Antenatal care

For many women, especially those having their first baby, it can be difficult to know where to start and who to contact and how to seek antenatal care.

If you are trying to conceive and notice that your period is late, it is sensible to check a pregnancy test at home to confirm whether you are pregnant or not. Modern pregnancy tests that you can buy from a pharmacy are very sensitive and measure the pregnancy hormone, HCG, in the urine. If you have a positive result, congratulations!

You may already know a gynaecologist or may have received advice in the pre conception phase but if not you can choose to make an appointment either at a public hospital or a private hospital or clinic to see a gynaecologist of your choice. At the first appointment, the doctor will usually take your medical history and perform an examination which may include an ultrasound assessment. This will enable the doctor to estimate the gestation of the pregnancy and approximately when the due date of the baby will be.

Subsequent appointments with your doctor will depend on how the pregnancy progresses and if any additional risks develop in the pregnancy, such as diabetes or high blood pressure. For a routine low risk pregnancy, it is usual to have appointments once a month in the first and second trimesters, with more frequent appointments as you approach full term.

Some obstetricians will perform a basic ultrasound in the clinic but may also refer for specialist fetal medicine scans. The most important scans for most pregnancies are usually around 12 weeks, to assess the risk of genetic conditions in the baby and evaluate the risk of preeclampsia and placental problems; 20 weeks to assess the growth and important structures of the baby including the heart and brain; and 36 weeks to assess the baby's growth in the late third trimester. These ultrasound examinations will help the doctor guide you through the pregnancy and inform any decisions of how to manage and follow up any abnormal findings.

As part of routine antenatal care, it is usual practice to check your blood pressure and urine test at each appointment as this can detect early pre-eclampsia before you develop symptoms and before it affects the baby. Other common areas to discuss are pregnancy symptoms, baby's movements and plans for the birth. There should be plenty of opportunity to discuss any issues or concerns you may have with your obstetrician before the birth and some obstetricians will encourage the use of birth plans to try to individualise the delivery to your needs and preferences.

You should feel comfortable talking about any concerns you have with your doctor during the pregnancy and it is often helpful to attend appointments with your partner as well.

Good luck!