Midwifery is catching

For SA: http://www.health.sa.gov.au/ppg/Default.aspx?tabid=54

First visit
§ Usually occurs with a midwife at around ten week’s gestation

Frequency of visits
§ Research suggests that antenatal midwife care of women with uncomplicated pregnancies is being extensively implemented with economic benefits for health institutions (Villar 2003)
§ The frequency of visits should be in accordance with the woman’s needs. For example, a healthy woman in her second pregnancy need only attend for a few visits (e.g. 5-8)
§ Suggested antenatal visits for first pregnancy are:
         o Booking visit; 19-20, 24, 28, 32, 36, 38, 40 and 41 weeks
         o Women in successive pregnancies may attend less often

Subsequent visits
§ Refer to the schedule of visits for each hospital
§ Healthy lifestyle programs may be offered during antenatal visits e.g. Quit

19 – 20 weeks
§ Morphology ultrasound (usually at 18 weeks)
§ Calculate final expected date of birth

26 – 30 weeks
§ Complete blood picture
§ Oral glucose challenge test (OGCT)
§ Antibodies
§ Prophylactic anti D to be given to Rhesus negative women having their first baby who have reached 28 weeks gestation
§ An antenatal psychosocial questionnaire is offered for women to complete (as per hospital criteria). The aim is to identify women who are in need of additional services / supports during their pregnancy or after the birth of their child

34 – 36 weeks
§ 2nd dose of prophylactic anti D to be given to Rhesus negative women at 34 weeks gestation
§ Visit with Consultant Obstetrician is required at 36 weeks for GP shared care
§ Each hospital has a protocol for the screening and management of Group B Streptococcus colonisation. Refer to the particulars of each hospital
§ Discussion / education with woman on the benefits of breastfeeding

41 weeks
§ Discuss induction of labour

Supplements in pregnancy
§ Calcium, vitamins and fluoride are not usually necessary
§ Offer screening for vitamin D insufficiency to at risk women (see chapter 5c – Antenatal screening of at risk mothers and prevention of deficiency in their infants)
§ Supplemental iron will only be required after proof of iron deficiency
§ Folic acid 0.5 mg / day should be taken at least one month before conception and until 12 weeks gestation. If the woman is at increased risk of neural tube defect, on antiepileptic drugs or has hyperhomocysteinaemia the dose should be 5 mg / day

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Welcome to Virtual Labor

Virtual labor will randomly choose for you how your labor begins, and as you make decisions, virtual labor will show you how your labor might progress based on your decisions. It is a different natural birth every time you try it.

Antenatal, labour, birth, postnatal, newborn, postpartum… everything.

1. What risks are involved for you and/or you baby if you do this test?
2. What information will be gained from this test?
3. Could the information gained change the course of action?

So, let’s take a screening test for an untreatable disease, offered during the antenatal period. If the test involved some risk to you (infection and distress) and to your baby (risk of damage, or risk of miscarriage), and the information had a high false-positive rater so the information potentially gained isn’t high value, and you wouldn’t choose to terminate the pregnancy regardless of the outcome, then you’d be able to answer the three questions…