Your pregnancy journey
“An enjoyable, positive pregnancy is what I hope for”
“My hope as an obstetrician is that women, their partners and families have an enjoyable, positive pregnancy experience and delivery resulting in a healthy, happy baby that can grow to its full potential.”
What to expect from your first appointment with Perth obstetrician Dr Richard Murphy?
I will do an ultrasound to confirm the pregnancy viability, the due date and the number of babies there are. If your GP has not done so I will check some routine blood tests.
We will also discuss screening options for chromosomal abnormalities such as Down’s syndrome and the option of screening for X-linked and recessive genetic conditions for you and your partner, though the latter is best done prior to pregnancy.
How often will I see my obstetrician during my pregnancy journey?
I will usually see you for your first time in the first trimester, then at 15-16 weeks, between your Down’s syndrome screening tests and the 19-week anatomy scan. At this time you will be feeling less pregnant, as your hormones naturally settle a little, and there is usually a few weeks to go until regular movements are felt.
After the anatomy scan I will see you every 4 weeks until 30-32 weeks. From this point you will be seen every 2 weeks, then every week in the last month, when increased monitoring is needed for signs of pre-eclampsia and monitoring of baby’s growth and wellbeing.
Your standard obstetrics schedule
- First visit: between 5 and 12 weeks
- Visit: 15-16 weeks
- Visit: between Down-test and 19-weeks scan
- Visit: 24 weeks
- Visit: 28 weeks
- Visit: 32 weeks
- Visit: 34 weeks
- Visit: 36 weeks and every week subsequently until delivery
Do you offer midwifery care as well?
Your pregnancy is very personal and as such I will see you at each of your visits personally. This allows us to develop an understanding and trust that should make your pregnancy and delivery more relaxed. If you have concerns in between visits I can be contacted by email or phone to address these directly. When you are in labour in hospital and postnatally you will be cared for in conjunction with the skilled and dedicated midwives at SJOG Subiaco Hospital.
High risk pregnancies
When is a pregnancy considered to be high risk?
Your risk level will be determined by the time it takes to conceive, your past obstetric, gynaecological, medical and family history and factors such as age, weight and smoking. It is easier to define what a low risk pregnancy is; a mother aged less than 35 with a single baby and no medical problems prior to or in the pregnancy. Everything else will be high(er) risk.
“Risk factors tend to act in an additive way, where 2, 3 or 4 risk factors collectively increase the risk to mother, baby or both in pregnancy.”
If you have concerns prior to conceiving then a preconception review to identify risks and plan how to manage these is very valuable. It is not uncommon that a few simple things done before you are pregnant can significantly reduce your risk of problems developing, with the benefit of less stress, less intervention and healthier mothers and babies.
Are you worried about your pregnancy?
It is perfectly normal to have worries and concerns about all the new information you come across when you are pregnant. One day you read about toxoplasmosis risks, or someone tells you about the cytomegalovirus. Your GP may have mentioned your iron levels. And then your friends discuss the NIPT test and here you are, unsure if you need to do it or not.
Let me go over some of the typical frequently asked questions that are part of the pregnancy journey:
The parasite Toxoplasma gondii can cause severe fetal effects especially if contracted early in pregnancy. In Australia it is rare. Infection occurs through ingestion of the parasite through contact with cat faeces or contaminated fruits and vegetables or undercooked meat. Good hygiene is essential with handwashing, washing fruit and vegetables and adequate cooking of meat preventing infection.
CMV is the most common virus affecting foetuses and the commonest cause of non-hereditary deafness. CMV status can be checked prior to pregnancy. There is no way yet to prevent infection for babies, with most cases occurring after reactivation of virus in previously infected mothers.
Iron levels in pregnancy
We will check your full blood count and iron early in pregnancy and again at 28 weeks. An iron supplement from 28 weeks until delivery should prevent iron deficiency anaemia.
Occasionally people may need an iron infusion if there is severe iron deficiency and/or intolerance of oral iron supplements.
NIPT test (Harmony test) and the First Trimester Screen
These are our 2 options for Downs syndrome screening in pregnancy. They have slightly different pro’s and con’s which we will discuss at 8-10 weeks.
Group B streptococcus
If a vaginal delivery is planned we will screen for GBS at 36 weeks. About 20% of women carry this bacteria at any time, causing no problems to mothers, partners and older children. It can cause devastating infections in newborns which is prevented by the use of an antibiotic in labour.
You will be screened for urinary tract infection in the first trimester. In the second half of pregnancy urine dipstick testing is done for proteinuria, one of the major signs of preeclampsia.
Why Dr Richard Murphy as your obstetrician?
I am passionate about helping couples through the journey from conception to delivery. This is not always straightforward and I can assist you with those really difficult times, where subfertility, miscarriage or the loss of a baby occur. I believe that support and communication are as critical on this journey as the medical care.
If a fun, enjoyable and beautiful vaginal birth experience is the image you have then I am here to help you aim for that experience and actively work to make it happen. I believe that if most women could choose this pathway, they would.