Obstetrician Perth | Antenatal care
Why is antenatal care important?
Most pregnancies end with a good outcome for both mother and child. However, we cannot guarantee a good outcome, and problems can and do occur. Some of them occur suddenly, especially during labour.
As an expert obstetrician who is specialised in women’s health and fertility, I use my many years of experience to ensure you have the best antenatal care throughout your pregnancy.
Goals of antenatal care
Evaluating your health, lifestyle, and any conditions that may need to be monitored or managed during the pregnancy. This includes lifestyle changes that can support optimal pregnancy outcomes, tailored to you.
Keeping an eye out for any symptoms or conditions that may occur, including those without obvious symptoms.
Monitoring the health of your growing baby, its rate of growth, and its position in the womb as the pregnancy advances.
Screening for any genetic conditions or physical abnormalities. Providing the appropriate support, planning, and medical intervention in the rare case of a serious problem.
Ongoing monitoring of both your and your baby’s health, and management of any symptoms or conditions.
What happens during antenatal appointments?
Trimester 1: From conception to 12 weeks.
The baby is forming. Normally, I will see you at around 10 weeks. Together we will:
- Confirm that the pregnancy is going well.
- Consider any early symptoms and manage them appropriately.
- Discuss Down’s Syndrome screening, with NIPT or nuchal fold screening.
- Consider carrier screening.
- Consider the management of any problems in your medical history and their potential impact on the pregnancy.
- Talk about your ideas, expectations, and goals for the management of the pregnancy.
- Discuss any lifestyle issues you can address to optimise pregnancy outcomes through diet, exercise, and weight control.
Trimester 2: From 12 weeks to 28 weeks.
The baby is growing but still small. Problems during this stage are relatively uncommon and, therefore, I will see you infrequently unless there are specific problems to address.
- At 19 weeks I will see you after the formal anatomy scan. This detailed scan can find extraordinary detail in the baby. Most commonly, no abnormality will be found. That is most likely because there is no problem to find, but there are some limitations to what can be detected. The range of potential problems is vast. On some occasions, very serious problems are detected. The scan will also find problems that ultimately do not matter. For example, abnormalities in the developing kidney system are common but rarely important.
- At the next visit, you will meet our midwife, Elaine, and she will set up the blood tests to screen for gestational diabetes, performed at the end of this trimester.
Trimester 3: From 28 weeks until delivery.
At this stage, we are heading into the pointy end of your pregnancy. You are getting bigger and the physical toll of carrying the pregnancy is much greater. If there are going to be problems, it is at this stage that they are more likely to occur. To monitor this, we see you more frequently. You will visit every fortnight up to 36 weeks, and then weekly until delivery. At each visit:
- We assess how you are going, and check for any particular symptoms that you may have.
- We will measure your blood pressure, and assess how the baby is growing and how it is lying in the abdomen.
- We follow up on issues that may have arisen. Do we need a follow up ultrasound? Do you need iron? If you have gestational diabetes, how is the management going?
- We monitor the growth of the baby. Is it too big? Is it growing poorly?
- Has the baby lined up the right way? Breech (bottom) first is relatively common around 30 weeks, but most babies will turn to the correct position by 37 weeks.
- We start to develop our plan for how the delivery is likely to go.
How many antenatal appointments will I attend?
Once we pass the first visit and the first trimester, we gradually increase the frequency of visits. Most of our appointments are scheduled around late pregnancy when silent problems are more likely to occur.
The normal interval is for a first visit at around 10 weeks for early screening, and then another after the mid-pregnancy anatomy scan at 19 weeks. Then we will meet at 25 weeks and 29 weeks, before shifting to fortnightly until 36 weeks. From this point, we see each other weekly until delivery. Higher risk situations, such as twins, demand more visits.
Why Dr Chris Nichols?
One of the key components of antenatal care is getting to know each other. I take a light-hearted approach to pregnancy care because pregnancy and giving birth is generally an exciting and positive experience. But rest assured that below the levity, I am always looking seriously at how your pregnancy is progressing.
There is a mutual exchange that we will undertake to build trust. You will learn and understand how I work, and I will learn how you respond to the demands of the pregnancy. This trust will be very important if things deviate from the ideal and add to the enjoyable experience when everything goes well.