Maternity (Obstetric) Care
Please Note: Anyone who has recently become pregnant (or is planning to), should start taking Folic Acid 5mg IMMEDIATELY
The 0.8mg dose reduces Spina bifida risk by about 80%, while 5mg [funded], if taken early enough, reduces spina bifida risk close to zero
and also reduces cleft palate and hare lip risk. I don't recommend other supplements, you are best to ensure an adequate diet.
You are also strongly advised to stop using cigarettes, Marijuana, alcohol or using any other recreational drug (don't wait till your first visit)!
The large Dunedin prospective study has also shown that stress in pregnancy is a large determinant for adverse medical and social outcomes
in children. Stress is our body's response to danger and uncertainty (the "fight or flight" response) so my advice is to minimise your stress
by sorting out your response to potential "stressors". Work on ways to deal with issues, how you will plan for the arrival of a baby in your life,
how you and your partner will manage differences and uncertanties and most importantly, learn to accept things you cannot change.
There is just no point in getting frustrated and stressing over things one has no control over, in fact it has been shown to create a demanding,
fretful baby, a selfish child, a delinquent youth and often a criminal adult!
Until recently, I remained one of the only GPs in New Zealand providing full maternity services including emergency back-up to local Independent Midwives.
However, for legal and self-preservation reasons, I can NO LONGER offer funded maternity services, in particular:
HOWEVER, our Practice currently continues to offer:
- ❌ Full antenatal and labour care
Please contact the surgery for a list of available Lead Maternity Carers (LMCs) if you
have any doubts.
In general we recommend a specialist obstetrician or an Independent Midwife who is also a Registered Nurse.
- ❌ Partial antenatal care
You will need to have all care from your LMC and any specialist providers they refer to.
- ❌ Emergency Obstetric support to local Independent Midwives.
Your LMCs will need to arrange timely transfer to Base for any labour complications that cannot or should not be managed in Hawera.
- ❌ Antenatal Screening (in pregnancy).
Your LMC will generally refer you for a 12 week MSS1 (including a "Nuchal Translucency" scan to determine the risk for trisomy,
which includes Down Syndrome) and a 20 week morphology Ultrasound screen is also usually offered.
- ❌ Stem Cell collection for banking.
- ✅ Pre-pregnancy Screening and advice (not covered by maternity funding).
Referal of couples with increased risk for genetic counselling.
Screening women for immunity who are at risk of toxoplasmosis exposure (such as vets), but in most cases standard antenatal blood testing isn't required.
Review of current medication to ensure it is needed and safe and if not what are your alternatives?
Even more importantly, it is sensible to stop all smoking, drinking and recreational drug use, as well as starting Folic Acid before conception
in order to achieve much higher protection than waiting until pregnant.
- ✅ Vaccinations of my patients (usually with the Practice Nurse)
- ✅ Free pre-natal Rubella vaccinations for anyone not protected (eg a negative Rubella screen in a previous pregnancy) -strongly recommended
- ✅ Free antenatal Pertussis (Whooping Cough) vaccination during the second or third trimester (aim about 30 weeks) in order to provide protection to the baby
until the 6 week vaccination.
-also strongly recommended
- ✅ Free antenatal Influenza vaccination at any stage of the pregnancy (also recommended, probably best given when having the Pertussis shot)
- ✅ Six week baby check and vaccination of my patients -who have been delivered under a hospital team or by a LMC (Independent Midwife or Obstetrician).