About this service

Refer yourself to our maternity service at Ipswich Hospital

You can self-refer to the Ipswich Hospital maternity service – you do not have to go via your GP.

The information you send to us will be treated in confidence and in order to provide appropriate care for you and your baby we may need to share information with the wider care team. We will take your email as an agreement to share your information.

How to self refer to Ipswich Hospital maternity service

Please use the information below to complete an email to our maternity team.

The information you submit will be treated in confidence and in order to provide appropriate care for you and your baby we may need to share information with the wider care team. We will take your email as an agreement to share your information.

To self refer, email the Ipswich Hospital maternity team .

Please include all the following information You can copy and paste the text below into your email. We need all this information in order to accept your referral.

You doctor’s details:

  • The name of the doctor you are registered with
  • The name of the surgery where you are registered

Your details:

  • Your title
  • Your full name (First name and Surname)
  • Your previous Surname (If you had one)
  • Your date of birth (in format dd/mm/yyyy)
  • Your NHS Number (If known)
  • Your Hospital Number (If known)
  • Your address
  • Your postcode
  • Your contact number
  • Your email address
  • Your preferred method of contact (e.g. email, phone)
  • Your first language
  • Your ethnicity
  • If you require an interpreter (interpreter required, no interpreter)
  • If you have lived in the UK for the past year

Medical and obstetric (maternity) history:

  • What was the first day of your last period (in format dd/mm/yyyy)(approximate date if not sure)
  • The number of previous pregnancies you have had (if none please state ‘no previous pregnancies’)
  • If you have had a miscarriage before (if none please state ‘no miscarriages’
  • If you have had any terminations (abortions) before (if none please state ‘no terminations’)
  • Please tell us of any other medical conditions you have
  • If you are a smoker (e.g. smoker, non-smoker)
  • If you have any previous pregnancy history (for example, caesarian section, Pre-eclampsia)

Next of Kin details:

  • Name of next of kin (First name and Surname)
  • Next of kin date of birth (in format dd/mm/yyyy)
  • Next of kin address
  • Next of kin post code
  • Next of kin contact number
  • Next of kin Relationship to you (e.g. partner, mother)

Any information you send to the maternity team will be from an unsecure server, however any reply you receive from the team will be sent via a secure server. How we protect your information at ESNEFT.

Other conditions

  • Are you and the baby’s other parent carriers of sickle cell, thalassaemia or another haemoglobin variant?
  • Are you already  known to have HIV, Hepatitis B or Syphilis?
  • Have you had a baby previously who had a chromosomal condition such as Down’s, Edward’s or Patau’s Syndrome?

If so please also contact the Antenatal and Newborn Screening Team by phoning 01473 703 644.

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