Private obstetrician Sydney

Antenatal care in more detail
Picture of Dr Anu Mahadik

Dr Anu Mahadik

Dr Anu Mahadik is a private obstetrician practicing at two locations in Sydney: Kogarah in Southern Sydney and Norwest in Greater Western Sydney

When to book your first antenatal consultation?

It is recommended that you go and see your GP as soon as you find out you are pregnant. They will do the standard blood tests and order an ultrasound to confirm a healthy and normally progressing pregnancy. Once that has been established, and you have chosen your private obstetrician, then usually we see you for the first consultation at around 7-8 weeks.

During your first antenatal consultation, we have a few important topics on the agenda:

  • Pregnancy issues: The specific things about your pregnancy that will need extra attention and care, for example, if we are talking about twin pregnancy. This is also when we discuss your pregnancy history, for example, if you have had pregnancy complications, for instance a small baby or preterm birth in the past. 
  • Medical issues: We discuss any medical conditions that you have that may need extra attention during your pregnancy: diabetes, high blood pressure or thyroid disorders, kidney problems, or heart disease for example.
  • Mental health assessment: This is the part where we go through a number of questions about your life, your mood and how your pregnancy impacts your life.

In our first conversation, we talk these things through in great detail to offer the best possible antenatal care going forward. We also perform routine assessments, so we can look after you in the best possible way. We then discuss an antenatal care plan, looking ahead at the tests at different stages of your pregnancy.  Since it’s our first meeting, we listen to you and your partner to understand your own expectations.   

At your initial consultation, we will need copies of your blood, urine and ultrasound results, as well as details like your Medicare card and your health fund card.  We encourage you to bring a support person with you for all your appointments as we would love to meet you as a family unit.

Where in Sydney do you consult as a private obstetrician?

I provide antenatal care services at my two practice locations: Kogarah in Southern Sydney and Norwest in the Hills District within Greater Western Sydney. No matter where we plan your consultations and delivery, I am here to help you with information and support.

private obstetrician Sydney

Antenatal appointments and FAQs

What to expect after that first antenatal visit?

Your antenatal appointments are planned throughout your pregnancy to cater for the routine tests and checkups that are advised at each stage: 

You would see me every 4 to 6 weeks, until 28 weeks. The frequency of visits will increase after 28 weeks to once every fortnight and then we switch to a weekly frequency after week 36 of your pregnancy. Here’s an overview of a typical antenatal care journey:

  • First appointment: 7-8 weeks. We discuss genetic carrier screening here and provide referrals.
  • Between 10 – 12 weeks: This is when we encourage you to have the first-trimester screening tests i.e NIPT and an ultrasound at 12 weeks. This ultrasound offers screening for early foetal morphology, pre-eclampsia screening, and nuchal translucency.
  • 18- 20 weeks: Foetal morphology scan.
  • 26-28 weeks: Blood tests to check your iron level, thyroid functions and screening test for pregnancy diabetes.
  • 28 week: Antenatal Class-I.
  • 36 weeks: A blood test to check iron levels and vaginal swab for GBS 
  • 36-37 weeks: Antenatal Class II – discussion about labour, pain relief options, antenatal expression of breast milk, perineal massage
  • 40-41 weeks: Assessment and discussion for induction of labour if you have not delivered by this stage.

These are some of the frequently asked questions we get from expecting mums:

It is easiest to contact me by email. I will give you my email on the first visit and you can contact me at all times if there are any issues. During daytime hours, 9:30 to 4:30 you can also call my rooms directly. We encourage you to book into the hospital in early pregnancy. We also encourage that if there are any urgent issues during your pregnancy you also contact the hospital birthing unit which is open 24 x 7 and speak to a midwife.

Morning sickness is nausea and vomiting in pregnancy. Most women experience this in the first trimester. It usually improves after that. Again, most women will have symptoms in the morning but depending on their pregnancy, women sometimes have symptoms throughout the day. In severe cases, some women are unable to tolerate any oral intake and that would be when they need to be admitted to the hospital and be treated there.

Morning sickness can be treated with a combination of lifestyle and diet modifications and medications. The dietary modification includes eating food that is less spicy and oily, splitting the meals into 6 small meals rather than 3 big meals, regular exercise, and complete abstinence from alcohol and smoking. There is some evidence to suggest that ginger can improve nausea and vomiting in pregnancy. If needed, we will prescribe anti-nausea medications that are safe for pregnancy.

Yes, uncooked or partially cooked meats and fish are best avoided, as are mould ripened soft cheese, pate, liver products, pre-packed foods and salads, unpasteurised milk, energy drinks and alcohol.

Most pregnancy supplements contain small amounts of folate. Although it is recommended to start taking these supplements 2 months prior to conception, it is still not too late to start them as soon as you find out that you are pregnant. Some women need a higher dose of folate and as your obstetrician, I will guide you on this if this is the case for you. Depending on your needs, you may need additional iron and Vitamin D supplements.

COVID-19 is a pandemic and most of us have had it at least once since the pandemic was announced. There have been different strains of the virus as well. The most important thing that you can do to reduce the severity of the infection (if you get it during pregnancy) is to get a COVID-19 vaccine. It is safe to take the vaccine during the preconception period, as well as during pregnancy and during breastfeeding. You can still get a COVID-19 infection in spite of being vaccinated but most women will have mild self limiting illness with flu-like symptoms. The vaccine reduces your risk of having severe infection needing admission in critical care unit and risk of dying.

Exercise during pregnancy

How about exercise and weight management

Most of the weight gain in your pregnancy would happen in your second and third trimester. Generally, in the first 12 weeks, you would put on around 1 to 2 kilos. After that, the desired weight gain during the pregnancy depends on your BMI (body mass index). Women with a normal BMI of 18-24.9 should gain between 11.5 – 16 kg during their pregnancy. Women who are overweight with a BMI between 25-29.9 should gain between 7-11 kg and obese women with BMI greater than 30 should gain between 5-9 kg during pregnancy.

This brings us to exercise. There are many benefits of exercise in pregnancy. The two most important are preventing excess weight gain and psychological well being. Regular exercise is also very important if you have gestational diabetes to help control your sugar level. Pelvic floor exercise is highly beneficial not only during pregnancy but also after childbirth to improve tone of pelvic floor muscles. A combination of aerobic exercises like stationary cycling, walking, swimming and strengthening exercises like light weights and resistance bands is often a good exercise program.

Breastfeeding advice

The big question about breastfeeding or not?

Breastfeeding advice will be available to you from a range of professionals here in Sydney: from lactation consultants and midwives to your private obstetrician. It is an individual choice that you make. We support the choices you make as we understand that not everyone is able to or wants to breastfeed. 

Having said that, I would like to say that breastfeeding does have definite advantages. Apart from the nutritional benefits to the baby, breastfeeding improves mother-baby bonding, protects babies against infections, and breastfed babies have a lower incidence of abdominal colic and constipation. Breastfed babies also have a lower incidence of SIDS. 

Apart from benefits to the babies, breastfeeding allows involution of the uterus to allow it to go back to its pre-pregnant shape. It reduces the risk of breast and ovarian cancer and also acts as a natural contraceptive. It also reduces the risk of some conditions like osteoporosis and Type II diabetes. If you are in doubt, we will have plenty of time to discuss your questions and the available research data, during your antenatal care visits at my Sydney practices.