Pregnancy
Antenatal (Pregnancy) Care
Pregnancy care encompasses advice and medical care from conception to 6 weeks post birth.
As soon as pregnancy is confirmed (home pregnancy test is enough) then it is recommended that a booking is made for pregnancy care. Simply call the office on 9417 1156 with details of the date of the first day of the last menstrual period to enable us to calculate the due date of the birth. It is recommended this is done as soon as possible as bookings fill up quickly. Also have your medicare and private health insurance details so that a hospital booking may be secured.
As part of the booking process, a hospital booking will be made at your hospital of choice and an appointment will be made for the first visit. The first visit is usually a longer appointment (allow approximately 45 minutes). Between booking for care and the first visit there may be a few weeks. Once a booking is made, however, the care begins so if any issues arise before the first visit (eg pain or bleeding) then contact can be made directly. Instructions regarding this will be explained in a letter sent to you after booking. Sometimes you will need to be seen or tests arranged prior to the actual first booked visit. Details of professional fees and other financial matters are also outlined in the booking letter but this can also be advised by my practice manager. I support full financial disclosure and consent. Any questions or queries can be directed to my practice manager who will be happy to provide as much information as possible.
The first appointment is a longer visit where pregnancy care is started in earnest and a plan made for the pregnancy. At this visit a comprehensive medical history is taken, an examination performed (which may include an internal examination), an ultrasound performed and tests arranged. It is also when questions can be asked and answered, and preferences with regards to antenatal care and birth can be discussed. Some people will come with an extensive background of investigation into the birthing process and have strong feelings about their preferences, whilst others will be blissfully naïve and wish to be guided. We accommodate for both and everyone in between!
Early in the pregnancy routine blood tests will be arranged (although in some cases the GP or referring doctor may have already arranged tests). These include tests such as that for your blood group, certain viruses, thyroid function, vitamin levels etc.
A major subject for discussion at the first visit is prenatal diagnosis (or testing for underlying chromosomal, genetic or structural abnormalities in the developing baby). There are various tests available although none are mandatory. This subject will be explored in detail and printed information will be given at the first appointment. People have personal opinions and preferences regarding this subject and all points of view are respected. Every individual pregnancy will carry a degree of risk but your own personal risk level and personal preferences will be established and explored in this discussion. In some cases the initial discussion and printed information are not sufficient to make decisions about the testing process and, if this is the case, further discussion or information can be provided at an additional visit or by telephone. Guidance is given for couples to choose the right path for them.
After the first visit then regular visits will be scheduled. This is usually at 15, 20, 24, 28, 30, 32, 34, 36, 38, 39, 40 and 41 weeks of pregnancy (if you get that far!). A full term pregnancy is 40 weeks (with the period of ‘term’, ie not premature, being 37 – 41 weeks). These visits are the ‘routine’ visits and provide a framework for care. In many cases, however, issues will arise between these appointments that will necessitate a visit outside of these times or a discussion by telephone. Details on how and when to contact us will be provided in the initial letter then in the package of information given to you at your first appointment.
There are many tests done during pregnancy including ultrasounds, diabetes tests etc and the nature and timing of these tests will be advised.
The second half of the pregnancy (from 20 weeks onwards) will begin to focus on the baby (or babies!) growth and the impending birth. Usually antenatal classes will be offered by the hospital and private classes can also be recommended. Private classes focus on specific styles of birthing care. Recommendations can be made for private classes that will be best suited to your style.
Discussion regarding the birth is tailored to your needs. Some people need more information than others. It is important to me that your needs are met to the best of my ability. There are some appointments that will be delayed or cut short due to other commitments (such as delivering a baby!) so the discussion regarding birth is over several visits rather than in one session. Questions will come up as the pregnancy progresses as a result of classes, speaking with family or friends, surfing the net or reading a blog, reading the newspaper or reading the ‘New Idea’. This is all able to be discussed at the regular visits.
I do not have a practice midwife (although some of my staff are nursing or midwifery trained) so every visit is with me personally. I value direct contact with my patients and prefer to provide personal contact for all aspects of pregnancy care. Sometimes telephone calls will be answered with a message relayed via my staff but clinical matters of any significance will be handled personally. All matters telephoned into the office are relayed to me personally. I do not communicate via email except under specific and individual circumstances. In all cases telephone contact is the preferred mode of communication in the first instance.
Care during the labour and birthing process is provided on a 24 hour a day basis. There is a weekend roster that I share with other doctors (details can be given at first visit). I value close care and supervision in labour, however long it takes. I personally attend regularly during the labour and deliver the baby myself, no matter how the baby is born. The birth is the culmination of a long pregnancy process and can be tiring, overwhelming and exhilarating. I will guide you through this, at all times respecting your individual circumstances and preferences.