Pre Pregnancy Counselling

Pre-pregnancy-counselling-Dr-Caroline-Hoggenmueller

Deciding you would like to try for a baby is a significant life decision. Many women benefit from some support and guidance through the new experience of planning a pregnancy, becoming pregnant and carrying a child. Pre-pregnancy counselling services will give you all of the information you need and advice about what to expect when you are expecting.

Establishing a bond with a trusted doctor before you become pregnant means you have someone you can discuss your concerns and questions with and that you will have consistent support during pregnancy.

Pre-pregnancy counselling services can include explaining testing options or conducting a pregnancy test. Guidance and information about the next steps is also provided in the case of both positive and negative pregnancy test results.

Pregnancy testing

A pregnancy test can be conducted to determine if you are pregnant or not. Pregnancy tests work by identifying a hormone called Human Chorionic Gonadotrophin (also known as beta hCG) within your urine. This hormone starts to be produced as soon as a sperm fertilises an egg and conception takes place. As fertilisation occurs, embryonic cells begin to replicate, and this causes the body to start producing beta hCG.

Pregnancy test kits can be purchased at supermarkets and pharmacies. There are two types of pregnancy tests available over the counter in Australia. The tests are either manual or digital.

Manual tests work through a biochemical colour change when the pregnancy hormone is identified, and they do not contain a battery.

Digital tests do contain a battery, and some can also display how many weeks pregnant you are.

Most pregnancy tests give a result quickly within a couple of minutes, indicating a pregnancy by displaying a line or dot.

When to start testing for pregnancy

You should start to test for pregnancy the week after your missed period. This is when you’re most likely to obtain an accurate result. If you don’t want to wait until then, consider waiting 1-2 weeks after having sex. This is because, if you’re pregnant, time needs to pass before the body develops a level of hCG a test can pick up.

Although beta hCG is produced from the time of conception, the levels of the hormone in urine can be very low for a week or two. Most tests are not able to detect low levels of the pregnancy hormone, and a test taken at this time will likely return a negative result, even if you are pregnant. Levels of hCG become more readily detectable at around two weeks after conception. For most women, this would be on or around the first day of a missed period. However, in some cases, HCG is not picked up by a pregnancy test this early. Waiting another seven days after a missed period will give you a much more precise result.

If you do not have a regular menstrual cycle, you may not know an exact date when your period would be due and may not necessarily notice a period is late. If this is the case, you may notice other early signs of pregnancy before you recognise that your period is late.

Levels of hCG are highest in the morning when you first wake up, so it is recommended to conduct the test during your first urination of the day.

What are the tests to be done during pregnancy?

Basic pregnancy testing is done using a urine sample to assess the levels of hCG in the urine. A doctor can also arrange a blood pregnancy test to be done. Pregnancy blood tests can be done as soon as 11-14 days after ovulation, which occurs about two weeks after your previous period. Blood tests are more accurate than urine testing, and depending on the type, can also provide an estimated gestation period.

Once a pregnancy is confirmed, several other prenatal testing techniques are recommended to be conducted during the course of your pregnancy. These tests may be carried out through a pregnancy ultrasound, internal examination or blood test.

  • You may request an ultrasound 6 weeks or so into your pregnancy.
  • First-trimester screening is typically carried out between weeks 11-14 of your pregnancy. This test often includes an ultrasound and a blood test to determine levels of placental proteins in your blood.
  • A structural anatomy scan can be done to look for chromosomal abnormalities, neural tube defects and heart problems.
  • A morphology scan is typically done at around 18 or 19 weeks gestation.
  • The Harmony testing pregnancy assessment, is a non-invasive prenatal testing technique that looks at fetal DNA in your blood.
  • In some cases, where there are known risks, you may be advised to undertake genetic testing pregnancy assessments.

How do I know if I’m pregnant or not?

The easiest way to determine if you are pregnant is to take a pregnancy test. These tests measure the levels of hCG in your urine. Some women notice other signs of early pregnancy either just before or at the time of a missed period. These early signs can include:

  • Tender or swollen breasts.
  • Nausea is often referred to as morning sickness, although can occur at any time of the day.
  • Food aversions and sensitivity to certain odours.
  • Fatigue, due to increased levels of progesterone.
  • Moodiness or feeling teary.
  • Bloating or constipation is a feeling of fullness in the stomach and gut.

What can I expect at a 6 or 7-week ultrasound?

For many women, the pregnancy ultrasound at 7 weeks or thereabouts is their first chance to see the formation of a baby in utero. You will be asked to have plenty to drink before you attend the clinic for your scan because when you have a full bladder it can make the ultrasound clearer.

Ultrasound scans are usually done by a radiographer, but can also be conducted by other medical professionals. You will be asked to lift your top to expose your belly and you may also need to lower your underwear a little.

A cold gel that improves contact between the probe and the skin will be rubbed onto your abdomen. The probe is moved around the surface of your abdomen and will transmit sound waves into your body. The waves the echo back are used to produce images.

At this appointment, the radiographer will check for the presence of a heartbeat, check that your baby is growing in the right place and assess fetal growth and development. The scan can also determine your baby’s due date and if you are pregnant with more than one baby.

Can a pregnancy test be wrong?

Depending on the circumstances, a urine pregnancy test may give you the wrong results. A “false negative” can occur if there is not enough pregnancy hormone in your body to be detected by the test. If you get a negative result before a missed period, wait until the period due date and test again. If your period still does not occur, wait another 5-7 days and repeat the test. It may only take a few more days for the pregnancy hormone level to rise into the detectable range.

Less common are false positive tests results, although they are still possible. A false-positive result may occur if the test you use is faulty, the equipment you use (such as the cup you catch the urine in) is dirty, or if you have blood or protein in your urine from an infection or illness.

Note that most common medicines, contraceptive pills, drugs or alcohol do not interfere with your pregnancy test results although some fertility drugs could be responsible for a false positive.

Planning a pregnancy?

To decide you will try for a baby is such a wonderful, exciting and sometimes scary decision. Dr Caroline provides holistic obstetrics services and can talk you through what to expect in the early days of pregnancy. She can also explain the reason for and purpose for any tests you are advised to take. With Dr Caroline, you will have an experienced, understanding and caring professional to be your guide during trying for a baby and beyond.

Dr Caroline can provide advice around all aspects related to conception, pregnancy testing and health. This includes the creation of a pregnancy diet plan or pregnancy meal plan to ensure you are getting adequate nutrition to support healthy development. She will talk you through concerns about your own health during pregnancy and give you all the information you need about supplements (such as folate) and vaccinations during pregnancy. She can also help you create a birth plan to outline your choices for delivery.

So many women describe their feelings of worry, concern and confusion during their conception journey. Dr Caroline provides clear and understanding information, counselling and medical services to women who are going through this exciting but completely new experience.