Pregnancy Guide & Danger Signs in Pregnancy

Congratulations on your pregnancy! On this page, you’ll find some useful information about finding a midwife, screening/testing in pregnancy, staying healthy, planning your baby’s birth, and more.


Finding a midwife

Book a Lead Maternity Carer (LMC) such as a midwife as soon as possible, preferably before 10 weeks pregnant. You can find a midwife by:

If you don’t have a midwife by 10 weeks, please book in with Doctor or the Hospital Primary Birthing care team.


Midwife appointments

During early pregnancy, the Midwife will want to see you every 4-6 weeks, then fortnightly, and then weekly during the last four weeks of pregnancy.

It is important to attend all check ups for a safer pregnancy and birth. The Midwife will check baby’s growth and make sure you’re both well. If needed, she can refer you to a specialist. 

Your midwife is also “on call” between visits for anything urgent or if you go into labour. For more information about the role of a midwife, please visit this site.


Testing and Screening

First Antenatal Blood Test (6-8 weeks)

At you first midwifery visit, you will be given a form to get the first antenatal blood test done to check your blood group, your HB (haemaglobin), iron stores, antibodies screen, blood type, platelets and to check for rubella immunity and HIV status. Blood tests can be done at one of the Wellington SCL locations. 

 

Nuchal Scan, MSS1 Screening and NIPT screening tests (10+ weeks)

Your Midwife will discuss with you Screening tests that can be done to check for genetic conditions. These generally involve a Nuchal Scan and MSS1 Blood Tests - you must decide if you want these tests done. Please see here for a discussion of some of the benefits vs the costs.

The screening tests provide a score with a high or low risk factor for a baby to have aneuploidy, Down Syndrome or another genetic condition. The results of these tests may lead to further screening tests that may be done by the National Screening Unit

You will need to book the scan at pacific radiology, horizon radiology, or Wellington Ultrasound.  Scans may have a cost. The Nuchal scan is from $25 for residents. Blood tests through SCL are free for NZ residents and generally no appointment is needed.

 

Alternatively there are other Non-Invasive Prenatal Screening (NIPT) tests (10+ weeks) - A variety of screening tests with accuracy of 75- 99% (cost involved $500-$700). These tests identify the most common chromosome conditions seen in newborns. These tests are available by request at Wellington SCL or with Dr Jay Marlow at https://www.wus.co.nz/nipt   Dr Marlow also offers genetic counselling as part of the test cost.  A negative test does not completely rule out all chromosomal abnormalities, but this is the most accurate form of non- invasive prenatal screening to date.

Any of the above tests may need to be followed up with more invasive procedures Amniocentesis or Chorionic Villus Sampling arranged by your midwife's referral to Maternal fetal Medicine at the hospital https://www.fertilityassociates.co.nz/media/1067/fertility-facts-amniocentesis-and-cvs.pdf 

 

Anatomy scan (18-20 weeks) 

This scan checks that your baby is growing as expected, and looks at your baby’s heart, lungs, stomach, etc, to identify any problems.

 

Second Antenatal Blood Tests (24-28 weeks)

This test re-checks your iron stores, HB and Platelets 

 

Glucose Challenge

The Glucose Challenge will check for gestational diabetes (GD). If you have GD, it is important to get treated as early as possible as it may have health implications for both you and your unborn baby.

 

Antibodies Blood Test (36 weeks - only if needed)

See here for information about this blood test.  This blood test is generally only needed if you’re in a ONeg Bneg ABNeg blood groups. 

 

Group B Strep Screening (35-37 weeks)

Screening for Group B Strep is done via a low vaginal swab. You can find out more about this screening here.

 

Additional post-date or growth scans/CTG (41 weeks)

At 41 weeks pregnant, you will be scans to check baby’s growth, the placenta, and fluid volumes. You will also be offered a cardiotocograph (CTG) to check baby’s heart rate and movements.


Vaccinations

 

Flu vaccine

The flu vaccine is given in the flue season to protect both mother and baby. It is free during pregnancy.

 

Whooping cough vaccine

The Whooping Cough vaccine is free to pregnant women, and is repeated during each pregnancy. It is given between 28 and 36 weeks of pregnancy. This vaccine helps the baby get immunity against whooping cough until the baby has had both their six week and 3 month vaccines.

New Zealand has a high number of cases of whooping cough in the community, and whooping cough is potentially fatal for young babies. Due to this, it is highly recommend for all pregnant women and their families. Though the vaccine is free for pregnant women, there is a cost involved for partners and whanau.


Supplementation

Your Midwife or Doctor can prescribe the following recommended pregnancy supplements for you:

 

Folic Acid

It is recommended that you take folic acid before pregnancy, or as soon as you find out you’re pregnant. This helps baby’s brain and spine to develop properly. More information is available at health.govt.nz.

 

Iodine

Iodine supplementation is recommended during pregnancy and while breastfeeding. More information is available at health.govt.nz.


Eating safely and well

Eat fresh, home cooked meals with a variety of freshly washed vegetables and salads. Add in protein. Meat should be piping hot, and balanced with carbohydrates such as potato, taro, or rice. Increase dairy products to keep calcium levels up. 

Cut down on food that has no nutritional value. Choose water or trim milk to drink, and cut down on sugar, fizzy drinks, fruit juice, tea and coffee.

Food Smart website has tips on how to avoid listeria. Listeria can be caught from unwashed food, uncooked / raw shellfish, sushi, and soft cheeses.

Eat wisely to grow a healthy baby! Visit the health.govt.nz website for more information about eating well in pregnancy.

You may also be eligible to join a free programme, the Maternal Green Prescription, that will help encourage positive healthy lifestyle changes while you're pregnant. This includes practical food and cooking workshops, physical activity support, regular reviews, and more. 


Weight gain

Your pregnancy weight gain will depend on your BMI, but it may be between 5 and 15kg.


Exercise

Keep moving, and stay physically active. Continue walking and swimming with light-to-normal activities.


Things to avoid

When you’re pregnant, it’s recommended you avoid smoking, recreational drugs, and alcoholic beverages as these may harm your unborn baby. 

Check if any herbal teas, prescribed medicines and over the counter pharmacy medications are safe.

 

Stop Smoking 

0800 778 778 Quitline 

https://quit.org.nz/     

             

Alcohol & Drug Helpline 

0800 787 797

https://alcoholdrughelp.org.nz/helpline/


Morning Sickness

If you have morning sickness and you’re unable to keep food or fluids down at all, please seek urgent advice from your Midwife, Doctor or Hospital Emergency Department.

You can find general information about morning sickness here. 


Miscarriage

If you miscarry, or think you might be miscarrying, contact your Midwife or go to the Emergency Department at the Hospital for help.

You can learn more about miscarriage and find support on the Miscarriage Support website.


Mental Health

If you are feeling mentally unwell, anxious, sad, depressed or suicidal, please get help immediately via your Midwife, your doctor or your emergency department. 

For information and help relating to mental health for mothers, fathers and families, please visit the Mothers Matter website.

If you are prescribed antidepressants in pregnancy, or you are already taking antidepressants, you can visit this site to learn more.


Zika Virus

Zika virus is passed on from mosquito bites in certain countries around the world (including some Pacific Isalnds). Complications from Zika can include baby malformations and serious side effects for unborn babies.


Planning your birth

Think about your choices of where and how you would like to give birth. Your Midwife can talk to you about your birthing options, and you can also visit https://www.maternity.org.nz/ for a range of excellent free pamphlets. 

Some of the main choices you have to make include where to give birth (at home, at a primary birthing unit, or in hospital), options for pain relief, support person(s), birthing positions, cutting the cord, what to do with the placenta, and much more.

Huggies have a birth plan template that you may wish to use (even as a starting point).


Earthquake Preparedness

It’s a good idea to get organised for a major earthquake or disaster before baby comes. Feeding your baby in a disaster may become more difficult – you can find advice here.

Danger Signs

- Baby is moving less than normal

- Vaginal bleeding

- Dehydration

- Abdominal pain

- Fever/High temperature

- Waters break before 37 weeks

- Waters break and are dirty looking, brown or greenish

- Contractions before 37 weeks

- Breathing difficulties

- High blood pressure

- Severe headache

- Swollen face, feet and/or hands

- Vision changes / eye sight abnormalities

- Tummy pain

- Odd coloured urine

- Pain or burning when you wee

- Thirst, but you can't wee

- Feeling unwell, throwing up in late pregnancy

If you have any of these symptoms, call a health professional immediately.

  • Your midwife
  • Your doctor
  • Health Line on 0800 611 116
  • Wellington Hospital Delivery Suite on 04 806 0845
  • Hutt Maternity on 04 566 6999 (ask for delivery suite)

Also see the health.govt.nz website for more information.

If in doubt, make the call!

 
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