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Your pregnancy - Notes for Antenatal Patients

Welcome to parenthood! 

Whether this is your first, second, third, or thirteenth (?!!) baby, each pregnancy is a brand new experience. With each baby, you become a new parent. Throughout your pregnancy, you will notice many changes:

imageYour body;

Your emotions;

Your activities;

Even your clothes.

Share this information with the people close to you. You, your baby, and your family will all benefit from this special time in your life.

The hospital will send confirmation of your booking soon. You should also receive information about the antenatal classes. I strongly suggest that both you and your partner attend these, or similar classes. The pregnancy and labour will be more satisfying the more you understand them. 

I am always available for urgent problems. Please contact me at 9418 8210 during office hours, or at home after hours if you have any concerns at all about the pregnancy. If you have difficulty contacting me, please ring the call service on 9387 1000 and they will page me immediately. I am on call 24 hours a day. On those occasions when I am on leave or at a conference, another experienced obstetrician will cover me. 

First Visit and Routine Investigations

 At your first visit, I will speak to you at some length, examine you, often perform an ultrasound, and order a number of routine tests.

imageThese include:

  • A Pap smear if not performed recently.
  • A full blood examination, iron stores, vitamin D levels, blood glucose and thyroid function. I will tell you whether you need to take iron and vitamin D by e-mail or at the second visit.
  • Blood group and antibody screen.
  • Rubella and varicella (chicken pox) antibody level.
  • Hepatitis B, HIV, and syphilis serology.
  • Thyroid function test
  • Random glucose level
  • Midstream urine for culture.
  • Ultrasound examination combined with a blood test at 12 weeks to screen for Down syndrome if you want this test – see Should I have a screening test for Down Syndrome?
  • Another ultrasound at 19 weeks to examine the fetus more closely.

Some additional tests will be done later in pregnancy. At about 26 weeks, I will order a blood test to see if you have developed gestational diabetes, as well as checking your haemoglobin and iron levels. If you are Rh–negative, you will have antibody levels checked at 26 weeks, and will receive injections of Anti-D at 28 and 34 weeks. At about 36 weeks, you will have a swab from the vagina to see if you carry group B strep, as this can affect the baby during labour and delivery.

I strongly recommend that if you are pregnant during the influenza season, you should be vaccinated against the ‘flu. I will arrange this for you. Your partner, and anybody else who will be in regular close contact with the newborn baby, should be vaccinated against whooping cough (pertussis). You will be vaccinated in hospital soon after the baby is born.

There are many interesting sites about pregnancy on the internet. Some that I recommend are MedlinePlusUpToDate, Royal College of Obstetricians and Gynaecologists (UK), Center for Disease Control, Society of Obstetrics and Gynaecology of Canada and National Association of Specialist Obstetricians and Gynaecologists (Australia). Be aware that all but the last of these are overseas sites, and the information may be a little different for Australia.

“Minor” Symptoms of Pregnancy

imageThere are many symptoms that are common in pregnancy, although they do not usually indicate any major problems.

Nausea and vomiting trouble up to 50% of pregnant women These symptoms usually resolve by about 12 weeks. Try to eat small frequent meals and drink lots of fluids. Pyridoxine (Vitamin B6) has been shown to be effective for morning sickness, at a dose of 100 mg/day. Ginger tablets 3 times a day may also help. These are available in combination as Blackmore's Morning Sickness Formula®. "Sea Bands", available from pharmacies, press on an  acupuncture point (Nei Guan), and may also help. Finally, Restavit® is an over-the-counter sedative which is safe in pregnancy and very effective for nausea - take 1/2 - 1 at night. If despite all these measures the problem    persists, please contact me. 

Mild abdominal pains are very common throughout pregnancy. Paracetamol (e.g., Panadol) is safe in pregnancy. Dizziness, fainting, nose bleeds, vaginal discharge and "stabbing"   vaginal pains are also common and usually not cause for concern. 

Leg cramps, especially at night, sometimes occur in late pregnancy. The only treatment that has been shown to have any effect is magnesium (e.g.  Magmin® 3 times per day). 

If back pain troubles you, physiotherapy can be very helpful. 

Indigestion will usually respond to Mylanta or other antacids. Ranitidine  is available  over the counter for severe problems.

Bleeding at any stage of pregnancy is always worrying, In early pregnancy, a small amount of bleeding (less than a period) usually does not lead to miscarriage. It is also normal to have a "show" of blood and mucus just before the start of labour. However, if you have any bleeding that concerns you at any time, please   contact me at once.

Labour and Delivery

Please feel free to discuss your plans for labour with me during the pregnancy. Learn here what you need to know about normal childbirth. You may wish to have a birth plan – here is a suggested format for you to download. imageBirth Plan

When you start to have contractions, or when your waters break, please contact the hospital. The midwives will advise you when to come into  hospital, and will let me know when you arrive. I will then come to see you and will usually  perform an internal examination to assess your progress. When in labour, you are free to find the most comfortable position, and to have pain relief as necessary.

For delivery, I am happy to delivery you in most positions. An episiotomy will only be cut if necessary, subsequent to consultation with you. After the baby is delivered, I recommend that you have an injection to reduce blood loss with the delivery of the placenta. I also strongly advise that the baby receives intramuscular vitamin K.

Circumcision

Neonatal circumcision is a highly emotive topic. There is no doubt that it has definite, though small, benefits, a well as definite, but very small risk. I am happy to discuss this with you during the pregnancy, and if you wish, to perform a non-religious circumcision for you son before you both leave hospital (this is not available at Frances Perry House).