🕓 Reading time: 5 minutes
Planning for a pregnancy can feel exciting and a little overwhelming, especially if it’s your first time.
Fortunately, in Australia, we’re lucky to have access to a wealth of information and services, including fertility support, IVF, public and private maternity care options, obstetrics, and genetic carrier screening.
ON THIS PAGE
- Getting a pre-pregnancy health check
- Understanding public vs private hospitals
- Having the proper medications prescribed
- Exploring fertility factors
- Discussing options for singles and LGBTQIA+ families
- Learning about genetic carrier screening
- Helpful links
- About Dr Achala Manchanda
If you’re thinking about trying for a baby, an important first step is to visit your GP.
Here are six reasons why.
1. Pre-Pregnancy Planning Health Checks for Peace of Mind
Getting a thorough pre-pregnancy health check is a must.
In addition to giving you a good once-over, your GP will check your blood pressure and weight, conduct a cervical screening test (if necessary), and inquire about your mental health.
They’ll order blood tests and ensure your vaccinations are up to date. As you’d expect, contracting rubella and chickenpox while pregnant can cause severe problems with your baby.
Since pregnant people are considered one of the high-risk groups for hepatitis B, I also recommend screening for this viral infection.
Any current medical conditions need to be carefully assessed and managed.
Women with epilepsy, diabetes, or asthma may need to update their treatment plans before trying to get pregnant.
Your GP can also refer you for prenatal genetic carrier screening. More on this below.
2. Understanding Public vs Private Pregnancy: Costs, Hospitals, and Benefits
Your GP can give you the low-down on having a baby through the public and private health systems.
Medicare mostly covers public obstetric care, and it is free or significantly cheaper than private care.
The quality of public care in Australia is exceptional, especially in larger hospitals such as the Royal Women’s.
In the public system, midwives will look after you throughout your pregnancy and when you give birth. You’ll also likely receive occasional obstetrician visits.
However, you can’t choose obstetricians, and you may see a different one each time. Some people prefer more consistency in their antenatal care.
Shared care is also an option for healthy women and low-risk pregnancies. You get to see the same doctor or midwife throughout your pregnancy and with some hospital visits.
There are often out-of-pocket expenses.
Private obstetric care is usually accessed through private health insurance. You’ll need an obstetric level of cover for at least three months before falling pregnant.
Depending on where you live, out-of-pocket costs for an obstetrician and anaesthetist (if you use one) can add up to more than $10,000.
The good news is that you can choose your obstetrician and the hospital where you deliver your baby.
You’ll likely have a private room, be allowed to recover for longer in your room and possibly even enjoy postnatal care in a fancy hotel upon leaving the hospital.
Your obstetrician will care for you from 10 weeks pregnant until your baby is six weeks old. Public care is from 17 weeks until you’re discharged from the hospital.
The public-versus-private decision can be tricky.
A visit to your GP is golden in deciding which path best suits your circumstances.
3. Getting the Right Medications Before Conceiving
As part of your pregnancy care, your GP will let you know which medications to take and those to avoid.
I recommend specific vitamins and supplements for pregnancy. In general, you’ll need folic acid, which reduces the risk of spina bifida, and iodine for brain and nervous system development.
I usually advise you to take both for around a month before becoming pregnant.
Depending on your levels, you may need a vitamin D and iron boost. Anaemia during pregnancy isn’t a good idea.
Some medicines, herbal remedies and creams need to be stopped before falling pregnant.
Obviously, the contraceptive pill is out; less obvious is the fact that it can take 3-6 months for regular periods to return after stopping certain contraceptives.
Medications to Avoid When Pregnant
You can’t take many acne treatments when pregnant. You must also avoid certain antibiotics, cold and flu remedies, and over-the-counter medicines, such as ibuprofen.
Vitamin A and many other supplements aren’t generally considered safe in pregnancy either.
4. Exploring Fertility Factors
I often joke with patients about how we spend our youth trying to avoid falling pregnant, only to surprise our adult selves when it doesn’t happen the instant we’re ready.
In fact, conceiving can be pretty hard for many people. According to Access Australia, one in six couples has difficulty conceiving.
For women, the likelihood of in-utero fertilisation decreases as we age. There’s a 20% chance of a 30 year old returning a positive pregnancy test during each cycle, and for a 40 year old, it drops to 5%.
Visiting your GP to help plan for pregnancy is essential.
They’ll look at your family history and complete a medical examination to see if you have any conditions requiring extra fertility care.
Your GP will advise on making good lifestyle choices to increase your chances — stopping smoking, cutting out alcohol and drugs, getting regular exercise and managing your weight.
We’ll also debunk myths about the best time to have sex. The same goes for other far-fetched theories on falling pregnant, such as whether you should hug your knees after sex and avoid exercise (the answers are no and no).
Every day, I’m asked how long it takes to get pregnant. Some couples take one cycle; others take a decade.
I generally advise women to see a doctor for fertility advice following more than 12 months of regular unprotected sex – six months for women over 35 or if there’s a suspected fertility problem with either partner.
Depending on factors such as age and pre-existing medical conditions, your GP may refer you to a fertility specialist.
Rest assured, not all referrals result in IVF. These specialists also offer other assistance, such as help with ovulation.
5. Options for Singles and LGBTQIA+ Families: IVF, IUI, and More
If you’re not in a position to fall pregnant naturally, your GP can outline your options. Medical science is racing ahead at mind-blowing speeds in this area.
Intrauterine insemination (IUI), in vitro fertilisation (IVF), and surrogacy are the three most sought-after methods.
Adoption and fostering are also great options.
Same-sex couples have many available options for having a baby. I recently met with two lovely ladies who were considering IVF egg sharing.
Egg sharing is where doctors use the genetic mother’s eggs to create an embryo and then transfer the embryo to the birth mother’s uterus.
What a delightful way to start a little family!
Understanding the many legal, financial and societal considerations is essential.
Again, your GP can point you in the right direction to gather more information on these topics.
6. Genetic Carrier Screening
Advancements in reproductive medicine continually amaze me. Genetic carrier screening is no exception.
Genetic screening is a test to determine if either parent has an increased chance of having a baby with certain genetic conditions.
Such conditions can reduce a child’s quality of life and lifespan. Examples include:
- Cystic fibrosis: 1 in 25 people are carriers / 1 in 2,500 people have the condition.
- Fragile X syndrome: 1 in 250 people are carriers / 1 in 4,000 people have the condition.
- Spinal muscular atrophy: 1 in 40 people are carriers / 1 in 6,000-10,000 people have the condition.
Almost all children born with these genetic conditions show no family history. Being the case, I’ll provide you with all the necessary info and leave the screening decision in your capable hands.
There’s no wrong or right choice.
Doctors conduct genetic screening by sending off blood or saliva swabs for testing. Ideally, we do this before you become pregnant, and people who plan to have multiple children with the same fertile partner only need to be screened once.
In the event of a positive screening result, your options depend on whether you’re pregnant or not.
Your GP can walk you through your choices.
It’s important to note that we can’t pick up chromosomal conditions such as Down syndrome with genetic carrier screening. Instead, we can conduct blood tests and ultrasound scans during your first trimester as part of your prenatal care.
Dr Achala Manchanda (MBChB, FRACGP, Dip Child Health) is a local GP at Doctors of South Melbourne.
She has a special interest in pregnancy care, women’s health, and kid’s health.
You can book an appointment with Achala online or call us on 8579 6838.
0 Comments