OBSTETRIC PROGRAM

No two pregnancies are the same, and accordingly not everyone needs the same level of care for their pregnancy. So here is a basic summary of my obstetric program.

Schedule of visits:

First Visit - between 8 – 10 weeks

Subsequent Visits

Every 4 weeks - up to 28 weeks gestation
Every 2 weeks - from 28 to 36 weeks gestation
Every week - from 36 weeks until your delivery your baby – Yeah!

Post Natal Visit - usually at 6 weeks after your birth.

Here is a brief description of what happens when you visit me at each appointment.

First Visit

This visit takes about 30 minutes and I ask details about past pregnancies, past medical conditions, family history and any medications you might be taking.
I will perform an ultrasound to confirm your pregnancy and confirm your pregnancies gestational age. I sometimes will need to perform an internal or vaginal ultrasound to see your pregnancy more clearly. This depends on a few factors such as whether your uterus is facing forwards or backwards, how full your bladder is, and how early your gestational age is.
Once I have confirmed your pregnancy is healthy, I then routinely perform a general medical check-up, including blood pressure, heart and lung examination, thyroid, breast and an abdominal examination. My practice midwife, Ally, will be present with you during this examination. If you have any concerns about this, please don’t hesitate to discuss this with me or Ally beforehand.
We will go through the paperwork and the process for you to book into the hospital you wish to deliver at.
We will discuss the costs associated with your pregnancy.
I will arrange various tests.

Each subsequent visit usually involves the following -

Ally my practice midwife will invite you in.
She or I will check your blood pressure, listen to your baby’s heart beat, measure your fundal height (after 20 weeks gestation) and check your weight.
I will also discuss any recent test results with you.
There is always opportunities to discuss any other relevant issues you are encountering.

At 28 weeks gestation, Ally or I will ask you to complete a confidential questionnaire. This is really important, and it relates to your risk of postnatal depression.

I like to see you approximately 6 weeks after your birth. You should allow approximately 30 minutes. At this visit, we will talk about your birth and discuss anything about it that might need clarification.
I will talk with you about your recovery and how your body is changing
I will discuss contraception with you
I will perform a breast examination and discuss any issues you may be having with lactation - or if you chose to formula feed. Ally my practice midwife is also a lactation consultant and will be on hand to handle any questions you might have.
If you are due - I will perform a cervical screening test.
Finally we will ask you to fill out a survey, that will help us get a feel if you are at risk of post natal depression.

Routine tests throughout your pregnancy -

Antenatal screening tests. (These might already have been completed by your referring GP)

Full Blood Count
Blood Group and Antibodies
Hepatitis B, C and HIV serology
Rubella, varicella (chicken pox) and syphilis serology
Thyroid function test
Vit D Level
Mid-stream urine test.

Screening for Down Syndrome and other chromosomal abnormalities. -

You may choose to have “Non Invasive Prenatal Testing” (aka NIPT). This is an optional blood test that can be performed after 10 weeks' gestation. This test has no Medicare rebate.
An ultrasound scan can be performed between 11 weeks and 13 weeks and 6 days. This “Nuchal Translucency” scan will determine the risk of your baby having Down’s syndrome, Trisomy 13, or Trisomy 18. This risk is calculated on ultrasound measurements of your baby, as well as your age and specific blood tests.

Morphology ultrasound -

This is performed at approximately 19 weeks and I will give you a referral to do this at a qualified obstetric ultrasound service.

Gestational Diabetes screening -

Between 26 – 27 weeks’ gestation, I will ask you to take a “75 gram Glucose Tolerance Test” (GTT) to determine if you have developed gestational diabetes. This is a series of 3 blood tests over 2 hours and involves you fasting for 12 hours prior, and then drinking a special drink of glucose. At this same blood test, I will recheck your haemoglobin and blood group antibodies. I may order other tests if clinically indicated.

Group B Streptococcus screening -

When you see us between 35 and 37 weeks’ gestation, we will offer a low vaginal swab test to check to see if you have Group B Streptococcus (GBS) in your vaginal flora.

That just about sums up my Obstetric Program. Some patients may need more frequent visits and I will organise that with you as needed.

Post Natal Visit