Caring for complications during pregnancy

Some pregnant women have or develop conditions which can make their pregnancy more complicated than normal. The Royal Free London specialises in many such conditions and we will support you throughout your pregnancy.

HIV and pregnancy

We support your HIV and pregnancy needs by providing a holistic, discreet and mutli-professional approach for you and your family.

Pregnancy care is provided by a specialist midwife and an obstetrician with special interest in HIV, together with the specialist HIV team. The team works together to plan individualised pregnancy care for each woman’s pregnancy and birth, aiming to normalise the pregnancy and birth as much as possible.

We have been providing care for people with HIV and AIDS since 1989 and have a wide range of services designed to meet the needs of HIV positive people at all stages of infection.

Find out more about the Ian Charleson Day Centre.

Haemophilia and other bleeding disorders during pregnancy

The Royal Free Hospital provides comprehensive pregnancy care for women with haemophilia and severe bleeding disorders, including preconceptual care delivery. Some women with less severe bleeding disorders will have pregnancy care shared between the Royal Free Hospital specialist clinic and their local maternity unit.

This joint clinic is renowned nationally and internationally, and we have visiting clinicians from across the world to help develop the service in their hospitals.

The service has a renowned research interest in haemophilia and the findings are seen as an integral part of evidence for national and international guidelines for the care of women with bleeding disorders.

Diabetes, thyroid disorders and other endocrine problems during pregnancy

We run a “one-stop” antenatal clinic with a combined team of obstetricians, endocrinologists, specialist nurses and dieticians providing a high standard of care to a special group of women. It takes place on both the ground floor of the Royal Free Hospital and while women are on our maternity wards on the fifth floor. The clinic is held every Thursday morning and additional telephone contacts are made through the week. 

Referrals to this service can be made by GPs, midwives, other obstetricians and other endocrinologists. Women who know that they have diabetes are encouraged to refer themselves as soon as they become pregnant.

Care for mothers who have had a renal transplant

We run a joint clinic providing pregnancy care for women who have had a renal transplant or who are undergoing dialysis. It combines the expertise of a consultant obstetrician who specialises in maternal medicine and high risk pregnancy and a consultant nephrologist who specialises in kidney transplant and pregnancy.

Planning a pregnancy will give the best chance of a healthy and successful pregnancy for women with serious kidney disease and kidney transplants.

Discussion with the relevant specialists before embarking on a pregnancy is very important. Preconception counselling provides an opportunity to discuss the risks and concerns in detail. Advice can be given about when would be the best time to get pregnant in relation to the transplant or renal disease.

During the pregnancy you will be seen regularly by the consultants in the same clinic to provide the best possible care and planning for your birth.

Support for vulnerable women

We have dedicated teams of specialist midwives and other healthcare professionals who support and provide continuity of care for vulnerable women. This includes women who have or are at risk of mental health conditions and who may have complex social issues such as homelessness or being at risk of domestic violence.

The aim is to improve the outcome for you and your baby, by ensuring continuity of care. You will be referred to this team if it is felt that this will be helpful for you.

Pregnancy care: anaesthetic clinic 

A small proportion of women will be referred to an anaesthetic clinic during their pregnancy. The clinic is for mothers who have medical problems that may affect what type of anaesthetic they can have during labour or delivery. Your doctor or midwife will refer you to this clinic if it is needed.