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Whether you’re a first-time mum or an experienced parent, pregnancy is a serious undertaking. Between your health, the baby’s health, and the delivery method, there’s a lot to think about during those nine long months—and that’s before you even take the little one home. Thankfully, a good support system and quality healthcare can go a long way towards ensuring a smooth pregnancy, which is why Matilda International Hospital recently introduced a special antenatal care service at pre-determined charges. The service, which commences at around week six to week eight of gestation, includes 13 antenatal visits, starting from $1,980, and covers essential blood tests, Down syndrome screening, oral glucose tolerance and Group B strep tests, as well as the standard antenatal check-ups and basic ultrasounds.
To learn more about the service, we chatted to their resident experts about the optimal antenatal care schedule for expecting mums.
According to international guidelines, your first doctor’s appointment should take place around between weeks six to eight of your pregnancy, ideally before week 10. At this appointment, you’ll be getting to know your designated obstetrician, planning out your future visits, and getting routine antenatal blood tests to check for your blood group, complete blood count, syphilis, rubella, varicella, hepatitis B, and Human Immunodeficiency Virus (HIV) status. By running all these tests at once, you will be prepared for a host of possibilities early on the pregnancy.
In this visit, your obstetrician will check your body weight, blood pressure, and perform tests such as urine screening for protein and sugar. Blood pressure and urine screening are important indicators of your chances of developing pre-eclampsia, which is a serious condition that affects both mother and baby.
Besides that, your obstetrician will perform an ultrasound scan to determine the size of your baby and assess your baby’s nuchal translucency (a fluid-filled space at the back of your baby’s neck), which might be an indicator of a chromosomal abnormality if the thickness of such space increases. Matilda also offers non-invasive prenatal testing (checking your baby’s DNA in the mother’s blood) to screen for genetic disorders like Down Syndrome due to its high sensitivity and specificity. Following your blood tests from the previous appointment, the doctor will also go over your results and identify any potential risk factors.
Just one month later, your baby will have likely doubled in length. By now, you might start to feel the baby move around a bit. As before, your doctor will go over the results from your previous appointment with you and explain any risk factors that the tests have revealed. Your physician will also assess whether your baby’s development is progressing normally.
At 18 to 21 weeks, your baby is capable of yawning, kicking, and sucking its thumb. Beyond your normal check-up, this is also the time when you’ll also get an important ultrasound, also known as the “20-week structural scan,” during which the obstetrician will check to see if your baby has any abnormalities in the growth or development, including in the heart, spine, stomach, kidneys, and limbs. It is important to know that while many abnormalities are picked up by this scan, not all of them are. The obstetrician can often tell if you are having a boy or a girl, with about 95 percent accuracy.
If you prefer to wait until the birth to find out the sex of your baby, it’s a good idea to ask the obstetrician not to mention it. Besides, the obstetrician will observe the position of the placenta, the umbilical cord, the amniotic fluid around your baby, and your uterus and your cervix. If your placenta is positioned low in your uterus, the obstetrician will inform you that you have a low-lying placenta. Usually another ultrasound is recommended in the third trimester to ascertain that your placenta has moved away from your cervix.
At week 25, your baby has developed its brain, digestive system, and lungs (though not fully just yet). Your little one is now sensitive to light and sound, meaning that you may notice it responding to your voice or any loud noises. You may start to feel the baby hiccoughing around this time, too! Your doctor will perform all the usual checks around this time, and you may even get to see the texture of your baby’s hair (if they have any) in this week’s ultrasound.
You’re now in the final trimester! On top of your regular antenatal check, you’ll be getting an oral glucose tolerance test (OGTT) to determine whether you have gestational diabetes. While we know the pregnancy cravings are incredibly strong at this point, you’ll need to fast overnight for between eight to 10 hours to ensure the efficacy of the test. Your blood will be drawn at the start, after which you’ll have a glucose drink and rest for one to two hours before having more blood samples taken. This test is especially important as gestational diabetes does not necessarily occur in women who are already diabetic, and can lead to problems such as a difficult birth, premature labour, pre-eclampsia, and low blood sugar or jaundice in your baby.
The beginning of the final trimester is also a good time for you to get vaccinated against whooping cough (pertussis). The rate of whooping cough has risen sharply in recent years and babies who are too young to start their vaccinations are at greatest risk. Young babies with whooping cough are often very unwell and most will be admitted to hospital because of their illness. When whooping cough is particularly severe, it can even prove to be fatal.
Scientific evidence has shown that pertussis vaccines are very safe for pregnant women and their babies. Getting vaccinated while you’re pregnant is highly effective in protecting your baby from developing whooping cough in the first few weeks of their life. The immunity you get from the vaccine will pass to your baby through the placenta and provide passive protection for them until they are old enough to be routinely vaccinated against whooping cough at 8 weeks old.
By week 31, your baby should have developed all five of its senses—and is inching closer to its birth size. During this time, the baby will be sleeping for longer periods of time, so you may notice more defined periods of rest and movement. Unfortunately for mums, this is when the fog of “pregnancy brain”—when the volume of your brain cells decreases—sets in. Don’t worry, it’s perfectly normal at the third trimester and your brain should go back to normal within a few months after you give birth.
During these weeks, your check-ups should be fairly routine (i.e. blood pressure test, urine sample, ultrasound—you know the drill). However, this is also a good time to start taking an antenatal course to prep for the baby’s birth, since Matilda recommends their courses to women are at least 28 weeks pregnant. Over three sessions, you’ll learn about stages of labour, pain relief, delivery methods, coping with parenthood, postnatal depression, newborn care and safety, breastfeeding, and more.
Group B Streptococcus (GBS) is a type of bacteria which normally lives in the intestine, urinary, and reproductive tracts of men and women. It can be found in 10–30 percent of pregnant women’s vagina or rectum and it is not a sexually transmitted disease. Most pregnant women who are colonised with GBS generally have no symptoms or health effects, but it can be dangerous to newborn babies if they get infected. At week 36, your obstetrician will run a GBS screening test for you during your check-up. The test involves a swab of both the vagina and the rectum. The procedure is quick and should not be painful. If you test positive, you’ll simply have to receive intravenous antibiotic injections during labour to avoid passing it onto your baby. Your baby will be under the paediatrician’s care after birth.
Week 38 is when the baby will be close to its birth size and weight. This is an apt time to finalise your birth plan with your doctor: whether you’ll be having a vaginal birth or caesarean section, whether you’ll be using any pain management during the birthing process, and other details.
You’re in the home stretch now! From weeks 39 to 41, all your check-ups should be fairly routine as your doctor will have run all the necessary tests and confirmed all your preferences for the labour. Your baby’s size will be more or less set between now and birth, but its brain is still growing. If you’re still pregnant at 41 weeks, your doctor may discuss the possibility of inducing labour via various methods.
Of course, having the little tyke is just the first part—especially for new parents, postnatal care can be just as overwhelming as pregnancy. Luckily, the Matilda team understands that everyone’s needs are unique, and can offer personalized care that’s tailored to your situation. Matilda also publicizes all the key costs involved in its maternity care package, meaning that you won’t be stressing about hidden costs and payment plans when you should be cradling your newborn baby. To provide a safe environment for patients and parents, Matilda also has an obstetrician on-site 24/7, as well as an anaesthetist and paediatrician. To book or enquire, call the Patient Service Centre at (+852) 2849 0355 or email [email protected].