[RosieA]

Hi Ladies,
I'm pregnant with my first baby and I have no idea what to do next! I've had 3 positive pregnancy tests, period is 2 week late & boobs feel like rocks so I'm definitely preggers, just need to get a timeline in my head of when I'm supposed to do everything. Do I see a GP straight away? I don't have one here yet because we just moved, I'd go to my normal clinic near work but I don't want to have to drive there every week or whatever for checkups after I stop working, it's 45 mins away. How often do you normally see the GP during pregnancy? When should I see an OB and how often do I need to see them during pregnancy also? What is covered by Medicare and what isn't covered? When do I need to book a birthing suite or centre? I really need to get a game-plan in my head, my sister & mum would be great for that but it's so early I don't want to tell them yet. I live in Maitland NSW. All advice appreciated!
-Rosie

[kindling]

Firstly, congratulations! 😄

I would make an appointment at any GP to get started. They will send you to a pathology place to get blood taken. They will test that for pregnancy as well as a variety of other things just to check your vitamin and immune levels as a starting point.

The GP will also write you a referral letter to see an OB. If you gave one you'd like to use or a specific hospital you prefer then take those details with you and the GP can refer you to them. If you don't know/mind then they will have a list that they usually refer to.

You really will only see your GP for non pregnancy related illness. For any pregnancy checks you will see your OB.

If you go public I believe everything is covered by Medicare. If private then you pay your OB fee in full, Medicare will rebate about $450 of that. You will also pay for all your scans and Medicare rebate a portion of those too.

Generally speaking you will see your OB at the following points in your pregnancy (this varies between public and private system);

Weeks
6-8 Blood type, rubella titer, blood counts, HIV antibody, syphilis, hepatitis screen, ultrasound.
10-12 Doppler detection of fetal heart; CVS, if planned.
11-14 First trimester screen/Nuchal translucency (11–12 weeks is best).
15-18 Second trimester serum screen (sometimes called quad screen); amniocentesis, if planned.
18-22 Ultrasound to evaluate fetal anatomy.
24-28 Glucose screen to check for gestational diabetes.
28-36 Every-other-week visits to check blood pressure, weight, urine protein, and fetal growth.
36-40 Weekly visits to check the same things noted for 28–36 weeks and to assess fetal position. Some practitioners do internal exams to check the cervix; some do a vaginal/rectal culture for group B streptococcus.
40-?? Twice-weekly visits to assure fetal well-being.

[niggles]

Go see your GP straight away and also start taking a pregnancy multivitamin if you are concerned your diet is not perfect. In particular, folate is very important at this stage.

The GP will answer all those questions and talk through your options with you.

If your wait for a GP is long it wouldn't hurt to also book an obstetrician straight away too (if you intend to use a private hospital to birth) as they fill up very quickly. You can get the referral after you see the GP.

Hope that helps. And congratulations.

[CheekyBuggers]

First you'll need to see a gp who'll do all the blood work and confirm preg and do your referral (are you going public or pvt) generally public you'll get a booking in visit with the midwives around 12wks where they take all your info. At this stage you can get nt screening done test for downs syndrome and few others.

Then you see doctors at the hospital generally 16-20wks. Up until 3rd trimester if everything is ok check ups are every 4 wks and you can choose to have either shared care which is where you just go to the hospital for those 2 early appts then at 36wks and all others see a gp or go to your hospital for all appts. 3rd trimester goes to 2 weekly then from 36 weekly.

[happygurl06]

First decide if your going public or private.

If your going public find a local GP or you can use your old one.

Then you need to decide if you will do your appointments at the hospital or if your GP does shared care you can just do your appointments there. Your GP will fax off a booking firm to your local maternity hospital.

With public your first appointment (from my experience) is at about 16-19 weeks. So your doctor usually organizes the first blood tests and 12 week ultrasound. From there I think the appointments are monthly??? Until later in the pregnancy then they go fortnightly and then weekly. Can't remember exactly.

My GP bulk bills and I chose to go to the hospital for appointments and ultrasounds so I was not out of pocket at all. Sine hospitals send you to private ultrasound places and costs can be upwards of $200.

If you go private I think you just choose an OB and go there for appointments and sometimes they do the ultrasounds there too.

[RosieA]

Thanks ladies! I feel ready for all this, been trying for 6 months & my naturopath has got me ready re: nutrition so I feel good.

When you say "going private", do you mean private health cover or private Obstetrician? Do have to have private health cover already or can I just join up anytime?

I'm particularly interested in a more relaxed birthing centre as I would like to avoid a "hospital" birth unless it's medically necessary. Has anyone had experiences with something like that? How does it work with OB's - do they have their own or do I see my own OB separately? And can I have my own independent midwife? Argh so much to think about!

[anotherid]

If you do not have private health insurance then you would go public. Going private and paying your own way could set you back $10-20 000 or more in a private hospital. To be covered by private health insurance you need to be a member for 12-24 months before your due date. You can not join and be covered after you are pregnant.

Look up birth centres in your local area. I know that there is one at Belmont and John Hunter Hospital. Then there is Wyong hospital as well. All birth centres have a midwifery model of care and you will usually see just one throughout your pregnancy, labour and birth and postnatally. You will also met their partner in case you birth on their days off. These services are all free and your only expense will be your ultrasounds.

If this is what you want you must be considered low risk (no diabetes, high blood pressure, obesity etc) and you must book in quick, as they will book out fast.

Alternatively just call Maitland Hospital and ask what their care options are. Ask about if they have a midwifery group practice model, which is the one on one care.

You will see your GP either way between now and your booking in appointment with the midwives. Your GP will organise your initial blood tests and ultrasounds and after that the midwives will.

If you develop complications in the public system your midwives will refer you to the public obstetricians. This service is also free.

Hope this helps.

This post has been edited by anotherid: 26/11/2012, 02:47 PM

[RosieA]

Hi ladies, thanks for all the advice. At the moment I'm doing shared care between my GP, naturopath (who I see normally anyway) and the Early Pregnancy Clinic (because I had a bleeding scare last week). All looks good so far! Found out there is a Midwifery Group Practice in Maitland that has only been running a couple of years, will speak to them soon. I'm leaning towards a planned home water birth so if the group practice doesn't do home births (I imagine they probably would) I've found a very experienced independent midwife who does home births. As long as it's safe I'd like to avoid the hospital!