Your pregnancy and health, and your baby’s health, are our primary concerns. We will advise you on what to expect throughout including what is happening to your body and what tests are carried out.
We want you to feel supported and cared for and are happy to answer any questions you may have. I find that women vary in the amount of information wanted so I make sure you have what suits you best.
If you have any questions about conceiving, your fertility or infertility, do not hesitate to ask us.
Assessing your prenatal health and that of your partner, is important for a successful pregnancy.
Pre-existing medical conditions
If you have any medical conditions, including mental health conditions and gynaecological conditions, discuss these with us or your GP before conceiving as they may affect your pregnancy. You should also have any sexually transmitted infections treated before you become pregnant.
If you are on any medication it is important to assess any impact they may have on your pregnancy as well.
Pre-conception carrier screening
It is possible for couples looking to conceive to undergo pre-conception carrier screening. You may wish to find out about the risk to your baby if you have a genetic disorder, or a family history of a genetic disorder. Such tests help show if your baby is likely to have the disorder and may help you to make important decisions related to conception and pregnancy.
You may be recommended to make some general lifestyle changes too. These may include:
Take at least 0.5mg of folic acid a day starting the month before you plan to conceive and for the first three months of pregnancy. Folic acid is a synthetic version of folate, a B vitamin. Folate is important for the first trimester as it reduces the risk of spina bifida (neural tube defects) in the baby.
Some people require a higher dose of folate if they have a previous history of neural tube defects, or are taking medications that reduce folate absorption (eg epilepsy and inflammatory bowel disorders).
It is recommended that you take an iodine supplement of 150mcg per day before and throughout your pregnancy and during breastfeeding as well. Iodine is important to the development of your baby’s brain.
Eat a balanced diet of appropriate proportions, aiming to eat as little processed food as possible and instead focusing on fruits, vegetables, grains, lean meat, poultry, eggs, nuts and dairy products.
You should undertake moderate exercise as it may help improve fertility. Exercise also has proven emotional benefits: it helps reduce stress, anxiety and depression and may improve your sleep.
Alcohol, Cigarettes and Drugs
If you are planning to become or are pregnant, I strongly advise that you avoid alcohol, cigarettes and drugs as they have proven to be harmful to the development and health of the baby. Alcohol can contribute to physical and mental abnormalities and there is no safe level of consumption in pregnancy; cigarettes can affect the growth and long-term health of the baby. Drugs can be harmful to you and the baby and can also lower men’s sperm counts.
Early Pregnancy Symptoms
Click here to read about the signs of pregnancy, and how to calculate your due date.
While every pregnancy is different, there are changes common across most typical pregnancies.
The further along in your pregnancy that you get, the more your body changes. One of the most obvious changes will be to your weight. During pregnancy, the average weight gain is 11 - 15 kg however your weight gain will depend on your starting weight. The healthy range extends from 5 - 20 kg. If you have any concerns about this, just talk to Malcolm.
It is important to talk to us or your GP about any medication you are taking to ensure that it will not impede the development of your baby. Some medications, such as ibuprofen, should be ceased during pregnancy. When you are buying medication over the counter, be sure to let the chemist know that you are pregnant.
If you are concerned about any medication, MotherSafe is a free comprehensive telephone service you may utilise. It advises mothers on medications during pregnancy and breastfeeding: 1800 647 848.
It is also important to ensure you have all your vaccinations up to date. As pregnant women are more at risk of contracting the flu, I strongly recommend that you have a flu vaccine.
During your first antenatal appointment, we will ask you to take a blood test to determine your blood group and whether your blood is rhesus positive or rhesus negative. If you are rhesus negative you will require an anti-D injection at 28 weeks, 34 weeks and in other situations such as vaginal bleeding. This will reduce the risk of you developing antibodies against your baby if it is rhesus positive.
It is safe to have a cervical screening test, or pap smear test, if you need one during early pregnancy.
A sugar test for gestational diabetes is undertaken at 28 weeks. Gestational diabetes occurs during pregnancy when you have high blood glucose levels due to the body’s inability to cope with the demand for insulin production. If you have gestational diabetes, your blood glucose levels will be monitored to reduce the risk of complications during pregnancy and birth.
Also, at 28 weeks, you should have a whooping cough vaccine as it helps transfer immunity to your baby. This is important as your baby will not receive its immunisations until they are 2 months old. Anyone in close contact with your baby should have a booster if it has been more than 10 years since their last vaccine.
At 37 weeks, a vaginal swab to screen for Group B Strep (GBS). 25% of pregnant women are carriers of GBS and not every woman will pass GBS to their baby. If you test positive to GBS, I recommend an antibiotic in labour or when you break your waters.
Further dietary changes may also be required as your baby grows. It is recommended that you don’t eat certain foods which may contain harmful bacteria such as listeria or salmonella.
The NSW Government Food Authority website provides an excellent overview about which foods to avoid when pregnant.
Exercise, Sport and Sex
Pregnancy is very physically and emotionally demanding on your body. Keeping reasonably active will help you manage your changing body and cope with the physical demands of pregnancy.
Try to do some moderate exercise each week; exercises you may consider include:
- Stationary cycling
- Strength training
- Yoga and Pilates
- Low impact aerobics
- Swimming or water aerobics
Try to avoid high impact or contact sports, heavy weights, or any activities or sports that cause you pain. You can talk to us, your exercise instructor or healthcare advisor regarding what exercises will best suit you and your pregnancy.
Most women can also continue to have sex when pregnant; it will not affect your baby. Click here to read a bit more about sex during pregnancy.
Pelvic Floor Exercises
I highly recommend that you do pelvic floor exercises. The pelvic floor are the group of muscles and ligaments that support your uterus, bladder and bowel. Doing pelvic floor exercises, or kegel exercises, will help support pelvic organs and help prevent incontinence. Childbirth is one of the main causes of weak pelvic floor muscles so it is recommended that you exercise them daily before, during and after your pregnancy.
You can find advice on how to do your pelvic floor exercises here.
Newcastle Private Maternity Hospital runs very useful and comprehensive antenatal classes. I will give you information on this when you have your first visit with me.
Midwives also provide excellent support. They offer a very caring, kind and highly professional service.
Malcolm covers questions about morning sickness, baby movements, ultrasounds, due dates, flights, travel and more on our Common Questions page.
Giving birth has a massive physical and mental impact on your body. As all pregnancies and births are different, how you imagined childbirth to be may differ from your experience. You may also feel overwhelmed at times, especially if it is your first baby. Talking to us or a midwife about how you are feeling may offer a sense of relief as they can help address these feelings and any problems you may be struggling with.
Recovering after childbirth
The Royal Women’s Hospital recommends the following to help recover physically from the birth of your baby:
Ice helps reduce pain and swelling around the vaginal area. Place ice in your pad for 20 minutes every 2-3 hours until the pain and swelling go away.
Supportive underwear will help reduce pain and discomfort by supporting your lower abdominal muscles. Control briefs are recommended to be worn for the first six weeks and should be two sizes bigger than your pre-pregnancy size.
Physical changes you experience after giving birth include:
For the first few days giving birth, you will experience vaginal discharge that is like a heavy period. The amount of blood will reduce and change colour from reddish-brown to pink and eventually watery until it gradually stops. Vaginal discharge can last for up to six weeks.
After giving birth, your uterus is usually around the level of your belly button. Your midwife will feel where your uterus is and after ten days it is usually below the public bone.
Vaginal Tears and Grazes
After giving birth there may be a graze or small tear in your vagina. You midwife or obstetrician will stitch these to help them heal. More than likely you will be unaware of any stitches and they are self-dissolving, so they will not need to be removed.
Bowels and Bladder
If you have any grazes or tears in your vagina these may cause a stinging sensation while urinating. Increasing the amount of water you drink will dilute your urine which will reduce stinging. You may also be a little constipated after having a baby. It is safe to use your bowels even if you’ve had stitches and are sore. Eating high-fibre foods will make bowel movements easier and less painful.
After having a caesarean most surgeons will use self-dissolving stitches. The area may feel numb for a few months; this is normal and not a problem. It is recommended that you sit and lie down gently to keep pressure off the stitched area.
Gentle exercises and pelvic floor exercises are recommended to help you return to your pre-pregnancy fitness.
A gentle walk for 30 minutes a day will help improve your general health and well-being. Continue your pelvic floor exercises and also start deep abdominal muscle exercises. (Click here for advice on how to do pelvic floor exercises.)
Avoid high-impact sports and activities during the first 12 weeks after giving birth. You should have a stronger pelvic floor before attempting high-impact activities.
For information on getting in and out of bed, back care and correct lifting technique click here.
You may be feeling very tired and overwhelmed the first few weeks after giving birth. It is important to rest as much as possible to help both your physical and mental health. You can maximise rest by:
- Sleeping when the baby does
- Letting others do chores and cook meals
- Not being afraid to ask for help
After birth you will not need to eat as much as before; however you should maintain a healthy diet. A good diet will help you recover and increase your energy levels as well as being good for your baby if you are breastfeeding.
Baby blues – or post-natal depression
Many new mothers experience the ‘baby blues’, a feeling of anxiety or teariness due to hormonal changes, for a few days after giving birth. Normally this goes away with no treatment required other than support and understanding from those around you. Emotional and physical exhaustion is normal and your feelings will fluctuate.
If your feelings of high anxiety, worry and sadness last longer than two weeks, or if you are particularly tearful for no reason, are unable to sleep, feel ‘numb’, then it is time to talk to family, friends and your family health nurse or GP as you may be suffering from post-natal depression. Beyond Blue has information on pregnancy and early parenthood.
Early interventions can make a huge difference and help you get back on track.
Sex and Contraception
It is normal to have little to no sex drive after giving birth and it is important to only have sex when you feel comfortable.
It is also possible to become pregnant again as early as three weeks after giving birth. If you want to have sex but do not wish to become pregnant, most forms of contraception are safe to use after childbirth. Talk to us or your midwife about which is best for you.
Breastfeeding provides your baby with all the nutrition they need for the first six months of their life. It protects them from infections and allergies and helps protect you from developing ovarian cancer and osteoporosis. Breastfeeding can also help you bond with your baby both physically and emotionally. For more advice visit the Australian Breastfeeding Association.
If you are unable or do not wish to breastfeed you baby, formula will provide all the nutrition they need. Some people also top up breastfeeding with formula feeds, if needed, or share the feeding with the father giving some feeds either with expressed breast milk or formula milk.
Whichever method or combination you choose, know that you are doing the very best for you and your baby and we will support you in your decisions.
Bonding with your baby is important as it influences their emotional, cognitive and neurological development.
Ways to bond with your baby include:
- Talking and singing to your baby
- Holding and touching your baby, especially skin to skin contact
- Spending time with your baby. You can carry them hands-free in a sling if you want to move about and get things done at home!
- Soothe them when they are upset or distressed
- Read stories to your baby. They love the sound of your voice!
You can also massage your baby to strengthen your bond. For information on baby massage, visit the Raising Children website.
Adjusting to Parenthood
Becoming a new parent is challenging, both physically and emotionally. Your lifestyle will more than likely change, and you may experience unpredictable emotions. These changes are completely normal. For information and advice on adjusting to parenthood, visit Karitane.
Malcolm and his team are committed to your health and ensuring you feel supported and cared for.
We will happily answer any questions you may have so you can make informed choices about what is best for you. After all, it is your body, your pregnancy, your baby.