Your health questions answered

Can I choose which hospital I give birth in? How can I avoid catching herpes from my unfaithful husband?

MATERNITY WARD WORRY

Q. I am hoping to become pregnant soon but have discovered that my local maternity unit has one of the highest death rates in the country and has been placed under special measures. Do I have any choice about which hospital I must attend for maternity services? I live in London so there are lots of hospitals within easy reach. Is there any kind of league table for maternity services that would indicate those with a good reputation?

A. The choice of where you have your baby is important, because you want to have a comfortable experience. But there are many other factors, apart from the hospital, that can contribute to a good birth. The NHS is now beginning to take patient choice seriously, and if you ask to go to a specific hospital, you should be able to arrange it. There may be some resistance from your GP or your Primary Care Trust. But if you feel strongly about a particular hospital, don't be pushed around. There are practical reasons why it may not be sensible to arrange to have a baby at a hospital miles from your home. Driving across London when you are in labour is neither sensible nor safe. And the midwives who are attached to your local hospital may be able to provide antenatal care much more easily than midwives who are miles away. Maternity units are required to publish data about their results, and much of this is collated on the Dr Foster website: www.drfoster.co.uk. Sometimes the best guide to how good a hospital maternity unit is is the personal recommendation of friends and family.

CAN I AVOID THIS STD?

Q. Eighteen months ago my unfaithful husband caught genital herpes, which I have not caught. My GP has prescribed aciclovir as a short-term treatment for my husband. What can I do to prevent myself from catching herpes?

A. Genital herpes is a highly contagious viral infection. Humans can sometimes effectively fight off herpes viruses, but after an initial infection the virus more commonly remains in the body in a dormant state. Occasionally, when an infection breaks out, the virus begins to multiply and this is the time of greatest infectivity. In men, the usual symptoms of an active genital herpes infection are sores and blisters on and around the penis. The infection can cause genital sores and blisters in women, but sometimes it is less apparent, with sores inside the vagina. Your best chance of avoiding infection is to avoid genital contact with your husband when he has an outbreak. But even this is no guarantee that you will not get infected. Condoms provide some protection, but they may not cover the whole infected area. Aciclovir prevents outbreaks, but it does not eradicate the virus. Have a look at the Health Protection Agency website: www.hpa.org.uk, or phone the NHS Sexual Health Helpline on 0800 567123.

Readers write

SF comments on hip pains that occur in bed at night:

"I am of a similar age and also enjoy aerobic exercise. I discovered a way of sleeping which removes pressure on the hip joint. Lie on the bed on your favoured side but slightly twist the lower part of your body, from the waist down, towards the mattress. Make sure the front of your foot is flat on the mattress. For example, if you are on your right side, the right foot needs to be positioned in this manner."

Please send your questions and suggestions to A Question of Health, 'The Independent', Independent House, 191 Marsh Wall, London E14 9RS; fax 020-7005 2182 or e-mail to health@independent.co.uk. Dr Kavalier regrets that he is unable to respond personally to questions