To prepare for the birth of your child there are many good books on pregnancy and childbirth to choose from for you and your partner. It may also be worthwhile to attend antenatal classes to help you prepare further. There are a number of options when it comes to antenatal classes. The Mater Hospital runs comprehensive classes over weekends and week nights. Hospital tours are also available.

There are other organisations that run antenatal classes:
Yoga Baby

Hypnobirthing

Breast milk is recommended for the first six– twelve months of life. Breast feeding can be a most wonderful experience however it is not always easy in those first few weeks. Whist considered natural, breast feeding is very much a learned skill and there is plenty of help and advice to assist new mothers in those all-important first few weeks after delivery.
The Mater Mothers hospital has a breast feeding clinic which provides valuable help and support to new mothers.

Lactation consultants are available both at the Mater and when you go home throughout Queensland. To locate a Lactation Consultant near you visit Lactation Consultants
Australia and New Zealand:

General breast feeding advice is available from the Australian Breastfeeding Association (ABA)

The collection and storage of cord blood stem cells provides an opportunity to use these stem cells should they be required at some stage later in life. There are two ways to store cord stem cells, altruistically or via the dedicated private cord blood banking services.
The Mater is one of 11 hospitals in Australia which contribute to Auscord the free cord blood banking service. Cord blood can be collected from the placenta following delivery throughout the week and there is no cost to parents. The banked stem cells are stored and can be used by anyone.
Alternatively a number of private companies offer a dedicated collection service where parents may choose to bank their child’s cord stem cells for use later in life. There are three private companies in Brisbane providing private cord stem cell collection services.
Cellcare

Cryosite

Stemlife

It is recommended that all pregnant women be screened in pregnancy for gestational diabetes between 26– 28 weeks gestation. The hormone HPL that is released from the placenta that causes diabetes is at its peak at this time. The significance of gestational diabetes is that your baby may grow at a greater rate and be larger at birth and hence more difficult to deliver. In addition, at birth the baby’s sugar level may drop causing hypoglycaemia.
A glucose tolerance test , GTT, is performed to diagnose gestational diabetes. This test takes two hours and involves a fasting blood test, a 75 g glucose drink and a 2 hour blood test. You will need to book in to have the test done and allow two and a half hours to complete the test. During this time you are not allowed to eat, drink, smoke or walk around.
If you have gestational diabetes it is important to monitor your blood sugar level by testing four times a day.  Many women can control their gestational diabetes with diet alone and a low GI diet is the best diet to be on. You will have more regular scans to monitor your baby’s growth.
Some women need oral hypoglycaemic agents such as Metformin® and others need therapy with insulin to keep the blood sugar in the required range. We can arrange a review by a dietician and a referral to an Obstetric Physician if you require insulin.

For further information see Diabetes Australia:

Healthy Low GI diet
It is important to have a healthy, balanced diet in pregnancy to provide nutrition to you and your growing baby. A low GI diet is best and it is important to eat food from all the food groups. Healthy eating in pregnancy ensures your weight gain will be normal and gives your baby the best nutritional start in life.


Listeria
There are a number of foods that should be avoided in pregnancy due to the risk of Listeria. Foods to avoid include cold meats, pâté, sushi, soft cheese, soft serve ice cream and unpasteurised dairy foods. For more information see Food Standards Australia

Iron
It is important to have a diet rich in iron during pregnancy. Red meat, green vegetables and mushrooms are all rich sources of iron. Your iron levels will be checked during pregnancy and if you are deficient in iron or you are vegetarian, an iron supplement may be necessary. Fefol®, FGF® or Ferrograd C® are all excellent supplements taken once per day with orange juice. If you are constipated, Spatone Liquid® is a good iron supplement to take.

Fish
Fish is a rich source of omega three and iodine which is necessary in pregnancy. It is important to be aware of the mercury content of certain fish. For more information see

If you are unable to tolerate fish in your diet a fish oil supplement may be of benefit.
Multivitamins
A healthy balanced diet can be supplemented by a multivitamin in pregnancy to ensure you are getting the minimum daily allowance of all the essential vitamins and minerals for your baby.
There are a number of commercially available pregnancy multivitamin preparations which you can buy over the counter.
See you pharmacist to check which one is best for you. It is important that the supplement you take is safe for pregnancy.
Vitamin D
Vitamin D is necessary for maintaining strong muscles, bones and teeth. It also helps your body to absorb calcium. Vitamin D is contained in some foods, namely sardines, mackerel, eggs, margarine and milk. Many pregnant women are deficient in Vitamin D due to the expanded plasma volume of pregnancy and our limited sun exposure as we work indoors.
Most of our Vitamin D comes from the sun and it is recommended to have a few minutes exposure every day.  A simple blood test can determine if you are deficient in Vitamin D and a Vitamin D supplement will be recommended if you are.

Iodine Supplementation
Iodine is an important nutrient needed to make Thyroid hormones, which are essential to ensure the normal development of your baby’s brain and nervous system. The NH&MRC recommends that all pregnant women take 22Ug of iodine per day and breast feeding women should have 270ug iodine per day.

Food Safety in pregnancy
The following general food safety tips will help you have a healthy pregnancy:
• Thoroughly wash all fruit and vegetables before eating
• Wash hands and chopping boards after cutting up raw foods
• Cook all meat thoroughly
• Avoid eating foods left out of the fridge for some time
• Ensure salads are freshly prepared and well washed
• Make sure cold foods are stored below 5 degrees C
• Don’t refreeze food once it has been thawed
• Make sure hot foods are cooked above 60 degrees C
• Reheat leftovers to above 74 degrees  for at least 2 minutes before eating
• Eat any leftovers within 24 hours

Regular exercise is important for general health and wellbeing during pregnancy. The physical changes experienced during pregnancy need to be taken into consideration when planning an exercise routine.
With the increased weight gain and change in body shape, a pregnant woman’s sense of balance and coordination are affected.
The hormone Relaxin makes joints and ligaments looser, potentially increasing the risk of injury. In addition, the heart rate, breathing rate and the core body temperature is increased in pregnancy.
Pregnancy hormones can contribute to a feeling of breathlessness.
Here are some tips to make you more comfortable:
• Drink plenty of water when exercising
• Wear cool, comfortable, loose fitting clothes and a good supporting bra.
• Exercise in a well ventilated area.
• Do a warm up stretching routine
• Be aware of your physical limitations
• Avoid hot tubs, saunas and spas
• Don’t exercise if you feel unwell or have a temperature
• Avoid exercise after 20 weeks lying flat on your back
• Avoid prolonged periods of standing
• Avoid sudden jerky movements such as bouncing, jumping or sudden changes in direction
• Do pelvic floor exercises
Joining an exercise class is a great way to stay fit and meet new friends during your pregnancy.
Recommended exercises in pregnancy:
• Pilates, Yoga
• Aerobics
• Aqua
• Walking, swimming, jogging
• Physiotherapy exercise classes and pelvic floor exercises
If you experience any of the following symptoms: pain, bleeding, chest pain, shortness of breath, uterine contractions, abdominal pain, decreased fetal movements or bleeding before, during or after exercise contact your Obstetrician.
If you have a complicated pregnancy (ie twins, placenta praevia, persistent bleeding) you may be advised not to exercise or to modify your exercise.
For further general information on exercise during and after pregnancy see Sports Medicine Australia.
Sports Medicine Australia fact sheet: Exercise in pregnancy

Sports Medicine Australia Fact sheet: Exercise and well being after pregnancy

Pregnancy is a great time to review your diet, exercise and overall health to ensure that you and your family are as healthy as possible before your baby arrives.
Below are a number of useful websites:
The Federal Government
Health Insite

Pregnancy Birth and Baby

ABC

Queensland Centre for Mothers and Babies 
The Queensland Centre for Mothers and Babies provides information for women throughout the state on services and resources in your area.

Women’s Health Queensland Wide provide general information for women throughout the state.

The Mater Hospital provides a range of services and resources for new mothers

If you have a specific question or concern during your pregnancy please don’t hesitate to contact your GP or Obstetrician for more information.

Group B Streptococcus (GBS) is bacteria commonly carried by up to 30% of women in the vagina, and is usually harmless in adults. Babies can pick up GBS during a vaginal birth and a small number of babies can develop a GBS infection which can be serious.
There is much debate internationally and nationally regarding the best way to prevent newborn GBS infections. One approach is to screen all pregnant women by taking a swab at 34–36 weeks from the vagina or vagina and anus and to treat all women who screen positive with IV antibiotics in labour. However, this approach can miss up to 5% of women who carry GBS as the culture result takes three days to obtain.
In Queensland a risk based approach has been adopted where IV antibiotics are administered to all women who are at risk of GBS.
Antibiotics are recommended during labour if you:
• Have a raised temperature (above 38 degrees) during labour
• Have prolonged ruptured membranes
• Are in premature labour (before 37 weeks)
• Have tested positive for GBS during your current pregnany
• Have previously had a baby with GBS infection
• Have tested positive for GBS during a previous pregnancy
For further information
Queensland Maternity and Neonatal Clinical Guidelines

Mater Mothers

Flu Vaccine
During pregnancy it is safe and recommended for all pregnant women have the flu vaccine.
The flu vaccine is free for all pregnant women. Please see your GP for the flu vaccine.

Whooping Cough
It is recommended that all family members and partners check that they are up to date with their whooping cough vaccinations. Young babies in the first six months of life are particularly susceptible to whooping cough which can be have very serious consequences.

Travel
If you are travelling overseas in pregnancy it is recommended that you see a travel medicine specialist for up to date advice regarding immunisations required in the countries you are visiting. For more information see Travel Medicine Alliance

The Travel Doctor

Dr Deb The Travel Doctor

Chickenpox
Chickenpox or Varicella, is a highly infectious viral infection that is spread by direct contact through coughing and sneezing amongst non-immune individuals. In pregnancy Chickenpox can cause congenital abnormality for the baby and can be a serious infection for the mother casing Pneumonia. Many women are immune to Chickenpox due to having the disease as a child . If you are unsure as to whether you are immune a simple blood test can determine if you are. Preferably, this should be done before pregnancy, giving the opportunity to have a Varicella vaccine booster prior to pregnancy.
If you are non immune and come into contact with Chickenpox you should contact your GP or Obstetrician who can arrange an injection Zoster Immune Globulin (ZIG)  within 3 days of exposure to protect you and your baby. For more information

Cytomegalovirus (CMV)

Coxsackie Virus (Hand, Foot & Mouth Disease)

Herpes

Hepatitis
During pregnancy it is recommended that all pregnant women are screened for Hepatitis B and C. For further information on Hepatitis in pregnancy please see:

Listeria
Listeriosis is caused by eating certain foods contaminated with the Listeria bacteria. Pregnant women are particularly susceptible to infection and it can cause miscarriage and premature labour. There are a number of foods that are best avoided in pregnancy. For further information on Listeria see:

Rubella
All pregnant women are screened for immunity to Rubella and ideally should have a booster vaccination prior to pregnancy if they are not immune. 

Parvo virus
Parvovirus or Fifth disease, otherwise known as slap cheek disease, is a common childhood illness particularly in young children. In pregnancy it can cause intrauterine growth restriction and a condition called hydrops and can result in stillbirth. If you suspect you have been in contact with someone with parvovirus a blood test will determine if you are immune or at risk of infection.

Toxoplasmosis

Whooping Cough

Zika Virus
Click here to view external website information

All Medicines have been categorised as to their safety in pregnancy. Category A Medicines are safe to take throughout your pregnancy. Your chemist will know what is safe to obtain over the counter for common symptom relief such as sinusitis, cough, fever, headache and pain. Your GP will also know what is safe to prescribe during pregnancy and when breastfeeding.
Definitions of the Australian categories for prescribing medicines in pregnancy:
Category A
Drugs which have been taken by a large number of pregnant women and women of childbearing age, without any proven increase in the frequency of malformations, or other direct or indirect harmful effects on the fetus having been observed.
Category B1
Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed.
Studies in animals have not shown evidence of an increased occurrence of fetal damage.
Category B2
Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed.
Studies in animals are inadequate or may be lacking, but available data show no evidence of an increased occurrence of fetal damage.
Category B3
Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed.
Studies in animals have shown evidence of an increased occurrence of fetal damage, the significance of which is considered uncertain in humans.
Category C
Drugs which, owing to their pharmacological effects, have caused or may be suspected of causing, harmful effects on the human fetus or neonate without causing malformations. These effects may be reversible.
Category D
Drugs which have caused, are suspected to have caused or may be expected to cause, an increased incidence of human fetal malformations or irreversible damage. These drugs may also have adverse pharmacological effects.
For more information see

If you are expecting more than one baby you will need to be seen more frequently and have more scans to monitor your babies’ growth. A multiple pregnancy brings lots of joy and immense reward, however may also involve additional risks for both the mother and babies.
Women carrying a multiple pregnancy are more at risk of miscarriage in the first trimester and premature labour in the second and third trimester. In addition, other risks that need to be screened for are the genetic risk, gestational diabetes and pregnancy induced hypertension.
Delivery will occur earlier depending on the progress of the pregnancy and may need to be by caesarean section, depending on the gestational age and position of your babies.
The Mater Mother’s Hospital runs a multiple birth workshop providing information on preparation for the birth, delivery, feeding and parenting for parents expecting more than one baby.
For further information contact the Mater Mothers booking office.

For further information and support contact your nearest Multiple Birth Association support group:

Newborn Immunisations
At birth it is recommended that all babies receive Vitamin K to prevent Haemolytic disease of the new born.  A new born baby is deficient in Vitamin K for the first few days of its life and Vitamin K is needed to make clotting factors in the blood to stop bleeding. This means that a new born baby is at risk of bleeding for the first few days of life and this risk is significantly reduced by the simple administration of a Vitamin K at birth.
For more information see

All babies are recommended to have immunisations as a part of the National Immunisation Program at birth, 2, 4 and 6 months of age. For further information see:

The Brisbane City Council holds immunisation clinics throughout the city of Brisbane and other clinics are available throughout the state, or see your GP.

Having a baby can be a stressful and difficult time. There is a lot to learn in those first few years and there is much help and support out there to assist parents . Below are some useful links to assist new parents.
Raising Children

Triple P Parenting program

Pregnancy is a wonderful and exciting time, however it can also be a challenging time. Around 20% of women can become depressed and anxious during pregnancy and the post-partum period. The hormonal changes in pregnancy can contribute to emotional highs and lows making it difficult to cope with the physical changes the body undergoes. During your visits you may discuss any concerns you have. If you are feeling anxious or depressed during your pregnancy please let us know as there is much we can do to help. There are counselling services available as well as simple things such as relaxation techniques and exercise that can help. Seeing a psychologist or psychiatrist can also be beneficial for more severe cases and there are medications that can help you to feel so much better.

During your hospital stay, if there are concerns with postnatal depression, a referral to the Belmont Centre or the Ellen Barron Centre may be very beneficial as they have much experience in this area. The important message is that you are not alone and there is much that we can do to help you feel better. Please don’t hesitate to contact our office if you are concerned that you may have postnatal depression. 
For further information
Belmont Centre for Postnatal Disorders

Ellen Barron Centre

Beyond Blue

Following your discharge from hospital you are most welcome to call anytime if you have any questions or concerns after your birth. We will arrange to see you for a check up six weeks after your delivery.
The Queensland Centre for Mothers and Babies provides useful information and resouces for mothers throughout pregnancy and post-delivery.

There are a number of drop in centres throughout Queensland providing newborn care

A full term pregnancy is 40 weeks. Delivery before 37 weeks is classified as premature. Approximately 7–10% of all deliveries occur before 37 weeks. The Mater Mothers’ Private Hospital has a Level 3 Neonatal Intensive Care Unit providing exceptional care to premature and sick babies. Premature babies are at risk of a number of possible complications including immature lungs, infection and cerebral palsy. There are a number of treatments that have been shown to improve the outcome for babies born prematurely, when they are given to the pregnant women before a premature birth.  Steroids are given to improve babies’ lung maturity, Antibiotics are given to reduce the risk of neonatal infection and Magnesium Sulphate is given intravenously to reduce the risk of cerebral palsy. In addition, a tablet called Nifedipine® can be given to reduce uterine contractions, giving the steroids time to work. Signs of premature labour can be vaginal discharge, bleeding, fluid loss, crampy lower abdominal pain, backache and uterine contractions. If you develop any of these signs during your pregnancy after 20 weeks, contact your Obstetrician or the Pregnancy Assessment and Observation Unit at the Mater Mothers’ Private Hospital immediately.
For information on breastfeeding and taking your premature baby home:

Air travel is safe during pregnancy however there are a number of aspects to consider.
• Most airlines allow women to fly up to 36 weeks domestically and 34 weeks internationally.  Before you fly, check with your airline as to their policy.
• You may need a letter from your Obstetrician stating you are fit to fly and your pregnancy is progressing normally without any complications.
• Shorter trips are preferable as the risk of DVT increases when flying and during pregnancy.
• Travel insurance is another issue to consider. Due to the risk of premature labour, in 5–7% of pregnancies, it is difficult to get travel insurance to cover your pregnancy after 24 weeks in some countries . Check with your travel agent regarding your policy and what you are covered for.
To reduce your risk of DVT the following tips are helpful:
• wear flight socks or TED stockings
• take a low dose aspirin (100mg daily)  if on a long haul flight
• drink plenty of water 
• walk around the cabin
• do leg  exercises regularly during the flight
Another aspect to consider is the standard of hospital care in some countries, should you need to be admitted while you are overseas, for a complication of pregnancy including the risk of infection. For more specific information please ask at your appointment or consult your GP or Travel Medicine specialists below.
Travel Medicine Australia

The Travel Doctor

Dr Deb The Travel Doctor

When to stop
Most women stop working at 34 weeks. If you are feeling well, and your pregnancy is progressing normally, you may wish to work a few weeks longer to maximise your maternity leave. We will be happy to write a letter for your employer at this time if it is safe for you to continue working.
Estimate Date of Confinement (EDC) letter
Most employers need a letter confirming your due date to apply for maternity leave. We are happy to provide this for you and usually do so early in your second trimester once we are certain all is progressing normally.
Carers leave
We are happy to provide a letter for partners, grandparents and carers who need time off work to assist you to recover from the birth in those all-important first few weeks at home. Please feel free to ask our friendly staff at your appointment if you need a carer’s leave letter.
For more information on work and leave entitlements when pregnant

and paid parental leave