Pre-Pregnancy

  • All couples are different – some fall pregnant straight sway while others take many months to conceive
  • The likelihood of conception after 6 months increases to 80% and 90% after 12 months
  • Maternal age
  • Stress
  • Poor diet
  • Overweight or underweight
  • Smoking
  • Alcohol
  • Sexually transmitted infections
  • Health problems that cause hormonal changes

Implementing changes to improve your health are not always easy, but the decision to try for a baby is a great motivator. Listed below are some suggestions to help try and achieve the best outcome possible and a list of things to bring when you come and see Dr Bishop for the first time.

Start tracking your menstrual cycle

Ovulation occurs 14 days before your period starts. This varies depending on the length of your cycle but a woman with an average 28 day cycle, ovulation occurs between Day 12 and 14. Sperm can survive for up to 5 days and the egg can be fertilised up to 12 hours from ovulation so you should be having intercourse every other day from Day 8 to Day 16 of your cycle.

Start Folate up in the weeks before and up to 3 months after you become pregnant

Research indicates that folic acid has been shown to reduce the incidence of fetal spine abnormalities or spina bifida. It is most important in the early weeks when most people don’t know they are pregnant yet, so taking it when you are trying is best.

Make sure you are a healthy weight

Being overweight or underweight can affect your chance of falling pregnant, increase your risk of miscarriage as well as increasing your risks during pregnancy.

Eat a variety of good food

It is important to eat a balanced diet with a mixture of fruit and vegetables to ensure you are having an adequate vitamin and anti-oxidant intake.

Taking a good prenatal vitamin will help to ensure this.

Maintain a good level of activity and look after yourself

Pregnancy is physically demanding. You can help manage your changing body shape as well as the demands of pregnancy, birth and early parenting by having a good level of fitness. Try and rest whenever you can, get enough sleep, reduce stress in your work and family life if you can and if possible, try and find time for yourself.

 

Early Pregnancy

Your first appointment should be between 8-10 weeks, or earlier if you have any concerns.

After your first visit you will have visits at approx 14, 20, 24, 28, 30, 32, 34, 36, 37, 38, 39 and 40 weeks.

Please contact us for information on your obstetric fees and any out of pocket costs.

It is recommended that all pregnant women have antenatal screening. This includes:

  • Full blood count
  • Blood group and antibody screen
  • Hepatitis B and C
  • Urine MC&S

You may require additional screening tests depending on your specific circumstance, including:

  • Screening for haemoglobinopathies: sickle cell or thalassemia.
  • Bacterial vaginosis: as diagnosis and early treatment <20 weeks may be beneficial for women with previous PTB.
  • Varicella, parvovirus, CMV, toxoplasmosis.
  • Ferritin and iron studies.
  • Vitamin D and folate.
  • Early oral glucose tolerance test.
  • Bleeding in early pregnancy can be very distressing, however it does not always mean you are experiencing a miscarriage.
  • Up to 1 in 4 women may experience bleeding during pregnancy and go on to have a heathy pregnancy.
  • If the bleeding is caused by a miscarriage, unfortunately there is no treatment that can stop this from occurring.
  • Ectopic pregnancy is a pregnancy occurring outside of the uterus (usually the fallopian tube) can also cause bleeding and pain. Without treatment an ectopic pregnancy can seriously affect your health and future fertility.
  • If you are experiencing bleeding or pain in early pregnancy contact Dr Bishops rooms or the maternity hospital.
  • During pregnancy your body needs extra vitamins, mineral and nutrients. The best way to meet both you and your baby’s nutritional needs is to eat and wide variety of nutritious foods and be as healthy as possible as early as possible.
  • In some individual groups additional supplementation may be necessary. We will let you know if you fit in to one of those groups.

Most babies are born healthy but there is always risk something can go wrong. The risk may be increased for some couples depending on age, lifestyle factors, medical or obstetric history.

Antenatal testing is advised to identify babies with increased likelihood of having certain chromosomal abnormalities, such as trisomy 21 and trisomy 18 and some structural anomalies such as neural tube defects.

There are two kinds of test that can be done in pregnancy:

Screening tests: can tell if you are at risk of your baby having a birth defect but will not give definite information about your baby.  Screening tests are as follows:

  • First trimester combined screening: For T21 and T18
  • This includes a blood test done from 9-13+6 combined with ultrasound measurement of fetal nuchal translucency between 11-13+6
  • NIPT (Noninvasive prenatal testing (NIPT) sometimes called noninvasive prenatal screening (NIPS), is a method of determining the risk that the fetus will be born with certain genetic abnormalities)
  • Second trimester screening: For T21, T18 and NTD
  • Blood from 14-20 weeks
  • Free fetal DNA: For T21, T18, T13, X and Y
  • Blood test from 10 weeks
 

Diagnostic tests: can tell you if your baby has a problem.  Diagnostic tests are:

  • CVS
  • Amniocentesis
  • No matter your body shape or size, pregnancy will challenge the way you feel about yourself and how you look.
  • Weight gain during pregnancy varies but the average weight gain is between 11.5 and 16kg.
  • The usual pattern is 1-2 kg during the first three months, followed by 0.4kg per week or 1-2kg per month during the final 6 months but not everyone follows this pattern.
  • Your optimal weight gain during pregnancy will be different depending on your pre-pregnancy weight, if you are underweight at the start of pregnancy you can afford to put on more than the average, if you are overweight your weight gain may need to be less than average.

During pregnancy your hormonal changes lower your immune system, which makes it harder to fight off illness and infection.  There are some food borne infections that can seriously affect your pregnancy and for that reason some extra care needs to be taken.

You can reduce your risk by:

Avoiding high risk foods

  • Unpasteurised milk or food made from raw milk
  • Pate, dips and soft cheese
  • Raw eggs in food: mayonnaise, mousse, batter
  • Raw or precooked meats or poultry
  • Uncooked, smoked or chilled pre-cooked seafood
  • Pre-prepared salads and coleslaws
 

Use safe food handling practices

  • Keep it cold
  • Keep it clean
  • Keep it hot
  • Check the label

Medications may be needed to help allow you to maintain adequate oral hydration including:

  • Metaclopramide (Maxolon)
  • Doxylamine (Restavit)
  • Ondansetron

There are some simple things that can help make you feel better.

  • Eat before or as soon as you feel hungry as an empty stomach can aggravate nausea.
  • Eat small, frequent, high carbohydrate, low fat meals
  • Eliminate spicy, fatty foods instead try dry, high protein foods
  • Cold, clear and carbonated fluids are better tolerated (ginger ale or lemonade).
  • Vitamin B6 and Ginger Powder taken regularly have both been shown to reduce nausea, dry retching and vomiting in early pregnancy.
  • Nausea and vomiting are some of the earliest symptoms of pregnancy and can affect up to half of all pregnant women.
  • Sometimes your nausea and vomiting can be so severe that you are unable to keep anything down and need admission to hospital for IV re-hydration and IV medications. If you are experiencing this severe nausea and vomiting it is best to present to you nearest hospital for assessment and treatment.