Common Questions when pregnant

Before your pregnancy it’s important to discuss ways you can optimise the health of both you and your partner to help conceive and achieve a healthy pregnancy.

General lifestyle measures include taking a pregnancy multivitamin which includes iodine and folate, updating vaccinations, and stopping smoking and drinking alcohol.

If you have any medical conditions it’s important to review and optimise these to minimise any impact on your pregnancy.

Your due date is calculated by adding 40 weeks from the start date of your last menstrual period (assuming a standard 28 day cycle). You can also use an online calculator if you want.

Sometimes when the embryo implants into the uterus you can have an ‘implantation bleed’ which can be mistaken as your last period. Usually this bleeding is lighter than your regular period.

It is important to note that babies stick to their own timetable and so a full-term pregnancy can range from 37 to 42 weeks.

• Morning sickness

  Nausea and vomiting is a common sign of pregnancy. It affects most women and can occur anytime of the day. It occurs because your body is adjusting to the pregnancy and your hormone levels are rising rapidly. It usually settles after 12 weeks.
  Ensure you stay well hydrated by drinking small amounts of water often and snacking on things like dry crackers.
  Over the counter medications include ginger, vitamin B6 and restavit (anti-histamine) which are all safe in pregnancy at the recommended doses.
  If your symptoms continue call us or your GP.

• Bleeding

  Bleeding during pregnancy affects up to 25% of all women and is most common during the first trimester and typically last up to three days. It typically takes the form of spotting, streaking or period-like blood loss.
  There are many causes including implantation as the eggs attaches to the uterus; bleeding after sex and an abnormally placed placenta.
  Give us a call if you are experiencing bleeding so that we can make an assessment of your condition.
  If your bleeding is heavy you should present to the nearest emergency department.

• Cramping

  Similar to period cramps your uterus is responding to your growing pregnancy. A hot water bottle and rest is the best way to help. Paracetamol is safe to use but avoid anti-inflammatories e.g. ibuprofen as they be harmful in pregnancy.

• Breast tenderness

  This is similar to feeling you get during your menstrual cycle. It is due to rising levels of progesterone. Your breasts are also undergoing changes getting ready for lactation when your baby arrives.

The following web-site provides excellent advice about foods to eat and avoid during pregnancy:
http://www.foodauthority.nsw.gov.au/foodsafetyandyou/life-events-and-food/pregnancy/foods-to-eat-or-avoid-when-pregnant

Some medications should be ceased during pregnancy, e.g. anti-inflammatories such as ibuprofen. It is important to discuss your own personal circumstances with your doctor as some medications maybe important to continue during your pregnancy.

MotherSafe is a free comprehensive telephone service for mothers about medications during pregnancy and breastfeeding Ph: 1800 647 848.

Be sure to let the chemist know that you are pregnant when buying over the counter medications.

We have the latest ultrasound technology in the rooms to have a quick check on your baby at each visit including 3D images.

If your GP hasn’t already, we typically arrange a formal ultrasound early in the pregnancy at 8-10 weeks followed by a nuchal translucency at 11-13 weeks and a morphology ultrasound at 20 weeks.

If there are any concerns throughout the pregnancy we will arrange a formal ultrasound to assess the weight, blood flows and fluid around baby.

If you’ve had a previous caesarean this doesn’t mean you have to have a repeat caesarean. Together we will review your previous delivery, discuss any issues and if appropriate you can aim for a vaginal delivery.

The first visit is about 8-10 weeks which involves talking to you about your medical history, performing an ultrasound and planning the rest of the pregnancy.

Depending on how your pregnancy is progressing visits are generally every four to six weeks until 28 weeks, every two to three weeks until 36 weeks and weekly thereafter.

Quite simply call us. Sharon can answer many simple questions and for all others she will make time in Malcolm’s diary to call you back. We aim to have a same day response.

Our delivery suite after hours contact number is (02) 4941 9267.

If for some reason you are unable to contact us then call your GP, after hours GP Access on 1300 130 147, or the emergency department of your nearest hospital.

You can work right up to your due date if you want, that will entirely depend upon the nature of your job and your personal experience of pregnancy. It is common for many women to stop at 36 weeks. Feel free to discuss this with Malcolm throughout your pregnancy.

This can be entirely normal but we would recommend induction of labour after 41 weeks gestation.

During this time if you are at all concerned then give us a call.

The position your baby is in for birthing is normally determined in the final weeks of your pregnancy. This is done by a physical examination of your abdomen and a bedside ultrasound. If needed, we will also arrange a formal ultrasound to review your baby’s size and other features.

If your baby is breech there are a number of options:

1. External Cephalic Version (ECV)

This involves Dr Malcolm placing his hands on your abdomen and attempting to lift and turn your baby to enable vaginal delivery. Ideally this is done between 36-38 weeks.

2. Caeserean Delivery

If an ECV is unsuccessful we can discuss the option of a caesarean section. You may also choose a planned caesarean without attempting an ECV.

Flu: It is safe to have a flu vaccine during pregnancy and because pregnant women are more at risk it is strongly recommended.

Whopping Cough: This is recommended after 28 weeks as this helps transfer immunity to your baby before it is born. This is especially important as your baby won’t receive its first immunisations until 2 months of age.

It is also recommended that anyone who comes into close contact with you or your baby to have a booster if it has been more than 10 years since their last vaccine.

For your baby:

• Baby clothes and nappies for as many days as you plan on staying. Allow for 4-6 nappies per day. Babies are very good at soiling their clothes so bring an outfit per day plus a couple of extras. Nappy cream in case baby gets a sore bottom from nappies. 
• Swaddling wraps or blankets – preferably one for each day and a few spares just in case. The hospital will usually provide some blankets and you are welcome to use them (they wash the hospital ones which is a bonus) but you may want to use your own and will definitely need some to take baby home in.
• Car seat – which must be organised before you leave hospital. 
• If you are planning on bottle-feeding your baby then you may want to bring these along so that you can start the process.

For you:

• Antenatal record.
• A loose comfortable night-dress or shirt for the labour.
• Loose comfortable clothes and slippers for your stay in hospital.
• Anything that helps you relax e.g. music, massage oils.
• Your favourite snacks, water, or sports drinks.
• Personal toiletries and hair care.
• Any medication you are taking.
• Nursing bras, breast pads and nipple cream.
• Maternity pads (3-4 packs should be sufficient) and comfortable underwear to hold them in place. You should allow for two pairs per day.
• Clothes for when you take baby home, bear in mind you will still look about four months pregnant.

Every woman experiences pain differently but preparing for your birth can reduce anxiety and help you cope better with labour. Antenatal education classes provided by Newcastle Private Maternity Hospital will help you to be more informed about the birthing process and the options available for pain relief.

Below are some of these options for you to consider:

Non-medical pain relief

• Breathing techniques.
• Distraction techniques such as music, your birth partner, heat packs and massage.
• Hypnosis.
• Mobilise.

Medical pain relief

• Nitrous oxide can take the edge off the intensity of contraction pains whilst still allowing you to remain in control.
• Pethidine or morphine injections.
• Epidural anaesthesia is a common form of pain relief numbs the pain whilst ideally allowing some movement. The anaesthetist will discuss this in more detail with you.

All medical options have potential side-effects and it is best to discuss the various options with us.

In most pregnancies you can have as much sex as you want. There are however some specific medical conditions such as low lying placenta that mean I would recommend you do not have intercourse. These are diagnosed after your ultrasound at 20 weeks.

I would also recommend abstain from intercourse for a few days if you experience any bleeding.

The average weight gain during pregnancy is 11-15kgs though this does depend upon a number of factors such as your start weight. Though every woman is different and the healthy range extends from 5kgs to 20kgs. If you have any concerns just talk to Malcolm.

Exercise during your pregnancy is encouraged as it good not just for you but also your baby. It builds your strength, reduces back and pelvic pain, and enhances your overall well-being.

Before deciding on the exercise that best suits you it is best to talk with your doctor, exercise instructor or healthcare advisor.

Most airlines allow women with singleton pregnancies to fly up to 40 weeks if the flight is under four hours or up to 37 weeks if the flight is over four hours. Airlines require a letter from your obstetrician, GP or midwife from 28 weeks with information stating your due date, single or multiple pregnancy and any complications. Please check with your airline and us when planning a trip. It is important to stay hydrated, mobilise and wear compression stockings.

Discuss with Malcolm if you’re planning a long trip.

First time mums will feel subtle movements from about 18 weeks onwards. With each passing week the movements will become more obvious, though if you are busy or working it is likely that you may not be aware of them.

By the third trimester your baby’s movements will become stronger and can be felt as kicks, rolls and other types of movements.

The best person to judge if you baby is moving normally is yourself. If at any time your baby’s movements have slowed down significantly it is often helpful to have a  glass of water and rest for an hour. If after that they still have not returned to their usual pattern give us a call and if necessary we will arrange an assessment. 

At your first antenatal appointment we will ask you to take a blood test. This is to determine your blood group, but more importantly whether your blood type is rhesus positive or rhesus negative.

15% of women are rhesus negative and require an anti-D injection at 28 weeks, 34 weeks and during other situations such as vaginal bleeding to reduce the risk of developing antibodies against your baby if it is rhesus positive. 

• www.breastfeeding.asn.au

The Australian Breastfeeding Association aims to provide information and support to mothers who wish to breastfeed their babies.

• www.pelvicfloorfirst.org.au

Information about general exercise during pregnancy, pelvic floor exercises, and returning to sport and exercise after childbirth.

• http://raisingchildren.net.au

Raising Children is a partnership between Australia’s leading childhood agencies and the Australian Government offering relevant, scientifically valid information for parents and caregivers to utilise to better care for their children and themselves.

• www.tresillian.org.au

Tresillian provides early parenting guidance, information and support for parents. They have a free online support service where parents are able to ask advice from a Tresillian nurse.

• www.karitane.com.au

Karitane is a charity providing support to parents and children up to five years old. Karitane provides services and education around parenting by professionally trained family health nurses, paediatricians, social workers, psychologists and psychiatrists.

• www.choice.com.au/babies-and-kids

Choice - Babies and Kids is an extensive section of the Choice website with articles, reviews and information about a wide variety of products and services related to babies and children.

• www.howisdadgoing.org.au

How Is Dad Going? is a website produced by Perinatal Anxiety and Depression Australia. It aims to equip new and expecting fathers with emotional and mental health support.

• www.blackdoginstitute.org.au

The Black Dog Institute aims to improve society’s understanding, prevention and treatment of mental illness. They undertake research surrounding mental illness and from this, offer education and resources around mental illness.

• www.beyondblue.org.au

Beyond Blue provides the Australian community with knowledge and skills to help protect and improve their mental health. There is a comprehensive section for pregnancy and new parents.