Prince of Wales Private Hospital

Expecting a baby? Here’s what to ask your obstetrician

Congratulations! You must be so excited and possibly a little nervous, too, especially if this is your first.

Mostly, you might be wondering, ‘What happens next?’

Knowing you have some control over your birthing journey is a great feeling. The more you know, the more relaxed you’ll feel over the coming months.

Dr Alexander Owen, obstetrician, gynaecologist and sonologist (ultrasound specialist) at Prince of Wales Private Hospital – a Sydney maternity hospital – shares some answers to the most common questions women ask during their pregnancy.

1. Should I make any changes to my diet?
“Eating a balanced, healthy diet helps ensure you’ll get the range of nutrients your baby needs for healthy development.”

During pregnancy, what you eat provides nutrition for both you and your baby. Eating a balanced, healthy diet helps ensure you’ll get the range of nutrients your baby needs for healthy development. This means a diet containing all the important food groups, including fruit, vegetables, grains, dairy, and a range of proteins.

Try to avoid ‘empty calories’, that is, foods that are high in energy but offer little nutritional benefit. These include sugary soft drinks, deep-fried foods, fatty meats, and sweets.

An adequate intake of fibre is also important because it helps to reduce constipation, a common symptom in pregnancy. Most fruits and vegetables contain high levels of fibre, as do legumes, oats, and whole grain breads, cereals and pastas. Be sure to drink plenty of water, too.

2. What foods should I avoid during pregnancy?
“It’s important to follow a few guidelines to reduce the risk of contracting a rare but serious infection … that could lead to problems with your pregnancy or your baby’s development.” 

During pregnancy, your immune system is ‘dialled down’. Therefore, it’s important to follow a few guidelines to reduce the risk of contracting a rare but serious infection, like toxoplasmosis or listeria, that could lead to problems with your pregnancy or your baby’s development.

Inappropriate food handling or cooking is a common source of infection. Although it may seem many of our parents never did so, it pays to take food safety seriously in pregnancy. Always thoroughly wash fruit and vegetables before eating them. Avoid cross-contamination from raw meat by using a different chopping board for preparing other foods and thoroughly cleaning your boards after use.

In terms of what you eat, you should avoid unpasteurised dairy products, raw eggs, and raw or cold meat and seafood. Any leftover meat is fine to eat, provided it’s reheated and served steaming hot.

3. How much weight should I expect to gain during my pregnancy?
There’s a wide range of what’s considered normal weight gain in pregnancy. It partly depends on your pre-pregnancy body mass index (BMI).

The scientific evidence suggests the days of weighing women at every antenatal visit should be behind us. Have a chat to your obstetrician about what is appropriate for you.

4. How much should I exercise?
Regular exercise is good for you, and this applies in pregnancy, too. However, you should avoid activities that carry a risk of abdominal trauma.

“Exercising a few times per week is definitely a good thing.” 

Extreme exercise (like doing CrossFit every day) is associated with higher rates of babies who don’t reach their full growth potential in utero, but exercising a few times per week is definitely a good thing.

There are many fantastic women’s health physios in the eastern suburbs who run pregnancy exercise/pilates sessions and can advise you on safe, healthy exercise in pregnancy.

5. Can I travel during my pregnancy?
“If you have an uncomplicated pregnancy, I think it’s reasonable to travel up to around 36 weeks gestation.”

I’m not a big fan of travelling to remote areas without easy access to medical attention. But if you have an uncomplicated pregnancy, I think it’s reasonable to travel up to around 36 weeks gestation, especially if you’re sticking to fairly major cities.

Keep in mind you’re more at risk of developing a deep vein thrombosis (blood clot in the legs) in pregnancy. If you’re planning a long drive, you should keep well hydrated and take plenty of breaks to get out and move your legs.

6. Will I be able to work throughout my pregnancy?
Yes. Depending on the nature of your work, and whether you have any pregnancy complications, it’s reasonable to plan your maternity leave from around 36 weeks gestation.

7. Can I continue taking my current medications?
“It’s best to chat to your doctor about any medications you’re taking, as there may be safer alternatives in pregnancy.”

Probably. Some medications are perfectly safe in pregnancy, and others are a balance between risk and benefit. It’s best to chat to your doctor about any medications you’re taking, as there may be safer alternatives in pregnancy.

There’s no medication-related question that can’t answered by the experts at MotherSafe. They can be contacted on 9382 6539 or 1800 647848. For non-English speakers, you can access an interpreter at no charge through TIS National by phoning 131 450. Tell the operator which language you speak, and that you want to contact MotherSafe.

8. How often are antenatal appointments, and what’s involved?
I usually see my patients for a first visit at around 8 weeks gestation. At this visit, I review your medical history and do a scan to check on the pregnancy. Typically, antenatal appointments are then every 4 weeks until 28 weeks gestation, then fortnightly until 36 weeks, then weekly until you have your baby.

“One of the benefits of private care is that you are welcome to attend any time between routine appointments for additional scans for your own reassurance.”

Sometimes there are medical issues that warrant more frequent appointments. One of the benefits of private care is that you are welcome to attend any time between routine appointments for additional scans for your own reassurance.

9. What tests do you recommend, and at what stages of my pregnancy?
All women should have blood tests in early pregnancy to check their blood group, blood count, and to screen for various infections like hepatitis. Most women wish to screen for Down syndrome and other chromosome conditions in the first trimester, usually with a blood test called a non-invasive prenatal test.

An early ultrasound is recommended at around 13 weeks gestation to check on your baby’s development. This is followed by a detailed ultrasound at around 20 weeks to review development, as well as the location of the placenta and the length of the cervix (which provides information about potential risk of preterm delivery).

We test for gestational diabetes at 24-28 weeks gestation, followed by another blood count at 36 weeks.

Women planning to have a vaginal birth usually do a vaginal swab around 36 weeks to check for a bug called Group B Strep. I do an ultrasound scan of the baby at every visit, as I think there is value in monitoring a baby’s growth in the third trimester, but this isn’t necessarily routine.

10. Do you recommend prenatal classes?
Yes. Prince of Wales Private provides great antenatal classes – I’ve done them myself! – which many women and their partners find useful in the lead-up to the birth.

Dr Alexander Owen is an obstetrician, gynaecologist and sonologist (ultrasound specialist) with a special interest in high-risk pregnancy. 

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