What follows is the typical antenatal care plan that I recommend for low risk pregnancies. It is important to understand that your care will be individualised to your personal circumstances and wishes. All of these investigations can be discussed in more detail if required. Click on each tab for more information.
6-8 weeks. Booking investigations
Blood tests for: blood count, blood group and antibodies, rubella, syphilis, HIV, Hepatitis B&C
Mid stream urine.
These are usually done by the GP. Tests such as ferritin, vitamin D and thyroid tests can be done in women at risk of abnormal levels.
8-12 weeks. Dating ultrasound
Not always required if you are certain of your dates or if you are having an ultrasound for the Down’s syndrome screening.
8-12 weeks. First obstetric visit
This is an extended consultation where we discuss your medical and pregnancy history, perform an examination, confirm the presence of the baby's heartbeat and its approximate size, and discuss a management plan for the rest of the pregnancy. There is an opportunity to ask questions. Financial information is provided.
10-13+6 weeks. Down's syndrome screening
The first trimester screen is the most common screening test for Down's syndrome available in Victoria. This is optional and requires pre and post test counseling. It requires a blood test (10 weeks) and an ultrasound scan (11 to 13+6 weeks). This can be arranged by your GP or by us. It is important to note that whilst screening tests are reasonably effective, they are not guaranteed to be 100% accurate.
A new blood test can detect common chromosomal abnormalities with near 100% accuracy. This non-invasive prenatal screening test (NIPT) measures fragments of the baby's DNA found in the mother's blood. Whilst it is more accurate it is also more expensive. I am happy to discus this with you.
16 weeks. Routine antenatal check
A chance to review any outstanding results and perform a general check up.
The anatomy ultrasound scan is arranged.
19-20 weeks. Detailed anatomy scan
The anatomy ultrasound scan is designed to perform a detailed review of the developing baby and placenta. It is able to detect the majority of major abnormalities that can occur, but may not always detect every problem that can arise. If you wish you can find out the sex of the baby at this scan (although many women are choosing not to find out until the birth).
We will meet at around 20 weeks to review the scan result
24-28 weeks. Routine checks and blood tests
Checks are performed at 24 and 28 weeks. At 26-28 weeks we recommend a blood test to check for anaemia, red blood cell antibodies, and a glucose test for diabetes. The new national guidelines recommend a 2 hour glucose test (blood tests before, one and two hours after a sugary drink) for all women.
If your blood group is Rhesus negative you will be advised to have an anti-D injection at this stage.
31-34 weeks. Routine checks
Visits become closer at this stage, usually every 2-3 weeks. At 34 weeks Rhesus negative women receive a second anti-D injection.
36-38 weeks. Birth planning and vaginal swab for GBS
Visits are now every 2 weeks. At 36 weeks we offer a vaginal swab for Group B Streptococcus (GBS), a common bacteria which many people carry in their bodies. Women who carry GBS are advised to have antibiotics in labour to reduce the small risk that the baby may contract an infection whilst coming through the birth canal. You can take the swab yourself prior to coming to the clinic.
If you wish to make a birth plan or discuss your birth options, we can do this during these visits, or at any point earlier in the pregnancy.
39-40 weeks. Routine checks and preparing for the birth
Weekly visits until the birth
41 weeks. Post dates planning
If you are going overdue, we can discuss the options including a stretch and sweep of the membranes and an induction of labour.