Your antenatal care

Your obstetrician or midwife will see you regularly during your pregnancy and more frequently as your due date approaches.

As soon as you know you’re pregnant, you can ask your GP for a referral to an obstetrician or midwife. If you’re planning to have your baby in a private hospital — or as a private patient in a public hospital — your obstetrician or midwife will provide both your antenatal care and delivery of your baby. As a public patient in a public hospital, you may have an obstetrician or midwife allocated to you.

It’s normal to have lots of questions when you’re expecting a baby. It’s a good idea to have your first visit to your obstetrician or midwife early so you have time to reconsider your health professional if you’re not comfortable with their answers to your questions. Some obstetricians and midwives are popular and may be fully booked if you leave it too late.

At your first antenatal visit, your obstetrician or midwife will give you information about:

• your diet during pregnancy
• your need for folic acid, iron and vitamin D supplementation
• any lifestyle changes you need to make to protect you and your baby’s health, such as stopping smoking and avoiding alcohol
• what screening tests you may need to have
• how often you need to have antenatal visits.

You’ll most likely see them every 4 weeks until 28 weeks, then fortnightly until 36 weeks and then weekly until your baby’s born. Your obstetrician or midwife may ask you to visit more often if you have other health conditions, a multiple pregnancy or past obstetric problems.

If you have problems or concerns at any time during your pregnancy, you can call your obstetrician, midwife or the hospital immediately for advice.

Screening tests

During your pregnancy, your obstetrician or midwife will recommend screening tests to check your baby’s health. Their testing recommendations will depend on your individual risk factors.

Ultrasound

Your obstetrician or midwife will usually order an ultrasound in the first 3 months of pregnancy to help determine your due date. In the second trimester, you may have an ultrasound to check your baby’s development and to assess the location and size of the placenta. Sometimes, an ultrasound is done in the third trimester to check your baby’s growth, amniotic fluid level and the position of the placenta.

Nuchal translucency scan

This is an ultrasound and a blood test that’s usually done between weeks 11 and 13 of your pregnancy. It assesses the risk of your baby having Down Syndrome and other chromosomal abnormalities. It doesn’t give a definite result, but it lets you know if you’re at high or low risk of having a baby with one of these abnormalities. It can help you decide whether to have more invasive testing.

Diagnostic tests

Depending on your risk of carrying a baby with a chromosomal abnormality, your doctor or midwife may offer you tests that involve collecting a sample of the placenta or amniotic fluid. These include:

• Chorionic villus sampling. A needle is inserted into your abdomen and a sample of your placental tissue is taken. This is done 10 to 13 weeks into your pregnancy.
• Amniocentesis. A needle is inserted through your abdomen and a small amount of amniotic fluid is withdrawn for sampling. This is done between 15 and 20 weeks.

While these tests look for genetic abnormalities, they don’t test for every one. They’re generally considered safe, but risks include infection, amniotic fluid leak, injury to the baby and miscarriage.

Strep B swab

This tests for a bacterium that 1 in 4 women carry in their vagina. If you carry it, there’s a small risk of transmitting it to your baby during birth. It can make your baby seriously ill and even lead to death. It can also give you an infection after the birth. Early detection and treatment with antibiotics during labour can reduce the risks. For this reason, your obstetrician or midwife may recommend taking a swab from your vagina between 35 and 37 weeks. You and your baby are unlikely to be at risk from this infection if you’re having a planned caesarean.

Booking into hospital

It’s a good idea to book into the hospital that your obstetrician or midwife visits as soon as you’ve decided on the obstetrician or midwife. Ask the hospital if you can have a tour of the maternity unit so you can become familiar with the surroundings and facilities.

Booking antenatal classes

Book your classes early on as they can fill up quickly. Ask your obstetrician or midwife, or get a recommendation from a friend. The classes will help you to learn about pregnancy, birth choices and caring for your baby. It gives you the chance to have your questions answered and to meet other parents-to-be. Most classes encourage partners to attend as well.

Some centres offer a range of classes including special sessions for women planning to have a caesarean birth.