Healthy pregnancy

Congratulations on your pregnancy! A healthy pregnancy is the aim for all women who birth with Monash Women’s.

You are most likely suitable for routine healthy pregnancy care if you:

are under 40 years of age,
have a normal body mass index and no major health problems,
are expecting one baby, and
have either not had a baby previously or have had a straightforward pregnancy and birth.

Women between the age of 35 and 40 are often suitable for healthy pregnancy care but may be recommended extra ultrasounds for growth and wellbeing of baby in the third trimester.

Healthy pregnancy care is available at all three maternity sites across Monash Women’s (Monash Medical Centre, Dandenong Hospital, Casey Hospital).

You will be offered care with a hospital midwife in the maternity clinic where input from medical staff is available if required, or can choose to see an accredited GP affiliate or midwife who can provide maternity care in their private rooms, or can choose your own Monash Women’s accredited obstetrician in their private rooms.

How many visits can I expect and when do they occur?

Women with healthy pregnancies can expect to have around ten visits in total. Some of these pregnancy check-up visits are in-person and some are conducted by Telehealth.

Starting with a hospital ‘booking in’ visit; a visit soon after your 20-week fetal anatomy scan; a visit soon after your 26-28 week diabetes test; and visits that get more frequent as you enter your third trimester.

What happens at my visits?

At each visit, your caregiver will:

ask you how you are going,
ask about fetal movements,
measure your baby’s growth, and
take your blood pressure (if in-person visit) or ask for your self-measurement recording if via telehealth.

Before 20 weeks, this examination is not very detailed as it is too early to determine which way your baby is facing and generally to hear the heartbeat.

After 20 weeks, you will be able to measure the height of your uterus (called symphyseal fundal height), and hear your baby’s heart rate during your clinic visits.

What does the height of my uterus (symphyseal fundal height) mean?

The uterus height is roughly the same as the number of weeks of your pregnancy and should steadily grow between visits. If your uterus does not steadily increase in size, you will generally be recommended an ultrasound test to check the growth of your baby.

What should my baby’s heart rate be?

A normal heart rate for your baby is between 110 and 160 beats per minute.

The heart rate can vary depending on if your baby is awake and moving or asleep, this is quite normal. This test cannot tell if you are having a girl or a boy, despite the old wives’ tale.

Your baby’s heart rate is also not a test for wellbeing. The most important indication of your baby’s wellbeing is the presence of normal movements.

How do I know my baby is facing the right way?

Your caregiver will perform an examination to identify your baby’s head, buttocks, back and limbs to determine the position of your baby in your uterus.

The normal position for your baby is facing head down towards the end of pregnancy. Closer to term you may also notice your breathing becomes easier as your baby’s head ‘drops’ down into your pelvis.

In your final weeks your caregiver will carefully assess the position of your baby to exclude a non-head down position as well as how well your baby’s head is fitting into the pelvis.

If your baby’s head is not descending towards the pelvis or is not head down on examination, you will be sent for an ultrasound test to confirm this and search for a cause. You caregiver will discuss options for your birth informed by the results of this scan.

What tests will I have?

This is covered in My pregnancy tests and visits. Here you can read what tests to expect in early, middle and late pregnancy and what they mean.

What happens after my due date?

Going past your due date is very common, particularly with first pregnancies.

If all has been healthy, your caregiver may offer you an internal examination and cervical membrane sweep, both to assess how ready your cervix is for labour and to help stimulate labour naturally. A membrane sweep is minorly uncomfortable but is very safe and can be effective to help you go into labour.

Your caregiver will also assess if there are any risk factors present, which will determine whether it’s safer to bring on your labour artificially (induction of labour) or watchful waiting is best. They will also arrange monitoring from 41 weeks (for most women, 39 weeks for women with South Asian ethnic origin) to ensure it is safe for your baby to stay pregnant, this includes a heartbeat trace (called a CTG) and a brief ultrasound to assess the amount of amniotic fluid (water) around your baby.

What happens if I develop a pregnancy complication?

Our pregnancy care system is well set up to identify when pregnancy is no longer routine.

If you develop complications in pregnancy, you will generally have a review with a senior obstetric doctor or obstetrician and your care plan updated. This may mean a change in caregiver/s for the remainder of your pregnancy depending on your situation.

Am I able to have a home birth?

Monash Women’s has a home birth service through Casey Hospital. Learn more about Casey home birth / check if you’re eligible.

In summary, you are generally eligible if:

you have no medical problems,
your BMI is less than 35,
you have not had a previous caesarean section,
you are pregnant with one baby,
you live local to Casey Hospital,
you are seeking a medication-free labour and birth
you have a suitable birthing space in your home, and
you do not develop any complications during your pregnancy and labour.

You will also need to have standard pregnancy tests including a 20-week anatomy scan and diabetes test to be eligible as without these tests it cannot be certain that your pregnancy is low risk.

You also need to be seeking a birth without pain relief medication and be prepared to transfer into the hospital in labour if your home birth midwife recommends this action.