You’re Pregnant! Now what? What to Expect at Your First Appointment and Beyond
Discovering you’re pregnant is an exciting moment filled with a mix of emotions and questions about what comes next. Whether you’re a first time mum or adding to your growing family, it’s important to know what steps to take to ensure a healthy pregnancy for both you and your baby. In this post, we’ll walk you through what to expect at your first prenatal appointment, the options for your schedule of care in Australia, dietary recommendations, necessary supplements, and essential testing.
What to Expect at Your First Antenatal Appointment
During this appointment, your GP will:
Confirm Your Pregnancy: Your GP may perform a physical exam and review any initial home pregnancy test results.
Review Your Medical History: Discuss your health history, including any previous pregnancies, chronic conditions, medications, family health and social history.
Estimate Your Due Date: Based on your last menstrual period or an early ultrasound, your GP will help calculate your estimated due date.
Discuss Lifestyle and Health: Your GP will provide guidance on diet, exercise, and lifestyle changes necessary for a healthy pregnancy.
Perform a Physical Exam: This may include measuring your weight and blood pressure and a basic physical examination.
Organise investigations: Blood tests; including pregnancy levels, blood group, general health markers, vaccination levels and infectious disease screening, a Urine test and a dating ultrasound to be formed from 6 weeks on.
Plan for Future Appointments: Establish a schedule for future antenatal visits and discuss what tests and screenings will be performed.
Testing During Pregnancy
Several tests may be recommended to monitor your health and your baby’s development:
Genetic Carrier Screening: This test checks if you are a carrier of certain genetic conditions that could affect your baby. It is only complete once throughout your life and ideally is done before planning your first pregnancy.
Non-Invasive Prenatal Testing (NIPT): A blood test that screens for certain chromosomal conditions, such as Down syndrome, with high accuracy. This an optional test that you can schedule privately from 10 weeks gestation. The cost in Australia ranges from $400 to $800, depending on the provider.
Ultrasounds: Typically performed at around 12 weeks (nuchal translucency scan) and 20 weeks (anatomy scan) to monitor your baby’s development and check for any abnormalities.
Routine Blood Tests: To monitor your health, including checking for anemia, blood type, and infections. You can expect blood tests at first appointment, 10-12 weeks, 28 weeks and 36 weeks.
Glucose tolerance test: is a screening test used to check for gestational diabetes by measuring how the body processes sugar, and it is typically done at 28 weeks. To prepare for the Glucose Tolerance Test (GTT), here's what you typically need to do: You will be asked to fast overnight, arrive in the morning for fasting blood glucose levels. You will then drink a sugary solution, then wait. You will need to wait and have repat blood tests at 1 and 2 hours while the glucose is processed by your body.
Common Early Pregnancy Symptoms
Missed Period: One of the first signs of pregnancy.
Morning Sickness: Nausea or vomiting, especially in the first trimester. It typically starts around the 4th -7th week of pregnancy. Symptoms can appear gradually or suddenly, and can occur at any time of the day or night.
Fatigue: Feeling unusually tired, especially in the first few weeks.
Tender or Swollen Breasts: Hormonal changes can make your breasts sensitive.
Frequent Urination: Increased blood flow to the kidneys can make you need to urinate more often.
Mood Swings: Hormonal fluctuations can affect your emotions.
Food Cravings or Aversions: Increased sensitivity to certain tastes and smells.
Mild Cramping: Light cramping or twinging is normal due to the embryo implanting into the uterus.
Spotting: Light spotting or bleeding is common during implantation but should be discussed with your doctor.
Increased Vaginal Discharge: A thin, milky discharge may occur due to hormonal changes.
When to seek urgent medical help
Severe Abdominal Pain: Intense or sharp pain, especially on one side
Heavy Bleeding: Bright red, heavy bleeding (more than spotting).
Severe Vomiting: If you can’t keep any food or liquids down (hyperemesis gravidarum)
Severe Headaches or Vision Changes
Painful Urination or Blood in Urine: Could indicate a urinary tract infection (UTI), which requires treatment.
Fever or Chills
Swelling or Pain in the Leg
Severe Back Pain: Unusual or persistent back pain could be a sign of complications like a miscarriage or ectopic pregnancy.
Dietary Recommendations
Both you and your growing baby need extra nutrients, and the best way to get them is to eat a wide variety of nutritious foods and be as healthy as possible as early as possible in your pregnancy.
These foods should include a variety of; Vegetables and legumes, wholegrains, nuts, seeds and tofu, Meat, fish, poultry, cooked eggs, if desired, Milk, yoghurt, hard cheese and dairy alternatives with added calcium.
Foods to Avoid:
Raw or Undercooked Seafood, Meat, and Eggs: These can pose a risk of foodborne illnesses.
High-Mercury Fish: Avoid fish like shark, swordfish, and king mackerel.
Unpasteurized Dairy Products: These can carry harmful bacteria.
Alcohol: avoid alcohol altogether.
Caffeine: Small amounts of caffeine are safe during pregnancy but excessive volumes may increase the risk of miscarriage and premature birth. It is recommended that pregnant women limit themselves to 200mg of caffeine daily.
Follow this link for NSW health safer eating in pregnancy brochure with colour coded foods listed by safety https://www.foodauthority.nsw.gov.au/sites/default/files/2021-07/Pregnancy_brochure_21_0.pdf
What else to avoid
Cigarette smoking and or other recreational drug use
Medications: such as ibuprofen, discuss your prescription medications with your doctor
Toxoplasmosis infection, whilst uncommon in pregnant women, it can occur if you eat undercooked meats, or unwashed fruit and vegetables, particularly from gardens with household cats. Most commonly, however, infection is caused by touching cat faeces when cleaning the cat litter tray or contaminated soil in the garden.
Essential Supplements
During pregnancy, certain supplements are recommended to support your health and the development of your baby:
Folic Acid: Essential for preventing neural tube defects. The recommended dosage is 400-800 micrograms daily.
Iodine: Important for brain developlement, recommended dose 150mcg/day.
Iron: Helps prevent anemia and supports increased blood volume. Your GP will recommend the appropriate dosage based on your needs.
Calcium: Important for bone health, with a recommended intake of about 1000 milligrams daily.
Vitamin D: Supports calcium absorption and bone health. The recommended dosage varies based on your levels and sunlight exposure.
Your Schedule of Care in Australia
In Australia, standard antenatal care includes regular visits to monitor both your health and your baby’s development. The general schedule is:
First Trimester: Initial visit and an early ultrasound to confirm the pregnancy and check for any early concerns.
Second Trimester: Typically, appointments every 4-6 weeks. Key tests during this time include the Nuchal Translucency scan and blood tests or NIPT test.
Third Trimester: More frequent visits, usually every 2-4 weeks. This includes monitoring for signs of complications and preparing for labor and delivery.
Postnatal Care: After birth, follow-up visits are scheduled to monitor your recovery and your baby’s health usually at week 1 and 6 post birth.
Your GP or obstetrician will tailor the care schedule based on your individual needs and any risk factors.
In Australia we have many options for which health professionals monitor your pregnancy, These can include:
GP shared care (Seeing your GP and the hospital maternity every second visit)
Midwifery care at public hospital or with a private midwife or Midwifery group practice (MGP)
Public obstetrician/ midwifery care at the local hospital
Private Obstetrician care
Vaccinations in pregnancy
Avoid live vaccinations during pregnancy.
Vaccination of pregnant women is strongly recommended to protect them against respiratory illness including
Influenza and COVID-19.
dTpa vaccine (whooping cough) is recommended as a single dose during the third trimester of each pregnancy. The optimal time for vaccination is between 20 and 32 weeks. It is also best to recommend your partner and close family and friends have a booster if they are due.
RSV vaccination (Abrysvo) can be given between 28 and 36 weeks to protect infants against sever RSV from birth up to 6 months.
Conclusion
Pregnancy is an exciting yet challenging journey that requires careful planning and attention to both your health and the health of your baby. From your first prenatal appointment to the various tests, recommendations, supplements, and care options available in Australia, staying informed and prepared will help ensure a healthy pregnancy. Always consult your healthcare provider to tailor your care to your individual needs and enjoy this special time with confidence.