Frequently asked

What do I bring for my first antenatal appointment and how often will I see Pip?

Your initial visit (11-12 weeks) will involve a thorough history and examination and ultrasound of your baby. I will offer a scan every visit, so you can see your little one grow. If I have any worries, I will be referring you for a formal scan.

After your second visit, visits will occur every 4 weeks, until 28 weeks, then every two weeks until 36 weeks and then weekly until delivery. The number of visits you will have depends on how many weeks your pregnancy goes for and the individual needs of you and your baby. The average women would have a total of 12 antenatal and one post natal visit. Most of these appointments take around 15 minutes and include checking your blood pressure, the baby’s growth (fundal height), listening to the baby’s heart beat, discussion and review of test results and discussing any other topics that arise. Should there be any issues at any point, I will increase the frequency of your appointments, and if necessary, arrange for you to be admitted to hospital.

Here is a brief summary of appointments and topics/investigations

Your antenatal visits will be:

  • 11-12 weeks (introduction, general health in pregnancy, genetic abnormality screening)
  • 14 weeks (reviewing results from scans/bloods)
  • 20 weeks (review anatomy scan results)
  • 24 weeks (with myself and Midwife Deb Young)

(26-28 week blood form will be given, this includes your Glucose Tolerance Test “GTT” iron levels, Full Blood Count, Blood Group and antibody screen.

Referral to physiotherapy if required (I encourage this for pelvic floor exercises and prevention of back pain.

  • 28 weeks (review of above results)

From 28 weeks you will need a Whooping Cough Booster from your GP. This is known as “Boostrix”

You will also need a Flu Vaccination (safe in pregnancy)

  • 30, 32 weeks (routine check, formal growth scan to be ordered if required)
  • 34 weeks (review of growth scan)
  • 36 weeks (review with myself and Deb Young)

(group B strep swab test)

Confirm baby’s position

  • 37, 38, 39, 40, 41 weeks
  • Post natal check, 6 weeks after birth

 

The investigations you need during your pregnancy include:

  • Initial antenatal blood tests-usually organised by your GP.
  • 8-10 weeks: Dating ultrasound
  • 10-13 weeks: Optional Downs screening testing (and other chromosomal abnormalities), either via non invasive prenatal testing (NIPT) or a nuchal translucency ultrasound screening and blood tests.
  • 18-20 weeks: detailed anatomy scan to detect possible structural anomalies
  • 26-28 weeks: Blood tests- diabetes screen, iron studies, full blood count.
  • 36 weeks: Vaginal swab test for Group B strep carriage.

Why should I sleep on my side during my pregnancy?

Research shows that going to sleep on your side from 28 weeks of pregnancy can halve your risk of stillbirth, compared to going to sleep on your back.

After 28 weeks of pregnancy, lying on your back presses on major blood vessels which can reduce blood flow to your uterus and the oxygen supply to your baby. You can go to sleep on either the left or the right side – either side is fine. It’s normal to change position during sleep and many pregnant women wake up on their back. The important thing is to start every sleep lying on your side (both for daytime naps and at night). If you wake up on your back, just roll over on your side. It does not matter if it is your right or left side.


How to I check my baby's movements?

Most women will be aware of baby’s movements by about 20 weeks, although this may occur earlier with a second or subsequent baby. You may still have quiet days up until about 26 weeks of pregnancy.

What do movements feel like?

Movements may feel like kicks, stretches, pushes or sometimes you may be aware of hiccoughs. Movements are related to development of the baby’s muscles and nervous system and are a positive sign. Each baby has their own pattern of movement and it is important for you to become familiar with what is normal for your baby rather than comparing with a previous pregnancy or someone else’s baby.

During the last few weeks of the pregnancy the movements may feel different due to less space in your uterus, but you should continue to feel movements right up to and during labour.

I will ask you about your baby’s movement patterns at each clinic visit and will strongly recommend that you contact the hospital if you have any concerns about a change in pattern or frequency of your baby’s movements.

Being aware of your baby’s movements during pregnancy is one of the simplest things you can do to help keep your baby safe and healthy. Regular and healthy movements are a good sign of wellbeing. It is a myth that babies’ movements slow down or become weaker towards the end of pregnancy.

Your baby’s movements are one of the signs that your baby can give you that they are well. Getting to know the pattern of your baby’s movements is important – it is a way your baby can tell you that they are well. There is no set number of normal movements. You should get to know your baby’s movements and what is normal for them. You will start to feel your baby move between weeks 16 and 24 of pregnancy, regardless of where your placenta lies, and you should feel your baby’s movements right up until they are born, even during labour.

A baby’s movements can be described as anything from a flutter or a kick, to a swish or a roll and these are signs that baby is well. When a baby is unwell, he or she may try to save energy by slowing down their movements. This may be the first sign of a problem.   If you are concerned about a change in your baby’s movements, contact your midwife or doctor immediately. You are not wasting their time.

It’s important that this information be shared with partners, family and friends so that they too can understand the importance of fetal movements.

Guide to help you to get to know your baby’s movements:

  1. Sit or lie down in a quiet place, try to relax, and focus on feeling your baby’s movements
  2. It is important to take time to learn the normal pattern of movements for your baby. Ten movements over a two-hour period is often given as an average number of movements for healthy babies. However research is limited and every baby is different. Some babies are very active others are not. Its important to get to know your baby. The easiest way to learn your baby’s normal pattern of movement is to choose a time when baby is usually active and focus on their movements
  3. You may wish to record each movement you feel, but be mindful of any changes in strength of the movements as well as the number.

If you are still concerned about your baby’s movements after doing this, contact delivery suite at Wollongong Private Hospital (or myself in my rooms)  that very day or night. We will almost always recommend you come in for a review, a ‘CTG’ to monitor the babies heart and check movements.


Why should I see a pelvic floor physio during pregnancy?

I recommend every patient see a pelvic floor physiotherapists at least once during their pregnancy. Education is the key to informed decision making during your birth, and your pelvic floor anatomy, function and recovery will be discussed.  For a vaginal delivery your pelvic floor muscles need to be able to relax, and in the postnatal period the correct technique for your pelvic floor exercises is important for recovery.

The length of your perineal body (muscle at the opening of your vagina, between the vagina and the anus)  may also influence your risk of significant perineal tears.  A vaginal examination is undertaken to assess for over-activity and inability to stretch for labour day, correct exercise technique for pregnancy and the postnatal period, and your perineal body length will be measured.  The resting tone and strength of your muscles will be measured so we have a baseline, which will guide goal setting in the postnatal period.  Perineal massage will be taught.

The benefit of doing pelvic floor exercises during pregnancy include a 30% reduction of leakage urinary stress incontinence) after the delivery.


How much coffee can I safely drink during pregnancy?

Yes! You can still drink coffee during your pregnancy (although many women often dont feel like it in the first trimester) You can safely have up to 200mg per day

  • one cup of instant coffee: 100mg
  • One medium coffee at a coffee shop (latte, cappuccino, flat white) 140mg
  • one mug of tea: 75mg
  • one can of cola: 40mg
  • one can of energy drink: 80mg
  • one 50g bar of plain (dark) chocolate: around 50mg
  • one 50g bar of milk chocolate: around 25mg.

High levels of caffeine can result in babies having a low birth weight, which can increase the risk of health problems in later life. Caffeine is naturally found in lots of foods, such as coffee, tea, chocolate


Can I exercise during pregnancy?

There are many benefits to be gained from regular exercise during pregnancy. These include the physical benefits and the prevention of excessive weight gain, as well as benefits for psychological wellbeing. Women with uncomplicated pregnancies should engage in regular aerobic and strength conditioning exercise, for an average 20 – 30 minutes four to five times per week. Activities that have a possibility of falling (ie horse riding, skiing, cycling) or impact to the abdomen (contact team sports) should be avoided.

The new advice recommends that pregnant women to build up to activity on most days, preferably daily, with weekly totals of 2.5–5 hours of moderate-intensity physical activity, or 1.25–2.5 hours of vigorous-intensity activity. It is normal during the first trimester (often longer up to 16 weeks ) to feel too tired to exercise. Your energy will return.

Muscle strengthening twice weekly is also recommended. The guidelines also say pelvic floor exercises should be done daily, and long periods of standing or sitting should be broken up.

Exercise Guidelines During Pregnancy

The current RANZCOG exercise guidelines during a pregnancy without complication include:

  • Women should participate in a mix of aerobic and strength training during pregnancy
  • Women should be active on most if not all days of the week, 30-60 mins duration
  • Women should accumulate 150-300 mins of moderate intensity exercise per week
  • Include 2 x strength training sessions/ week
  • Include pelvic floor exercises 3-4x/week

Physical & psychological benefits of exercise during pregnancy include:

  • Maintaining general fitness
  • Management of back & pelvic pain
  • Preventing excessive weight gain
  • Reducing risk of pregnancy complications such as hypertension and pre-eclampsia
  • Decreased overall complications compared to women who are inactive
  • Shorter, less complicated delivery
  • Fewer neonatal complications
  • Contributing factor in reducing risk of gestational diabetes
  • Reduced symptoms of peri -natal anxiety and depression.
  • Reduced fatigue and stress

What are antenatal classes?

We run antenatal classes at our clinic, Amelie Private. I contributed to the writing and content of the classes, which are full of up to date and relevant information to help you navigate pregnancy, birth and the post natal period. The classes are run by our experienced and knowledgeable midwives.

Antenatal Classes – Pregnancy, birth & parenting series

Our course focuses on providing you with helpful information about your overall birth journey. It is great for new parents looking for a little extra help with early parenting skills.
This is a two part series run over two separate evening classes.
Our classes are offered to patients of Dr Pip Gale & Dr Jodi Croft

SERIES ONE TOPICS

Preparing for the birth of the baby
What to pack for Hospital
Pre-labour and labour
Stages of labour
Induction of labour
Pain relief
Instrumental deliveries
Unplanned Caesarean Sections
After delivery in hospital, what to expect

SERIES TWO TOPICS

Newborns, what to expect at the time of birth
Newborn sleep patterns
Feeding patterns
Settling techniques
SIDS guidelines
Swaddling, holding and massage
Wound and perineal care
Physiotherapy & exercise
Looking after yourself
Returning to intimacy


What is an induction of labour?

I consider many factors before inducing labour, including how the pregnancy is progressing, your age, medical history, and your own wishes for birth.  Our understanding of when to recommend induction has changed  in recent years, due to a number of major scientific studies that were published, including the ‘ARRIVE’ trial which recommends delivery at 39 weeks to reduce maternal and foetal complications (including the reduction of emergency caesarean sections).

Labour induction is the use of medications or other methods to start labour. The most common type of induction is a hormone gel induction. Another method of inducing labour is to insert a soft balloon catheter just inside cervix. I determine which method is the safest and best for you.

Prostin gel is synthetic hormone similar to the one your body procedures naturally. This hormone softens and opens the cervix ready for labour. It is used when the cervix hasn’t ripened by itself. Natural ripening usually happens over a few days before labour commences. When the gel is used to the cervix usually ripens overnight, it gradually opens and thins the cervix overnight with the aim of being able to rupture your membranes (break your waters) the following morning. Sometimes women go into labour with the gel, and spontaneously rupture their membranes overnight.

You will come to Wollongong Private Hospital the afternoon before your induction, at 3pm (Maternity ward, level 2). Bring your packed hospital bag. Partners are welcome to stay overnight with you.

On arrival, you will be given a room in the Maternity Ward. A midwife will be assigned to your care and will ask you some questions about your pregnancy and feel your abdomen to find out the position of your baby. A CTG (fetal heart tracing) monitor applied. A CTG involves placing 2 straps around your abdomen with a monitor attached, which records your baby’s heart beat (trace) for about 30mins.  If your induction is with a hormone gel (prostin), it will be inserted by your midwife into your vagina and the CTG will be put back on for another 20mins. Lying down for that time will also assist in absorption of the gel. As the gel is absorbed, most women start to contract.  For some women this will be mild period-pain type cramps and for others it will be strong labour-like contractions.  This may all settle down after a few hours or it may progress into labour.

You will be further reviewed about 6 hours labour to determine if you need a second dose of Prostin. If your cervix is already thinning and about 2cm dilated, you will not need a second dose. The second examination can sometimes be more uncomfortable as your cervix is starting to change and you will start to pre labour. Please let your midwife know if you are in any pain, we can offer you pain relief and a sleeping tablet if you need.  If you are in early labour and in discomfort,  you will be transferred to the Birthing Unit. Some women will go into labour during the night.

Things you should be aware of :

Prostaglandin sometimes causes vaginal soreness and irritation.
A small number of women experience some reactions such as nausea, vomiting or diarrhoea. Very occasionally, prostaglandin can cause the uterus (womb) to contract too much. If this happens, you will be given medication to relax the uterus.

The next morning

Your induction will commence around 8 am the following day. Your will be transferred to the Birthing Unit  (on the same floor) where you will meet your midwife who will look after your during your labour.  You will have a small drip inserted into your hand or arm, so we can give you fluids and your oxytocin drip. I will see you in the morning, I will examine you, and with permission, I will perform a vaginal exam and break your waters. I use a small clip that fits over my finger, rarely do I need to use the long hook that you may have seen in antenatal classes.

Your oxytocin drip is started and I encourage you to be as mobile as possible, as once your waters have been broken, gravity helps the baby’s head put pressure onto the cervix and helps dilate the cervix.

A small number of women (approximately 2 out of 1000) will not go into labour despite breaking the waters and starting an IV drip. These women will need to have a caesarean section.

Risks of induction of labour

Induction of labour has the following possible complications:

  • The Prostin may over stimulate the uterus causing contractions to be too rapid. This is why it is important to monitor your baby after the Prostin gel. If this occurs we give you medication through a drip to help relax the uterus. Overstimulation may cause distress to the baby and there is a very small chance you may need an emergency caesarean section.
  • You may not go into labour despite treatment.

The baby’s cord may prolapse (the cord come out of the cervix before the baby is born) after your membranes are ruptured (very rare) If this occurs you will need an emergency caesarean section.


What is a Caesarean section?

A Caesarean section is an operation in which a cut is made in your abdomen and in the wall of your uterus so that your baby can be delivered without passing down through your vagina. The cut is made low at the level of your bikini line.

It is a very safe and common operation, but with any surgery, complications can occur. Not all of these risks are unique for caesarean section but are increased compared to having a vaginal birth.
These consequences include:

  • Blood loss (slightly more than a vaginal delivery)
  • Wound infection (<5%)
  • Blood clots in your legs (known as a deep vein thrombosis, or DVT)
  • A blood clot that moves from your leg to your lungs (known as a pulmonary embolus). You will be given once-daily injections (clexane) while in hospital to minimise the risk of developing clots in your legs and lungs. This is a rare, but serious, complication of caesarean section.
  • Potential damage to organs near the operation site, including your bladder. This might require further surgery.
  • Anaesthetic risks such as low blood pressure, nausea and vomiting and post-dural puncture headache. This occurs when the epidural or spinal needle punctures the dura (tissue which surrounds the spinal cord). When a puncture occurs, it causes the spinal fluid to leak out of the hole and it is this which causes a headache. Most headaches will settle within a few days but some may last longer. Information about the risks of anaesthesia during a caesarean section and for pain relief can be found at anzca.edu.au/Patients
  • Slower recovery
  • Post operation neuropathic pain, a nerve pain around the wound that continues after 6 weeks. This is rare and usually settles with time.

Risks for the baby

The most common problem affecting babies born by caesarean section is temporary breathing difficulty. It is important to note that some babies are still difficult to deliver during a caesarean and forceps or vacuum may be used. They therefore may still have bruising around their head or body.

Benefits of a Caesarean Section

  • An elective caesarean is associated with small but reduced perinatal mortality (death of a baby) compared to a planned vaginal birth. This is because elective caesarean result in earlier delivery and we think because babies are not as big. Every day spent in the uterus carries a risk of unexplained stillbirth.
  • Elective caesarean prevents anal sphincter tears, which are much more common than previously assumed at 10–20 per cent of women who delivery vaginally, and the main factor for faecal incontinence in women
  • Elective caesarean prevents levator (pelvic floor muscles) and irreversible hiatus (muscle)l over-distension, which affect 12–35 per cent of women after a first vaginal birth and which are the main causes of female pelvic organ prolapse.

Operating theatre

The procedures for a caesarean section are very similar whether the operation is elective or an emergency.

When you arrive in the operating theatre, there will be a number of people present. All of them have an important role to play to ensure the safety of you and your baby.

  • Anaesthetist – will provide your anaesthetic and pain relief
  • Obstetrician – will perform the operation and deliver your baby (me)
  • Surgical assistant – assists the Obstetrician
  • Scrub nurse –coordinates the theatre and passes the instruments to the doctor
  • Scout nurse – assists the scrub nurse and gathers additional equipment that is required
  • Anaesthetic nurse – assists the Anaesthetist
    Midwife –receives the baby and cares for it until you return to the postnatal ward
  • Theatre technician – helps move you on and off the operating table, positions lights and equipment.
  • Support person-you are allowed one person with you

There will be a buzz of activity happening at this time, before the operation starts. A plastic cannula (thin tube) will be put into the vein in the back of your hand or arm so that fluids and medication can be given to you. A urinary catheter (a soft, plastic tube) will be inserted into your bladder to keep your bladder empty during the operation.  Your partner can stay with you during this time.

During the Caesarean, you will not feel any pain, but you will feel a lot of pressure and pulling.

A Caesarean Section usually takes about 40 minutes.

You will be wearing special stockings known as ‘TED’ stockings during the surgery until you are moving around after the operation. The purpose of these stockings is to reduce the risk of blood clotting during inactivity.

Baby friendly Caesarean Section

When your baby is born, we offer the drape to be dropped so you can see your baby being born (not everyone wants to). Your baby is lifted up so you can see your baby immediately, I then pass your baby directly to the midwife and if your baby is well, the baby will go directly into your arms for skin to skin. We aim for minimal separation of you and your baby and offer breast feeding in recovery with the support of our midwife. If you have an emergency Caesarean Section, sometimes this is not always possible, but we try our best to provide this to you.

Recovery after a Caesarean Section

Pain relief
You will get regular pain relief medication (paracetamol, an anti-inflammatory and a slow release stronger pain relief) You will also be charted for extra strong pain relief (endone or buprenorphine), as every woman has different pain relief requirements, you will need to ask for these. Please make sure you do, especially for the first 48 hours. Your pain will rapidly improve each day, you are walking the day after your Caesarean Section and are usually you will only require paracetamol and an anti-inflammatory when discharged home. I recommend taking this regular pain relief for at lease 3-4 days once you get home.

Bladder protection

  • Before the operation a catheter (tube) is placed into the bladder to allow urine to drain. This keeps the bladder empty and out of the way during the operation. The catheter is inserted in theatre after the anaesthetic has taken effect, usually within the first 12-24 hours depending on your mobility.
  • Following catheter removal the amount of urine will be measured. The bladder is generally back to normal when you have a normal urge to urinate, you pass 150 to 600mls of urine on more than two separate occasions.
  • Empty your bladder every two to three hours. Following the birth you will be losing body fluid that you gained during your pregnancy. This creates a lot of urine in the first few days. Keeping it empty will prevent over stretching of the bladder, help control wound pain and reduce the amount of bleeding from your uterus.
  • You should be aiming to drink 2-3L of fluid per day, especially when breast feeding.
  • After having a baby some women may experience discomfort or difficulty when passing urine, incontinence (leaking) of urine or a lack of sensation of a full bladder. Please let your midwife and Obstetrician know, these symptoms are usually short lived.

You may notice increased swelling in your hands and feet at this time which is normal. Continue to drink fluids, walk and go to the toilet regularly and the swelling will go away. When resting, lie on your bed and elevate your legs above the level of your heart.

Wound care

I use an absorbable suture for your wound, they are absorbed by the body and do not need to be removed. You will have a clear dressing on your wound which will be removed the day you leave hospital. Keep your wound clean and dry. Wear loose clothing and look for signs of infection (such as redness, pain, swelling of the wound or bad-smelling discharge). The incision will heal over the next few weeks. During this time, there may be mild cramping, light bleeding or vaginal discharge, as well as pain and numbness in the skin around the incision site.

Most women will feel well by six weeks postpartum, but numbness around the incision and occasional aches and pains can last for several months.

Try not lift any weight that is heavier than your baby. Be careful of your back when you lift and don’t lift anything that causes you pain. You should not drive a car until you have fully recovered and your wound has healed. This may take up to 6 weeks. I will see you at 6 weeks post delivery, but if you want to be cleared to drive earlier, see your GP. Avoid sex until you feel comfortable. After birth of any kind it is quite normal to take weeks, even months, before you are ready to have sex. If you are breast feeding, your vagina often feels sore and dry (this is because of decreased oestrogen as you generally do not ovulate).

Future births

As the number of previous Caesarean Sections increase, so does the risk of rare but serious complications. You should consider the size of the family you want. If you have four or more caesarean births, some complications become more common.

These include:

  • Problems with your placenta implanting low in the uterus, near your scar, in future pregnancies. This condition is referred to as placenta praevia.
  • Problems when your placenta does not come away as it should when your baby is delivered. This condition is known as placenta accreta and increases with each caesarean section
  • Extra procedures that may become necessary during the caesarean section such as a blood transfusion or emergency hysterectomy, particularly if there is heavy bleeding at the time of your caesarean section. A hysterectomy would mean you are unable to have any further children. The risk of needing to undergo a hysterectomy at the end of a subsequent pregnancy increases with each caesarean section, but overall is still very low.

What is delayed cord clamping?

Delayed cord clamping occurs when the umbilical cord is NOT immediately clamped after the baby is born.  The interval can be anywhere from 60 seconds to a number of minutes – some people refer to this as the ‘golden minute’.  Delayed cord clamping is recommended as standard practice by the Australian College of Obstetricians and Gynaecologists.

The baby will receive 50-100mls of blood, depending on the baby’s birth weight and most of this occurs in the first minute after birth.

The main benefits are increased iron stores in the first 6 months after birth.  Better circulation in the newborn infant. Less likelihood of anaemia, cerebral haemorrhage and necrotising enterocolitis. These benefits are more significant in premature or growth restricted infants.

The disadvantage of delayed cord clamping is an increased risk of jaundice with the baby more likely to require phototherapy with UV lights.

If you want to bank your baby’s cord blood then less will be available for storage with delayed cord clamping.

If the baby has the umbilical cord tight around the neck, it will require clamping and cutting before the shoulders are delivered.  If the baby requires resuscitation then it is more appropriate to clamp and cut the cord immediately to facilitate treatment.  In these situations delayed cord clamping will not be possible.

 


What is Group B strep?

Group B Streptococcus is a bacteria that is present in the vaginal or bowel flora in approximately 20% of women. Most women will not have any symptoms, however GBS can be significant for women in labour. We test for GBS (a vaginal swab) at 36 weeks gestation.

What happens if you are GBS positive in pregnancy? 

  • If a woman carries GBS and it is untreated there is a 1-2% chance the baby will get a significant lung (pneumonia) or blood (septicaemia) infection with serious consequences to the baby’s health.
  • Most babies who come into contact with GBS will not suffer any ill health, but unfortunately, we cannot tell which babies will get sick and which will not.

Women who are attempting a vaginal birth will normally be screened for GBS by having a low vaginal swab at around 36 weeks gestation.  The result only takes 2 days to return.If the result is positive, then the mother will be given intravenous penicillin in labour or when the waters break. Another antibiotic (Clindamycin) will be used if the mother is allergic to penicillin.

What happens if labour or the waters break prior to 36 weeks?

  • In these circumstances, a swab will be taken and antibiotics administered, as preterm labour has a higher association with GBS.

What happens if my labour is so quick that antibiotics are not given at least an hour before delivery?

  • The baby will have swabs from the groin and umbilicus taken and its temperature/observations monitored for 48 hours.

What about women who are having an elective Caesarean section?

  • Usually GBS swabbing is not necessary, as the baby does not come into contact with GBS during an elective Caesarean section.
  • On the rare chance of the waters breaking prior to the planned Caesarean section date then antibiotics may be given prior to the Caesarean section being performed.

When does your period return after giving birth?

It’s hard to be exact about when your periods will start again, as everyone is different.If you are breastfeeding your baby, your periods may not return for months or even years after childbirth. If your baby is being fed using formula, you may find your periods return shortly after childbirth, usually at the 6 week mark.

How long before your periods return while breastfeeding can depend on:
• your baby’s breastfeeding pattern (how often and how long your baby is breastfeeding)
• how sensitive your body is to breastfeeding hormones


How long after birth can you have sex?

When to have sex again is mostly about when you feel ready. The general advice is to wait until your 6 week check up with your doctor or midwife.

If you had stitches following your delivery, those sutures need time to dissolve, and the tissue needs time to heal so that it’s strong enough to withstand sexual intercourse. Many mothers feel pain or discomfort during sex, but this usually improves with time. Using a lubricant might make sex more comfortable. Sometimes discomfort can be because of muscle spasms or anxiety.

If you had a tear-free vaginal delivery and no other complications, you can resume sexual activity as soon as two weeks after giving birth, if you so choose.

You can fall pregnant before your cycle returns, so even if breast feeding (not a reliable contraceptive) contraception needs to be considered.

Breast feeding can cause vaginal dryness and pain, this is due to the lack of oestrogen in your system that occurs when you breast feed. Breast feeding can also affect your libido.

Some women and their partners find that sex is less satisfying because the muscles are too loose after being stretched during the birth. The muscles will gain tone again – pelvic floor exercises can help.


How long after birth do you bleed?

On the first day you may soak up to one sanitary pad each hour. Over the next several days, the bleeding will slowly get less each day and change colour from bright red to a pink or brown colour and then to a creamy colour. Most women will stop bleeding between four and six weeks after giving birth. Some women may bleed for longer or shorter than this. It is common for the bleeding to be irregular, often changing in colour.

You may have heavier bleeding:
• in the morning when you get up
• after breastfeeding
• after exercising


What to pack in the hospital bag

  • Long charger cord
  • Healthy snacks
  • Hair brush
  • Hair dryer
  • Makeup bag
  • Bio oil
  • Dry shampoo/nice smelling shampoo/haircare
  • Face wash
  • Contacts/glasses
  • Loose clothing
  • Bras
  • Loose undies
  • Computer & charger
  • Maternity nighty
  • Hair tie, bobby pins and clip
  • Essential oils
  •  headphones
  • Nursing tops
  • Thank you card (for staff)
  • Body wash
  • Pawpaw cream
  • Slippers
  • Dressing gown
  • Wipes
  • Adult Nappies and maternity pads
  • Hydrogel nipple pads
  • Nipple balm
  • Nipple shields

Bub:

  • Wipes
  • Going home outfit/nice wrap for photo
  • Bottles and steriliser if wanting to formula feed
  • Dummy (if needed)
  • Sudo cream
  • Sleep suit
  • Wraps x 3
  • Socks x 4
  • Nappies
  • Onsies x 3
  • Singlets x 4

How early can you test for pregnancy?

You can carry out most pregnancy tests from the first day of a missed period. If you don’t know when your next period is due, do the test at least 21 days after you last had unprotected sex. Some very sensitive pregnancy tests can be used even before you miss a period.


When do pregnancy symptoms start/most common

Pregnancy symptoms can start very early on, from the first day of your missed period. The most common early symptoms are

  • Sore/sensitive nipples and darkening of the skin around (areola)
  • Implantation bleeding. This is often described as ‘spotting’ and it’s not something every expectant mother will experience. It can sometimes be mistaken for an early period but is usually nothing to be concerned about.”One in four women will bleed in early pregnancy, many of whom go on to have a healthy baby.”
  • Cramping
  • Extreme tiredness- Many women has tweaked that they are pregnant after falling asleep sitting up at 3pm. Some women also experience increased breathlessness on exertion.
  • Nausea- Some experience nausea in the very early days of pregnancy, either in the form of subtle weakness and unease in the stomach, or in the more extreme cases, actual vomiting. It usually starts at the 6 week mark.
  • Night time bathroom visits
  • Constipation
  • Change in taste/sensitivity to certain smells
  • Feeling light-headed or dizzy- this is usually due to low blood pressure, which is a normal physiological reaction to pregnancy.
  • Mood swings

Of course, many of these symptoms are considered ‘normal’ for many women, but if you’re experiencing multiple, you might want to do a test when you can.


Is Panadol safe during pregnancy?

Yes

Paracetamol is the first choice of painkiller if you’re pregnant. It is commonly taken during pregnancy and does not harm your baby. It helps with pain and fever.

You can take normal doses of paracetamol (one or two 500mg tablets, every 6 hours up to 4 times in 24 hours with a maximum of 8 tablets in 24 hours)


When do you start showing in pregnancy?

Women will usually start to show around the 16 to 20-week mark with your first pregnancy. However, not every woman will experience pregnancy in the same way and may not start showing until the end of the second trimester or even in the third trimester.

Some women will not show until at least 28 weeks.
With your subsequent pregnancies you often show much earlier, the tone of the abdominal muscles, which tend to weaken after a first pregnancy..


How accurate are pregnancy tests?

The earliest most at-home pregnancy tests will read positive is 10 days after conception  Some early-detection pregnancy tests may read positive as early as eight days post-conception with about 75% accuracy. However, all pregnancy tests are most accurate if you wait until after your period is late, on or later then your expected due period. Testing is approximately 99% accurate if the test is taken correctly.


What is the full pregnancy term?

Full term is calculated at 37 completed weeks (your due date is dated at 40 weeks).


What are obstetricians?

An obstetrician is a specialist doctor whose area of interest is concerned with a woman during her pregnancy, labour and delivery

  • Antenatal care: During a woman’s pregnancy, an obstetrician is responsible for monitoring the health and wellbeing of the woman and her baby. Various tests and investigations are ordered to ensure the growth of the baby and the physical and mental health of the mother. Obstetricians are specialised doctors who also manage complications during pregnancy, such as medical issues, high blood, pressure, pre eclampsia and diabetes, as well as obstetric complications such as placenta praevia, pre term labour.
  • During labour: During labour, the obstetrician provides care during the birthing process and if complications arise, makes decisions on the mode of delivery and performs instrumental deliveries if required (vacuum or forceps)
  • Obstetricians also perform caesarean sections.
  • Post-delivery: The obstetrician is responsible for the woman and her newborn baby for six weeks during the post-partum period and will review the mother and her baby usually six weeks following.

Does private health cover obstetrician fees?

In Australia, Obstetetric private health insurance covers only hospital presentations, delivery and post partum care. Private health does not cover antenatal visits.


Meet Pip

I am very lucky to have a job that I love, that is rewarding and very humbling. I love coming to work each day, my days are always different, and it will never cease to amaze me the joy and excitement I feel when delivering a baby into the world. In Obstetrics the joy of seeing a baby born never diminishes.

Jodi and I have established a Women’s centred specialist clinic ‘Amelie Private’ one of the first Women’s health clinic in Australia that offers supportive and specialist medical and allied health services. Our clinic is centred around exceptional Obstetric and women’s healthcare.

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