Antenatal care

Congratulations on your pregnancy!
What an exciting, nerve-racking, eye-opening time of your life!

Antenatal care is all about guiding and supporting you through your pregnancy. For most, it flows smoothly with only the few minor expected pregnancy issues like sore hips, tiredness, and reflux. For others, it is not so straight-forward.

I’m pregnant, so what do I do now?

Your family and friends all seem to sail through pregnancy – one moment they’re pregnant, the next moment they have an adorable little bundle of joy in their arms. They tend not to talk about the minor detail of the pregnancy process.

First, confirm the pregnancy. Pregnancy symptoms, an enlarging belly, missed periods and a positive pregnancy test are pretty good indicators. If more is needed (such as ongoing disbelief and denial), you can do a blood test for the pregnancy hormone beta-hCG.

The next steps are:

  • See your GP
  • The GP should order routine pregnancy blood tests that screen for Rubella, Syphilis, Hepatitis B, Hepatitis C, HIV, sometimes Varicella and also a Full Blood Count to check for anaemia and a Blood group and antibody screen – although any issues found with these tests are uncommon, if they are found, it can affect your pregnancy significantly
  • Decide if you want a dating ultrasound scan if you are unsure of when conception occurred or want to know a due date – note that dating ultrasounds are generally done after 6 weeks gestation as the pregnancy is too tiny to see well before then. An early ultrasound may also be reassuring if you have had miscarriages in the past
  • Decide if you want a nuchal translucency ultrasound done at around 12 weeks gestation – this screens for chromosomal problems such as Down’s syndrome and can look for early fetal anomalies. This ultrasound is recommended for all people who want to check for these issues regardless of their age – young age does not guarantee that Down’s syndome will not occur
  • The new alternative to nuchal screening is Non-Invasive Prenatal Testing (NIPT), which tests your blood for free fetal DNA – see your Doctor for more information or our information page
  • Decide early on what model of antenatal care you would like (see below)

Other things to expect in your pregnancy

Generally, pregnancy checks are done about every 4 weeks until 28 weeks then every two weeks until 36 weeks then weekly until delivery. Visits may be more frequent if issues arise such as high blood pressure or gestational diabetes.

Other investigations in your pregnancy will include:

  • A morphology ultrasound scan done at about 20 weeks gestation is recommended for all pregnancies to ensure the baby and the pregnancy are developing normally
  • At 28 weeks gestation, you have a blood test for Full Blood Count (to look for anaemia), Blood group and antibody screen, and a Glucose Tolerance Test (to look for gestational diabetes). It is now recommended that everyone does the fasting 2-hour Glucose Tolerance Test – previously, ‘low risk’ women could do the non-fasting 1-hour test but it was not picking up all women with gestational diabetes
  • At 36 weeks, you’ll be pleased to know that (unless any complications develop) this is the last blood test of the pregnancy with a Full Blood Count and a Blood group and antibody screen. Sometimes, if the result was very good at the 28 week blood test and there are no risk factors, you might be able to miss this blood test
  • Ultrasound scans after the morphology scan are not routinely needed and most people will not need another formal ultrasound in the pregnancy. We will do quick bedside ultrasounds at each visit to check for any concerns but a full detailed scan is usually not needed. If there are concerns about baby growth or any pregnancy issues, we may request a formal ultrasound scan.

Models of antenatal care

It is usually only after falling pregnant yourself that you start realising pregnancy care is not straightforward. In the movies, they just go to hospital after breaking their waters and out comes a baby before the next ad break.

In reality, you have to book in to somewhere well before you have your baby. There have been occasions when people have no visits or bloods or ultrasounds during their pregnancy and turn up at a hospital at the last minute – but that leaves them open to all sorts of surprises (some unpleasant) that could well have been found out (and possibly prevented or planned for if known) had they had the usual antenatal care – this includes more than one baby unexpectedly popping out.

Your choices for antenatal care in Australia are:

  • Seeing a private obstetrician for your pregnancy care and delivering at a private hospital
  • Seeing a private obstetrician for your pregnancy care and delivering at a public hospital (this option is not always available)
  • Seeing a public antenatal clinic for your pregnancy care and delivering at a public hospital: if your pregnancy is uncomplicated, many antenatal visits may be at your GP or with a hospital or private midwife rather than the antenatal clinic (this is called Shared Care)
  • Seeing a private midwife for your pregnancy care and delivering at a public hospital with the private midwife performing the delivery (this option is not always available) – if complications arise, the public obstetrician on call that day will need to be consulted
  • Seeing a private midwife or an unregistered birth assistant (such as a doula) for your pregnancy care and delivering at home – if complications arise, transfer to a public hospital may be required, especially if there is any threat to the welfare of mother or baby

Not all models of care are available in all places. Delivery at a private hospital is only available if booked in with a private obstetrician who has admitting rights at that hospital.

Why choose private care over public care?

Despite bad press, Australia has reasonable quality public health services – and it is free.

Women choose private health care for their pregnancies as they:

  • Want to choose the obstetrician that will be looking after them – not just whoever happens to be on call that day
  • Want to be able to see the same obstetrician at every visit – rather than a different doctor/midwife each time
  • Want to be assured that the obstetrician performing their delivery has knowledge of their preferences and will help them achieve the pregnancy experience they are after
  • Want to be assured that the obstetrician performing their delivery is skilled and reliable and able to manage their delivery safely & effectively – they may not want to have trainees or random unknown people performing their deliveries
  • Want to be assured that the obstetrician performing their delivery will be able to handle any complications that may arise – be it bleeding, fetal distress, a need for an assisted vacuum delivery, or an emergency Caesarean section
  • Simply want to use the private health insurance that they have spent so long and so much money paying (yet barely using)
  • Want the comfort and privacy of private hospital rooms and services – where single rooms are guaranteed and there are the little extras that make their stay that much better
  • Have clear preferences for their pregnancy & delivery and would like an obstetrician to support them in their choices

If you would like to know more, call us today on 1300 166 146.

Link to information on Delivery