Patient information

While pregnancy is a journey unique to every woman, most mothers-to-be share similar questions and concerns. We have compiled some of the most common pregnancy questions, pregnancy symptoms and pregnancy resources for you to make the journey that little bit easier.

Pre pregnancy questions

What will be discussed at a pre-pregnancy appointment?

Before you become pregnant, it’s a great time to ensure your physical and mental health is at its best. In this first appointment, Dr Claire Francis, Dr Mikhaila Lazanyi or A/Prof Fiona Brownfoot will ensure that you are on the right supplements, your vaccinations are up to date and they will discuss how to optimise the chances of falling pregnant.

If you have (or may have) a medical condition, they will discuss the risks to your health of becoming pregnant, maintaining a pregnancy and the risks your condition poses (or may pose) to the pregnancy and the foetus / baby. This appointment also gives you the opportunity to meet Dr Fiona Brownfoot, Dr Claire Francis or Dr Mikhaila Lazanyi in person.

MOGS Pregnancy Information Freemason Hospital For Women

Very common questions and answers

Your due date is generally 40 weeks from the first day of bleeding from your last menstrual period. Sometimes, your due date will change after you have an ultrasound, as it can be more accurate. We have an excellent due date calculator at CLICK HERE.

Folate and iodine are important vitamins for the healthy development of a baby’s brain and nervous system.

In most pregnancies, we recommend taking 500mcg of folate and 150mcg of iodine for 3 months before you become pregnant. We also recommend you continue to take folate until 12 weeks gestation and we recommend that you take the iodine throughout your pregnancy. Of course, this will depend on your personal circumstances and medical history.

You may need extra supplements such as iron, vitamin D or calcium and Dr Fiona Brownfoot or Dr Claire Francis will advise you about this at your appointment or after a blood test. Find out more HERE.

It is really important to stay healthy during your pregnancy and exercising is generally encouraged.

Low impact, non-contact exercise is generally safe to continue in pregnancy.

High impact exercise or extreme exercise or sports however should be avoided.

There are antenatal exercise classes that patients enjoy such as ‘Preggy Bellies’. If your pregnancy is complicated, Dr Claire Francis or Dr Fiona Brownfoot may advise that you stop exercising. To find out more HERE

Yes, flying is not known to cause any harmful effects to your unborn baby.

If your pregnancy is uncomplicated, then as a general rule, Dr Claire Francis and Dr Fiona Brownfoot take the view that international travel is safe up to 26-28 weeks and interstate travel is safe up to 34-36 weeks of pregnancy. Of course, the answer will depend on a number of factors including any possible or likely complications.

Before you book your flights, we recommend that you  double check the airline’s policy on flying while pregnant and making sure you have adequate travel insurance.

You are at increased risk of clots in your legs so keep your fluids up, walk around and use compression stockings. Caution should also be exercised on what food or drink you consume. For more information CLICK HERE.

Yes, you can have sex while pregnant so long as your pregnancy is progressing normally. There are a few situations in pregnancy when sex is not advised such as if you are diagnosed to have a placenta praevia. This is where the placenta lies over the cervix. We generally identify this at your 20 week ultrasound. We will let you know after this scan and advise you to stop having intercourse.

If you have a pregnancy complication would the country and location you are in be able to offer you adequate care? If a complication arose you may be stuck in a location far from family and friends. Furthermore it can get very expensive, in the hundreds of thousands of dollars. It is also important to avoid travel to countries with Zika. These can be found at: HERE.

Yes you can dye or bleach your hair and use tanning products as they have not been shown to cause problems in pregnancy. It is however best to avoid the fumes from a spray tan so if you did want to have a fake tan once or twice in pregnancy perhaps the lotions would be best.

You can have a bath or a spa when you are pregnant however it is important that you don’t get too hot. If you feel like you are sweating then the temperature needs to be reduced. Saunas are too hot and not safe to have while you are pregnant.

It is important to have good oral hygiene in pregnancy and seeing your dentist is definitely recommended. It is important to have emergency dental work and local anaesthetic and antibiotics have not been shown to cause harm. Perhaps delay any elective dental procedures until you have had your baby.

FAQs

Nausea and vomiting is really common in early pregnancy. By around 14 weeks the nausea and vomiting tends to subside however in a small number of patients it can continue up to delivery.

There are a few things you can do to reduce your symptoms to make you feel better. These include eating small but frequent meals, avoiding foods that make the nausea worse such as spicy or greasy foods and ensuring you are drinking plenty of fluids including water or mineral water. Lemonade or dry ginger ale can also help.

It is a good idea to start taking a pregnancy multivitamins, as you may not be able to eat a balanced diet. If your symptoms are not improving with these simple measures, some patients find vitamin B6 (pyridoxine) is helpful. If your nausea continues to persist, there are many safe anti-nausea medications that we can prescribe for you. If you are not able to keep any food or fluids down then please contact Dr Fiona Brownfoot or Dr Claire Francis as you may need to be admitted to hospital.

Constipation is really common in pregnancy.

There are some simple measures that you can take to reduce this including increasing the amount of fibre in your diet by eating things such as all bran breakfast cereals and by increasing your fluid intake.

There are also a number of medications that help with constipation that are safe in pregnancy and these include: Metamucil, fybrogel or lactulose. Make sure you also keep up some exercise as this can also help. As always, we recommend that you seek medical advice.

Please contact us if you have bleeding in pregnancy so we can see you and organize your care.


In general, however, a small amount of bleeding in early pregnancy is quite common and usually nothing to worry about. If you have heavy bleeding, persistent bleeding or pain associated with the bleeding, it might mean you are having a miscarriage so please contact us so we can help..

Bleeding later in pregnancy is not common and it might be a sign that there is a complication with your pregnancy. For example, the placenta might be detaching. It is really important that you call Dr Claire Francis or Dr Fiona Brownfoot as soon as possible if this happens.

It is really common to experience some cramping in early pregnancy. If the cramping is persistent or if it is associated with bleeding it might be a sign of miscarriage so please contact us.

Some women experience pain on either side of their abdomen at around 16 weeks of pregnancy. This is very common and most likely due to stretching of the ligament (round ligament) that attaches the sides of the uterus to the abdominal wall. Generally these pains will subside over days. Placing a heat pack over the area can be helpful.

Later in pregnancy, you may notice pain at the front of your pelvis or around your pelvic girdle that is worse with movement and on walking. This is really common and called pubic symphysitis. It occurs due to the hormones of pregnancy relaxing the ligaments of the pelvis. Generally, as your pregnancy grows and becomes heavier the pain worsens. Once you have your baby the pain generally improves. Make sure you avoid activities that exacerbate the pain and ensure you are wearing flat shoes. Often, keeping your legs together helps so sitting down to put your clothes on or using a plastic bag on a chair such as in the car so you can swivel around can really help. A physiotherapist can also help by giving you different exercises to strengthen your abdominal, pelvic and back muscles. Sometimes, a hip brace can help and the physiotherapist can fit you with this. When the pain is extreme, some women need crutches.

Some women find they have shooting pain down either leg in later pregnancy and this is called sciatica. It usually occurs due to compression of the sciatic nerve by the growing uterus. Usually, moving or rolling over onto your other side can help reduce the pain. This pain usually resolves once you have your baby.

It is really important to stay healthy in pregnancy and eat a well balanced diet.

There are a few dietary restrictions which we recommend implementing to reduce the chance that you could pass any potentially harmful infections on to your baby.

The main infections which can be transmitted through food that we want to prevent are listeria, toxoplasmosis and gastroenteritis. Some fish contain high levels of mercury so it is recommended to limit your intake of these.

Listeria is a bacteria commonly found in the environment and can be present in unpasteurised milk products, raw vegetables, raw meat and seafoods. It is killed by thoroughly cooking foods. It is, therefore, best to avoid (for the whole of the pregnancy)

  • Unpasteurised dairy products,
  • Soft cheeses and soft serve ice cream
  • Pre-prepared cold salads
  • Raw or partially cooked meats or seafood
  • Cold cooked meats
  • Processed meats or seafood
  • Any reheated foods
  • Excessive caffeine including products that contain high levels of caffeine
  • Any alcohol, illicit drugs or nicotine products (including vapes).

Toxoplasmosis is a parasite that can be found in the soil due to the presence of animal faeces (mainly cat). It is really important to wash fruits and vegetables thoroughly, ensure meats are cooked all the way through, wear gloves whilst gardening and ensure you wash your hands after patting animals and get someone else to change the cat litter.

Gastroenteritis is caused by an infection or toxin in the digestive system. Symptoms include abdominal cramps, vomiting and diarrhea. To try to avoid gastroenteritis, ensure you thoroughly cook raw animal products including eggs, ensure re-heated food is steaming hot throughout and make sure you wash your hands prior to eating. If you develop gastroenteritis in pregnancy, make sure you keep your fluids up with water and other clear fluids such as apple juice, cordial or lemonade and use rehydration sachets. If you are not able to keep any fluid or foods down or have abdominal cramps then please contact us.

It is also important to restrict your intake of fish that could contain mercury as, when consumed in high quantities, this can be harmful to a developing nervous system. Fish that can contain mercury include shark (Flake) or billfish (swordfish, marlin): you should limit your intake to 1 serve per week. For catfish or orange roughy (deep sea perch), you should limit your intake to 1 serve per fortnight. Salmon, prawns and shellfish are fine to eat up to 2 – 3 times per week.

For more information on safe foods in pregnancy please see https://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/n55h_healthy_eating_during_pregnancy.pdf OR http://www.foodauthority.nsw.gov.au/foodsafetyandyou/life-events-and-food/pregnancy/foods-to-eat-or-avoid-when-pregnant

Heartburn, also known as reflux, is really common in pregnancy. This is because the hormones of pregnancy cause the muscle around the oesophagus to relax. Also, as your uterus grows, there is increased pressure in your abdomen and this also predisposes you to reflux.

Eating small frequent meals, avoiding rich or spicy meals, chocolate, citrus, tomato and coffee can reduce reflux. Also, try and avoid lying down straight after you have eaten. Antacids such as Mylanta and Gaviscon are considered safe and can really help to ease reflux.

If reflux persists. then it is a great idea to start a preventer such as omeprazole but we recommend seeking medical advice.

You will generally start to feel your baby moving by around 16-22 weeks of pregnancy. Usually, the first movements you feel will be flutters, swishes or kicks. At first, your baby won’t seem to move very much, however, the baby’s movements will increase over the course of your pregnancy.

By 28 weeks of pregnancy, your baby will be moving regularly and it is really important that you take note of this.

If you think your baby’s movements have reduced, it is really important to have a drink of water and something to eat and sit or lie quietly for 1 – 2 hours and monitor your baby’s movements. If you have less than 10 movements in 2 hours or still feel like they are reduced compare to your baby’s usual movement pattern then contact us so we can arrange for you to come into the Epworth.

The amount of weight to gain in pregnancy differs based on your body mass index (BMI) and other pregnancy factors such as if you are expecting twins. For average weight women with a single baby you would expect to put on 11.5-16kg over the course of pregnancy. If you are underweight, then you should put on more weight than this and if you are overweight you should put less weight on than this.

Please see Mercy Perinatal website for a more detailed overview https://mercyperinatal.com/images/uploads/resources/Gestational-weight-gain-singletons.pdf

If you have a medical condition and are on medications let your GP and/or specialist know you are pregnant and also please inform us of what medication you are taking, the dose and the frequency with which it is taken.

Haemorrhoids are really common in pregnancy due to the increasing abdominal pressure from your growing uterus and baby and constipation.

Haemorrhoids will generally get worse over the course of your pregnancy and subside once you have had your baby.

To try and reduce the symptoms, it is important to avoid constipation by and minimise the time you spend standing up. If the haemorrhoids are painful, you can safely use topical treatments such as Rectinol ointment but please let us know if these measures do not work

Thrush is really common in pregnancy and can be treated with Canestan cream. It is generally safe to apply the Canestan cream vaginally.

Common conditions and
safe medications to use include:

  • Aches and pains:
    Paracetemol taken in line with the recommended dosage and for the purposes intended is generally safe. You must not take non-steroidal anti-inflammatory medications such as Voltaren, Nurofen or Ibuprofen.
  • Infections:
    Antibiotics including Amoxicillin, Erythromycin, Keflex are all safe. Please tell your GP if you are pregnant and being prescribed any form of antibiotic.
  • Allergies:
    Antihistamines (taken in line with the recommended dosage and for the purposes intended) including Polaramine and Restivit are safe.
  • Constipation:
    Metamucil, Fybrogel and Lactulose are safe
  • Nausea and vomiting:
    Vitamin B6 (pyridoxine) and Giner are safe
  • Thrush:
    Canestan
  • Reflux or heart burn:
    Mylanta or Gaviscon

You should always seek specific medical advice before taking or consuming any medications, especially if you have not taken them before. You should also read the instructions carefully and understand the possible side effects. Medication must be used properly. If you have a severe reaction to any medication, seek medical help immediately.

safe medications to use
sleeping position

Sleeping position

After around 20 weeks of pregnancy, it is best to lie on your side to sleep if you can. This is because the uterus is getting bigger at this point and can compress the large vessel (the inferior vena cava) that takes blood from your lower body up to your heart and can potentially compromise blood flow to you and your uterus, placenta and baby.

A number of recent studies have found that falling asleep on your back after 28 weeks of pregnancy is associated with stillbirth. If you wake up and find you are on your back then do not worry and simply roll over so you are on your side. Placing a pillow behind your back can help to keep you on your side whilst sleeping.

finish work

When should I finish work?

If you have an uncomplicated pregnancy we would advise you to finish work when you are around 34-36 weeks pregnant. If you have a physical job or your pregnancy is complicated, we might advise you to finish work earlier.

It is great, if you can, to try and take some time to enjoy yourself prior to having your baby. Go out with your friends, have dinner and a movie with your partner and enjoy a (pregnancy approved) massage.

Make sure you rest. Your life is about to really change. There will likely be sleepless nights and new challenges (and joys) ahead.

Useful links [MOGS is not responsible for the content, currency or approach of external websites]

Commonly used apps [MOGS is not responsible for the content, currency or approach of external websites or apps]:

app

Pregnancy

What to expect app

app

Health & parenting

Pregnancy+

app

Parenting

The wonder weeks

app

Diabetes and pregnancy

Pregnant with diabetes

Books

book

Birth Skills

Juju Sundin

book

Baby Love

Robin Barker

book

What to expect when you’re expecting

Heidi Murkoff

book

The Birth Book

Prof Stephen Tong

Research [MOGS is not responsible for the content, currency, validity, approach or results of any research or research publications]

This trial showed that women who have heavy bleeding after birth may be helped by a medication called tranexamic acid as this can help reduce complications.
For more info:

https://mercyperinatal.com/journal/the-woman-trial
https://ac.els-cdn.com/S0140673617306384/1-s2.0-S0140673617306384-main.pdf?_tid=6c479b07-b95c-49a4-8fd5-2d56859e0635&acdnat=1523625432_e6056189a6832cbacd0b0809629fcc44

This trial demonstrated that ultrasound in the third trimester detected more small babies than clinical assessment alone. Unfortunately, it did over-diagnose small babies and for every 1 small baby detected, two were thought to be small, however, were found to be normally grown.

https://mercyperinatal.com/journal/screening-for-fetal-growth-restriction-with-universal-third-trimester-ultrasonography
http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(15)00131-2.pdf

This trial demonstrated that induction of labour for macrosomia (a really big baby) reduced the incidence of shoulder dystocia (shoulders getting stuck when the baby is being born) and increased vaginal delivery rate compared to waiting for spontaneous labour.

https://mercyperinatal.com/journal/induction-of-labour-versus-expectant-management-for-large-for-date-fetuses
http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(14)61904-8.pdf

This trial showed that delivery for preeclampsia, compared to close monitoring of the patient at 34-37 weeks gestation, resulted in fewer complications for the mother but more respiratory complications for the baby. The researchers concluded that it is best to wait until term to deliver the baby if it is medically safe to wait and the disease isn’t severe.

https://mercyperinatal.com/journal/immediate-delivery-vs-expectant-monitoring-for-hypertensive-disorders-of-pregnancy
http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(14)61998-X.pdf

This trial examined whether induction of labour compared to continuing the pregnancy at 39 weeks in women aged greater than 35 years in their first pregnancy was safer. They found really similar results in both groups and therefore, the conclusion is that induction and continuing the pregnancy is a reasonable option to consider.

https://mercyperinatal.com/journal/randomized-trial-of-labour-induction
http://www.nejm.org/doi/full/10.1056/NEJMoa1509117#t=article

This study showed that it is probably best to deliver uncomplicated twin pregnancies at around 37 weeks gestation.

https://www.bmj.com/content/354/bmj.i4353

This study showed that going off to sleep on your back in the third trimester might increase your risk of stillbirth. Therefore, it is best to fall to sleep on your side. If you wake up during the night and you are on your back, don’t panic, just make sure you fall off to sleep again on your side.

https://www.tommys.org/pregnancy-information/sleep-side/sleep-position-and-stillbirth-risk-press-release
https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.14967

This trial showed that, if you are at high risk of developing preeclampsia in your pregnancy, taking 150mg of aspirin reduces the risk you will develop preterm preeclampsia. Make sure you discuss this with your doctor before starting Aspirin.

http://www.nejm.org/doi/full/10.1056/NEJMoa1704559