What is Antenatal care?

Antenatal care or pregnancy care is one of the oldest screening programs in medicine. The aim initially was to screen for pregnancy problems but as medicine has progressed, antenatal care is now also designed to either prevent or minimise the impact of pregnancy complications.

Your GP will perform initial investigations to confirm the pregnancy and determine a due date. After this you will be referred to an Obstetrician. An Obstetrician is a doctor who has spent an average of 15 years training to specialise in women’s health issues - 6 years at medical school, 3 years of training on average as a junior doctor in the public hospital system and 6 years of specialist training. In Australia you will have a choice of either being referred to a private Obstetrician or referred to your local public hospital maternity unit. I work exclusively in the private sector because it means that I can provide continuity of care to all of my patients and this is one of the safest models of Obstetric care in Australia.

I like to see patients initially at 6-10 weeks so that I can take a careful history and perform a risk assessment. This, along with tests that are performed between 10-14 weeks enables me to determine which patients have a higher risk of some pregnancy complications. This is a critical time in your antenatal care because we can determine your individual risk of pregnancy complications such as pre-eclampsia, growth restriction and the risk of pre-term labour. While we may not be able to stop these issues, when detected early we can often delay these and minimise the impact. In addition to this, these investigations will also tell us which babies are at risk of chromosomal disorders.

At 20-22 weeks you will have a morphology scan to make sure that you baby is developing normally. For low risk women this is often the last formal scan that they have in pregnancy unless issues are detected. I like to scan patients myself at every appointment so that I can make sure that the baby is moving, that the fluid around the baby is normal, the blood flow through the umbilical cord is normal and I can get an idea about the growth of the baby - this is not a formal scan and if you need to have the growth assessed I will send you for a formal growth scan.

So what happens at my appointments? At every appointment your blood pressure will be taken, the growth of the baby will be assessed, the fetal heart rate calculated, we will discuss any pregnancy symptoms you have and recent investigation results and as you get closer to your due date we will discuss plans for your delivery. Most private Obstetricians will also scan the baby themselves at each appointment but this often isn’t done in the public sector because they don’t have the resources to do so.

On top of this, you will have 24 hours per day, 7 days per week cover for unexpected issues that arise. In my practice, I have a call arrangement with 4 other private Obstetricians. From 8am Monday until 5pm Friday each of us look after our own patients. Between 5pm Friday and 8am Monday and on public holidays one of us is on call for all patients. In the public sector you will have cover from the midwives and Obstetric registrar (doctor training to be an Obstetrician) at you local hospital. The Obstetric registrar will be able to involve a consultant Obstetrician if needed.

I hope that this clarifies a very important part of your journey to parenthood.