Your first antenatal visit will involve the following:

Blood Test

A blood sample will be taken to determine your blood group including rhesus factor and will also be checked for venereal disease, rubella, antibodies and anaemia.

Urine Test

You will be asked for a urine sample to monitor the presence of sugar, protein, ketones and urinary tract infection. For best results, take a sample with you, collected midstream during your first visit to the bathroom that morning.

Weight

Your health professional will weigh you to record your original weight.

Blood Pressure

Normal blood pressure is 120/80. Your pressure will be taken to see that it falls within acceptable limits. Significant increases may indicate the condition known as pre-eclampsia.

Internal Examination

Your health professional will carry out an internal examination by inserting two fingers into your vagina and pressing your abdomen to palpate your uterus. A speculum may be used to inspect your cervix and take a cervical smear sample.

Breast Examination

This will be carried out to identify any problems including inverted nipples.

Family Medical History

You will be asked questions about both your families’ medical history. Be sure you have the relevant information.

This may be your first opportunity to discuss ongoing antenatal care with your health professional. Have in mind questions you may wish to ask including options or advice regarding where to give birth in your area.

Private

• With private medical care you have your own obstetrician who will provide ongoing care throughout your pregnancy and will often deliver your baby.
• Privately paid obstetricians can deliver babies in private or public hospitals or birth centres. Find out where your obstetrician works. Depending on which obstetrician you choose, the cost of private medical care can start anywhere between $600 to $3000 with private health cover that includes pregnancy care. Find out exactly what your private insurance will cover. Does it include all visits to the obstetrician? Does it include an independent midwife? Does it include the obstetrician’s entire fee? Do you wish to have a paediatrician available? Is this covered?
• Statistics show that the chance of medical intervention or having a Caesarean section is higher in private hospitals.

Public

• Having a baby can be free if you choose public health care.
• Usually you will have your check ups at the hospital’s prenatal clinic, or in the obstetricians rooms, or in a midwives clinic. Medicare covers your prenatal visits, and your stay in hospital, although you are unable to choose your obstetrician or midwife. While most public hospitals endeavour to provide consistency in their care, the risk that you will see a different midwife or doctor at each antenatal visit still exists. If this is a concern for you, another option is to have an independent midwife who you could pay for privately.
• Your birth will take place in the maternity ward. Depending on which hospital you choose, there is likely to be hospital staff, midwives, trainee midwives, trainee obstetricians called registrars, general doctors doing hospital training called residents, and an obstetrician.
• It is not necessary to have a referral from your general practitioner. You can ring your local hospital offering maternity services and make an appointment. Usually the hospital will run prenatal classes as well as postnatal classes on breastfeeding and early parenting. Make sure you book prenatal classes for you and your partner as these will help you both learn more about what’s to come.
• Different hospitals will have different policies on the use of video cameras, cameras, the number of people present and the use of a natural therapist during labour and birth. Make sure you check so you are not disappointed at the last moment.

Where Shall I Give Birth?

Consider all options and factors in deciding where to have your baby. Your decision may be influenced by whether or not you have medical cover and the costs involved. Often your health professional will advise a hospital birth for your first baby because equipment and expertise are readily available in case of complications. Home birth and birthing centres are usually advised for low-risk pregnancies.

Hospital Birth Advantages

• a clean environment if your home is not suitable
• if you need help or advice, you have access to 24 hour support
• full medical back-up is available should complications occur
• you are able to mix with other mothers and newborns
• you are free of the housework

Hospital Birth Disasdvantages

• there may be a lack of privacy
• medical intervention is more likely
• you may be exposed to more noise and activity
• you may arrive at a busy time and not receive the prompt attention you had hoped for
• hospital is an unfamiliar environment
• your carers or midwife may change throughout your labour as shifts end

Home Birth Advantages

• a more private and intimate birth is possible
• freedom from hospital routines and intervention
• no need to travel
• you may arrange your birthing environment in advance
• your partner and family have a more active involvement in the birth
• familiarity and comfort of your own home environment

Home Birth Disadvantages

• should complications develop you may need to be transferred to a hospital
• you may find your home a busy environment after the birth as eager neighbours, friends and family are able to easily access you
• you may make a mess!

If your ideal birth involves having as little medical intervention as possible, then opt for a birth centre. You need to be in the low-risk category for a birthing centre delivery. Many of these centres are attached to large public hospitals but offer a more relaxed environment in which to give birth. It may be worth finding out how busy or full the centre is as sometimes mothers are moved to hospital wards if the centre is full. On a positive side, mothers can be quickly transferred to hospitals if needed. Medicare covers public patients. Many clinics schedule appointment times to cut waiting times. Birthing centres are staffed by midwives offering antenatal classes and help you through delivery. You may employ an independent midwife if the centre allows it. An obstetrician is usually on-call if needed during the birth. With private insurance, you could arrange to have available your own obstetrician.

Hospital-affiliated Birth Centre

Some birth centres are not attached to hospitals. Usually you will have to pay more for this service and you will need to check if whether your health insurance covers the one you choose and if you are entitled to a Medicare refund.

Independant Birth Centre

Some birth centres are not attached to hospitals. Usually you will have to pay more for this service and you will need to check if whether your health insurance covers the one you choose and if you are entitled to a Medicare refund.

Home Birth

One or two midwives usually attend a home birth. You may choose to have an obstetrician present as well though your choice may be limited by the fact that few obstetricians want to be involved in home births due to the risk and issue of insurance.

Different health funds have different policies on home births. Check to see if Medicare or private funding covers the doctor’s involvement. Medicare usually covers home births attended by a doctor/obstetrician but not those attended by midwives only. A small refund is usually available for the cost of the birth and any postnatal visits by domicilary nurses. Sometimes it’s worth negotiating part-payment for an independent midwife. If you are planning a home birth, consider ambulance cover in case of emergency.

Other Options

Special Clinics

Clinics designed for women with high-risk pregnancies. Appointments will be more frequent and at each visit an obstetrician will see you.

Team Midwifery Programme

Offered at certain hospitals, you will be seen by the same team of midwives from your first appointment, through labour and for postnatal care.

Midwives Clinic

This is the most common service providing midwives during your clinic visits and an obstetrician or staff registrar to deliver your baby.

Shared Care

This is a team approach to your pregnancy. It is a common choice of antenatal care in Australia. It could comprise:

• a combination of visits to your doctor and local hospital
• a community health centre and hospital
• a team of independent midwives who visit you at home along with a public/private hospital obstetrician

One of the key issues to consider is where and how you would like to have your baby. There are several choices available to suit preference and budget. If you live a distance from a city or regional hospital, you may not have as many options. If you have special requirements or choose to give birth in water or at a birthing centre, start looking around as soon as possible and book in early.

When making your decision, bear in mind the following considerations:

• General facilities available
• Birthing options
• Hospital and birthing centre policies or restrictions that may affect your wishes
• The availability of professional assistance
• Available facilities in an unexpected emergency
• The degree of medical intervention in a routine birth including the induction of labour, artificial rupturing of membranes, monitoring and internal examinations
• The rate of Caesarean delivery

Your medical cover status and budget may also be a deciding factor.