Our Services

Appointments

At your first appointment a physical check and a dating scan are performed if not already done. Genetic testing is also discussed. Please bring all your blood tests and ultrasound results for your first appointment.

The subsequent appointments are every 4 weeks until 28 weeks, every 2 weeks until 36 weeks of pregnancy and weekly thereafter. You may need more frequent appointments if the pregnancy has complications.

A shared Care model with your GP is also available if your pregnancy is normal.

Your postnatal appointment will be 6 weeks after delivery.

Tests performed during pregnancy

Genetic testing

These tests are performed for detecting a baby carrying abnormal chromosomes and involves various different tests:

• A blood test from 10 weeks called NIPT which involves a cost of $ 400-600 and is 99% accurate (there is no Medicare rebate for this test).
• A blood test at 10 weeks and ultrasound at 12-13 weeks which is 90% accurate
• Blood tests called MSST between 15-20 weeks which is 80% accurate

These tests only give the probability of having baby with Down’s syndrome or other chromosomal abnormalities.

The definitive tests are:

• CVS (placental biopsy) done up to 13 weeks
• Amniocentesis from 15 weeks onwards

These tests have a 1% risk of miscarriage and are usually not recommended as a primary test.

You can choose not to do any of these tests

Genetic carrier testing

It is now recommended for all couples to see if they are carriers for following genetic conditions

Cystic fibrosis, Fragile X syndrome, Spinal muscular atrophy

These tests involve a cost of $400- 500 (there is no Medicare rebate for this test)

You can choose not to do this test.

Other tests

• At around 26-28 weeks you will have a test for diabetes.
• At approximately 36 weeks a vaginal swab to test for Group B Streptococcus bacteria is done.
• Ultrasound scans are usually done at 13, 20 and 36 weeks.

Nausea and vomiting in pregnancy

Nausea and vomiting are common symptoms in early pregnancy. The symptoms usually improve by 16 weeks. Following measures may work in alleviating the symptoms:

rest, frequent small meals, avoiding spicy and fried foods first, before taking medications.

dry ginger cookies in early morning, ginger candies or ginger chocolates. Ginger tablets are also available in a chemist shop.

Please seek medical help if vomiting continues for more than twice a day and/or you are losing weight rapidly. Hospitalisation may be required for treatment of dehydration.

Pains

Occasional headaches, abdominal pains usually due to stretching of ligaments or vaginal pressure are quite common in pregnancy. Panadol can be safely taken for alleviating these symptoms. Seek medical help if symptoms persist.

Bleeding in pregnancy

Spotting in early pregnancy and slight mucus mixed bleeding (less than 20 cents coin size) in late pregnancy are quite common. Seek medical help, if there is any bleeding above that.

Weight Gain in Pregnancy

The average recommended weight gain for pregnancy is between 7-12kg depending upon the weight at the start of pregnancy. If you are overweight even no weight gain is acceptable provided it is not compromising the baby’s growth which is periodically checked by ultrasound.

Other common harmless pregnancy issues

Swollen feet, nose bleeds, dizziness.

Leg cramps improve with Calcium/Magnesium supplements.

Medications in pregnancy

Category A and B medications are safe in pregnancy. It is recommended that you avoid taking over the counter and herbal supplements. You can contact Medicine helpline on 1300633424- Mon- Fri-9am-5pm or click on the link below for advice

https://www.thewomens.org.au/patients-visitors/clinics-and-services/support-services/medicines-information

Travel in Pregnancy

• Short distance travel (< 4hours) in pregnancy is acceptable until 28 weeks but carries a small risk of preterm labour.
• Long distance travel in pregnancy should be avoided as there is a risk of developing clots in the legs.

Contact your airlines and travel insurance before planning your journey for further information.

Safe foods in pregnancy

• Avoid raw meats, smoked fish, soft cheese, pre- prepared salads, and unpasteurised milk.
• Fish should be limited to once a fortnight. Meat should be thoroughly cooked.
• Vegetablesand fruits should be thoroughly washed.

For more information click the link below

http://www.foodauthority.nsw.gov.au/_Documents/foodsafetyandyou/pregnancy_brochure.pdf/

Exercise in pregnancy

Moderate exercise is safe in pregnancy. High impact exercise and contact sport should be avoided

Sexual intercourse

Normally intercourse is safe in pregnancy except if you have bleeding or have low lying placenta.

Vaccination in pregnancy

Influenza andPertussis (whooping cough) are the 2 recommended vaccines in pregnancy. These vaccines are provided by your GPs free of cost as a government initiative and can be taken at any stage of pregnancy without causing any harm to the baby.

Partners and family members are also recommended to take whooping cough vaccine if not taken in last 10 years.

Sleeping position

You should try to sleep on your left side after 20 weeks of pregnancy to avoid compression of large blood vessels of your body which can affect blood flow to the baby. If you wake up lying on your back don’t panic turn on your side .

Your baby’s movements in pregnancy

• Most women will start feeling the movements of their baby by 22- 24 weeks.
• There is no normal number or pattern of movements, every baby is unique.
• Movements can be felt as kick or flutter or hiccup or a roll.

After the pattern of baby’s movements is established, if you do not achieve that unique pattern or number of your baby’s movements please contact the midwife and the rooms.

Watch the video by clicking the link below

https://www.tommys.org/pregnancy-information/symptom-checker/baby-moving-less/movements-matter-raising-awareness-fetal-movements

Pain relief in labour   

To help lessen your pain, you can:

• Do relaxation or breathing exercises
• Take a warm shower or bath
• Have someone massage your lower back
• Put heat or cold pack on your lower back
• Listen to music
• TENS machine can be hired for initial phases of labour

Medications to relieve pain in labour

• Laughing gas
• Opioid medicines – Given as an injection, makes you feel sleepy, so that you do not feel as much pain.
• An epidural block – For an epidural block, a doctor uses a needle into your back and gives you medicine that will numb the lower part of your body so that you cannot feel the pain.
• A pudendal block –It is sometimes done if the doctor has to do an “assisted” delivery like using “forceps” or “suction cup” to help get the baby out.

The doctor will discuss the side effects of the different medicines and procedures at the time.

Induction of labour

Induced labour is when your labour is started with artificial methods.

You will only be offered induced labour if there is a risk to you or your baby’s health. Your doctor might recommend induced labour if:

• You are overdue (more than 41 weeks pregnant)
• There is a concern the placenta can’t keep your baby alive
• You have a health condition, such as diabetes, kidney problems or high blood pressure
• There is a concern with your baby, such as fewer movements, changes to their heart rate or they aren’t growing well
• Your waters have broken but the contractions haven’t started naturally

If the doctor decides it is medically necessary to induce labour, first your doctor or midwife will do an internal examination by feeling inside your vagina. They will feel your cervix to see if it is ready for labour. This examination will help them decide on the best method for you.

The different ways of inducing labour are:

• Sweep and stretch- This is done with an internal check-up and can be a bit uncomfortable.
• Hormone infusion (oxytocin)
• Breaking your waters (ARM)

Prostaglandin gel or cervical ripening balloon catheter- To soften the cervix (neck of the womb)

It can take from a few hours to as long as 2 to 3 days to induce labour. It depends how your body responds to the treatment.

Risks of induction of labour include:

• it won’t work
• your baby will get distressed with strong contractions.
• you may need urgent Caesarean

If the induction doesn’t work, your doctor will discuss your options with you. You may go home and try again another day or you might need a caesarean.

Normally induced labour leads to a successful vaginal delivery.

Perinatal anxiety and depression

As much as 1in 5 women suffer from anxiety and/or depression in pregnancy or after child birth.

The signs may include: Feeling sad/low, persistent worry, being on the edge, feeling irritable, lack of appetite, panic attacks.

Please advise your doctor if you have any doubt or call help line on 1300726306

Additional information about all the pregnancy and labour issues  is available through Royal Women Hospital site which has many informative fact sheets https://www.thewomens.org.au/health-information/fact-sheets/