Being pregnant is an exciting time for prospective parents. Recently, Dr Kath Turner wrote the following article for the Ryde District Mums.

Now that your are pregnant…

Congratulations… you’re pregnant!! Amongst the excitement/disbelief/shock is the thought of “what do I do now??”  Hopefully by the end of this article you will have some answers and be feeling much more comfortable about the journey ahead.

Now that you’ve missed your period and probably pee-ed on the stick (be honest… it was more than once – perhaps 3 or 4 tests!) it’s time to make an appointment with your GP.  The initial appointment will involve a lot of information sharing and education. We will ask you when was the first day of your last menstrual period (LMP). This is the date we use to calculate the expected date of delivery (EDD), which is 40 weeks after the LMP. We will also ask questions regarding your menstrual cycle, any previous pregnancies and deliveries, any relevant family history. It is a good time to check if you need help to quit smoking or avoid drinking alcohol.

Now you visit your doctor…

Your pregnancy will be confirmed by a blood test (measuring a hormone called BHCG) – we also will check in this blood test a standard series of markers including your haemoglobin, your blood group, screen for viruses including Rubella, chicken pox, Hepatitis, Syphilis and HIV. A urine test will also be requested and it is important to check if your cervical screening test is up to date.

Your GP will discuss the many options for care during your pregnancy. We are very fortunate in our area to have access to excellent services offered by RNSH & Ryde Hospitals. You can choose from Antenatal clinics at the hospital, midwife led care, GP shared care, or you may elect to see a Private Obstetrician.  Throughout your pregnancy journey you will see your care giver at regular intervals and you can expect to have further blood tests, ultrasound scans and other investigations depending on your individual clinical circumstances.

At the initial consult your GP will also provide education regarding appropriate supplementation (ensuring you are on folate and iodine), food safety in pregnancy, appropriate vaccinations, discuss the importance of exercise and optimising your mental health and wellbeing. We can also offer preventative advise – for example, managing morning sickness.

Most people elect to have a dating scan which can be done at around the 7-8 week mark – this is to check that the size of the baby matches the expected dates.  In addition to this, there are certain times during the pregnancy, especially in the first trimester, when we have the option to organise specialised blood tests and ultrasounds as screening investigations for various genetic conditions, including Downs Syndrome. You will also be offered reproductive carrier screening (to see if you carry the gene for common conditions like Cystic fibrosis). All of these tests are optional and your Doctor will assist you in the decision making process.

Throughout your pregnancy you will see your care provider on a regular basis. Your partner is welcome. At each visit we will check your blood pressure and weight, feel your tummy and listen for the heartbeat. It is a great opportunity to ask any questions or discuss any concerns you may have.  Even if your pregnancy is going well, it is important you attend these visits so that any potential risks or harms can be identified and prevented, or at least minimised.

Allied Health Services that may be useful to you

Other services co-located at HHMP that may be of interest to you during the pregnancy planning include:

• Physiotherapy (including pelvic floor Physio)
• Pathology collection is available on-site
• Molemap skin cancer checks for pre-prgenancy or post-pregnancy skin check
• Endocrinologist especially for gestational diabetes and thyroid issues
• Paediatrician for the care of your child
• Psychologist for issues with falling pregnant and post natal depression
• Dietitian for the management of weight and diabetes

Local Hospitals you may consider delivering at

The birth of your baby can occur at a number of locations. This can include specialist obstetric care, birthing in a public hospital, a private hospital or at home. Your GP can discuss your care during your pregnancy and your available birthing options.

Local hospital options include:

• Royal North Shore Hospital (Public)
• Ryde Hospital (Public)
• North Shore Private Hospital (Private)
• Mater Hospital (Private)
• Sydney Adventist Hospital (Private)

If you are planning – start planning!

Pregnancy can be a wonderful and exciting time – it can also be overwhelming. Talking to your doctor or midwife is so important – your GP is here to help guide you though the maze. Remember to enjoy the journey as much as you can and we look forward to travelling the path alongside you.

 Planning a baby is an exciting time for prospective parents. Recently, Dr Kath Turner wrote the following article for the Ryde District Mums.

Planning a Pregnancy

When you are planning on becoming pregnant and during your pregnancy, your GP is able to provide ongoing care and support to help you have a healthy pregnancy and give your baby the best start in life.

When planning a pregnancy there are many things to consider, even if it isn’t your first baby. It is ideal that women and their partners visit their GP at around three to six months prior to trying to conceive. This will allow us to discuss changes that can be made to maximise the mother’s health prior to becoming pregnant.

Most healthy fertile couples will become pregnant within 12 months of trying, however women over the age of 35 years can take up to twice as long to conceive. If you have been trying to become pregnant for 12 months without success, or if you are over 35 years old and have been trying for 6 months without success, you should arrange for a discussion with your GP. We will be able to discuss fertility issues with you, and where necessary, arrange for the next steps to assist you with access to specialty fertility services.

Pre-pregnancy planning with your GP will cover a number of different issues. These include:

Health checks and tests

We will check your overall health and discuss any prescribed, herbal, or over the counter medicines you are currently using. This is to understand any issues or medications that may have an impact on your, or your baby’s, health. We will also arrange for some blood tests to check if you are immune for Chicken Pox and Rubella, and potentially for other conditions that may affect your baby, for example, Thalassaemia. If needed we can provide these immunisations, or other important vaccines such as influenza vaccine to help protect you and your baby.

It is important your cervical screening test and breast check are up to date and if not, we can arrange this for you. We can also help check for sexually transmitted infections (STIs) which may affect your ability to fall pregnant.

When you come in to see your GP, we will also encourage you to start thinking about what sort of antenatal care you might like.  You should check your health insurance policy to ensure appropriate coverage.

Health issues and family medical history

If you have a family history of genetic disorders, if you are over 35 years old, or if you have previously had a child with a genetic disorder, you are at a higher risk of genetic issues. Discussing your history with your GP will enable us to discuss your options around genetic testing and counselling. Technology has progressed and we are now able to offer screening tests to check if you are a carrier for specific diseases such as Cystic Fibrosis (CF), Spinal Muscular Atrophy (SMA) and Fragile X Syndrome (FXS).

Nutrition and supplements

For the good health of both you and your future baby it’s important to have a balanced and nutritious diet. Eating more healthy foods will help with your chances of conceiving and maintaining a healthy pregnancy. Freshly prepared, low fat, high fiber food options are best during pregnancy. Food safety in pregnancy and when trying to conceive is important and there are excellent resources to be found at Pregnancy | NSW Food Authority

We recommend you commence on a folate and iodine supplement, preferably three months before you start trying to fall pregnant.

Folic Acid – Taking folic acid has been proven to reduce the risk of a baby being born with a neural tube defect such as spina bifida. Your GP will advise you on the right folic acid dosage for you.

Iodine – Iodine is an essential requirement for thyroid hormone production, which, in turn is vital for your developing baby’s brain and nervous system. Many Australian women don’t obtain enough iodine from their diet. You should discuss with your GP the right amount of iodine for you during your pregnancy.

There are many different supplements on the market and we strongly encourage you to talk to your GP about what may be the right one/s for you.

Lifestyle

If you don’t have a regular exercise regime, it is good idea to set this in progress before becoming pregnant and then continue throughout your pregnancy. Exercise is great for your overall wellbeing, helps maintain a healthy weight and is also fabulous for your mood.   Ideal exercises throughout pregnancy include walking and swimming. It is best to avoid intense exercise and becoming too hot whilst pregnant.

There are other important lifestyle modifications you can make that will improve your chances of conceiving and maintaining a healthy pregnancy. Quitting smoking (ideally three months prior to conception), limiting your alcohol intake (there is no known safe level of alcohol in pregnancy), reducing your caffeine intake and avoiding illicit drugs.

Planning pregnancy seems complicated and perhaps you are overwhelmed after reading all this?  There is a lot of information (and misinformation) out there and remember your GP is a wonderful resource for you and will assist with any concerns you (or your partner) may have.

Allied Health Services

Other services co-located at HHMP that may be of interest to you during the pregnancy planning, antenatal and postnatal process include:

• Physiotherapy (including pelvic floor Physio)
• Pathology collection is available on-site
• Molemap skin cancer checks for pre-prgenancy or post-pregnancy skin check
• Endocrinologist especially for gestational diabetes and thyroid issues
• Paediatrician for the care of your child
• Psychologist for issues with falling pregnant and post natal depression
• Dietitian for the management of weight and diabetes

Planning your antenatal care

Antenatal care is the care you receive during your pregnancy. You can discuss with your GP your options for antenatal care and the birth of your baby. This can include specialist obstetric care, birthing in a public hospital, a private hospital or at home. Your GP can discuss your care during your pregnancy and your available birthing options.

Local hospital options include:

• Royal North Shore Hospital (Public)
• Ryde Hospital (Public)
• North Shore Private Hospital (Private)
• Mater Hospital (Private)
• Sydney Adventist Hospital (Private)

If you are planning – start planning!

If you are thinking of becoming pregnant, arrange for a consultation with your GP to discuss any concerns you might have, and get started on the planning process to ensure the good health of you and your baby.