Questions

There are many medical conditions that a baby can inherit genetically. Almost all people carry some defective genes but given that we have two copies – one from each parent – most of these defects do not cause us any problems provided we have one working copy. If both genetic parents carry a defective copy of the same gene, there is a one in four chance that the baby could double up with the problem gene. This type of inheritance is called autosomal recessive and resulting conditions range from minor to extremely severe. Some will present during pregnancy and some not until some months to years after the baby is born. A well know example of this type of condition is cystic fibrosis.
Testing of all women and their partners, is available and ranges from a three gene test ($389 per person), to tests that cover 500-1000 genes ($1200-2200). It is ideal that if carrier testing if considered it is performed prepregnancy or in very early pregnancy.
Please contact Dr Neil to arrange testing. Search VCGS prepair for patient information.

On the whole, coronavirus is unlikely to seriously impact a pregnant woman or her baby. Many infections will be mild and can be managed at home. Occasionally in the third trimester a coronavirus infection can cause difficulty breathing in an unvaccinated woman, which added to the increased demands of pregnancy may become critical. This is very rare in vaccinated women and a little more likely if there are chronic medical conditions such as severe obesity, asthma or heart disease.
Jessie McPherson and Cabrini are both well situated to manage women who are critically unwell with Covid-19 and have ICU beds available.

In the absence of a medical indication for caesarean section, most evidence would favour a vaginal birth as being safest for both mother and baby. For many reasons some women will request Caesarean section. I am happy to discuss all the pros and cons of elective caesarean section vs a normal birth with you. In the end the final decision is yours.

Each situation is unique, but I support most women to have a normal birth after one previous caesarean section or in a twin pregnancy.

My preferred option is to turn the baby to head-first position in order to avoid a caesarean section. I do this for public and private patients once a fortnight in the fetal monitoring unit at Monash Medical Centre.

If this is unsuccessful, a caesarean section is lower risk than a vaginal breech birth, however, I am happy to support a woman to attempt a vaginal breech birth after discussing the risks.

I encourage women to exercise within reason during pregnancy. Maintaining fitness is important and most of the time, your body will tell you if you are overdoing it. Swimming is often the easiest form of exercise particularly in late pregnancy. There are also many well known pregnancy exercises classes that may interest you if you have the time.

There are certain foods that should be avoided to further reduce the very low risk of a listeria infection. Government websites are a good resource.
Caffeine should be limited to one strong or two normal coffees per day. There is no safe level of alcoholic consumption in pregnancy.

The combined weight of the baby, fluid, placenta, as well as increased size of the womb and breasts adds up to an average of 12Kg so a weight gain of 10-18Kg should be expected.

Unless you have been diagnosed with a low placenta, or have ruptured membranes, sex is a safe and normal part of pregnancy.

Folate should be taken by all women at a dose of 0.5mg per day, although some women at higher risk will be asked to take 5mg per day. This has been shown to reduce certain defects of the spine and nervous system.
Vitamin D levels are insufficient in most Australian women, and it has been shown that very low levels are associated with some pregnancy complications. It seems prudent and safe to take 1000U of Vit D per day if you are deficient.

Please contact me.
In the first third of pregnancy, bleeding may be the result of a miscarriage, but often it is nothing to be concerned about. I will organise to see you and perform an ultrasound to check on the baby.
Heavy bleeding later in pregnancy can be due to separation of the placenta, which may be an emergency for the baby.

Please contact me.
Most women start to notice movements around 18 weeks. These should continue regularly and frequently until the baby is born. A sudden change in pattern may be a sign of a problem, but almost always everything is fine.
If you notice reduced movements and are over 28 weeks gestation, you will be asked to attend the hospital for a fetal heart rate monitor (CTG), and I would normally check the baby’s growth and fluid on ultrasound in my rooms.