Request an appointment with a midwife

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How many weeks pregnant are you? *

Have you already self-referred to a hospital? *

Yes

No

Would you like to self refer now? *

Yes

No

You should self-refer to whichever hospital you want to have the baby when you discover you are pregnant. You do not need to see the GP unless you have any medical concerns.

Visit University Hospitals of Derby and Burton’s website:

www.uhdb.nhs.uk/maternity

Alternatively, visit your local Hospitals website to self-refer.

Which hospital are you having the baby at? *

What date should the midwife appointment be? *

Please use date format DD/MM/YYYY

How many weeks will you be on this date? *

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