Frequently Asked Questions

What if my Baby is Premature?

If your baby should require pre-term delivery at less than 34 weeks gestation, then your care will be transferred to King Edward Memorial Hospital.

This would mean that Dr Blair would not be able to continue looking after you at that time. However, he would continue to be available for obstetric advice and counselling.

It is important that in a situation where your baby may arrive prematurely that there is a “Level Three Nursery” available.

The importance of good Diet and Health During Pregnancy

Listeria is a common bacterium present in many foods. The associated infection is not generally serious but pregnant women unfortunately may develop a high temperature and miscarry or go into early labour. To reduce the risk of contracting listeria, pregnant women should avoid pate, rare meats and soft cheeses, and eat freshly cooked and prepared food. Any pre-packaged foods like sandwiches, fruit platters, salads and sushi should not be eaten. The Health Department has produced an informative leaflet which we can supply if you would like more detail of which can be accessed through this link.

Iodine Increasingly our diets are becoming deficient in Iodine. Iodine deficiency can influence your baby’s brain development so we recommend that you use iodised salt during the pregnancy along with a multivitamin designed for pregnancy which includes folate and iodine. You will require an extra 150 micrograms of iodine per day. FabFol Plus and Elevit are multivitamins that would meet this criteria.

Calcium – It is also important to maintain to keep your calcium levels up. If your diet is low in calcium, consider supplementing it with a preparation such as Caltrate each day.

Weight Gain – Talking about diet, you can obviously expect some weight gain during your pregnancy. Weight can vary quite a bit between individuals, but we suggest that a gain between 8 and 12 kgs is in the healthy range.

Influenza is an illness that can affect a pregnant woman more seriously due to the immunosuppression of pregnancy, which means that there is a higher risk of pneumonia and associated pregnancy complications. The National Health and Medical Research Council recommend that all pregnant women should consider influenza vaccine during the pregnancy. Your GP can arrange this or visit your local pharmacy.

Sleep is valuable. We all like to have a lie-in occasionally, however during your pregnancy you should listen to your body even more and rest whenever you feel you need to. Remember that your body is undergoing significant change and is under more pressure than usual, so you can expect to feel tired.

Regular exercise is good for everyone, including pregnant women. Keep up regular walking and stretching but avoid anything overly strenuous or that involves high levels of contact or impact. We are happy to talk through an exercise plan with you.

Stay hydrated! Drink according to thirst to avoid dizzy spells and fainting which can be caused by the hormonal effect of pregnancy.

Overheating – Western Australia’s weather means it is usual for all of us to feel the heat. A pregnant woman needs to be careful not to overheat though, so please seek the shade if outdoors and avoid saunas, spas and hot baths that may raise your body temperature and make you more prone to fainting. You do however need around 45 minutes of sunshine per day, without getting sunburnt, to keep up your vitamin D levels.

Bleeding – it is quite common for some spotting to occur during your pregnancy, but you should contact us if the bleeding is heavy, recurrent, or continuous, or if you are concerned at all.

Cord Blood

Cell Care provides umbilical cord blood and tissue stem cells storage solutions should this be of interest.
Click here to download a form requesting further information.

Genetic Screening

More information about Prenatal Screening for Chromosomal and Genetic Conditions can be found through this link.

Vaginal Examinations

You will be required to complete a “Consent for Vaginal Examination” form which will be included in your Dr Blair Care Kit. While we understand this may make you a little uncomfortable, these examinations are important during the course of your pregnancy to investigate:

• Any unusual vaginal bleeding
• Suspicion of ruptured membranes
• Concerns regarding possible infection
• Timing of pending labour
• The degree of dilation of the cervix during contractions
• The progress of labour every three to four hours
• Pap (CST) smears

These examinations are a routine part of obstetric and gynaecological care to provide essential information that guides the advice and care we provide.

PERINEAL MASSAGE

What is Perineal Massage?
Perineal Massage involves the gentle stretching of the tissue that surrounds the opening to the vagina. This massage is particularly focused on the perineum, the area of skin between the vagina and rectum. A 1999 study by Labrecque and colleagues reported that 24% of women who performed perineal massage had vaginal births without tears – compared to 15.1% of women who did not use massage.

What are the benefits of Perineal Massage?
• An increased chance of an intact perineum at delivery, reducing the tears that require an episiotomy.
• A decreased stinging sensation during the crowning of the baby’s head.
• To familiarise yourself with the stretching sensations that occur during birth. Allowing you to more easily relax those muscles at the time of birth.

When should you start Perineal Massage?
Perineal Massage should begin in the 34th week of pregnancy, and be performed for 10 minutes each day.

How do I perform Perineal Massage?
• Wash your hands thoroughly and find a private, comfortable space in which you can relax.
• Apply a water-soluble lubricant to your thumbs and perineum.
• Place your thumbs 3-4cms inside your vagina.
• Press downward towards your rectum, and to the sides of your vagina. Use firm but gentle pressure until you feel a slight burning or tingling sensation.
• Hold the pressure for 2 minutes until the area becomes numb.
• As you keep constant pressure with your thumbs, slowly and gently massage the lubricant back and forth into the tissues of the lower half of your vagina for around 3 minutes.
• Relax and repeat once.

When is it not recommended to perform Perineal Massage?
It is not recommended to undertake Perineal Massage if you have active vaginal infection or herpes lesions.

For those interested in Perineal Massage, we also recommend exploring EPI-NO training.

Keeping the Placenta

There are some myths and truths around the ‘power’ of the placenta with some parents choosing to keep it.

Talk to Dr Colin Blair and his team for more information and if this is a choice you would like to consider.

Post Delivery Complications

Your body has been through a significant event, and sometimes recovery can be slow or compromised.
It is important that you contact Dr Blair, your GP or a Medical Emergency Department if you have concerns related to any of the following or anything else unusual.

• Lower abdominal pain 10-14 days after birth can be a sign of endometritis (infection in the uterine lining). Other signs are offensive discharge, bleeding and/or fever.

• Mastitis (breast infection) can occur at any time and can make you feel unwell with fever, redness on the breast, nausea and vomiting. This needs to be addressed to avoid developing an abscess or generalized infection.

• A painful or swollen leg, or pain in the chest with shortness of breath can be symptoms of a blood clot, and should be treated as an emergency.

• If you have had a caesarean and there is any extreme redness or lumpiness around the wound, or you are in pain or have a high fever, an infection may be present that needs to be quickly treated.

Around day 3 or 4 after birth, you may experience ‘the blues’ which is a very emotional time. Ensuring you get as much sleep as possible in the first few days may help, as will accepting support from health care professionals, family and friends. You’ve just participated in one of the most wondrous experiences and your life has changed, so it is quite natural to experience a range of emotions.

Circumcision

The Obstetrician does not perform circumcisions, or arrange for them to be undertaken.
The Australian College of Paediatric Surgeons currently advises against circumcision just after delivery.

USEFUL INFORMATION

For more information about pregnancy conditions, treatments and wellbeing, please refer to the Links section of this website.