You are pregnant

Congratulations on your pregnancy. Sometimes it is difficult to know what to do next. The information here is focused on early pregnancy and how to link in with the right pregnancy care for you and your families’ individual needs.

Your GP

No matter where you plan to have your pregnancy and birth care, we recommend you have your first pregnancy appointment with your local doctor (GP).

If you do not currently have a local GP, pregnancy is a good time to find someone who can be your family GP. You can ask friends or family members who they recommend or, if you are looking for a GP who speaks a certain language or who understands your culture, ask people in your community about who they recommend.

Your local GP can do the early pregnancy visit and organise your first tests and investigations, such as early blood tests and ultrasounds. They can also answer any questions you may have.

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Tests you may need

Your GP can order blood tests to check the following:

Blood group and antibodies
Full blood count including haemoglobin
Immunity to rubella (German measles)
Whether you have been exposed to hepatitis (a disease of the liver)
Sexually transmitted diseases such as syphilis and HIV (this test is offered with pre and post-test counselling)

For women who are at risk a blood test is also offered to check for:

Vitamin D (deﬁciency that can occur from lack of exposure to sunlight)
Hepatitis C
Thalassemia (an inherited disorder that affects the production of haemoglobin).

Your GP can also organise the following tests:

Urine test - to check for infection.
Cervical Screening Test - if you are due, this can be done safely in pregnancy. Find more informationhere.
Genetic tests- There are a number of different tests available to assess the health and development of a baby before birth. Find more informationhere.
Ultrasound – which can look for a number of problems in your baby like spina bifida, heart and limb defects and to check your due date.
If you are a GP and would like more information please see to thePregnancy Health Pathway

You can also talk to your GP about:

When your baby is due
Any concerns you might have about your pregnancy or general health, including mental health
Diet and exercise
Smoking, alcohol and other drugs and if needed support to help you quit
Any medications you are taking and check they are safe in pregnancy, including any natural or alternative medicines
Any issues that may affect your pregnancy such as your family’s health.

Aside from medical issues, the doctor may also ask about your circumstances such as:

Whether you might be at risk of family violence
What you have support from family and friends
Previous miscarriages or terminations and how you are feeling about them

This is to make sure that all women are offered appropriate information, support and referral.

Options of care

In Northern Sydney Local Health District we believe that every pregnancy is unique and that care should be personalised to each individual’s needs.

Our team of midwives, doctors and allied health care professionals provide collaborative care, where the woman and her family remain at the centre of the experience and involved in all decisions about pregnancy, birth and the postnatal period.

We encourage you to talk to your midwife or doctor early in pregnancy to discuss your options. We can’t always accommodate your preferences, however we will work with you to find a model of care that meets your needs.

Most of the cost of your care is covered by Medicare, if you are eligible.

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Midwifery clinics

If you are having a healthy, normal-risk pregnancy, having your baby under the care of the hospital midwives may be a good option for you. If you choose this option, you will probably receive care from a few different midwives during your pregnancy. If something unexpected happens, and you need additional care, you would be referred to a doctor at the hospital. When you have your baby, you will be cared for by the midwives and doctors on duty in the birth unit. After your birth, the midwives on the postnatal ward care for you. When you take your baby home, the midwives from the midwifery-in-the-home team can visit you and you baby in your home. Your midwives can assist in coordinating any additional supports, if you need them.

You may also be offered the opportunity to have a student midwife provide extra support to you throughout your pregnancy and birth. They will always be supervised by a registered midwife.

Shared care

This model of care takes place in partnership with your general practitioner (GP) and our hospital obstetricians or midwives. Some of your care is with your GP, and you come to the hospital for some appointments. When you have your baby, you will be cared for by the midwives and doctors on duty in the birth unit. Our hospitals can help you find a GPs in your area who provides GP shared care as well those who speak specific languages.

One of the benefits of GP shared care is that you develop a long-term relationship with your doctor who can continue to look after you and your baby in the future.

Obstetric clinics

With this option, your pregnancy care is through the hospital doctor’s clinic. This option is for women who have special circumstances relating to their pregnancy and/or health such as twins. It is likely you will see a few different midwives and doctors during your pregnancy. When you have your baby you will be cared for by the hospital midwives and doctors. When you take your baby home, the midwives from the midwifery in the home team can visit you and you baby in your home.

Midwifery group practice (MGP)

In this care model, a small group of midwives care for you during your pregnancy, labour, birth and after birth through home visits. Most of your care is given by one midwife, called a primary midwife.

Maternity antenatal postnatal service (MAPS)

With this option of care, most of your antenatal care is attended by a known or primary midwife. When you have your baby, you will be cared for by the midwives and doctors on duty in the birth unit. After your birth, the midwives on the postnatal ward care for you. When you take your baby home, the known midwife will visit you and your baby at home.

Private obstetrician

You may choose to have your care with a private obstetrician who will provide all your pregnancy care.

Labour care will be provided by birth unit midwives and your obstetrician will be present at your birth. Whilst in hospital you will be cared for by midwives in maternity.

You will need to check with your health fund regarding hospital expenses and check with your obstetrician with regard to their professional fees.

Early pregnancy concerns (the first 12 weeks)

During pregnancy, there are many changes going on in your body. While some fatigue, mood swings, and body aches are common during pregnancy and usually not concerning, other pregnancy symptoms are potentially more serious. Many are minor annoyances, but some can be an indicator of a pregnancy complication.

It is important you attend your antenatal visits, have the tests and screenings your health care provider recommends, and always seek healthcare advice if you have any questions or concerns. We are here to care for you and will take your symptoms seriously.

When to call your doctor

If you are worried or unsure about any pregnancy symptom in early pregnancy, we recommend you call your GP for advice in the first instance.

If you experience any of the following symptoms please see your GP or go to your local hospital emergency department (ED) if it is out of hours or you cannot reach your doctor.

Vaginal bleeding (If you are having heavy vaginal bleeding or have severe lower abdominal pain, please present to your nearest emergency department or phone 000 for an ambulance).
Abdominal Pain
Excessive nausea and vomiting (It's normal to have some nausea and vomiting during your first trimester. If it's severe or makes you dehydrated, if you can’t keep any water or fluids down for more than 12 hours, call your doctor).
High temperature (fever)
Vaginal discharge and itching
Pain or burning during urination
Leg or Calf Pain, or Swelling on One Side
Severe Headache
Flare-Ups of Chronic Diseases (Women who have certain pre-existing medical conditions -- such as diabetes, high blood pressure, asthma, or lupus -- should note any changes in their condition during pregnancy).
Mental health concerns (feelings of a low or sad mood, loss of interest in fun activities, changes in appetite, sleep, and energy, problems thinking, concentrating, and making decisions, feelings of worthlessness, shame, or guilt, thoughts that life is not worth living.

Early pregnancy assessment

Occasionally women have early pregnancy symptoms that require review in a specialist early pregnancy clinic. You will need a referral from either your GP or an emergency doctor prior to making an appointment.

For more information, please visit External Link

Early Pregnancy Assessment Service (EPAS)

Nausea and Vomiting in Pregnancy and Hyperemesis Gravidarum

NSLHD provides a service to women who are suffering from Hyperemesis Gravidarum, providing access to clinical care and psychosocial support. Your GP can refer you External Link

to the Virtual care service for a full assessment of your symptoms, an individualised care plan and access to IV fluids if you need them.

Mothersafe information sheet

Early pregnancy resources

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