8 - 10 weeks
Time for your first visit
Congratulations! I’m sure you’re feeling very excited right now and perhaps a little apprehensive not knowing quite what to expect – apart from a baby.
A lot is changing and now’s the time to discuss things to do immediately and how to plan for the months ahead. Read on for some helpful first trimester info and contact me to make an appointment as your journey begins.
How You May Feel
By now you will have missed your period and may well be experiencing sore breasts. Some women also feel bloated and tired, nauseated with vomiting and have an altered sense of taste and smell.
At this point, you’ll be very excited about bringing a whole new life into your family. You’ll also be a little nervous, wanting the pregnancy to go as well as possible.
What You Can Expect From Me
We’ll have our first consultation at around 9 to 12 weeks. When you call, if possible, know the first day of your last menstrual period and if your cycle is regular. I like to meet with both you and your partner for 45 to 60 minutes so we can have a wide-ranging discussion, including:
- the schedule of visits to see me
- what tests are needed and when they are done
- when to plan going on maternity leave
- travelling when pregnant
- exercise and nutrition
- booking a hospital and birth classes and my philosophy of childbirth
- parental leave
Screenings and tests
When you first see me, I perform a physical examination including your blood pressure and weight, and do an ultrasound to confirm your due date. We’ll discuss screening for chromosomal abnormalities (if you choose to have this done). I’ll also discuss your emotional wellbeing and will recommend some great apps, websites and reading material.
Some of my favourites include:
‘Up the Duff – the real guide to pregnancy’ by Kaz Cook
‘So you are going to be a Dad’ by Peter Downy
‘What To Expect When You Are Expecting’ by Heidi Murkoff and Sharon Mazel
Questions You May Have
When should I first see Dr Rachael?
Between 9 to 12 weeks into the pregnancy, or earlier if you are concerned.
How often will I see Rachael?
Your appointments happen at 16, 20, 24, 28, 32, 34, 36, 37, 38, 39, 40 and 41 weeks.
If you develop a medical complication during your pregnancy, you may need to see Rachael more often.
Please note: If you are booked into North Shore Private Hospital to have your baby, please book your emotional wellbeing assessment online. This interview is an important part of screening for prenatal depression and anxiety in pregnancy.
Alternatively, if you are booked with the Mater Hospital, you can book an emotional wellbeing appointment through your midwife.
If you would like more information on prenatal depression or emotional wellbeing, I recommend visiting the following websites:
What are the Obstetrician fees?
Contact us to learn more about my Obstetrician fees and what your out-of-pocket costs will be.
What happens if I have some spotting / bleeding in early pregnancy?
If this occurs it can be quite concerning and make you feel very anxious. Contact my office during business hours or call the hospital where you are booked after hours and on weekends.
If you have a negative blood group, you may need to have anti-D administered
When do I start telling people?
This is a personal choice. Most people tell their families early in order to get support. People often wait until they have had screening for chromosomal abnormalities, but there are no medical guidelines to consider.
What tests will I need?
These will include syphilis, rubella immunity, FBC, blood group and AB screen. Also HIV, Hep B, Hep C, urine screen for infection.
Consider having a dating scan if your period is irregular or you don’t know the last day of your menstrual period.
What’s happening in my body?
There are lots of physical changes that you may experience as your body accommodates the growing baby inside you. Some of the symptoms caused by these changes may include: tiredness, nausea, sore breasts, needing to go to the toilet more often, pelvic stretching pains.
The ‘What to Expect’ app can give you a week by week overview of your baby’s development.
Download the app here
What exercise is good for me?
If possible, do 30 minutes of low impact exercise every day, including swimming, yoga, pilates or walking. At your first appointment we’ll discuss the best options for you.
View this great site with lots of ideas.
Will I get morning sickness?
Not necessarily. Some women don’t have any nausea at all and some have ‘morning sickness’ all day for whole pregnancy. A very small percentage have severe, debilitating nausea and vomiting and need to be admitted to hospital for anti-nausea medication and hydration. If you are unable to keep fluids down please call the delivery suite of your booked hospital.
How much weight will I put on?
Most women will put on around 10-15 kg over the course of the pregnancy. The timing of weight gain varies between individuals. If you are overweight or underweight, we will discuss your optimal weight during pregnancy and I may refer you to a dietician. Read more more in my 2nd Trimester guide.
When should I leave work?
Depending on what type of work you do, most women will finish work from around 36 weeks. Some complications of pregnancy may need you to finish work early and we can provide a medical certificate. Similarly if you are feeling well, you can work as long as you choose.
Do I need to go on a special diet?
The best way to meet both of your needs is to eat a wide variety of nutritious foods. Some foods aren’t recommended for pregnant women mainly because of a higher risk of harmful bacteria such as listeria or salmonella.
Listeriosis (Listeria monocytogenes) is an infection that can lead to harm to your unborn baby by eating the wrong foods during pregnancy. Pregnant women are at a higher risk of becoming infected because their immunity is lowered due to the effects of the pregnancy. Please refer to the NSW Food Authority pregnancy guide.
How does pregnancy affect my immune system?
Pregnancy is such an intense physical (and mental) experience that your immune system adjusts itself to properly support both you and the baby. The baby is a part of you and a foreign entity at the same time, so certain elements of the immune system are enhanced and some are suppressed to account for this. This is why pregnant women are advised not to eat foods that contain certain bacteria.
A suppressed immune system is more susceptible to contracting viruses like Cytomegalovirus (CMV), which is common viral infection and usually infects young children but it can pose risk to an unborn baby. Although a large majority of adults have had CMV some have not and can be at risk of contracting it later in life and during pregnancy. Please refer to this useful guide with tips how to prevent becoming infected during your pregnancy.
Can I travel by plane?
Generally yes, if your pregnancy is uncomplicated. It’s best to check with your airline and travel insurance company to find out more, as different airlines have different restrictions. – read more more in my 2nd Trimester guide..
Can I take vitamins?
Prenatal vitamins are developed to be used in pregnancy and they contain important supplements such as folate and iodine (150mg). High dose folate (5mg) is recommended for women with a BMI >30, and those women on anti-epileptic medical due to an increased risk of neural tube defects (e.g. Spina Bifida).
If you are a vegetarian or eat little red meat, it may be important to take iron supplements and if you are carrying twins you will need an iron supplement. The main vitamin to avoid in pregnancy is Vitamin A. The most important thing is to make sure you eat a well balanced and healthy diet.
Can I have sex while pregnant?
Absolutely. As long as there are no issues with the location of the placenta. You can read more about it in this article from the Mayo Clinic.
What can my partner do to help?
Things To Do and Checklists
Here are some simple steps to help you during your 1st Trimester and a checklist of things to bring to your first appointment.
What to do:
- Book in to the North Shore Private or The Mater Hospital and arrange a tour of the facilities.
- Consult your health fund to work out private costs, what you are covered for and what your out of pocket costs will be.
- See your GP and obtain a full antenatal screen (blood group and antibody test, HIV, Hep B, Hep C, Rubella, Syphilis, full blood count, urine test and varicella immunity.)
- If you have an irregular cycle, have your GP book a dating scan.
- Find out the maternity leave and payment policy at your work. For partners, find out about paternity leave arrangements. Here’s a link to the government’s parental leave pay policy: http://www.humanservices.gov.au/customer/services/centrelink/parental-leave-pay
- Stop smoking and drinking alcohol.
- If you have any questions, consult a medical practitioner versus trying to self diagnose using the results from a Google search.
- Choose and book your preferred birthing classes. These are a great idea as they can give highly practical information about labour, pain relief options, and generally preparing for the birth and beyond. The Mater and North Shore Private hospitals offer antenatal, breastfeeding, and parenthood classes. But so many other options are available. A private midwife can come to your home and go through things, you could take hypnobirthing classes, Ju-Ju Sundin’s active birth classes, just to name a few.
- Start thinking about nursery equipment, a pram, car capsule and baby clothes. You’ll be surprised how quickly the due date arrives.
- Start wearing well-designed and properly fitted maternity bras without underwire, for complete support over the months to come.
- Grab some great reading including:
- ‘What to expect when you’re expecting’ by Heidi Murkoff and Sharon Mazel
- ‘Up the Duff’ by Kaz Cooke
- ‘So you’re going to be a Dad’ by Peter Downey
What to bring:
- A referral letter from your GP
- Any recent results of blood tests and ultrasounds
- Records of Rubella and Chicken Pox vaccinations if available
- A list of your current medications and the dosages
- Any letters or referrals from other specialists
- Your partner (if possible)
- Your questions for me
With so many public forums online, it’s easy to get opinion confused with verifiable fact. I think the best places to go for information (apart from calling me) are: