Pregnancy

It is good practice to see your GP before planning a pregnancy. They can do a general and specific health check for you before pregnancy to ensure you are in your best health before you get pregnant. They may need to change your medication to what is safe in pregnancy.

We would strongly recommend you for pre-pregnancy counselling if you have conditions such as:

Ritu Rana Medical would love to congratulate you on your pregnancy! Dr Rana, along with her midwives, Sarah & Alana are here to provide specialised obstetric and midwifery care before, during and after the birth of your baby.

Our goal is to provide compassionate, individualised patient focused care for every family. Together Dr Rana and her midwives will strive to achieve the best outcomes for both you and your baby.

Screening tests for chromosomal abnormalities

Each human cell typically has 46 chromosomes. If chromosomes are altered, extra chromosomes are present or chromosomes are missing, a chromosomal abnormality has occurred. There are many types of chromosomal abnormalities and may cause varying health conditions.

There are two main antenatal screening tests. Combined First Trimester Screening and Non-Invasive Prenatal Test, that you may opt to have during your pregnancy, and these will be discussed with you at your first appointment with our midwives. These screening tools will determine if your baby has a high or low risk of chromosomal abnormalities. If a high-risk result is obtained through these screenings, you will be offered diagnostic testing.

Combined First Trimester Screening

The combined first trimester screen is performed between 12 and 13+6 weeks of pregnancy to determine your baby’s risk of Down Syndrome (trisomy 21), Edwards Syndrome (trisomy 18) and Patau Syndrome (trisomy 13).

The combined first trimester screening consists of two parts, a blood test, and an ultrasound scan. First trimester biochemistry (PAPP-A and Beta-hCG) is performed within the two weeks before your ultrasound scan. The ultrasound, called Nuchal Translucency Ultrasound, is performed between 12 and 13+6 weeks of pregnancy.

This ultrasound will measure your baby’s nuchal fold which is the fluid layer that is under the skin on the back the head and neck. In babies with chromosomal abnormalities this fold is “thick”.

To complete the ultrasound component, the sonographer will also be looking for the presence of a nasal bone, measure the length of your baby and measure the fetal heart rate. Your risk of chromosomal abnormalities is calculated by assessing the results of both the blood test, ultrasound findings and your background risk based on your age.

Non-Invasive Prenatal Testing

Non-Invasive Prenatal Testing (NIPT) is a blood test that screens for the most common chromosomal abnormalities, such as those analysed in the combined first trimester screening. The blood test can be performed from 10 weeks of pregnancy. The blood collected is then used to analyse your baby’s DNA to assess the risk of your baby having the tested chromosomal abnormalities. This test also offers the option to identify the gender of your baby.

If you choose to perform the NIPT test, you will not require the combined first trimester screening. However, you will be referred for a second trimester ultrasound that will assess the development of your baby.

Morphology Ultrasound

A morphology ultrasound is a routine detailed scan performed at approximately 20 weeks. The sonographer will measure your baby to assess growth. They will also check baby’s organs and bones. The sonographer will also check the placental position and function, the amniotic fluid that surrounds your baby and assess your uterus and cervix.

Blood Tests During Pregnancy
During your pregnancy you will be offered several blood tests. Some of these blood tests are routine and offered to all women, however, some blood tests may only be performed if your obstetrician or midwife deem it necessary.

Antenatal Screen

A full antenatal screen will be carried out in the early weeks of your pregnancy and will be ordered by your GP or your obstetrician/midwife. These tests allow us/health care professionals to identify any conditions that may affect you or your baby during pregnancy. Below is a brief explanation of the tests included in the antenatal screen.

Full Blood Count (FBC)

This test provides an indication of your overall health and gives us important information on different components of your blood, in particular your haemoglobin and platelet levels. This test will be completed later in pregnancy and these initial results will provide a comparison to identify how your body is coping with the increased demands of pregnancy.

Blood Group and Antibody Screen

This test will identify your blood group. This is important information if you require a blood transfusion during pregnancy or birth. This test will also detect if you are Rhesus Positive or Rhesus Negative.

Women who are Rhesus Negative will require Anti-D immunoglobulin during pregnancy. One of our midwives will discuss this further at your first appointment for those women who are Rhesus Negative.

The antibody screen will identify any antibodies in your blood that can cause potential harm to your baby.

Vitamin D

The development of healthy bones depends on Vitamin D. During pregnancy, your Vitamin D requirements increase, and many women become deficient in Vitamin D. If your levels are low, you will be advised to start supplements.

Infectious Diseases Screen

A component of the routine antenatal screen includes several infectious diseases that can cause significant harm to your baby. These include rubella, hepatitis B, hepatitis C, HIV and syphilis.

Urine M/C/S (microscopy, culture, and sensitivity)

A sample of your urine will be analysed for the presence of bacteria. Urinary tract infections can occur during pregnancy, and it is important to treat these infections to prevent kidney infections and premature labour.

26-28 Week Blood Tests

All women require further blood tests between 26 and 28 weeks to ensure your body is coping with the increasing demands of the pregnancy. They include FBC, blood group and antibody screen, iron studies and glucose tolerance test.

Iron Studies

As pregnancy progresses, your iron requirements increase, and your iron levels can become depleted as many women cannot keep up with your body’s needs. Iron studies will identify women who have low iron levels and anaemia. Depending on your results, a midwife may suggest starting an iron supplement.

Glucose Tolerance Test (GTT)

The GTT assesses how efficiently your body responds to glucose and therefore, is used to diagnosed gestational diabetes. This test requires you to fast (no food or drink, except water) for 8-12 hours prior to the blood test. You will have a fasting blood test performed and then consume a drink that contains glucose. One and two hours after finishing the drink, you will have a blood test performed. If your blood glucose levels are elevated, you will be diagnosed with gestational diabetes.

Antenatal Classes (GTT)

Our experienced midwives, Sarah and Alana, run monthly antenatal classes, Birth Essentials. Our program is designed to assist you and your partner in what to expect in the final stages of pregnancy, labour and birth, and the immediate postnatal period. These sessions are best attended from 28weeks’ gestation but before your 36 weeks appointment with your midwife, in which birth preferences will be discussed. Please contact either your midwife or Ritu Rana medical reception staff to book.

Labour

Your labour and birth care will be provided at the Mater Mother’s Hospital Mackay. You have 24-hour access to an on-call obstetrician, who will provide your care throughout labour and birth in collaboration with Mater hospital midwifery staff.

Your obstetrician and midwives will also discuss many of these pain relief options with you during your pregnancy. If you need more information about epidurals or would like a more in-depth discussion of labour pain-relief options specific to your needs, your obstetrician can arrange for you to meet with one of our specialist anaesthetists during your pregnancy.

Giving birth in an environment where you feel comfortable is important. If you feel at ease, you will be more relaxed and less anxious about your labour. This can help to reduce the amount of pain you feel. Having a friend or birth partner with you while you are in labour can also be helpful.

At Ritu Rana Medical we believe that being well informed about your pain relief options before labour will contribute to a positive and safe birthing experience.

Postnatal Care

Postnatal inpatient care will be provided by the midwifery staff at the Mater Mother’s Hospital in Mackay. You will be visited daily while in hospital by Dr Rana.

Postnatal care is very important as significant physical, emotional, and mental changes occur following birth. Our midwives will provide a phone consultation at approximately two weeks postpartum to ensure you are recovering well from birth and to assist with your transition to parenthood. A six-week postnatal check will be completed with Dr Rana at Ritu Rana Medical.

Physiotherapy in Pregnancy

Women’s Health Physiotherapy Mackay was proudly started in 2021 by Lauren Neill.

Lauren moved to Mackay in 2014 with husband Matt, and since then has created a family of two boys and a fur baby, and proudly call Mackay home.

Lauren saw the gap in Mackay healthcare, particularly for women, and decided to create Mackay’s FIRST dedicated Women’s Health Physiotherapy clinic… WHPM (Women’s Health Physio Mackay).

The vision for WHPM is to integrate within the Obstetricians, Gynaecologists, Midwives and specialist doctors of Mackay to provide a space for women to access all the care they need for their pregnancy, post-natal and menopause journey. Creating this “one stop shop” allows continuity of care, ease of handovers, and integration between the speciality health professionals to ensure women have holistic care for their journeys.

During pregnancy and birth, the body goes through significant physical and hormonal changes. These might include:

• postural changes due to a growing belly and breasts
• softening of the ligament and fascia in the pelvis (and all other ligaments in the body, specifically hands and feet)
• softening and stretching of the pelvic floor and abdominal muscles
• increased stretchability of blood vessels
• widening of the rib cage
• slowing of intestine contractions and additionally compression from growing baby
• delivery effects on the body (either vaginal or caesarean)

These changes affect many body systems, so it’s no wonder the body can feel a “not quite right” during this relatively quick changing period.
The great news is that there is so much that can be done to prevent symptoms and treat areas of discomfort or pain.