Congratulations on your pregnancy!
It is common to feel a little bit overwhelmed by the pregnancy 'homework', particularly the first time around. Fortunately, pregnancy care is well set up to guide you through things and nearly all of the time visits are timed to ensure you have the right information to have the right test at the right time and also have an opportunity to discuss the results in a timely fashion.
What visits can I expect?
In a healthy pregnancy you can expect to be seen anywhere from 10- 14 times.
A sample schedule of visits, along with the key tests that happen around the same time, are shown below.
The following brochure, although a little outdated as it does not include NIPT and some other newer tests available, has very good explanations of care, vists, tests and their reasons and is well worth a read.
What vaccines do I need?
As an evidence based practitioner who has a vested interest in the health and wellbeing of yourself and your baby I recommend the following vaccines:
- whooping cough booster for mums and families as this protects newborn babies before they can be protected by vaccination by both antibodies from mum crossing the placenta and by cocooning your new baby with immune adults/
- flu vaccine each flu season (year), starting in April. Your pregnancy can cross two flu seasons depending on timing
- COVID 19 vaccination and boosters.
- Both Hep B vaccination and vitamin K is recommended for your baby after birth. Although you may not have hepatitis B, babies who are exposed to a carrier (caregiver, carer, contact) with hepatitis B who contract it in infancy are very likely to have chronic infection for life which has long term consequences and is easily vaccine preventable. Vitamin K prevents hemorrhagic disease of the newborn safely (risk 1:200 without prevention and often in critical areas, once this happens it is too late to give vitamin K to prevent harm).
Both influenza and COVID can cause serious complications for pregnant mothers (and I do not know who will not get sick and who will get very sick and can prevent this by vaccination!) and their babies and are vaccine preventable with vaccines that are well established as safe and effective.
What tests are important for me to do?
All tests that are recommended in pregnancy have good clinical reasons for their inclusion but sometimes there are multiple options available and testing is not always essential. This particularly applies for Down Syndrome screening. If you have questions about any pregnancy test please ask during your visits so we can establish shared decision making about the what and why!
Please note I do not provide homebirth obstetric backup care or planned exclusion of key-test pregnancy care- at a minimum to provide safe care I need to know a reliable due date (early or 12 week ultrasound), location of the placenta and anatomy of your baby (20 week scan) and if you are diabetic or not.
What can I expect to happen at a typical visit as my pregnancy progresses?
After your 20 week scan you can expect to hear, and usually see, your baby at each visit as well as a measurement of the height of your uterus ('symphysiofundal height') and a check of your blood pressure.
In late pregnancy you may have a vaginal examination to assess how your cervix is preparing for labour in order to plan birth, particularly if your labour is planned to be induced.
At any point, if you have a complication detected at your visit you may also need to attend your hospital of birth for blood tests, fetal monitoring or have a further ultrasound.
What symptoms are common for me to experience?
Apart from a bigger tummy, pregnancy has some less enjoyable accompaniments.
In the first trimester nausea and vomiting is common and is treatable. It also usually settles with time.
Starting from later in the second trimester, you are likely to develop symptoms related to laxer ligaments from the hormonal effects of pregnancy including pelvic pain, hip pain with sleeping and backache. These are usually manageable with simple measures including support belts, a good pillow, heat packs, simple pain relief and physiotherapy.
Your growing tummy can contribute to reflux and you can become constipated. These are also treatable. After 20 weeks I encourage side sleeping, if you wake on your back, don't worry but do roll onto your side.
Sleep disruption is also very common late in pregnancy- this is caused by hormones, frequent urination, a blocked nose, and aches and pains from hips and tummy.
Please let me know if you are having symptoms which are causing trouble so they can be addressed- while not all can be cured without having a baby, most can be significantly improved!
What happens if I go overdue?
Part of your early pregnancy care includes a clear plan for when and how you plan to give birth. If you go overdue, in general there will be monitoring of wellbeing of your baby twice a week until you give birth or the agreed date/time to intervene and induce labour is reached.
Can I exercise?
Yes!!! I highly encourage an active pregnancy as good for you and baby.
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