The birth of your child will be one of the most thrilling and gratifying experiences in your life. This should be made as safe and pleasant as possible for both you and your baby. We will endeavour to help you achieve this goal.

You should present to your obstetrician as early as possible in your pregnancy, ideally before 12 weeks. Your obstetrician should then assess your general health and 12

• Tell you how taking folic acid (0.4mg a day for up to 12 weeks) can reduce certain health risks for your baby.
• Offer you screening tests (blood tests, 1st Trimester ultrasound screening test for genetic abnormality) and make sure you understand what is involved (what does it mean if the results turn out “positive”, what are the options and follow-up) before you decide to have any of them.
• Offer you an ultrasound scan to estimate when baby is due if you are not certain of your date.
• Measure your blood pressure, height and weight.
• Offer you help to stop smoking if you are a smoker.
• Organise an ultrasound scan at 18–20 weeks at a private radiology department near you to check the physical development of the baby.
• Please bring along your ultrasound scan report and all available blood test results.
• You should be offered tests to find out your blood group and your Rhesus D (RhD) status. If you are RhD negative you should be offered anti-D injections at 28 and 36 week gestation to prevent future babies developing problems.

Each Antenatal Clinic Appointments:

• At each appointment, you should be given information with an opportunity to discuss issues and ask questions.
• Your obstetrician should tell you the results of all tests and have a system in place to do this.
• Attendance of antenatal classes is recommended, especially if this is your first successful pregnancy.

Before 28 Week Gestation:

• 4 weekly antenatal check with your obstetrician.

28 Week Gestation:

• You will be given a request form for a Glucose Challenge Test (GCT) at 28 week gestation in the hospital. The result will be sent to your GP. GCT is a screening test for gestational diabetes, which happen in 5-8% of pregnant women. If your GCT is positive, you will be asked to return for a confirmation Glucose Tolerant Test (GTT). A negative GTT is reassuring. If the GTT is positive, your pregnancy will need additional care and you will be referred to the Diabetic Clinic for further medical advice.
• The request will include the 2nd screening tests for anaemia and red cell antibodies, If you are Rhesus Negative blood group, your obstetrician will discuss anti-D prophylaxis with you and administer the Anti-D to you as an intramuscular injection with your consent.

28 to 36 Week Gestation:

• Fortnightly antenatal check with your obstetrician.

36 Week Gestation Hospital Antenatal Clinic:

• Your obstetrician would organise your 36 week gestation screening tests for anaemia and red cell antibodies.
• If you are Rhesus Negative blood group, your obstetrician will discuss the second anti-D prophylaxis with you, and administer this as an intramuscular injection to you with your consent.
• Your onbstetrician will assess your baby to see if he/she is presenting head first. If the baby is presenting feet first (Breech), which happen in 4% of the case at 36 weeks gestation, option of turning the baby will be discussed.

40-41 Week Gestation Hospital Antenatal Clinic:

• Only 1 in 5 pregnant women will need to keep this appointment, the rest will usually deliver before 40 weeks.
• Half of those who have not delivered by the estimated due date, would have done so within the first week.
• 1 in 10 pregnant women will be overdue for more than a week. Your doctor will discuss with you the option of labour induction.
• If you and your baby are well, it is preferable to wait for the labour to start spontaneously. Medical intervention or labour induction is safe but not without risks.

How and when to seek medical advice:

You can call your obstetrician or if it is after hour, the Maternity Desk at Sunnybank Private Hospital (TEL: 07-3344 9308/ 9309) for any concern that you may have during pregnancy. Especially the following:

• Vaginal bleeding of any nature
• Persistent abdominal pain
• Leakage of fluid of any nature from the birth canal
• High fever
• Concern about baby’s movement
• Severe headache with changes in your vision

Pain relief during childbirth:

• Some women achieve adequate pain control with the breathing and relaxation techniques learned at childbirth classes, nitrous oxide gas or narcotic injection, others may find them inadequate.
• Many mothers are reconsidering the idea that childbirth is “natural” only without medication, and they are choosing to have pain relief during labour and delivery to help them experience a more comfortable childbirth.
• Be assured that your obstetrician will prescribe or administer medications only in the amounts and during those stages of labour that are best for the safety and well-being of your baby.
• Epidural provides the most effective pain relief. It decreases the amount of medication circulating during labour; allows patients to be well rested when it is time to push; and prevents the need for hyperventilation and its possible bad effects.
• With Epidural, you will not be able to stand up and walk around, and a urinary catheter will be necessary. Lowering of blood pressure & itching occasionally occurs. Slowing of labour may occur. Often it is a slow and difficult labour that prompted an epidural request, rather than the other way round.
• You should feel free to talk with your midwife or obstetrician about your options for pain relief and their possible side effects.

Monitoring during childbirth:

• Most babies come through labour without problems but there are a few who don’t cope so well. During contractions blood can’t get through the placenta (afterbirth) so easily. This is normal and most babies cope without any problems. If a baby is not coping well, this may be reflected in the pattern of their heartbeat.
• Sometimes your midwife or obstetrician may offer and recommend continuous monitoring. This may be for a number of reasons relating to you or your baby’s health.
• Continuous monitoring keeps track of your baby’s heartbeat for the whole of your labour. The monitor records your baby’s heartbeat as a pattern on a strip of paper. This is sometimes called a “trace” or a “CTG”.
• Occasionally a Fetal Scalp Electrode (“clip”) may be recommended. The electrode picks up your baby’s heartbeat directly. It is attached to your baby’s scalp through the vagina and is then connected to the monitor.
• If the trace suggests that your baby is not coping well, further action may be taken. This could include immediate delivery of your baby or carrying out a further test called Fetal Blood Sampling.
• Fetal blood sampling involves taking one or two drops of blood from your baby’s scalp (through your vagina). This blood is tested to show if your baby is not coping well with labour. The test can help to clarify how well the baby is coping and avoid you having an unnecessary Caesarean Section.