Congratulations on your pregnancy! A positive pregnancy test is an exciting event for any family, but is also often met with some apprehension about what will follow. Below is an outline of the usual care provided by your obstetrician and midwives at O&G, however every pregnancy is different and you may require additional visits or input from other specialists.
The first step is to make a visit to your GP, who will order some of the usual tests in pregnancy. These tests are designed to make sure that any problems with the mother’s health can be addressed and minimised for the developing fetus. We recommend you consider influenza vaccination before conceiving or in early pregnancy.
Essential blood tests:
- Full blood count, blood group and antibody screen, hepatitis B, hepatitis C, HIV, rubella & syphilis.
- Urine test for infections and protein.
If you have any pain or bleeding your GP may also request an early pregnancy ultrasound. We can perform this for you at O&G or it may be requested at an ultrasound practice closer to your home.
Your First Obstetric Visit
At this visit you will meet your obstetrician for the first time, usually between 8 and 12 weeks after your last menstrual period. She will take a comprehensive medical history & discuss any troubling pregnancy symptoms with you. She will then perform a clinical examination, and if appropriate, an ultrasound to look at the developing fetus. This visit will take about 30 minutes.
Things to bring to your first visit include:
- A referral from your GP.
- The results of any tests you have had so far.
- Your obstetric first visit questionnaire.
- 2 x ultrasound request forms from your GP if you choose to have your nuchal translucency and morphology ultrasounds at O&G with Dr Woolcock, our sub-specialist in women’s ultrasound. These referrals are required for you to access a medicare rebate for these services.
10 – 13/19 weeks
Screening for Down syndrome and other fetal abnormalities is available. You may choose to have a nuchal translucency ultrasound, combined with a blood test for pregnancy hormones, and in additional you may elect to have a blood test for cell free fetal DNA. Please see First trimester screening for down syndrome and other abnormalities to read about these further and discuss with your obstetrician.
13 – 16 weeks
Your next visit to see the obstetrician will be at 13 – 16 weeks, at which you will discuss the results of any of the early pregnancy tests you have chosen to undertake, and any troubling pregnancy symptoms you be may experiencing. Your blood pressure will be checked and a pregnancy ultrasound may be appropriate.
You will see your obstetrician at around 20 weeks after a comprehensive anatomy ultrasound at 19-21 weeks of pregnancy. At this stage some mothers may find they are feeling some movements from the baby.
After 20 weeks the visits become more frequent, but can vary depending on any medical problems encountered by you or your baby. During these months it is important to prepare for birth and a newborn. You can attend information sessions and antenatal classes at your chosen hospital to familiarise yourself with the hospital and the options available for your birth. Please discuss any issues or questions you have with our midwife or your obstetrician during your visits.
26 – 32 weeks
Between 26 – 28 weeks you will be offered screening tests for gestational diabetes, anaemia and blood group abnormalities. These are fasting blood tests, which must be booked in with the laboratory ahead of time.
Between 28 and 32 weeks pregnant we encourage you to have a whooping cough vaccination to protect your baby for the first weeks of their life. At O&G we firmly believe that this immunisation can save the lives of vulnerable newborns, and we recommend it in every pregnancy.
At O&G we are mindful of the effect pregnancy can have on your body; particularly your abdominal and pelvic floor muscles. We recommend all women have a planned visit with one of our Physiotherapists between 20 and 26 weeks. The goal of this visit is to ensure any musculoskeletal or pelvic floor problems are identified early, managed appropriately or prevented altogether. As part of the antenatal physiotherapy visit, we may recommend a pelvic floor assessment which allows the physiotherapist to assess your muscle strength and support of the pelvic organs, identify any early pelvic floor weakness, concerns or symptoms and develop an appropriate management plan for the pregnancy and the postnatal period. A supervised pelvic floor exercise program with confirmation of the correct exercise technique by a Physiotherapist trained in pelvic floor assessment has been shown to prevent postnatal bladder leakage. We can also discuss appropriate fitness options to keep you exercising safely and comfortably during pregnancy.
32 – 36 weeks
You will be offered 2–3 weekly appointments with your obstetrician after 32 weeks, during which time you can discuss your preferences regarding labour and birth. Please keep in mind that birth is unpredictable, and that your obstetrician will work with you to get the safest outcome for you and your baby.
At 36 weeks we will offer testing for group B streptococcus (GBS) colonisation of the vagina for those intending to have vaginal births. This is not an infection, but can cause a severe illness in your baby if not treated with antibiotics in labour.
We also recommend you schedule an appointment with one of our Physiotherapists around 6 to 8 weeks postnatally. Pregnancy and childbirth have a profound effect on your body and at O&G we understand the benefits of prioritising your health, particularly that of your abdominal and pelvic floor muscles, early in the postnatal period. Our physiotherapists will assess the recovery of these muscles, along with any other aches or pains you may be experiencing. They can also provide advice on safely returning to exercise and gradually increasing your fitness levels. Please do not hesitate to arrange an earlier postnatal appointment with our Physiotherapists if you are experiencing any aches or pains or breastfeeding problems such as blocked milk ducts, mastitis, breast engorgement and postural discomforts.