Congratulations on your Pregnancy!

Name
Date of Birth
Address
What was the 1st Day of your last period

Folic Acid

You should be taking 400mcg of folic acid until you are 13 weeks pregnant. To assess whether a higher dose of folic acid is required for you, please complete the following fields.
(ft / in)
(kg)
Are you a diabetic?
Are you on medication for epilepsy?
Are you currently taking any other medications? If yes please list below

Neural Tube Defect

Neural Tube Defect is a birth defect affecting the brain, spine or spinal cord.
Have you or your partner got a condition known as neural tube defect?
Have you had a previous baby with neural tube defect?
Have you or your partner got anybody in your family with a neural tube defect?

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https://www.coch.nhs.uk/all-services/maternity-services/welcome.aspx

For further information on how to self refer to the midwife team please click the link above