maternity care patient information - albury wodonga health · maternity care patient information...

Maternity CarePatient InformationBring to your pregnancy care appointments

AlburyWodonga

Health

INDEX

Welcome Page2Options for care Page2Services provided by Wodonga hospital Page2Preparing for your stay Page3Support people Page3Telephones and television Page3Visiting hours Page3Hand hygiene Page4Antenatal classes Page5Young mums group Page5Fit for birth classes Page6Breast-feeding antenatal checklist Page7-8Australian Breastfeeding Association: Breast-feeding classes Page9Choices of antenatal care Page10Midwife care program Page10Emotional and psychological health screening Page11Birth plan information Page12Danger signs in pregnancy Page12Diet and pregnancy weight gain Page13-14Supplements in pregnancy Page15Diet precautions in pregnancy Page16-17Alcohol, smoking and drugs in pregnancy Page18-19Exercise in pregnancy Page20Teeth in pregnancy Page21Pregnancy and travel Page21Minor ailments of pregnancy Page22-23Labour Page24Cultural considerations Page25Koori maternity enhancement worker Page25Postnatal care Page26Maternity unit social work service Page27Discharge planning Page27Domiciliary postnatal care Page28MITH Page28Community support services Page29Maternal & child health nurse (MCHN-Vic) or Child & family health nurse (CFHN-NSW) Page29Abbreviations Page31Resources and links Page31References Page31Contact numbers Page32

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Congratulations on your pregnancy. We look forward to assisting you throughout your pregnancy and labour and through the postnatal period. The information provided in this brochure will assist you through the antenatal period and for planning your stay with us.

OPTIONS FOR CARE (More information available on page 10)(Private and Public)

• MidwifeCareProgram(Publiconly).• ObstetricGeneralPractitioner(GP)Provider.• GPandObstetricGPProvider(sharedcare).• Obstetrician.• ObstetricianandGP(sharedcare).

SERVICES PROVIDED BY WODONGA HOSPITAL• ConsumerAdvocacy.• ContinenceNurse.• DiabetesEducator.• Dietician.• DomiciliaryMidwifeProgram(PostnatalHomeVisiting).• SocialWorkService.• KooriMaternityEnhancementWorker• Level2SpecialCareNursery(SCN).• MidwifeCareProgram(MCP).• MITH(MidwiferyInTheHome-AntenatalCareandPost-natalCare).

Welcome to Albury Wodonga HealthWodonga Hospital Maternity Unit

• Physiotherapy.• PostAcuteCare.• PreparationforParenthoodClasses.

USING PRIVATE HEALTH INSURANCE AT AWH-WODONGA HOSPITALSupport your local hospital by using your private health insurance.

BychoosingtouseyourprivatehealthinsuranceatAWH-WodongaHospitalyouwillbeentitledtothefollowingbenefits:

• YourtreatmentwillbeprovidedbyaSpecialist/VMO• Choiceofasingleroom(subjecttoavailabilityandindividualhealthfundcoverage)• FreeTVrental• Freelocaltelephonecalls• Freedailynewspaper(Monday-Saturday)

Help us to help you.

Byusingyourprivatehealthinsuranceyouareactivelysupportingyourhospitalin:• Maintainingfacilities• Purchasingnewequipment• Improvingpatientservices.

As there is variation between Private Health Funds and entitlements please contact your fund early in pregnancy to check your entitlements.

ForfurtherinformationpleasecontactourPatientLiaisonOfficeon:0260517663

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PREPARING FOR YOUR STAY

Yourself:• ClothingandnightweartosuityourstayintheMaternityWard.

•Toiletries.

• Nursingbrasandnursingpads.

• Maternitysanitarypads. Your Baby: • Babyclothes(eg:singlets,bodysuits,mittens,beanie)foruseinhospital.

• Bunnyrugs.

• Disposablenappies(newbornsize).

• Babywipes.

• Baby’ssoaporbathsolution.

SUPPORT PEOPLEYoumaychoosetohaveextrasupportpeople,amaximumof3familymembersorfriendsarepermittedduringyourlabour.Itisimportantthattheyhavebeenpreparedforthisveryimportantrole,asthelabouringwomanyoushouldfeelcomfortablewitheveryonepresent.Privacylawpreventsdisclosureofpersonalinformationbyhospitalstafftoallbutthepatientandimmediatenextofkin(NOK).

NO SMOKING POLICYAlburyWodongaHealth(AWH)WodongaHospitalpromotesasmokefreeenvironment.

TELEPHONES & TELEVISION

• Aphoneserviceisavailabletoreceivecallsonly.Thereisapublicphonelocatedintheward.

• PhoneCardsareavailabletopurchasefromtheHospital’sMainReceptionforwomentocalloutoftheward.

• Apatienttelevisionhireserviceisavailable.

• Mobilephoneusageisnotpermittedwhilstinsidethehospital.

VALUABLES

Patientsandvisitorsareadvisednottobringinvaluablesorlargesumsofcash.

VISITING HOURS General visiting hours are from 2.30pm to 7.30pm.

PartnersONLY7.30pmto8.00pm.ForyourcomfortandrecoveryNOvisitorsorphonecallsareallowedbetween12.00pmand2.30pmorafter7.30pm(unlessspecialarrangementshasbeenmadewiththeUnitManager).

TherearevisitingrestrictionstotheSpecialCareNurseryandvisitorsaresubjecttospecialrequirements.InformationonvisitingtheSpecialCareNurserywillbegiventoparentsonadmissionoftheirbaby.

Anyonewhois,orhasrecentlybeenunwell,isnottovisittheMaternityUnitorSpecialCareNursery.

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HAND HYGIENE

Anumberofinfectionsandinfectiousdiseasescanbespreadfromonepersontoanotherbycontaminatedhands,particularlygastrointestinalinfectionsandHepatitisA.Washinganddryingyourhandsproperlycanhelppreventthespreadoftheorganismsthatcauseillnessanddiseases.

You should wash your hands thoroughly: • Beforepreparingfood.

• Beforeeating.

• Betweenhandlingrawandcookedorready-to-eatfood.

• Beforebreastfeeding.• Aftergoingtothetoilet.

• Afterchangingnappies.

• Aftersmoking.

• Afterblowingyournoseorsneezing.

• Afterhandlingrubbishorworkinginthegarden.

• Whenhandsarevisiblysoiled.

• Afterfeedingandhandlinganimals.

• Afterattendingtosickchildrenoradults.

How to Wash your Hands Properly:• Wetyourhandswithwarmwater.

• Applyonedoseofliquidsoapandlatherwellfor40—60seconds(orlongerifthedirtisingrained).• Rinsewellunderrunningwaterandmakesurealltracesofsoapareremoved,asresiduesmaycauseirritation.

• Patyourhandsdryusingacleandrytowelorpapertowels.Makesureyourhandsarethoroughlydry.

• Dryunderanyringsyouwear,astheycanbeasourcesoffuturecontaminationiftheyremainmoist.Ifpossible,removeringsandwatchesbeforeyouwashyourhands.

• Hotairdrierscanbeusedbut,again,youshouldensureyourhandsarethoroughlydry.

• Athome,giveeachfamilymembertheirowntowelandwashthemoften.

• Toprotectyourhandsapplyawaterbasedabsorbenthandcreamthreetofourtimesaday,ormorefrequentlyifyourhandsareconstantlyinwater.

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ANTENATAL CLASSES

Antenatalclassesprepareyouforthearrivalofyourbabyandprovideanunderstandingofthebirthprocessandwhattoexpectinthefirstweeksafterbirth.Classesprovidespecificdetailrelatingtopregnancy,labourandearlyparentingforfirsttimeparentsandanopportunitytodiscussrelevanttopics.Allwomenhavingtheirfirstbabyareencouragedtoattendantenatalclassesrunbythehospital.

There is a charge for classes. DatesandcostsofAntenatalClasseswillbeprovidedtoyoubytheAntenatalReceptionistbyphoneoratyourbookinginvisit.YoucanphonetheAntenatalDepartmenttomakeenquiriesaboutclasses.Itisrecommendedthatyoubookforclassespriortothe20thweekofyourpregnancy.

Options for ClassesClassesareconductedonselecteddates.Youmaychooseeither:

Five Week Series:When: Monday,Tuesday,WednesdayorThursday.Time: 7.00pmto9.15pm

All Day Class:When: WeekdayorSaturdays(Selecteddates)Time:9.30amto4.30pm

Foralldayclassespreferenceisgiventothosewhohavegenuinedistanceproblems,ie:liveoutoftownorhavedifficultytravellingatnight.Lightlunchandrefreshmentsareprovided.Venue: AlburyWodongaHealthWodongaHospital,AntenatalRoomoffWilsonStreet,Wodonga.Antenatal Reception Phone Number: (02) 60 517 240.

YOUNG MUMS GROUP

Sessionsareheldforyoungmothers.Thisgroupfeaturesasmallgroup,arelaxedandfunatmospherewithalightlunch.ItisledbyMidwiveskeentohelpyouthroughlabourandbirth.Youcanbringalongyourpartner,supportperson,friendormum.Pleasephoneantenatalreceptionforsessiondates.

You will learn about labour, what to expect in labour and baby care.

When:Weekdays—2x1/2daysTime: 12.00pm-4.00pmVenue:AlburyWodongaHealthWodongaHospital,AntenatalRoomoff WilsonStreet,Wodonga.

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What to bring / wear:• Comfortableexercisegear.

• Runners.

• Towel.

• Waterbottle.

How to register for the class:1.ContactthePhysiotherapyDepartmenton(02)60517400(BH)Youwillbeaskedtoprovideyourcontactdetails.Youwillbesentanindemnityform.

2.CompleteandreturnindemnityformtothePhysiotherapyDepartmentwithintwoweeksofreceivingtheform.

3.Onceindemnityformisreturned,youwillbeadvisedofadatewhenyoucancommencetheclasses.

For more details please contact:Physiotherapy Department on (02) 60 517 400 (BH).

Thereisasmallcostforeachclass.

FIT FOR BIRTH CLASSES

AWHWodongaHospitaloffersFitforBirthclassesforpregnantwomen.TheweeklyclassisprovidedbyPhysiotherapistswithexperienceinantenatalcareandexercise.

Each class will consist of:• 45minutesofvariedexercises.

• Shortinformationsession-adifferenttopiceachweek.

Aims:• Toprovideaguidedexerciseclass,appropriateforallstagesofpregnancy.

• Toteachappropriatetypesandintensitiesofexerciseduringpregnancy.

• Toanswerhealthandfitnessquestionsrelevanttopregnancy.• Toallowparticipantstomeetothermumstobe.

When: TuesdayTime: 5.15pm-6.30pmWhere:CommunityRehabilitationCentre(CRC)VermontStreet,Wodonga.

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AWHWodongaHospitaliscommittedtotheprotection,promotionandsupportofbreastfeeding,however,AWHWodongaHospitalrecognisesthatnotallwomenchooseorareabletobreastfeed.

The Benefits of Breastfeeding:

Benefits for your baby: • Breastmilkprovidestherightnutritionforyourbaby’sneedsforgrowthanddevelopmentforthefirst6monthsoflife.

• Protectsyourbabyagainstgastroenteritisanddiarrhoea,chestandearinfectionsandmayalsoprotectagainstallergiesanddiabetes.

Benefits to mother:• Closenesstomother.• Bondingwithbaby.Reducesriskofbleedingafterthebirthofyourbaby.• Helpsyoureturntopre-pregnancyweight.• Protectsagainstbreastandovariancancerandosteoporosislaterinlife.• Itisconvenient,safeandfree.

Nipple Preparation for Breastfeeding• Askthemidwife/doctortocheckyournipples.Iftheyareappearinvertedorveryflatyoucandiscussstepstoassistincorrectingthis• Unlesstheskinisdrynipplecreamsarenotnecessary.• Pullingandrollingthenipplesbetweenyourthumbandfingercanbehelpful.• Gentlypatnipplesdryaftershoweringorbathing.

The Importance of Skin to Skin Contact after Birth:Placingbabystraightontothemother’sskinenablesthebabytofeelcalmandwarm.Italsoproducesastronghormonalresponseinthemother.Thisinitialskintoskincontact,foratleastonehour,beforeinjectionsandotherproceduresareattendedisshowntopromotetohigherbreastfeedingsuccessandlongerbreastfeedingduration.Itisalsopossibleafteracaesareanbirth. Getting Position and Attachment Right:Thefirstfewdaysallowachanceformotherandbabytolearnbreastfeedingskills.Itisimportantthatthemotherlearnshowtoholdandcorrectlyattachherbabytothebreasttohelpavoidpainandensureyourbabyreceivesthemostmilk.Breastfeedingisalearnedskillthattakestime,patienceandpractice.Thebreastsaresoftandthehighlynutritiouscolostrumwillchangeintomaturemilk.

Demand Feeding:Yourbabywillfeedaminimumof7to8timesandupto12timesin24hourswhilebreastfeedingisbeingestablished-thisisverynormalandwillsettlewithtimeasmilksupplyestablishes.

Rooming In:TheMaternityUnithasa24hourroominginpolicy,ie:thebabystayswiththemother.Keepingyourbabywithyouhelpsyoutorecognisewhenyourbabyishungry,tiredorneedsacuddle.

BREASTFEEDING ANTENATAL CHECKLIST

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Using Teats, Dummies and Complementary Feeds:Yournewbabyislearningtobreastfeedandcanbecomeconfusedifofferedateatordummybeforetheyhavelearnttobreastfeedwell.Offeringfluidsotherthanbreastmilkwilldecreasethetimeyourbabybreastfeeds,whichwillreduceyourbreastmilksupply.Frequent,unrestrictedsucklingatthebreastwill

satisfythebaby.1

For More Information and/or Assistance:

Australian Breastfeeding AssociationLocalgroupsinAlbury-Wodonga,CorryongandWangaratta.Phone1800686268NationalHelpline

Parents and Babies Unit, Mercy Health Service PooleStreet,AlburyNSW.Phone(02)60421446.

Lactation Day Stay Unit. Northeast Health34CusackStreet,Wangaratta,Victoria.Phone(03)57220111.

Albury Wodonga Health - Wodonga Hospital Breast Feeding Support ServiceMaternityUnit(offWilsonStreet).Phone(02)60517240

At booking ask the Midwife for:• “BreastorBottle.Whatwillyouchoose?”Brochure.

• “7reasonswhymother’smilkisbetterforyouandyourbaby.”BrochureAustralianBreastfeedingAssociation.

• BreastfeedingEducationClassesLeaflet.

• BreastfeedingSupportService.

1. Developed March 2008.

1. Royal Women’s Hospital Antenatal Breastfeeding Checklist (2008)

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Breastfeeding,whilenatural,isstillalearnedskillforbothmotherandbaby,ithelpstolearnasmuchasyoucanbeforethebirth.Confidence,supportandknowledgeallhelp.Weencourageexpectantparentstocomeandjoinourbreastfeedingeducationclasses.Thesecomprehensiveworkshopstylesessionsaimtoexpandupontheknowledgegainedatantenatalclasses.

Comealongwithyourpartnerorsupportpersonandensurethatyouhaveuptodateinformation,knowledgeandsupportonbreastfeedingyourbaby.

For dates and to book into classes contact: Sharon on (02) 6041 2351 or email sharonaba@bigpond.com

Places are limited for each class.

Classes:Saturdays1.00pm—5.00pm(Selecteddates)

Venue for Classes:AlburyWodongaHealth,WodongaHospital,AntenatalRoomoffWilsonStreet,Wodonga.

Cost:Acostappliesandincludes12monthsmembershiptotheAustralianBreastfeedingAssociation.

AUSTRALIAN BREASTFEEDING ASSOCIATION BREASTFEEDING EDUCATION CLASSES

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CHOICES OF ANTENATAL CARE:

Obstetric General Practitioner (GP) Care:AllappointmentsarewithanObstetricGPathis/herMedicalClinic.

NOTE: Obstetric GPs are specialist trained GP’s (different to “normal” GP’s) who provide all antenatal care throughout pregnancy and who can deliver your baby.

GP Shared Care (with Obstetric GP):VisitsarewithyourregularGPforantenatalcheckupsandadditionalvisitsarerequiredwithanObstetricGP.

GP Shared Care (with Specialist Obstetrician):YouwillvisityourregularGPforantenatalcheckupsandadditionalvisitsasrequiredwithaSpecialistObstetrician.

Midwife Care Program:TheMidwifeCareProgram(MCP)isavailableatAWHWodongaHospitalforuncomplicatedpregnancies.MostantenatalappointmentsoccuratAWHWodongaHospitalwithMidwivesandsomeappointmentsarewithanObstetricGPathis/herMedicalClinic.

MIDWIFE CARE PROGRAM:

TheMidwifeCareProgram(MCP)atAWHWodongaHospitalofferswomenwithuncomplicatedlowriskpregnanciesanalternativetotraditionalformsofcare.ThefocusoftheMCPisoneducation,preparation,involvementandactivebirth.Theprogramprovidesanopportunityforwomen,theirpartnersandfamiliestoparticipatefullyinthepregnancyandbirth.

Midwivesareresponsibleforyourcarethroughoutthepregnancy,birthandpostnatalperiod.Afterdischarge,careiscontinuedbyourCommunityMCP.Pleasebeawarethatwedohavesetcriteriaandthereareconditions,listedonMidwifeCareReferralForm,thatmayexcludeyoufromthisprogram.ThefinaldecisionrestswiththeMCP.Shouldcomplicationsdevelop,youwillbereferredbacktoyourObstetricGPProviderwhoisabletoprovideantenatalcareandspecialistreferralifrequired.

The program runs on Mondays, Wednesday’s and Thursdays.

Appointmenttimesarescheduledaccordingtoyourstageofpregnancy.

For further information or to arrange an appointment please contact the Antenatal Receptionist at Wodonga Hospital on Phone: (02) 6051 7240.

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Pregnancyandthefollowingyearisatimeofgreatchangeinawoman’slife,anditiscommonforwomentoexperienceawiderangeofemotions.Whilstmotherhoodcanbeatimeofgreatjoyandfulfilment,formanywomenitcanbeexhausting,lonelyandfrightening.Thisexperiencecanbeconfusinganddistressingforboththewomanandherfamily.Formanywomen,feelingsofworryandstressresolvebythemselves.Butinsomewomen,pregnancyandearlyparenthoodcantriggersymptomsofmoreseriousmentalhealthproblems.Thelikelihoodisgreaterforwomenwhohavehadmentalhealthproblemsbefore,donothaveenoughsupport,orhavebeenthroughdifficulttimes(e.g.familyproblems,abuseorloss).Forwomenwhofeelisolatedeitherbydistance,cultureorboth,thelikelihoodmaybeevengreater.AtthetimeofbookingroutineassessmentofemotionalhealthandwellbeingwilltakeplacewiththeMidwifeaskingyouanumberofquestionsabouthowyouarefeeling.Whileestimatesvary,researchsuggeststhatdepression,anxietyorbothareexperiencedbyatleastoneintenwomenduringpregnancyandoneinsixwomenintheyearfollowingbirth.Lesscommonly,severementalhealthdisorderssuchaspuerperalpsychosisandbipolardisorderariseorrecur.Depressionandrelateddisordersaffectthewellbeingofthewoman,herbaby

andhersignificantother(s)(e.g.partner),andhaveanimpactonrelationshipswithinthefamily,duringatimethatiscriticaltothefuturehealthandwellbeingofchildren.Seekinghelpearlyisbeneficialtothewomanandherfamily.Ifawomanhaspsychosocialfactorsand/orsymptoms,thehealthprofessionalusesclinicaljudgementtodecidewhethershewouldbenefitfromfollow-upcare.Referralifrequiredtofollowupcarewillbeorganisedwithyourconsent.(Adapted from Beyond Blue Clinical Practice Guidelines, Depression and Related Disorders - February 2011)

EMOTIONAL AND PSYCHOSOCIAL HEALTH SCREENING

PEHP - Perinatal Emotional Health Program

Thisisaspecialistearlyinterventionservicesupportingemotionalhealthduringpregnancyandearlyparenthood.PEHPisafree,home-basedserviceforwomenandfamiliesexperiencingemotionaldifficultiesduringpregnancyandchildbirth.Theserviceprovideseducation,counsellingandfacilitationofsupportgroups.Referral can be made by contacting the service or by your Doctor, Midwife or Social Worker making a referral with your consent.

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BIRTH PLAN INFORMATION:

AWHWodongaHospitalMaternityUnitprovidesqualitycareforpregnantwomen.Werecognisethatbirthplansandpreferencesarepreferredbysomewomenduringlabourandbirth.IfyouchoosetocompleteabirthplanitisimportantthatitisdiscussedwithyourMaternityCareProviderandwiththeMidwivesandDoctorscaringforyouduringlabour.

Please ask at time of booking in if you require a Birth Plan Form.

Ifatanytimeyoufeelconcernedoryouhaveacomplicationorproblemrelatedtooraffectingyourpregnancy,youcancontacttheMidwives at the hospital on (02) 6051 7250.

TheMidwiveswillprovideadviceormayaskyoutoseeyourGPortoattendtheMaternityUnitforanassessment.

Please contact the hospital immediately if you experience any of the following:

• Vaginalbleeding.

• Rupturedmembranes.

• Decreasedornofetalmovementsfor12hours.

• Severeconstantpain.

• Anyregularpainfulcontractionspriorto37weeks.

• Severeheadacheand/orblurredvision.

• Offensivevaginaldischarge.

• Abdominaltraumasuchasablowtotheabdomen,caraccidentorfall.

DANGER SIGNS IN PREGNANCY:

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Thegoodnewsisthatitisrelativelyeasyforthemotherandbabytoavoidputtingontoomuchweightinpregnancy.Youdonotneedtobeonadiettodothis;infactwomenshouldn’tdietduringpregnancy!However,pleasenoteyouonlyneedtoeatforone!Youdonotneedtoeatanyextraforyourbaby.

Weightgainduringpregnancyisrelatedtoyourpre-pregnancyweight.Thetablebelowindicatestheexpectedweight,usingyourbodymassindex(BMI).Overall,lighterwomangainmoreweight,andheavierwomenwillgainlessweight.

Steadyweightgainduringpregnancyisnormalandimportantforthehealthofthemotherandbaby.However,itisimportantnottogaintoomuchweight.Whenawomanbecomespregnant,notonlydoeshertummybecomelarge,shealsoincreasesherfatstoresinpreparationforbreastfeeding.Thismaybearoundherbuttocks,thighs,tummy,backandbreasts.

Inpregnancyitisveryeasytogainmoreweightthanisrequiredwhichisunhealthyforthepregnantwomanandbaby.Itcanmakeithardtoloosethisweightwhenthepregnancyisover.Ahealthyweightgainforthepregnantwomanalsoensuresthebabyachievesoptimalgrowthandthereforereducestheriskofcomplicationsatbirth.

Inaddition,itisveryeasyforthedevelopingbabytobecometoofat.Ifababyisbornwithtoomuchfat,itisatriskofbirthinjuriesanditismorelikelytogrowintoanobesechildandeventuallyanobeseadult.Obeseadultsareatincreasedriskofmanyserioushealthproblemsastheygetoldersuchasdiabetes,highbloodpressure,heartdisease,somecancers,arthritis.

DIET AND PREGNANCY WEIGHT GAIN

Underweight(<18.5)

Normal weight (18.5-24.9)

Overweight (25-29.9)

Obese (>30)

12.5-18kg

11.5-16kg

7-11.5kg

5-9kg

0.4-0.6kg/wk

0.3-0.5kg/wk

0.2-0.3kg/wk

0.2-0.27kg/wk

Pre-pregnancy BMI Total weight gain Kg/ week (13 weeks onwards)

“To achieve and maintain a healthy weight gain,

be physically active and choose amounts

of nutritious foods to meet your energy

requirements.”

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Breads, Cereals

Vegetables

Fruit

Yoghurt, cheese, milk *low fat and sugar, high calcium

Meat, fish, chicken, eggs, nuts, legumes

Fluids

8-9

5

2-3

3

1½-2

2litres

1slicesbreadI/2cupcookedrice/pasta/noodles2/3cupcereal1/4muesli

½cupvegetables1cupsalad

1mediumapple

1cupmilkorsoymilk2slicescheese(40g)200gyoghurt

100gmeat1cuplegumes30gnuts

WaterisbestAvoidalcohol

FoodGroups Serves Exampleof1serve

A healthy pregnancy diet ‘in a nut shell’

Eat Most: Wholegrainsincludingbreads,cereals,rice,pasta. Fruitandvegetables.Eat Moderately: Proteinrichfoodsincludingfish,chicken,legumes,nuts, seeds,eggs,dairyproductsandleanmeat.Eat Occasionally: Monosaturatedfatseg:oliveandcanolaoils.Limit: Sugar,salt,tea,polyunsaturatedfats,suchassunflower andsaffloweroils. Caffeine;coffeeorequivalenttonomorethanoneaday. Milk,nomorethanoneglassaday. Saturatedfatssuchasfatonmeat,butter.Avoid: Allsweeteneddrinks(softdrinks,cordials,sports drinks,icedcoffees,sugaredteaandorcoffee). Fruitjuice!Itisrichinfruitsugar. Hotchipsandpotatochips.Thisandsugardrinksare themaincauseofexcessweightgaininpregnantand non-pregnantwomen. Takeawayfoodhighinsalt,fatandsugar. Alcohol.Cigarettes.

TheAustralian Dietary Guidelinesprovidesadviceontheamountsandkindsoffoodtoeatduringpregnancyforgoodhealthandwellbeing.www.eatforhealth.gov.au

A healthy pregnancy diet includes the following:

Ifyouadheretotheabovedietadviceanddosomeexercise,(see‘ExerciseinPregnancy’)youwillfinditmucheasiertoreturntoyourpre-pregnancyweightandin,yourbabywillbehealthieratbirth.

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Iron:Requirementsforironincreasemarkedlyduringpregnancy,particularlyduringthesecondandthirdtrimesters.Itisessentialfortheproductionofhealthyredbloodcellstocarryoxygentoalltissuesinthebodyincludingtheplacenta.

Meatsourcesofironcontainthehaemformofironwhichiswellabsorbedinthebody.Vegetariansareatgreaterriskofirondeficiencyinpregnancythanmeateaters.VitaminCincreasestheabsorptionofthenon-haemironfoundinvegetablesources.

Folate in Pregnancy: (Folic acid folate)Folate(folicacid)isaB-groupvitaminfoundinavarietyoffoods.Greenleafyvegetablesareanexcellentsourceoffolate.

Itisrecommendedthatwomenplanningapregnancystartafolicacidsupplement6-12weekspriortoconceptionandforthefirstthreemonthsofpregnancytoreducetheriskofneuraltubedefectssuchasspinabifida.

Thereisstrongevidenceshowingabenefitintakingfolate,alsoknownasfolicAcid(seebelow)inearlypregnancy.Thereislessconvincingevidenceshowingbenefitintakingamulti-pregnancysupplementsuchasElevit,BlackmoresPregnancyandBreastfeedingsupplement.However

westillrecommendyoustartoneassoonasyouthinkyouarepregnant,andideallythreemonthsbeforeyouconceive.Agoodsupplementwillincludeiodine(Australiangrownfoodtendstobedeficientinthisimportantmineral),ironand400mcgofFolate.Thereissometheoreticalevidenceinfavouroftheadditionalcomponentssuchasfishoil,vitaminD3,calcium,magnesium,Zinc,andBgroupvitamins,butitremainsunproven.

Calcium: (There is no need for extra calcium during pregnancy) Until2006,Australiandietaryrecommendationsadvisedincreasedcalciumintakeduringpregnancyandlactation.Thisadvicehassincebeenrevised.Althoughthereisalarge‘shift’ofcalciumtothebabyduringthethirdtrimesterofpregnancy,asitstartstodevelopandstrengthenitsbones,themother’sincreasedcapacitytoabsorbdietarycalciummakesupforthislosswithouttheneedforincreasingcalciumintake.

Therecommendeddietaryintakefornon-pregnantwomen(1,000mgperdayforwomenaged19-50yearsand1,300mgperdayforadolescentsorthoseagedover51)remainsunchangedduringpregnancyandbreastfeeding.Dairyfoods,suchasmilk,cheeseandyoghurt,andcalcium-fortifiedsoymilkareexcellentdietarysourcesofcalcium.

SUPPLEMENTS IN PREGNANCY:

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Vitamin D

LowvitaminDlevelsareassociatedwithpooreroutcomesinpregnancysuchasgestationaldiabetes,pre-eclampsiaandlowweightbabies.MostvitaminDismadeinourskinbythesun’sultravioletrays.YouareatriskofavitaminDdeficiencyifyouhavetoolittlesunlightexposure.Thismayhappenifyouspendalotoftimeindoorsoryoucovermostofyourskinwithclothing.

ItisimportanttogetenoughsunlighttoproducevitaminDwithoutincreasingyourriskofskincancer.Insummer,manyfairskinnedpeoplemakeenoughvitaminDfromhavingtheirhands,armsandface(orequivalentareaofskin)inthesunforafewminuteseachdayduringnormal,daytodayoutdooractivities.Ifyouarefairskinneditisbesttoavoidthesunbetween11amand3pminsummerunlessyouarewearingsunprotection.Darkerskinpeoplewillneedmoresunexposurethanfairskinpeople.

YourvitaminDlevelsarecheckedearlyinpregnancy.Iftheyarelow,increaseyoursunexposure.YouwillbeadvisedtotakeasupplementsuchasOstelinorOste-VitD.

Vitamin B12Ifyouareaveganiesomeonewhoavoidsallanimalproductsintheirdiet,youmaybedeficientinvitaminB12.Itisimportanttotellyourdoctorsohecancheckyourlevelwithabloodtestandtreatifnecessary.

Liver and vitamin A

Liverisarichsourceofiron,howeveronlysmallamounts(50gramsperweekatmost)arerecommendedbecauselivercontainsverylargeamountsofvitaminA.VitaminAinexcesscanbeharmfultothedevelopingbaby.ThereisnodangerofexcessivevitaminAintakefromotherfoods.

VitaminsupplementsalsoneedtobecarefullycheckedfortheirvitaminAsource.VitaminAcomesintwoforms;retinolandbeta-carotene.Beta-caroteneisconsideredsafeeveninhighdoses,butsupplementscontainingretinol(thetypeofvitaminfoundinliver)shouldbeavoidedasthedosemaybetoohigh.Checkwithyourpharmacistifindoubt.

Fish and pregnancy

Fishisagoodsourceofomega3fattyacids,whichareneededforbrainandnervoustissuedevelopmentinthebaby.Oilyfishsuchassalmon,sardines,herring,mackerelandtunaarethebestsources.Therearealsosmalleramountsofthesefattyacidsinwalnuts,spinach,soybeans,linseeds,andcanola(oilandmargarine).Ingeneralonetothreeservesperweekoffisharerecommendedforallmembersofthepopulation.Howeverduetopossiblehighermercurylevels,certaintypesoffishshouldbelimited.

FOOD SAFETYIN PREGNANCY:SUPPLEMENTS IN PREGNANCY

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Shark(flake),broadbill,marlinandswordfishshouldnotbeeatenmorethanonceafortnightbypregnantwomen,womenplanningapregnancy,orchildrenupto6yearsold.Ifthesefishareeaten,nootherfishshouldbeeatenduringthefortnight.Limitorangeroughy(seaperch)orcatfishtooneserveperweek.Iftheyareeatennootherfishshouldbeeatenduringthatweek.Serve sizes are 150g for adults and 75g for young children.

Avoiding food borne illnesses

Theriskofcontractingalltypesoffoodborneillnessesduringpregnancycanbereducedbygoodfoodhandlingpractices.Theseincludewashinghandsbeforepreparingfood,ensuringfoodsarefreshandrefrigeratedandavoidingcrosscontaminationofrawandcookedfoods.

Listeria

Listeriaisabacteriumthatcancontaminatefoodandcauseinfection.Inpregnantwomenthisinfectioncanbepassedontothebaby.Listeriainfectionisnotacommonproblemandtheriskcanbeminimisedbygoodfoodhandlingpractices.

Here are some suggestions to help minimise your risk of listeria infection.

•Ensuregoodhygieneandcleanutensilswhenpreparingfood.•Thoroughlywashrawvegetables.•Avoidfoodssuchaspate,coldcookedchickenandslicedmeats,

coleslawsandsalads(unlessyouaresuretheyhavebeenfreshlyprepared),unpasteuriseddairyproducts,softcheeses(e.g.brie,camembert,ricotta,feta,bluecheese)softserveice-cream,uncookedorsmokedseafoodandprecookedprawns.Freshlycookedseafoodissafe.•Listeriaiskilledbycookingfoodtoboilingpointso,whenreheatingfoodsmakesuretheyarepipinghot.

Toxoplasmosis

Toxoplasmosisisanotherinfectionthatcanaffectunbornbabies.Acommonsourceofthisinfectioniscatsdefecatinginfreshlydugvegetablegardenbeds.Toreducetherisk,meatshouldbethoroughlycookedandsaladvegetablesthoroughlywashed.Pregnantwomenshouldavoidcontactwithcatfaecesandshouldweardisposableglovesifhandlingcatlitter.Handsshouldbewashedaftergardeningorhandlingpets.

FOOD SAFETYIN PREGNANCY:

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ALCOHOL, SMOKING & DRUGS IN PREGNANCY

AlcoholTheevidencelinkingalcoholwithbirthdefectsisstillinconclusive.Weknowthatheavydrinkingmaybeharmfultothebaby,particularlyduringtheearlystagesofpregnancy;howevertheeffectoflowtomoderatealcoholintakeislessclear.

Somestudiesshownoeffectswhileothersshowthateventhisamountmaybeharmful.Theconsensusviewisthatalcoholshouldbeavoidedthroughoutpregnancy.

Caffeine containing drinksTea,coffeeandcoladrinksallcontaincaffeine.Thereismixedevidenceabouttheeffectsoflargeamountsofcaffeineonthedevelopingbaby,howevermoderateamountsappearsafei.e.upto3cupsofcoffeeor5cupstea.Don’tforgetcoladrinksinadditiontocontainingcaffeine,alsocontainlargequantitiesofsugarandforthisreasonwerecommendyouavoidthemcompletely.Someenergydrinksinadditiontocontaininglargeamountsofsugar,alsocontaincaffeineorguarana(aplantthatcontainscaffeineandcaffeine-likesubstances).Werecommendyouavoidthemcompletelyinpregnancy.

Smoking and Pregnancy:Smokingisharmfultothehealthofyouandyourbaby!Pregnantwomanshouldstopsmokingtopromotethehealthandwellbeingofbothmotherandbaby.

Awomanwhosmokeswhilepregnantisatincreasedriskofexperiencingawiderangeofproblemsincludingectopicpregnancy,miscarriageandprematurelabour.

Womenwhosmokeareuptothreetimesmorelikelytogivebirthtoalowweightbabycomparedtonon-smokers.Lowbirthweightbabiesaremorevulnerabletoinfectionandotherhealthproblems,suchasbreathingdifficulties.

Everytimeapregnantwomansmokesacigarette,herunbornbabyisdeprivedofoxygenandexposedtothesamecocktailofchemicals,includingchemicalswhichcausecancer.Smokingduringpregnancycanimpairachild’shealthinfutureyears.Healtheffectsmayincludeimpairedlungfunction,increasedincidenceofasthma,andanincreasedriskofdevelopingbehaviourproblems.

Speak to your Doctor or Midwife if you need help to quit or call the Quitline on 137 848 (24 hours).

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Pregnancy and Drugs:Mostwomentakesomekindofdrug,substanceormedicationduringpregnancy,oftenwithoutrealisingthepotentialforharm.Drugsormedicationtakenbythemothermaycrossovertotheplacentaandreachthedevelopingfoetus.Thepossibleeffectsmayincludeprenataldeath(stillbirth),developmentaldelay,intellectualdisabilityandbirthdefects.

Youshouldalwaysgiveyourdoctorormidwifeafulllistofalldrugsormedicationyoutake,orhaverecentlytaken,including:

• Prescriptionmedicines.

• Over-the-countermedicines.

• Nutritionsupplements(likevitamins).

• Complementarymedicines(suchasherbalmedicine).

• Illegaldrugs.

• Drugsusedtotreatopiateoralcoholdependence,eg:Methadone.

Harmful Effects of Drugs or Substances on the Foetus and Pregnancy:Generallyadrug,substanceormedicationcancauseharmby:

• Interferingwithnormalfoetaldevelopment.• Damagingtheplacentaandputtingthebaby’slifeatrisk.

• Increasingtheriskofmiscarriage.

• Bringingonprematurelabour.

YoushouldalsotellyourDoctororMidwifeifyousmoke,drinkalcoholortakeanymedicationsorillegaldrugs,evenifyouonlytakethemoccasionallyorsocially.

Prescribed Medications during Pregnancy: PregnantwomenmayberequiredtotakemedicationsprescribedbyaMedicalOfficer(MO).Suchmedicationswouldbeprescribedforapre-existingmedicalconditionoramedicalconditionthatarisesduringpregnancy.TheDoctorwilloutlinetherisksandbenefitstoyouandyourbabyoftheprescribedmedications.Untreated,someillnessesorpregnancycomplicationsmayriskthehealthofthemotherorbaby,orboth.DiscussanyconcernsyoumayhaveaboutmedicineswithyourDoctororMidwife.

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EXERCISE IN PREGNANCY

Whenyouarepregnantweencourageyoutobeashealthyasyoucan.Thismeanseatinghealthilyandexercisingmostdays.Moderatetovigorousexercise(exercisethatelevatesyourheartratebutwhereyoucanstilltalk)ispreferabletogentleexercise.Breathinghardduringexerciseisnotharmfulforyouoryourbaby.30minutesofexerciseadayisexcellent,forinstanceabrisk30-minutewalkisperfect.Ifyouthinkyouaretoobusyforthis,rememberthat15minutesismuchbetterthannoexercise.

Exercisesuchaswalking,swimming,aquaaerobicsoryogaduringpregnancyhasmanybenefits,forinstance•Youwillbebetterpreparedforthephysicaldemandsoflabourandmotherhood•Yourpostureimproves•Youandyourbabywillhaveasmallergainofbodyfat•Youwillhaveahealthierbaby•Youwillrecovermorequicklyafterbirth•Pregnancyachesandpainswillbelessbothersome•Moodandenergylevelswillimprove•Balance,strength,coordinationandflexibilityareimprovedormaintained•Fasterreturntopre-pregnancyweightandfitness.

Risks of exerciseOccasionallyyourdoctorwillaskyoutominimizeexercise,forinstanceifyouaredevelopingpreeclampsiaorifyouareatriskofbleedingduringyourpregnancyfromalowplacentaandsoforth.Inaddition,youneedtobecauciouswhenyouarepregnant.Yourposturechangesandyoucanunbalancemoreeasily.

Don’texposeyourbabytotheriskoffallsorhardbumpstoyourtummy,forinstanceplayingcontactsport,skiing,andhorseriding.Avoidvigiriousexerciseinhotweather

Checkwithyourmidwifeordoctorbeforestartinganewexerciseprogram,toensureyouandyourbabyarenotatrisk.

Youshouldavoidrunningandstrainingexercisessuchasgymnasticsandweightliftingforthefirstsixweeksafterbirthsoyourpelvicfloorcanrecoverfromchildbirth.

Tips for being physically active during and after pregnancy:•If30minutesistoohardbreakitup,try10minutesexercise3timesaday.•Beactivethroughthedayinasmanywaysasyoucan,aimtomovemore.•Ifyouroccupationrequiressittingforlongperiods,stand,stretchanddoalightexercisesuchas5-10squatsevery30minutes.•Jointhehospital“Fitforbirthclasses”•Avoidlyingflatonyourback.

Sport and PregnancyUnlesswomenhavecomplications,itshouldbepossibletoenjoyyoursportatsomelevelthroughoutpregnancy.Itisnotrecommendedtocontinuecontactsportsafter4monthsofpregnancy.ItisimportanttodiscussthesportandtherequiredlevelofactivityandassociatedriskswithyourDoctororMidwifeandsportingorganisationbeforeyoumakeadecisionregardingcontinuingordiscontinuingyournormalsportingactivities.

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If you experience tooth ache or bleeding gums during pregnancy consult your Dentist promptly.

TEETH AND PREGNANCY:

Appropriateandregulardentalhygieneisessentialbefore,duringandafterpregnancy,toassistyouinmaintaininghealthyteethduringyourpregnancy.Baddantitionandgumdiseasehasabadeffectonyourpregnancy.

Regular and appropriate dental hygiene includes:• Brushingteethtwicedailywithfluoridatedtoothpaste.

• Flossbetweenteeth.

• Visityourdentistregularly.

• ShouldyouneedtovisittheDentistduringpregnancyinformyourDentistthatyouarepregnant.

Pregnancycancausewomentobemoresusceptibletogumproblemsduetotheeffectofpregnancyhormones.Gumproblemsincludeswelling,bleeding,guminflammation.Usingasoftertoothbrushmayhelppreventgumproblems.

PREGNANCY AND TRAVEL:

Thesafesttimeforpregnantwomentotravelisduringthesecondtrimesterifthepregnancyisprogressingnormallyandtherearenocomplications.ConsultwithyourDoctororMidwifeifunsurewhetheryoushouldtravel.Beawareoftheavailabilityofmedicalcareatyourtraveldestinationincaseyourequiremedicalcare.

Pregnantwomenneednotberestrictedfromflying.Mostairlinespermitpregnantwomentoflyuntiltheendofthe35thweekofpregnancy,afterthistimeexpectantmothersarestrictlyadvisednottofly.

Exactstipulationsfromairlinetoairlinevary,itissuggestedthattherelevantairlineiscontactedinadvanceofflyingtoconfirmtheirregulations.Someairlinesmayrequestamedicalcertificatespecifyingtheexpecteddateofdelivery.

Wearing seat belts while pregnantItisalegalrequirementtowearaseatbeltatalltimeswhentravellinginacar.Whenyouarepregnantyouwillneedtomakesomeadjustmentsforsafetyandcomfort.1.Placethelappartofthebeltunderyourbaby,aslowaspossible,soitisnotsittingacrossyourbaby.2.Adjusttheangleoftheseatbeltbyusingtheseatbeltlocator.3.Placethesashpartofthebeltinbetweenyourbreasts.

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MINOR AILMENTS OF PREGNANCY:

Heart Burn / Indigestion:Pregramsrelaxesthevalveattheentrancetothestomach,whichmakesiteasierforstomachacidtoflowintotheoesophagus,resultinginaburningsensation.Yourbabycanalsopressonthestomachwhichagaincausesstomachacidtoflowupwards.Youwillusuallynoticeheartburnwhenlyingdown,strainingorcoughing.Youcantrytoavoidheartburnbykeepingyourmealssmallandfrequentinsteadoflargeandfew,drinkingaglassofmilk(tohelpneutralisetheacid)particularlybeforebed.Donoteatspicyfoodsorfoodsthatarehighinfat.

Consult your Doctor, nurse or Pharmacist if you would like to take antacids.

Morning Sickness:Somedegreeofmorningsicknessisexperiencedby2/3ofwomenduringthefirsttrimesterofpregnancy.Itgenerallysubsidesbythe12thweekofpregnancy.Commonlywomenexperiencenauseaandvomitingandlossofappetite.

Asmallnumberofwomenwillexperiencemorningsicknesspast12weeksofpregnancy.Thecauseremainsamysteryhoweverthereisabeliefthathormonalchangescancausemorningsickness.

Morningsicknesscanrangefrommildnauseatoconstantvomitingrequiringhospitalisation.Despiteit’slabel,morningsicknesscanoccuratanytimeoftheday,howeversomepregnantwomenfinditoccurswhentheyhaven’teatenforsometime(eg:inthemorningaftera

night’ssleep–hencethename‘morningsickness’).

Therearemanydifferentremediesformorningsickness,someofthemoldwivestalesandsomeofthemactuallyworkforsomewomen–everyoneisdifferent!

The following may help:• Drinklotsoffluids.• Avoidsmellslikecigarettesmokeorcookingsmellswhichtriggernausea.• Eatsmallermeals,morefrequently.• Carrysomedrybiscuitsorsmallsnacksincaseyoufeelawaveofnauseacoming.

Nauseawillalwaysbeworseifyouaretired.Trytorestwheneveryoucanifyouhaveotherchildrentocareforbylyingdownwhenevertheydo.

Thereareanumberofnaturalremedieswhichmayhelpalleviatesymptoms,includingvitaminB6(checkwithyourDoctororPharmacistfirstfortheappropriatedose)andginger.Youcouldtrygingerbiscuitsforsnacks,oreventheherbinacapsuleformmayhelp.Peppermintteamayalsobehelpful–drinkacupofpeppermintteaandeatapieceoftoastbeforegettingoutofbed,andtwomorecupsduringtheday.

Ifyouareunabletokeepanyfoodand/orfluidsdown,pleaseconsultyourObstetricianordoctor,whocanassessyouandseeifyourequirefurtherattentionorhospitalisation.

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PELVIC FLOOR EXERCISE

Pregnancyandchildbirthcanhavealastingeffectonyourpelvicfloormusclefitness.Itisthereforeimportanttolookafterthesemusclesduringthisimportanttimeofyourlife.

Whenyou’repregnantthehormone‘relaxin’isreleasedthroughoutyourbody.Thissoftensthetissuesinyourbody,allowingittoexpandasyourbabygrows.Italsoallowsyourpelvicfloortostretchduringbirth.

Thesofteningeffectofrelaxinandtheincreasingweightofyourbabyplacespressureonyourpelvicfloormuscles.Thiscanmakeitharderforthemusclestoholdyourpelvicfloororgansintheircorrectposition.Thepelvicfloormusclesandligamentsarealsostretchedatbirth,whichcansometimeslengthenthetissuespermanently.

Somewomenaremoreatriskofpelvicfloorproblemsduringpregnancyandchildbirththanothers.Theseincludewomenwhohavehad:•multiplebirths•largebabies(over4Kg).•instrumentalbirths(usingforceps)

Pelvicfloormuscleexercisesareaneffectivewaytomaintainyourpelvicfloorfitnessduringandafterpregnancy.

Forfurtherinformationonpelvicfloorsafeexercises:www.pelvicfloorfirst.org.au

Goodpelvicfloormuscletoneassistswomentomaintainbladderandbowelcontrolthroughoutpregnancy.Theyalsohelpsreducetheriskofdevelopingaprolapseduringorafterpregnancyandassistswithrecoveryafterbirth.

ForfurtherinformationvisitacontinenceprofessionalorcontacttheNationalContinenceHelplineonfreecall1800330066

Common Concerns:

•VaricoseVeins

•Tiredness

•Haemorrhoids

•FoodCravings

•Rashes/itches

•Cramps-legs

•Stretchmarks

•Irritablelegs

•Backache

For more information

discuss these concerns

further with your Doctor

or Midwife.

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LABOUR:

Mostwomenwillcomeintospontaneouslabour,howeversomewomenwillneedtobeinducedformedicalreasonsoriftheirpregnancyisprolonged(thatis10daysafterduedate).Ifaninductionisbooked,womenneedtobeawarethatcircumstancescanchangewiththevarieddemandsintheBirthingSuiteandtheinductionmayneedtorescheduled.YourinductiondateandmethodwillbedeterminedbyyourDoctorinconsultationwithyou.

Considerations for the Labour Ward:WhenyouareinlabourpleaseinformrelativesandfriendsnottocalltheBirthSuite.Itisappreciatedthatphonecallstobirthsuitearerestrictedanditisrequestedthatyourrelativesandfriendswaitforsupportpeopletoinformthemofyourprogress.

Phone Calls in the Labour Ward:Clientsareaskedtoinformsupportfamily/friends,etc,torestrictphonecallswhilstintheLabourWard.Pleaseaskyoursupportperson(s)toinformfamily/friends,etc,ofyourprogress.

Pleaseconsiderbringingyourownselectionofmusictolabourwardtosuityourneeds.Yoursupportpeoplemayliketobringasnackandadrinkfornourishmentwhilsttheysupportyouinlabourward.

Support People:• Partner.

• Familymember.

• Friend.

Training Hospital:AWHbothAlburyandWodongaHospitalsarecommittedtothetrainingofMedical,NursingandAlliedHealthstudents.AtWodongaHospitaltherearestudentMidwives,studentdoctorsandjuniordoctorsundergoingtraining.Caremaybeprovidedbythesepeopleinconjunctionwithexperienceddoctorsandmidwives.

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AWHWodongaHospitalofferstheservicesofaKooriMaternityEnhancementWorkerforwomenthatarehavinganAboriginalbaby.Thisisaprogramthatprovidesadditionalandculturallyappropriatesupportduringtheantenatalperiodandtheimmediatepostnatalperiod.Supportisconfidentialandisdeliveredbyoutreachorwithinthehospital.FormoreinformationcontacttheAntenatalbookingarea.

KOORI MATERNITY ENHANCEMENT WORKER:

CAESAREAN SECTION:

Forwomenbookedforacaesareansectionyouwillbeadmittedonthemorningofyourscheduledsurgery.

YoumayberequiredtoattendtheMaternityUnitforananaestheticconsultationintheweekpriortoyourplannedcaesareansection.

Aletterorphonecallwillinformyouifyouarerequiredtoattend.

CULTURAL CONSIDERATIONS:

ItisunderstoodthatsomewomenfeelmorecomfortablewithafemaleDoctororhealthcareworkerduringlabouranddeliveryorwhenhavingavaginalexamination.WherepossibleshouldyourpreferencebeforafemaleDoctororhealthcareworkeryourpreferencewillbemet,howeveritcannotbeguaranteed.

AllDoctorsaretrainedtoberespectfulandtounderstandandconsideryourconcernsincludingculturalandgenderissues.IfyouhaveparticularconcernsaboutseeingamaleorfemaleDoctoritisrecommendedthatyoudiscussyourconcernswithyourDoctorandaMidwifepriortolabour.

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POSTNATAL CARE:

Postnatalcarebeginsimmediatelyafterbirthandtheprimaryaimsaretoprovide:•recuperationfromthebirthingprocess•breastfeedingeducationandsupport•parentingeducationandsupport•clinicalcaretopromotethephysicalandpsychologicalhealthandwellbeingofthewomanandherbaby.

Theaiminthedeliveryofpostnatalcaretoensurebestqualitycareisprovidedtoallwomenandtheirbabies.Thereforeweaimtomeetyourneedsduringthepostnatalperiodandtoassistindoingsofurtherinformationwillbeprovidedtoyouclosertoyourduedate.

General advice and information is provided on:

•Nutrition.

•Selfcareandhygiene.

•Perinealcare.

•Changestoyourbodyfollowingbirth.

•Immunisation.

•Breastfeeding.

•Careofthebaby.

•Roomingin.

•Contraception.

•Emotionalsupport.

•Physiologicalwellbeingandconcerns.

•Dischargeplanning.

•Postacutecare.

•Relevantsupportservices.

Thetimethatwomenspendinhospitalfollowingchildbirthhassteadilydeclined.In2009–10,theaveragelengthofstayforapublichospitalbirthepisodewastwodaysforanuncomplicatedvaginalbirthandfourdaysforacaesareansectionwithoutmajorcomplications(DepartmentofHealth,2012).

Thisreflectsimprovementsinacutecareandthedevelopmentofalternativeandappropriatecaresettings,includingthewoman’shome.Whetherthesettingforcareisthehospitalorawoman’shome,thefocusshouldbeonthemostappropriatecaresettingforeachwoman.Whetherpostnatalcareisprovidedinhospitalorinthewoman’shome,itisimperativethatthecareprovidedisofthehigheststandardandmeetstheneedsoftheindividual.

Whenyouaredischargedfromhospitalafteryourbirth,youwillneedtomakeapostnatalappointmentwithyourdoctor.Thisislikelybutnotnecessarilytobethedoctorwhocaredforyouduringyourpregnancy.Alternativelyitmaybeyourusualfamilydoctor.Thisappointmentisacheckupforyourselfandinadditionyourbaby.APapsmearmaybecollectedandcontraceptionislikelytobediscussed.Remember to bring your babies health record.

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Pregnancyandgivingbirtharemajoreventsforwomenandtheirfamilies.Whilethiscanbeahappyandexcitingtimeforsome,forothersitmaybeachallengingtime.SocialWorkersintheMaternityUnitarepartoftheteamofskilledhealthprofessionalsthatincludesDoctors,MidwivesandotherAlliedHealthstaff.Whileyouareinhospital,MaternitySocialWorkersareabletoassistwithavarietyofissues.

These could include:• Familyorrelationshipproblems.

• Familyviolence.

• Feelinglonely,unsupportedorconfused.

• Feelinganxiousordepressed.

• Grief,bereavementandloss.

• Problemswithfinances,legalorhousingmatters.• Assistyoutodealeffectivelywithstress.

• Adjustmenttoparenthood.

Ifnecessaryareferraltoothercommunityhealthandwelfareagenciescanbemadeforfurtherfollowuponceyouhavebeendischargedfromhospital.IfyouwouldliketoseeaSocialWorkeryoumayaskotherhospitalstaff(DoctorsorMidwives)toorganisethisforyou.

MATERNITY UNIT SOCIAL WORK SERVICE: DISCHARGE PLANNING:

HospitalMidwiveswillplananddiscussyourdischargewithyoufromthetimeyoubookuntilyouaredischargedhomefromhospitalcare.Follow-upcarewillbeprovidedbyamidwifeathome.

Dischargeisexpectedatapproximately48hoursforuncomplicatedbirths.Youwillbeencouragedandsupportedtoplanforyourdischargehomewithyournewbaby.

Womenwhohavehadacaesareansectionareplannedfordischarge72hoursfollowingbirth.

Discharge time is by 11.00 am on the day of discharge. If you foresee any problems with discharge please let the Midwife know.

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Preparing for and going home with baby:TheMidwifewilldiscusswithyouyouroptionsfordischargefromhospital.AMidwifeisavailabletovisitmothersathomeafterdischarge.IfyouliveoutoftowntheMidwifewillbefromyourlocalarea,referredtoasanoutreachMidwife,andifyoulivewithinAlbury-WodongatheMidwifewillbefromtheMaternityUnit.

All mothers are encouraged to go home soon after 2 days (48 hours) following a vaginal birth and approximately 4 days following a caesarean section birth.

Attimesalongerstayisrequired.Theneedforalongerstaywillbediscussedwithyouandyourpartner.TheMidwivesencourageyoutosettleinathomewithyourbabyassoonaspossibleafterthebirth.Inyourhomeenvironmentyoucanfocusonyourneedsandtheneedsofyourbabyinarelaxedandfamiliaratmosphere.Youwillbewellsupportedandyourcareindividualised.

The hours of the Domiciliary Midwife service are:

8.00 am to 4.30 pm each day (Except Christmas day and Good Friday).Phone queries: (02) 60 517 254.

MITH:

MidwifeInTheHome,isaserviceprovidedtoselectedpatientswhowouldnormallybecaredforinhospital.Theynowhavetheopportunitytobecaredforintheirownhome.Thisresultsinlessstresstothefamilyunitcausedbythehospitalseparation.Midwiveswillattendtoyourneedsinyourownhome.

There are 3 types of admissions:

1. Pregnant women who are having complications. The Doctor will formally admit the patient to the program for daily assessment.

2. Mothers or Babies after birth may require daily visits for specific complicated problems eg: mastitis (Mother), wound infections, etc.

3. Mother who go home on the same day that they deliver may have daily visits for 2 days.

DOMICILIARY POSTNATAL CARE:

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COMMUNITY SUPPORT SERVICES:

Protocol Regarding Infant Restraint:Atthetimeofdischarge,allinfantsinvehiclesmustbesecuredinanapproved,correctlyfittedinfant/childrestraintwhichmeetsapprovedAustralianStandards.

Itisthelegalresponsibilityoftheparentstoensurethatthechoseninfantrestraintiscorrectlyandappropriatelyfitted.Thisrestraintshouldpreferablybefittedduringtheantenatalperiodwithdueconsiderationforfamilyrequirementsandvehiclesize.

• ParentandBabyUnit.

• Maternal&ChildHealthCentres.

• AustralianBreastfeedingAssociation.

• MultipleBirthAssociation.

MCHNorCFHNusuallycontactsyoubyphonewithinthefirstweekfromdischargefromthePostnatalDomiciliaryHomeVisitsServiceordischargefromhospital.

Theseservicesaimtopromotethehealthofinfants,childrenandtheirfamilies.

YourspeciallytrainednurseprovidesarangeofserviceswithinAlbury,WodongaandHumeShire.

Theseservicesmonitorthegrowthanddevelopmentofbabiesandyoungchildrenprovideeducationalsupporttoparents/carers.

MATERNAL & CHILD HEALTH NURSE (MCHN—Vic) or CHILD & FAMILY HEALTH NURSE (CFHN—NSW):

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NOTES / QUESTIONS FOR THE MIDWIFE OR DOCTOR:

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ABBREVIATIONS

AWH AlburyWodongaHealthMCP MidwifeCareprogramMITH MidwiferyInTheHomeNHMRC NationalHealth& MedicalResearchCouncil

RESOURCES AND LINKS

Formoreinformationonpregnancyandlifestyleduringpregnancyandlabour:

http://maternity.health.vic.gov.auwww.3centres.com.auwww.australianbaby.infowww.awh.org.auwww.betterhealth.vic.gov.auwww.breastfeeding.asn.auwww.druginfo.adf.org.auwww.genetichealthvic.net.auwww.health.nsw.gov.auwww.nhmrc.gov.auwww.quit.org.auwww.rwh.org.au/wellwomenswww.health.vic.gov.auwww.wch.sa.gov.au

REFERENCES

3 Centres Consensus Guidelines on Antenatal Care, Mercy Hospital for Women,Southern Health and Royal Women’s Hospital, 2006.

DISCLAIMER

AlburyWodongaHealthdoesnotacceptanyliabilitytoanypersonfortheinformationoradviceprovidedinthisbooklet.Weprovidethisinformationontheunderstandingthatallpersonsreadingittakeresponsibilityforassessingitsrelevanceandaccuracy.Womenareencouragedtodiscusstheirhealthneedswiththeirhealthpractitioner.Ifyouhaveconcernsaboutyourhealth,youshouldseekadvicefromyourhealthprovider.Ifyourequireurgentcareandyouaremorethan20weekspregnant,youshouldphoneWodongaMaternityon60517250.Ifyouarelessthan20weeks,pleaseattendEmergencyatWodongaHospital(preferable)oralternatively,atAlburyHospital.

GP GeneralPractitionerBMI BodyMassIndexMO MedicalOfficer

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Albury Wodonga Health Wodonga Hospital Contact Numbers

Wodonga Hospital Reception (02)60517111Antenatal ‘Booking-In’ Bookings (02)60517240Midwife Care Program (02)60517240Antenatal Education Bookings (02)60517240Maternity Unit Wodonga Hospital (02)60517250Breast Feeding Support Service (02)60517240Physiotherapy Fit-For-Birth Class Bookings (02)60517420Social Work Unit (02)60517242 or(02)60517246Koori MaternityEnhancement Worker (02)60517257Perinatal Emotional Health Program (PEHP) (02)60517950www.awh.org.au

Specialist Obstetricians (Referral Required)

Dr Hang Chau 66VermontSt,Wodonga3690 (02)60245433Dr Simon Craig 66VermontSt,Wodonga3690 (02)60242027Dr John Salmon 66VermontSt,Wodonga3690 (02)60245060Dr Bhupen Khara 36VermontSt,Wodonga3690 (02)60565770

Federation ClinicDrFionaChristieDrPhillipSteele1FordeCtWodonga3690Tel:(02)60592500

Gardens MedicalCentreDrMichaelThomasWodongaPlaceAlbury2640Tel:(02)60215333 West Wodonga Medical Centre

DrPeterSartori195MelbourneRdWodonga3690Tel:(02)60562447

Corowa Medical Centre

DrAntoinetteDelPopolo61GuyStCorowa2646Tel:(02)60331211 Myrtleford Standish StSurgeryDrLeighBennieDrSimonShute107StandishStMyrtleford3737Tel:(03)57519900

Bright Medical CentreDrChrisO’Brien115GavanStBright3741Tel:(03)57501000

Mt Beauty MedicalCentreDrSkyeDelaneyDrJeffreyRobinsonDrMarkZagorskiTawongaCrsMtBeauty3699Tel:(03)57543400

Central Medical GroupDrJennyGiddensDrGregGladmanDrTessGoodwinDrAlisonGreenDrDavidTillett224BeechworthRdWodonga3690Tel:(02)60243233

Accredited Obstetric General Practitioners

Hospital Access to theMaternity UnitAlburyWodongaHealthWodongaHospitalislocatedfiveminutesfromtheHumeHighway.TheMaternityUnitentranceislocatedoffWilsonStreet.

LimitedparkingisavailableintheMaternityUnitcarparkoffWilsonStreet.StreetparkingneartheMaternityUnitisavailablebutistimerestrictedandpoliced.

AlburyWodonga

Health

VersionNo.:3DateApproved:May2013DateforReview:May2015

Albury Wodonga Health Service Wodonga HospitalMaternity UnitVermont Street, Wodonga Vic 3690

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