confused after 1st doctors appointment, advice please

Hi
I am now 8 weeks pregnant. I went to the doctors at 6 weeks, he took my blood pressure and weight. He told me to next come back at 15 weeks, for some tests (triple something??? anyone know what that would be? I think he said 'triple' anyway), does he just mean blood tests? I thought I was suppose to have a blood test early on but haven't had one. I have a pregancy book but it says nothing about tests at 15 weeks, only earlier or later in pregnancy. He also gave me a referral for a 12 week scan in Albany (I live 2 hours from there, in the country). I've been left a bit confused..... I didn't find out anything about which hospital I would give birth in etc.... I assume it would be albany (wa) as thats the nearest and I don't have private healthcare. Or could I go to Perth? (but thats 5 hrs away!, albany is 2) I like the idea of using a birthing pool (or an active birth, dont really want to be lying on my back) but can I only do that if I have private health care? sorry I don't know anything about the health system here as I have moved here from England.
(I forgot to mention above, that I have had the pregnancy confirmed, but not my a blood test, I had a scan at 5 and a half weeks, due to spotting and a previous miscarriage, but everything is ok now, no spotting)



Please can someone give me some advice, thanks :)

Hi,
at 12 weeks you will do a Nuchal Translucency (not sure about the spelling) which is a scan that measures the thickness behind the neck of the baby. this with a blood test and your age will give you a result about the risk of having a baby with down syndrome or other genetic anomalies. I guess that because it is a quite specific exam you need to have it done somewhere where they are specialised (believe me, you want to have somebody good to do it, to avoid useless scares!!!)... Maybe that's why they send you to Albany? it is a normal routine exam for what I know...
Hope this helps, even though it doesn't answer all your questions.
If you don't feel comfortable with the doctor you have seen, maybe you should try to find another. Don't be afraid of asking questions, no question is a stupid question!
good luck
xxx

thanks for your reply Titti, yes the doctor has sent me to Albany for the scan as its the nearest place that can do it.



I assume I will have our baby in the nearest hospital but would love to know what other options I have (eg water birth)

You can have home birth, but you need to have an hospital close by, just in case the birth doesn't go according to plan.
I wanted a completely natural birth, no intervention at all... and a water birth. That was my ideal delivery... how naive!!!
my DD was 14 days overdue. the day I was going to be induced my waters broke naturally. I was sooooo happy!!! but after walking up and down the hospital's stairs for 6 hours I wasn't dilating enough... so I was induced, then again I wasn't dilating enough but I had hurge to push, so I had an epidural (not without a fight! I did not want one! but they just told me the truth... by the time my daughter was going to be ready to come out I would have been exhausted!), 27 hours afer my water broke I had my DD... and required heaps of stiches... so not always it goes as we wish...
be open mind, but at the same time it is good that you know what you want. The problem is that being in the country you have less choices than being in the city. You never know though... ask around, see if there are midwives you can talk to. Just remember that babies are born when they are ready...
let's hope there is somebody that can help you a bit more than me... :-)
good luck

Hi Jen

The triple test is your NT scan to test for Downs Syndrome and other genetic diseases. These days, the doctors look at your blood test results, age and the thickness of the baby's neck to determine your level of risk. I had my scan at 13 weeks and 4 days then I had to see my obstetrician for a follow up at 15 weeks (today) so I'm thinking that is what your doctor was implying.

I was given strict instructions from my obstetrician to have my bloods taken in week 11 then my scan was to occur between week 12 and week 14 - there was actually a 10 day window and that was it. I don't know if everyone's doctor is as strict as this but that's what I had to do. When I phoned to book my scan, the ladies at the Ultrasound clinic also calculated the exact window I could get the scan done based on my EDD. Something to keep in mind.

Sorry I can't help with any info on your birthing options as I'm going private in Perth. Maybe just phone the receptionist at the surgery and ask if they know if you need to contact the hospital or if there are birthing centres, etc and which one they recommend.

thanks again Titti

I don't feel confident enough to have a home birth (2 hours to nearest hospital) but I wonder if the hospital lets you have water births? prob not. I also have no idea if I will need pain relief or not? I would prefer to not use drugs but I am a bit of a wimp when it comes to pain.
I will try and get another appointment with my doctor maybe to get more infomation :)

thanks Taurean, yes I think you are right, he must of meant the NT scan, I think I will make another appointment with him, just to clarify and to ask some more questions :)

there are 3 different combined scans used for screening for DS.
There is a first trimester screen which involves a bt at 10-11 weeks and the scan at 12 weeks. There are also triple and quad screens that you can get where the blood tests are taken later. Which one you have depends on you OB/nidwife, and to a dregree what you ask for or consent to.
12 weeks scans are not required but are routinely offered by many carers.

Where you can go to hospital depends on the hospital - some have intake areas and some are first in first serves, so ring up the one you want to go to and see whther you need a referral to book in or whether you can just do it yourself.

All scans and blood tests are optional- you don't HAVE to have any. Google all the tests that have been mentioned and decide for yourself what you want. Make sure the sites that you read are reliable. With my first DD I had my first appt with the midwives at 16 weeks and no other blood tests prior other than one to confirm the pregnancy. I chose not to have things that I didn't want or didn't agree with.
If you want a home and/or water birth you will need to do lots and lots of reading to inform yourself of what is required. There is the homebirth midwife association (in Fremantle I think) if you call them and have a chat to someone there. Getting books from the library and lots of internet reading will help also.
On the other hand if Albany is your nearest hospital you can chose to go there and have a midwife attend the birth and an ob if required. YOu won't be able to have a waterbirth at any hosp that I know of in WA. There is no real advantage to a Perth hosp over the Albany one and if you need to get there in a hurry is is actually a disadvantage. Unless you have relatives you can stay in Perth with in the final weeks?? Then again your DF may not be able to attend the birth.
If I were you I would go back to your GP or give him a call and make it clear that you are not aware of your options and can he please explain them to you. They see so many preg women they forget to give all the necessary details! And write down everything he says!

Jen27 - as for your hospital options ring your nearest hospital and ask to be put through to the maternity ward. You will be able to chat to a midwife and they will tell you about the options. Usually you have to be booked in by 20wks but this vary's from place to place. Some birth centres have waiting lists and obviously public hospitals you can just walk in off the street and they will deliver you but ideally it's best to book in. You can also do a tour of the maternity ward and birth suite and see what facilities they have. My hospital also offered an appointment at 36wks where we spoke to the midwife about our birth plan etc. In the public system you generally have the choice of midwifery care with an attending OB or GP shared care where you can see your GP for all of your appointments and just give birth at the hospital either with your GP or with the rosted OB.

You can give birth in a private hospital without insurance but it will cost upwards of $3000

Hope that is of some help and all the best with your pregnancy

you are supposed to have bloods at 8 weeks. My stupid doctor didn't do these either, and the hospital ended up having to do them at 20 weeks which they were unimpressed about. It's to check your iron levels, rubella status and soemthing else... white cells I think? can't remember. Anyways you will need to head back and get them done.

The blood test for rubella immunity also includes hiv, hep b?, varcella (chicken pox) immunity, blood type, rh +/- and i cant remember what else. If your m/c preg was not too long a go sometimes they don't repeat the bloodwork or only repeat some (i had a tests done @6wks preg and m/c when i got preg again about 3mths later she didn't bother repating most of the tests but have had them all again now preg with no.2)

Like other people have said ring your nearest hosp and do a tour, they may also have an early preg class which will cover a lot of your questions. All would have preg class for later about the birth etc but you may need to book in early as they can fill up. You will find out in these about facilities such if water birth is an option, medication options, breathing tech, other birthing interventions such as forssips, vacuum etc. At ours they had some to touch so if we needed them on the day it wasn't all new and scary.

If you live far away they may also have closer accomodation that is not actually in the hosp. I am in the territory and they get people from the communities to come into town about 3weeks prior to edd, if they don't have somewhere to stay they do have accomodation you can pay to use near the hosp but not actually in the hosp. But a lot of communities are unreachable by road in the wet so that might be why. Not sure what they would do for a 2hr drive. To me it seems a long way to have to travel during labour.

HI Jen27,

I am interested to find out how you went with your quest for help on water birth/Home delivery? you sound as though you live some where near me and i am looking to give birth in a similar way but with no avail. I also miscarried my first pregnancy around 6 weeks and have some reservations about the treatment from the local doctors. I am really interested in how you are going with you plans.

Thanks