Frequently Asked Questions

 
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In addition to the information provided on my website, all of my antenatal patients are given an Antenatal Pack.

A downloadable version is available here:

 
 
 

Travel in Pregnancy

 

The primary concern I have for pregnant women who wish to travel is that, if you deliver away from Melbourne, the risks to you and your baby are greater:

  • You will need to find a new hospital and a new doctor, neither of whom will have a record of your history.
  • If you deliver even slightly prematurely, you are not permitted to travel until the newborn is the equivalent of 40 weeks gestation.
  • It is very difficult to get travel insurance to cover you for pregnancy after around 24-26 weeks internationally, or 34-36 weeks domestically.
  • The costs for an international delivery can be as high as $1 million, and are rarely covered by insurance.

It is for these reasons that I do not recommend pregnant women fly internationally from around 24 weeks, and domestically after around 34 weeks. If you do need to fly, the airlines will require a letter from me authorising you to fly (either internationally or interstate) after 20 weeks gestation. Please contact me to discuss this.

Travel and illness:

In some countries, hygiene standards may not be as stringent as they are in Australia, and the risk of infection (and thus complications) is substantially higher.

Guidelines:

  • Everyone knows about ‘Bali Belly’, but it can occur in many countries and can result in premature labour or other complications.
  • When travelling, avoid salads, ice, water (including bottled water unless you can be certain you are the one who broke the seal) or anything else that may have been rinsed in water.
  • Also try not to eat food of which you cannot guarantee the safety.
 
 
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 Nausea and Vomiting

 

It is quite common to have some degree of nausea during the first trimester. This will generally begin at around six weeks, peak at around nine to ten weeks and gradually resolve between 12 and 14 weeks. Sometimes the nausea may be severe and persistent and occasionally associated with excessive vomiting.

This is termed hyperemesis gravidarum (commonly known as ‘morning sickness’, although it can occur at any time throughout the day.) It is the normal increase in pregnancy hormones that causes these symptoms. Rarely, there may be an underlying cause to make the symptoms more severe. These situations may include a urinary tract infection, an overactive thyroid gland or a multiple pregnancy.

At its most extreme, vomiting can be so severe that hospitalisation is required and strong medication is necessary to prevent more serious complications. This is extremely unusual. If you are at the stage where you are vomiting more than twice a day, you should not hesitate to contact me, so you can avoid getting into this more serious situation.

There are many options to control the symptoms but there is virtually no treatment that will eliminate them completely. Treatment involves a combination of rest, dietary modification, vitamins, complementary therapies, conventional medicine and occasionally intravenous fluids.

 

 Prenatal Testing

 

One of the difficult issues to face in early pregnancy is the option for prenatal testing. In recent years, several new tests have become available primarily aimed at testing for Down syndrome.  These tests are offered in addition to the usual blood and urine tests in early pregnancy, and are also additional to the detailed ultrasound examination at around 20 weeks. These tests are looking for various genetic conditions in your baby. They are optional but need to be considered carefully.

This information sheet provides a summary of the tests available and is intended to be a reminder of the issues that need to be considered. You should not feel pressured to undertake any of these tests if you do not wish to do so. It is important to recognise that the choice of testing, and what you do with the results, is yours. I will give you advice on the different types of tests and options available but the ultimate decisions must rest with you.

I have provided you with some information about the different tests available, and what they are looking for.

There are two main groups of screening tests available to you:

  • Genetic tests performed before or very early in pregnancy
  • Prenatal tests performed at various stages throughout pregnancy
 
 

 Childbirth Education

 

Frances Perry House conducts childbirth education and early parenting classes. Information will be provided by Frances Perry House when you receive your hospital registration. Fees for private classes are usually covered by your health fund although there may be some out of pocket expense. I encourage both you and your partner to attend these classes, as they will prepare you better for labour, delivery, breast feeding and early parenting.

Several of these classes are available as an online program. Feedback from many of my patients has been very favourable for this format. There is still an opportunity for a hospital tour which I encourage.

 
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 Labour

 
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When you commence having contractions, or if your membranes rupture (waters break), please telephone the Delivery Suite directly on 9344 5100. The midwife in Delivery Suite will advise you about the appropriate time to come into hospital. After you have been admitted, the midwife will phone me with a progress report and I will usually come to see you shortly afterwards. It is normal to have a small “show” of blood prior to the onset of labour. If the bleeding is more than a teaspoon full, or occurs before you are 34 weeks pregnant then you should contact me immediately.

In labour you will have a range of pain relief available to you. This will include gas, morphine, TENS and an epidural if necessary. Nothing will be given without your permission and pain relief will always be discussed with you before a decision is made. You have the choice to have an enema on admission to labour ward, although this is by no means a necessity.

Provided there are no medical complications, you may deliver in whatever position you find comfortable at the time. I do not routinely cut episiotomies unless it is necessary to prevent a large tear. Following delivery, you will then have an injection to help deliver the placenta more quickly in order to prevent excessive bleeding. I recommend strongly that your baby has an injection of Vitamin K (rather than the oral form) in order to prevent internal bleeding complications that affects approximately one in 1000 babies. If this injection is given, the complication is never seen.