Saturday, 3 September 2011

You're pregnant - what to do next?

One question i had while trying to conceive was, once i fall pregnant and have confirmed this with a pregnancy test, what do i need to do next? I read lots of forum posts and googled the question, but didn't really come up with anything concrete. It seemed most of the posters were on their second or subsequent child and already knew what to do, or if they were on their first didn't mention what they did... or were clueless like me. So, to help others, this is a list of my suggestions of what you should do. I'm going from my own experience and i chose to go public, so if you're choosing to go private and want an obstetrician, during your first doctors appointment for the blood test confirmation, ask for a referral and probably from then on you'll see your obstetrician. Also i'm trying for a home birth so i have midwife appointments as well.

  • Confirm your pregnancy with an HPT - a home pregnancy test. Try as hard as you can do to this *after* your period is due... many pregnancies are lost in the first few days after implantation and it will be disappointing to see a positive test before your period is due, only to have your 'period' (in this case an early miscarriage) arrive shortly afterwards.
  • Think about your birth options - you'll be asked about them at your first doctors appointment and may get a referral to the hospital of your choice. If you're going public they're set by the area you live on. Make a note to ask your doctor if there are any patient forms you need to fill in for your chosen hospital or obstetrician.
  • Make an appointment with your doctor, tell them you are pregnant, and ask for a full blood test including thyroid (TSH, thyroid antibodies, free T3 and T4) and an hCG count. Subclinical hypothyroidism affects 3-5% of women, hence the thyroid test. If you ask for a doctor at your clinic who specialises in pregnancy, you'd probably get the hCG automatically, but i didn't realise it would be an idea to ask for this.
  • At the appointment, ask for a referral for the 10 week blood test and the 12 week NT scan. It's a good idea to have this done, as even if you would not terminate due to a problem with the baby, at least you're prepared for a special needs child rather than being shocked after their birth. You may be charged for the blood test, and you'll almost definitely be charged for the scan unless you're on an HCC - they're around $200 and Medicare doesn't rebate any of it.
  • Contact your doctor a few days after the first blood test to see if there are any abnormalities.
  • If you're lucky enough to get the results of your NT scan on the day, and they're low risk, fantastic! Otherwise, ring the radiology clinic a few days after the scan for your results.
  • Announce to your family and friends.
  • Make an appointment with your doctor to discuss your NT results and get a referral for your 18-20 week morphology scan.
  • If you have a thyroid abnormality like me, at around 15 weeks, you'll see the pregnancy medicine clinic at your chosen hospital.
  • At 16 weeks, you'll have your first meeting with a midwife to confirm if they think you're low risk enough to birth at home.
  • Go for your 18-20 week scan, and if you don't have the results on the day call your doctor/radiology a few days later. This is also the scan at which the sonographer can make an informed guess about the gender, if you so choose.
  • At 20 weeks, you'll have an appointment with the antenatal clinic at your hospital if you're not homebirthing. If you are homebirthing, you'll have an appointment with your midwife.
  • At 24 weeks, you'll have an appointment with your midwife.
  • At 28 weeks, you'll have an appointment with your midwife.
  • At 31 and 33 weeks, you'll have an appointment with either your midwife or backup hospital
  • At around 35 weeks, you'll meet your backup midwife. She takes over if your main midwife is attending another birth, and will also take over if your midwife has been with you during the birth longer than 14 hours.
  • Once a week from 37 weeks until the birth, you'll have an appointment with your midwife.

As i'm only up to 13 weeks at the moment, everything beyond that is still unknown and i'm just going off the schedule provided by the midwife association. I'll keep updating as i go through.