenous treatments, for example iron infusions, immunoglobulin (IGG) infusions and intravenous antibiotics
    • 20 week anomaly scan
    • fetal assessment scans
    • management of bladder care post-delivery
    Centre for Fetal Medicine

    The Centre for Fetal Medicine in the Maternity Hospital provides a range of additional services for the:

    • management and diagnosis of fetal abnormalities
    • management of certain high risk pregnancies

     

    Referrals are made by obstetric consultants across the region and we give priority to urgent cases.

    The service is supported by the genetic, paediatric / neonatal and paediatric surgical teams. Appointments are coordinated wherever possible.

    Contact details

    • 028 9063 3239
    • 028 9063 3191
    Anomaly scan

    The anomaly scan is carried out by obstetric radiographers and checks the structure of your fetus.

    Your scan will be arranged at your booking appointment. If you need to change your scan appointment, please telephone: 028 9063 2496.

    Please note that only one person will be permitted into the scan room with you. Children are not permitted.

    Fetal assessment scans

    Fetal assessment scans are carried out by specially trained midwives who check for fetal growth issues.

    Appointments are made by the obstetric team. To check your appointment details, please telephone:

    • 028 9063 3191
    • 028 9063 3239
    Fetal cardiology clinic

    The fetal cardiology clinic is a regional service. Consultants generally scan fetuses after the 24th week of pregnancy.

    Referrals are made by obstetric consultants.