By Georgia Page – GP at your family doctors erina
In one of our previous articles we talked about pre–pregnancy planning so you can be the healthiest you can be before you fall pregnant, and to increase your changes of conceiving and having a healthy baby. If some of those tips helped and now you are pregnant, you may be wondering; what do I do next?
Firstly, congratulations! It is a very exciting time in your life, and we wish you a comfortable and healthy pregnancy. A good place to start is to see your GP for your first pregnancy visit around the 4 – 8 week mark.
Your GP can confirm your pregnancy and dates, assess your health and organise routine antenatal tests recommended for your pregnancy. They will also give you information regarding where you can receive your ongoing pregnancy care and where you can deliver your baby. Outlined below is a ten point pregnancy checklist to help you achieve a healthy pregnancy.
PREGNANCY CHECKLIST
1. Blood tests in pregnancy
Your GP will order some initial bloods tests including your blood group and antibody testing (for Rhesus factor). They will also screen for infections that can affect you and your baby. Other blood tests may be carried out depending on your circumstances and may include testing your iron, thyroid and vitamin D levels. An initial urine test will be sent off to exclude infection as well.
If you have not previously had Genetic Carrier Screening tests this may also be offered. Your doctor will check if you are up to date with your cervical screening tests. Blood tests will be repeated at various stages of your pregnancy including screening for gestational diabetes which is usually done at 26 – 28 weeks, or earlier for those at high risk.
2. Ultrasounds in pregnancy
If you are unsure of the date of your last period, an early ultrasound can help determine how many weeks pregnant you are and your approximate due date. Two routine ultrasounds are commonly recommended:
- First trimester ultrasound: (between 11 – 14 weeks)
- Second trimester ultrasound: (between 18 – 20 weeks) to check the baby’s growth and development, including their organs.
3. Antenatal screening tests
Antenatal screening tests are offered to all women in the first trimester of pregnancy to assess the chance of having a baby with certain chromosomal conditions. These tests are optional.
The Non–Invasive Perinatal Test (NIPT) is a blood test of the mother, performed at around 10 weeks of pregnancy. This test analyses small amounts of the baby’s DNA present in the mother’s blood to screen for common chromosomal changes. Currently this test is not covered by Medicare and involves an out–of–pocket cost.
Alternatively, a special ultrasound, called the Nuchal Translucency Scan, in combination with a blood test can be done at approximately 12 weeks. This test may also have some out of pocket costs, so please discuss with your doctor.
4. Multivitamins in pregnancy
Folic acid supplements are recommended during your pregnancy to reduce the risk of neural tube defects such as spina bifida. The usual recommended dose is 0.5mg daily, although women may require 5mg depending on their medical history.
Iodine (150 micrograms daily) is also recommended for brain and nervous system development. Check with your pharmacist that the pregnancy multivitamin you are taking contains the recommended amounts. Other supplements may be recommended such as iron or Vitamin D, depending on your circumstances.
5. Diet and exercise in pregnancy
A healthy, well–balanced diet with a wide variety of fruits and vegetables is recommended during pregnancy. Despite the saying, you do not need to ‘’eat for two’’. Usually, two additional healthy snacks is enough.
Foods to avoid during pregnancy include any raw or undercooked meats, raw seafood, soft cheeses and unwashed salads. These precautions help reduce the risk infections such as Listeriosis. Caffeine is still allowed, but it is recommended to limit intake to two cups of coffee or four cups of tea a day.
Staying fit and active during pregnancy is important for both physical and psychological wellbeing, and can help prepare your body for childbirth. Aim for around 30 minutes of moderate exercise 4 – 5 times per week. However, avoid contact sports, high–risk activities and overheating.
6. Vaccination during pregnancy
During pregnancy the immune system is reduced, which makes women and their unborn baby more susceptible to certain infections. When pregnant women are vaccinated, protective antibodies pass to the baby, so they also receive protection.
Three government funded vaccines are recommended during pregnancy:
- Influenza vaccine: (given at any stage of pregnancy)
- Whooping cough (pertussis) vaccine: between 20 and 32 weeks.
- RSV vaccine: (between 28 and 36 weeks).
- If you are due for a Covid–19 vaccine booster, this can be safely given at any stage of pregnancy.
7. Medications during pregnancy
If you are on any regular medications, it is important to talk to your doctor or pharmacist to check if they are safe during pregnancy. This also applies to any over the counter medications or herbal supplements. A useful resource is the MotherSafe hotline (02 9382 6539) at the Royal Hospital for Women in Randwick.
8. Smoking and alcohol during pregnancy
Smoking can be harmful to your unborn baby and increase the risk of early pregnancy loss, prematurity, low birth weight and stillbirth. We recommend you do not smoke or vape and preferably not be in the company of smokers for lengthy periods of time.
Alcohol can also affect a baby’s development, particularly the brain. There is no consensus on safe levels of alcohol that can be consumed during pregnancy, so it is best to avoid.
9. Antenatal Care options
There are many options for antenatal care and delivery, depending on your circumstances and preferences. Options may include:
- Referral to the local public hospital antenatal clinic for care managed by midwives and doctors.
- ‘’Shared care’’ with your GP with delivery at the public hospital.
- Referral to a private obstetrician for delivery at a private or public hospital.
During your pregnancy you will have regular check–ups to monitor your blood pressure, weight, urine, your baby’s heartbeat and growth of your baby.
10. Mental wellbeing during pregnancy
Looking after your mental health during pregnancy is just as important as looking after your physical health. If you have noticed an increase in symptoms of anxiety, stress or depression, it is important to talk with your doctor, partner or support person. You can also call PANDA – Perinatal Anxiety and Depression Hotline on 1300 726 306.
We wish you well during your pregnancy and hope you have a memorable, enjoyable and healthy experience.
Resources: Pregnancy Birth and Baby – https://www.pregnancybirthbaby.org.au/
Raising Children Network – https://raisingchildren.net.au/pregnancy