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OBSTETRIC NOTES FOR EXPECTANT MOTHERS

Congratulations and welcome to my practice. For many of you (having your first child) this
will be the beginning of a new era in your life. For those already with children, I hope this is
another rewarding experience.
CHOOSING YOUR HOSPITAL
I deliver at the North West Private Hospital. By limiting myself to this location, I hope to
provide a high standard of service. As soon as convenient you should book in, even if you
have had your baby there before. Ring the hospital to book in. They take bookings from 15
weeks onwards. If you have a premature baby of less than 33 weeks and need to be
delivered at the Royal Womens, I will continue to care for you there.
North West Private Hospital Phone 1800 555 549 between 8am-6pm Mon to Fri

ANTENATAL EDUCATION
I would encourage you and your partner to learn as much as possible about your pregnancy
and childbirth. You will be given information about antenatal classes at the hospital when you
book in. A good book is “What to Expect When You’re Expecting”.
ANTENATAL TESTS
On booking with me you will have a number of blood tests performed. These include your
blood group, haemoglobin (to exclude anaemia), Rubella (German Measles) serology and
Hepatitis B serology. A pap smear will be performed if necessary. I often perform an office
ultrasound at the first visit to check foetal viability. I also offer a scan at 19 weeks to make
sure the baby is healthy and to check the position of the placenta. Twins will need to be
excluded also, of course! A glucose screening test is often performed at 28 weeks to exclude
pregnancy induced diabetes.
Down’s Syndrome is rare, occurring in 1 in 800 babies. The incidence increases with
advancing maternal age. A screening test is available to determine whether Down’s
Syndrome is likely in your pregnancy. This is a scan performed at 12 weeks. It is not perfect.
It picks up 8 out of 10 Down’s Syndrome pregnancies. Also 5% of women are told this scan
is abnormal when only a much smaller number actually have a Down’s Syndrome pregnancy.
If this screening is abnormal, then a follow-up amniocentesis is performed. This “nuchal
translucency scan” is totally optional. Many couples choose to have this test for reassurance
while others are happy to wait and see. You may wish to discuss this further with me.
GENERAL HEALTH
It is normal to put between 10 and 12 kilograms during pregnancy. Excessive or minimal
weight change does not necessarily indicate a problem with the baby. For this reason I do
not weigh my patients but encourage you to use the scales available in my office. Iron
supplements are advisable although not essential. A daily Ferrograd C tablet may help to
prevent anaemia. If unable to take iron supplements then a diet rich in iron is a suitable
alternative. Dairy foods or calcium tablets are also helpful. Vitamin supplements are not
necessary and sometimes are harmful.
EXERCISE
It is important to maintain a generally healthy lifestyle with gentle, regular exercise. Walking,
swimming and yoga are good. I would strongly recommend you attend the Antenatal Classes
at North West Private Hospital, phone 3246 3133.
ANTENATAL VISITS
Antenatal visits are usually monthly from booking until 28 weeks, fortnightly until 36 weeks
and then weekly until delivery. More frequent visits will be necessary if there are
complications. For low risk women, I like to alternate antenatal visits with the midwives, Kris
and Jenny. This means that some of your visits will be conducted entirely by a midwife.

WARNING SIGNS
Do not hesitate to contact me or the labour ward staff in the event of any of the following:
Any bleeding from the vagina at any time Rupture of the membranes – any clear watery clear persistent discharge especially if less than 36 weeks. Any pain which is persistent or unresponsive to Panadol Any sudden decrease in the baby’s movements. In this case, rest quietly and feel the movements for 1 hour. If the movements remain poor, contact the labour ward.
ADVICE
Our registered midwives, Kris and Jenny are available Monday to Friday mornings for phone
advice. If you have a non obstetric problem such as asthma, a respiratory tract infection or
gastroenteritis please see your General Practitioner or Emergency Centre in the usual way
unless there are particular obstetric concerns.
MEDICATIONS
The following are quite safe to take during pregnancy
Canesten (used internally for thrush and now available over the counter at pharmacies) All Penicillin based antibiotics (Amoxil, Keflex) Avoid Aspirin and supplements containing Vitamin A
ON CALL ARRANGEMENTS
I am available 24 hours per day from 6am Monday until 6pm Friday. I am on call for 1
weekend in 6 and share weekend call with my colleagues, Dr Darcy-Evans, Dr Howland, Dr
Price, Dr Sheahan and Dr Tuicolo. This means that if your baby comes at any time during the
week I will be fully responsible for your care with very rare exceptions. If your labour starts on
a weekend, your labour may be supervised and the delivery conducted by another doctor.
HOLIDAYS & CONFERENCE LEAVE
A list of leave dates will be posted on the waiting room notice board. We make every effort to
notify women of my absences when they book in. My leave arrangements are usually made
at least 9 months in advance.
HOSPITAL STAY
Most women stay for 4 days maximum with a vaginal birth and 5 days maximum with a
caesarean. This convention has been established by arrangements made between the
hospitals and health insurers. Many women find it difficult to comply with these arrangements
particularly if they deliver on a Monday afternoon and are expected to leave on the Thursday
morning for example. You may wish to engage the services of a lactation consultant who can
help you with the breast feeding. Lists of lactation consultants are supplied in the Hospital.
Bridget Ingle (Ph: 3862 8332) is very popular.
CORD BLOOD STORAGE
Some women are choosing to have their umbilical cord blood stored. This blood is drained
from the placenta after the baby is born. It can be used as a source for bone marrow cells if
your child should tragically develop leukemia or a similar cancer. It is difficult to estimate the
probability of needing this blood but a fair estimate is a probability of 1 in 300 to 1 in 3000.
Storage costs around $3000. Once the blood is stored it is only available to your family.
Siblings have a 1 in 5 chance of being compatible if they should need a bone marrow
transplant at a later date.
PAEDIATRICIANS
It is conventional to have your baby checked by a specialist Paediatrician when he/she is
born. The Paediatrician will also supervise the baby’s neonatal care and arrange for a 6
week check-up. I would be happy to arrange a Paediatrician of your choice but otherwise
refer your baby to the most suitable person available at the time.

WHEN YOU COME HOME FROM HOSPITAL
One in five women develop mastitis. This presents as a red tender breast and often raging fever. Keep breastfeeding and seek antibiotics as soon as possible. Please make an appointment for a six week postnatal visit with me. Contraception will be discussed at this visit. All the best Bob Watson

Source: http://drbobwatson.com.au/PDF/OBSTETRIC%20NOTES%20FOR%20EXPECTANT%20MOTHERS%20.pdf