Antenatal Care

I aim to provide an non-judgemental, open and caring environment for women and partners to discuss and explore their antenatal care and birthing choices.

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At my practice, Amelie Private, I provide antenatal and postnatal care for women who plan to have their baby at Wollongong Private Hospital.


I offer comprehensive antenatal care tailored individually to your needs. This antenatal care includes regular antenatal appointments at key gestations during pregnancy, along with planning for the safe birth of your baby. These will be discussed with you during your first antenatal appointments.

During the  routine scheduled appointments, I organise all ultrasound scans, blood tests and referrals for you. Patients are always welcome to come in for an extra check up and a scan for reassurance at any stage during the pregnancy, particularly in the early weeks until movements are felt. The antenatal period provides a valuable opportunity to meet with our health professionals, such as our pelvic floor physiotherapists, midwives, dietician and psychololgists if required.

We offer our own antenatal classes through Amelie Private, with our experienced midwives.

I support vaginal births for women when is it a safe and achievable option. I am open minded toward conception, pregnancy and birthing preferences.  I have the skills to provide vaginal births, instrumental births, Caesarean births, VBAC births and CALM births.™

I aim to provide an non-judgemental, open and caring environment for women and partner to discuss and explore their birthing choices. 

Your birth is not about right or wrong, it’s about feeling empowered so we both, together, make the safest plan for you and your baby.

Although an uncomplicated vaginal delivery is desired, there may be obstetric and maternal situations where it is not safe and a Casearean Section is recommended. I support women’s informed choices and support women to make their own, informed choices about their birth plans, including choosing elective caesarean section.

Partners, children and friends are welcome to all visits. I enjoy meeting families, and it’s a delight to see children that I delivered visit me when they are toddlers or older. I have a drawer full of stickers and stamps to keep them entertained and always involve them in the appointments.

Quality of Care and Personalised Attention

So that I can offer time and flexibility for my patients, I have a limit of women I accept per month. This allows for time for my patients and their families and to ensure I am not too tired and to ensure safety and clinical excellence.  I am on call for you and for emergencies 24 hours a day. If I am away, my patients are cared for by my Obstetric colleagues at Amelie Private, Dr Jodi Croft and Dr Natasha Luk, both wonderful women and Obstetricians. All my patients  are offered the opportunity to meet Jodi and Natasha during their pregnancy.

I believe that personalised care is not just about addressing medical needs but the emotional and psychological . It involves fostering a sense of trust and collaboration, so you can confidently make informed decisions that align with your values and preferences.

Collaborative care

The collaborative care model at Amelie Private includes midwives, lactation consultants, physiotherapists, psychologists, and dietitians, working  together to provide an exceptional level of care for your pregnancy. Book an appointment to benefit from our unified approach, ensuring you receive comprehensive support and access to quality educational classes, including antenatal (birthing classes), as well as first aid and CPR classes for grandparents and carers.

My practice (Amelie Private) is a welcoming haven, it is beautifully designed and my support staff are friendly and approachable, nothing is too much for them. At Amelie Private, you will meet our midwives, lactation consultants, physiotherapists, psychologists and dietitian as part of one team. I can organise an appointment as we all work closely together as a team to provide an outstanding level of care. We pride ourselves in offering quality educational classes, including antenatal (birthing classes) and grandparents and carers first aid and CPR classes.  We are the only Obstetric clinic in Wollongong that offers such a unified and collaborative care model.

Amelie Private

High risk pregnancy

For some women pregnancy may be considered high risk,  such as multiple pregnancy or fetal abnormalities, or maternal factors like pre-existing or pregnancy related health issues.

I have experience in  providing care to pregnant women with health issues including diabetes, cystic fibrosis, rheumatoid arthritis and auto immune conditions, psychiatric illness, as well as multiple pregnancies and pregnancies complicated by pre-eclampsia or hypertensions. In many cases he will provide care to these women in conjunction with other medical specialists.

Frequently asked about Antenatal Care

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


When do pregnancy symptoms start?

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.


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..


What is the full pregnancy term?

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


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My plan for birth is simple, for a healthy baby and a healthy mother

The care I provide for my patients is based on open communication, education and support.

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