Sign In
Ongoing care
​​​

​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​Each pregnancy is unique and your care will be tailored to your specific needs. Below is a guide for what to expect when you have your antenatal appointments with your chosen pregnancy carer e.g. midwife, GP or obstetrician. 

We have also added some information and discussion points. Click on the links to find out more

Each visit will be approximately 30 minutes long and include an assessment of you and your baby. This includes blood pressure, weight, and general health and wellbeing. We will, ask about baby’s movements​ and measure baby’s growth. Each visit is an opportunity to share information, so please bring your questions​​


On this page:



Screening for gestational diabetes


External LinkGestational diabetes mellitus  (sometimes referred to as GDM) is a form of diabetes that occurs during pregnancy. 

Gestational diabetes is diagnosed when higher than normal blood glucose levels appear during pregnancy. Some women have risk factors that predispose them to gestational diabetes and so they are tested in early pregnancy. For everyone else we recommend they are tested at around 26 weeks gestation. 

Most women will no longer have diabetes after the baby is born.

The test we recommend at 26 weeks is called a 75 Gram Glucose Tolerance Test (75gGTT). It is a blood test and involves the following: 

  • You will need to book an appointment at a pathology service and allow two hours for the test.
  • It is a fasting blood test so we recommend you try and have it done early in the morning before breakfast
  • You will need to fast (no food) from midnight the night before but you can drink water 
  • When you arrive the pathology staff will attend the following;
    1. take the first blood test 
    2. give you a special  glucose drink 
    3. take your blood one hour after you finished the drink
    4. ​take your blood again, two hours after you finished the drink 
  • For this test to be accurate, you cannot eat or drink or do any activity up until all blood tests are completed
  • We recommend you bring something to read or do to occupy your time.


Regular appointments


Every pregnancy is unique, therefore the schedule of antenatal appointments will be tailored to your individual needs. As a guide, women will be seen approximately 10 times in their first pregnancy and about eight in subsequent pregnancies. These appointments may be with midwives or doctors depending on the circumstances. Please leave enough time for parking and endeavour to come on time to these appointments. A support person, and other children are welcome to join you if they are well.

alternate text 47 ​​​

20 weeks

​Your pregnancy care provider will;

  • Discuss  your morphology ultrasound results
  • Provide information about the pelvic floor. See moreExternal Linkinformation about incontinence
  • Discuss the recommended blood test. See screening for gestational diabetes information section above. To check forExternal Linkgestational diabetes and provide a referral to have the test between 24-28 weeks  
  • Discuss the importance of your baby’s movements and strategies to reduce the risk of stillbirth. SeeExternal Linkmore information here
  • Provide information aboutExternal Linkinfluenza,External LinkCovid-19 andExternal Linkwhooping cough​ vaccinations in pregnancy.

​ 24 weeks

Your pregnancy care provider will;

  • Discuss pregnancy, birth and early parenting classes. Please see book an antenatal class section on this page below
  • For those with a negative blood group, we will discuss the Anti D immunoglobulin. See morePDF iconinformation here​

​ 28 weeks

Your pregnancy care provider will;

​ 31 weeks

Your pregnancy care provider will;
  • DiscussExternal Link​breastfeeding​ and with consent they will attend a breast check. We encourage you to book in to a breastfeeding class. If you report any concerns you may be referred to a lactation consultant​

​ 34 weeks

Your pregnancy care provider will;

​ 36 weeks

Your pregnancy care provider will;
  • Ask you to do attend a perianal swab to test forExternal Linkgroup B streptococcus
  • Discuss your birth preferences and answer any questions you may have 
  • For women having a plannedExternal Linkcaesarean section​ operation: this is when you will have an appointment with an anaesthetist and an obstetric doctor

​ 38 weeks

Your pregnancy care provider will;
  • Discuss the option of aExternal Linkcervical sweep at your 40 weeks visit 
  • Discuss your birth preferences and answer any questions you may have

​ 40 weeks

Your pregnancy care provider will;

​ 41 weeks

Discuss the likelihood of anExternal Linkinducti​on of labour​ if labour has not started. (Most babies are born 39 – 41 weeks) and confirm a plan for induction of labour in line with your preferences

Book an antenatal class​

alternate text 47 ​​

​ Royal North Shore Hospital

Childbirth and Early Parenting Education is a pre-natal education unit within the Lower North Shore Health Promotion Unit.

A range of face to face and online childbirth and early parenting courses are available. 

Choose from birthing and parenting courses, hypnobirthing, breastfeeding, baby and child CPR and exercise programs. Some courses are also available in Korean and Mandarin. 

Visit our page in the link below to view all courses available and course descriptions.

​ Hornsby Ku-ring-gai Hospital

Hornsby Ku-ring-gai maternity services offer assisted self-learning packages and face to face birth and early parenting courses.

Childbirth and early parenting education classes are held in the Education Room, which is within Maternity Services located next to the antenatal clinic

Please talk to our staff to see which option best suits your needs and visit the below link to secure a place.

​Specialist services​

alternate text 47 ​​​

​Maternal Fetal Medicine Unit

You may be referred to our service by your GP, treating hospital or your private obstetrician. Your referring doctor will need to complete the RNSH Maternal Fetal Medicine Unit Referral to give us all the necessary information. Please give your referring doctor your correct phone number for the referral form. If we are not the right service for your needs your referring doctor will be contacted. We will call you with your appointment date and time. 

The Royal North Shore maternal fetal medicine unit provides support and care for women and families with a complex pregnancy. 

Our role is to support and inform you to enable you to make the best decisions for you and your baby. To do this, we coordinate a broad team of health professionals including maternal fetal medicine specialists, midwives, neonatologists, paediatricians, social work and clinical geneticists.   

The services that are available at the maternal fetal medicine unit include:

  • Comprehensive care of complex pregnancy
  • Ultrasound scans for growth and development
  • Diagnostic testing including amniocentesis and chorionic villus sampling (CVS)
  • Pre-pregnancy counselling 
  • Care of families following pregnancy loss

Referrals

You may be referred to our service by your GP, treating hospital or your private obstetrician. Your referring doctor will need to complete the RNSH Maternal Fetal Medicine Unit Referral to give us all the necessary information. Please give your referring doctor your correct phone number for the referral form. If we are not the right service for your needs your referring doctor will be contacted. We will call you with your appointment date and time. 


Referral information for doctors

Please ensure that the MFM referral form is completed correctly to ensure timely triage

The following must be provided with the referral request

  • Copy of all previous ultrasounds
  • Copy of all antenatal blood screening, blood group, antibodies, HIV, Hep B and Hep C
  • Prenatal screening e.g. NIPT
  • We ask that those women referred have a dating scan attended prior to referral
  • Referral criteria for GPs can be found in the following Maternal Fetal Medicine ReviewExternal LinkHealth Pathway


Appointments

Appointment times are Monday to Friday from 8:00am to 3.30pm.

You will need to arrive 10 minutes before your appointment time to complete paperwork, if you are more than 10 minutes late for your appointment it may be necessary to re-book your appointment.

Please drink one glass of water one hour before your scan.

Please bring your Medicare card 


Cancelling or rescheduling an appointment

The timing of your appointment can be very important to your care and management. We encourage you to attend the appointment you have been given and if you need to cancel and re-book please contact us as early as possible, so we can arrange another appointment time that will be suitable.


Interpreter services

If you need an interpreter for your appointment we can provide a professional interpreter for discussions with the MFMU staff.  Please let us know when booking your appointment. If we cannot book an interpreter the telephone interpreter service will be used.


Location and contacts

We are located on level 3, Clinical Services Building, Royal North Shore Hospital

Westbourne St, St Leonards NSW 2065

MFMU can be contacted Monday to Friday between 7:30am & 4:00pm on

Tel: 02 9463 2370

Fax: 02 9463 1005

Email: NSLHD-MFMU@health.nsw.gov.au


Cost

For Medicare card holders there will be no cost to you for any ultrasound scans. Non-Medicare patients are required to pay the standard consultation fee, which is to be paid either on Level 2 of the Clinical Services building or at the cashiers on level 3 of the Acute Services Building. Please allow 20 minutes before your scan to complete this payment.

​Specialist Obstetric clinics

Most women have an uncomplicated pregnancy, however, some women either have existing medical conditions or develop pregnancy related complications. Both Royal North Shore and Hornsby Ku-ring-gai hospitals have specialist obstetric clinics that provide care, in combination with the midwives, for these women.

If you need to see an endocrinologist, diabetic educator, renal consultant, dietician and/or an anaesthetist you will be referred by your midwife of doctor.

Each clinic operates within the services maternity unit.

Some women may see up to three specialist doctors during their appointment time. For this reason appointments can be lengthy so please allow several hours.​

alternate text 47 ​​​

​ Perinatal mental health

​Pregnancy and parenthood is a time of big change for new parents. What’s often not spoken about are the challenges that can come with it. Mental health struggles can come in the wake of a pregnancy or when raising an infant and are far more common than many people realise.

Perinatal mental health conditions affect mood, behaviour, wellbeing and/or daily function of an expecting or new parent. The term ‘perinatal’ refers to the time from conception and pregnancy through to the first year after birth.

Coping with the physical and emotional changes of pregnancy, childbirth and parenting, lack of supports and experiencing difficult times, as well as change in sleep associated with pregnancy and having a new baby, can increase a person’s vulnerability to developing anxiety and or depression in the perinatal period.

For women who have already suffered a mental health problem they may fear a relapse will occur during this time.

Treatment of mental health problems is very important. Without treatment, women, babies and families can suffer and sometimes there can be long term effects. It is important to seek early support to maintain good mental health.

As soon as you know you are pregnant please discuss with your GP (General Practitioner) any past or current mental health concerns so the right supports can commence for you.

The Perinatal Psychiatry Service is a small specialist service for inpatients and outpatients.  The team provides care for women in pregnancy and up to six weeks after birth. This maternity service is available for women in the NSLHD (Northern Sydney Local Health District).

The Perinatal Psychiatry Service may provide assistance to you and your healthcare team to plan and manage your mental health needs during your pregnancy and during the early perinatal period. This includes:

  • Perinatal mental health assessment and consultation
  • Providing advice about medications used for mental health conditions in pregnancy and breastfeeding
  • Support for women as they move from hospital care to community services.

If you think you need support for a mental health concern talk to your obstetrician or midwife and together a plan can be made for ongoing support and referral to our services. 

Urgent mental health support:

For urgent mental health support 24 hours a day you can call the Mental Health Line on 1800 011 511 or go to your nearest Hospital Emergency Department or call 000

​ Social work

Social work is an important component of the maternity services team at Royal North Shore Hospital. We complement the medical, nursing and other allied health services, and advocate for women and their families in their journey through the health system during their perinatal care.  

Our team of skilled social workers is dedicated to maximising women's choice and control over their own health care, and enhancing the wellbeing of parents and babies.  We offer services to women, babies and families from diverse backgrounds and support women and their families with complex social and medical needs.

Social workers offer assistance based on your individual needs. We provide information, counselling, support, service coordination and advocacy in response to health and social needs.


Who we support

  • pregnant women and their families during their antenatal care
  • women, families and their babies in hospital after birth
  • women and their families with a baby in our Newborn Care Centre
  • families consulting with Maternal Foetal Medicine
  • families experiencing pregnancy loss


Social workers in maternity services can

  • listen to your story and treat you as an individual, with respect and dignity
  • aim to provide a culturally sensitive service
  • arrange an interpreter, if you need one, so you can explain your situation and needs fully and understand everything we discuss
  • offer counselling and support for you and your family
  • provide support with life stressors including relationships, financial hardship and housing
  • offer grief and bereavement support 
  • provide support, education and referrals in relation to domestic and family violence
  • offer support when families are working with the NSW Department of Communities and Justice
  • offer counselling around making difficult decisions in pregnancy
  • provide information and make referrals to other services that can provide you with ongoing support in your community
  • refer to legal and migration support services
  • offer support if you or your baby has a disability or health problem
  • provide service coordination related to your care, as required
  • advocate on your behalf within the hospital and community
  • support you in  navigating hospital systems and be present if you need to attend meetings within the hospital
  • assist with preparation for discharge from hospital


How to access social work 

Ask your midwife or doctor you see in the hospital if you can talk to a social worker​

Pregnancy care resources





​B​ack to topalternate text 47​​​​​​​​​​