Care in Pregnancy
Pregnancy is a collaboration between you, myself and the midwife team of the Hospital you choose to deliver in. I place individualised care at the fore front of the management of your pregnancy and personally attend to all your antenatal visits and labour. In doing so, I maximise my understanding of your needs and concerns. I beleive the best outcomes are derived from the relationship and communication developed over time from such continuity of one to one care.My management includes:
- Checking all the relevant tests have been performed.
- Counselling of screening for genetic disorders including Downs syndrome
- Screening for Pre eclampsia
- Pelvic floor assessment
- Organise ultrasounds at 12, 20 and 32 weeks of pregnancy
- Screening for diabetes, group B Streptococcus colonisation of the vagina
- Anti D administration in susceptible women
- Discussion on cord blood storage
- Advice on minimising pelvic floor damage in labour
- Monitoring and management of medical complications in pregnancy
Antental vists are scheduled early in pregnancy. At the first appointment, I will check to ensure that all your relevant tests have been performed and to undertake more testing if required. It is also the time when we will chat about the value and options of genetic screening and undertake these if desired. Normally I will see you 4 weekly as the pregnancy progresses until aout 28 weeks when we switch to 2 weekly visits. Weekly visits commence from 36 to 38 weeks onwards till delivery.
As the pregnancy progresses, we will be discussing issues that may concern you including pain relief, birthing plans etc. An assessment of mental health issues will also be offered. This is a Medicare requirement although you can always decline this assessment if you so desire.
Pre eclampsia screening is now available and should be considered. It uses a number of proteins in the blood test for Downs syndrome like Papp A, together with the 12 week ultrasound to try to predict if a woman will develop this condition in pregnancy. If the risk is raised than precautions can be taken to try to minimise the risks.
I am a firm believer in good pelvic floor care. All women will be offered the opportunity of an assessment of their pelvic floor muscle strength in early pregnancy. Arrangements can be made for learning pelvic floor exercises in women who require it. I would recommend a specialist pelvic floor physiotherapist for this. The use of a pelvic floor trainer to help minimise pelvic floor damage in childbirth and to aid pelvic floor exercises will be discussed. At the 6 week check post delivery, I will again assess your pelvic floor integrity and initiate treatment if required.
Communication is an important aspect of your care. Copies of investigations undertaken are routinely forwarded to the Hospital and family doctor. All my patients are given a medical record that is easily carried in a handbag. This forms the communication between myself and any other doctor that may attend to you, as well as the Hospital. it is important to bring this card in when you see me and also for any admission into the Hospital.
I see it as my role to provide you with information to allow you to make decisions appropriate to yourself and your baby. Of course I will also provide my guidance and opinion to help you come to decisions on issues that arise.
When in labour, I liaise closely with the midwives caring for you. Whilst some of the examinations can be performed by them, I will see you at regular intervals to assess your progress. Management decisions made in labour are usually joint ones between yourself and I, with input from the midwives.
In the postnatal period when you are in Hospital, I will review you on a regular basis. it is one of the most difficult times for new mothers. Tiredness and breast feeding difficulties often come to the fore. Commonly with the expertise in breastfeeding from the midwives, things improve. My role is to oversee your recovery in that period of time. Subsequent to your hospital discharge, I am still available for you to call upon should you have concerns. Normally I will see you again at the 6 week check and if all is well, will discharge you back to your family doctor.