Pregnancy services in Western Sydney

Auburn Hospital

Midwives clinic (antenatal or before birth)

Opening hours: 7am to 3:30pm, Monday to Friday

Phone: (02) 8759 3278 or (02) 8759 3244

Email: WSLHD-Auburn-WomensHealth@health.nsw.gov.au  

Location: Level 2, Outpatients Department, Auburn Hospital, Auburn NSW 2144

Blacktown Hospital

Midwives and Women's health clinic

Opening hours:

• 8am to 7:30pm, Monday to Friday
• 8am to 3:30pm, Saturday

Phone: (02) 8670 8356 or (02) 8670 8352

Email: WSLHD-BMDHWHC@health.nsw.gov.au 

Contact hours for enquiries: 8am to 4:30pm, Monday to Friday

Location: Women's health clinic, Level 3, Blacktown Hospital, NSW 2148

Westmead Hospital

Midwives and Women's health clinic

Opening hours:

• 8am to 4pm, Mondays, Wednesdays, Fridays and Saturdays
• 7am to 7pm, Tuesdays and Thursdays

Phone: (02) 8890 6508

Email: WSLHD-WestmeadPregnancyBookings@health.nsw.gov.au 

Location: Women’s Health Clinic, G Block, Ground Floor (Level 2), Westmead Hospital, corner of Hawkesbury Road & Darcy Road, Westmead NSW 2145

After you're booked in, you will generally continue to visit on the same day of the week.

At each visit your midwife will ask how you are and if you have any concerns, and check your:

• weight
• blood pressure
• urine (if required)
• blood test results
• baby's movements
• baby's position and size.

The midwife will also:

• discuss the progress of your pregnancy
• share important moments, like listening to your baby's heartbeat
• refer you to a doctor for any health concerns
• refer you to other health workers for specialised support.

Learn more about what midwives do  

Outreach clinics are midwife clinics located in community health centres in Castle Hill, Constitution Hill and Greystanes. Many women enjoy attending a clinic close to their homes. 

Westmead midwives work at these outreach clinics and offer the same midwifery services offered at the hospital. 

Appointments for routine visits are held in the morning and booking in appointments are done in the afternoon. 

Clinic times

Depending on your pregnancy care choices, your midwifery visits can be scheduled at the clinic, at Westmead hospital or in your home. 

Your midwife will follow the recommended schedule of visits set by the NSW Ministry of Health. Learn more about the checkups, tests and scans available during your pregnancy.

View and read the schedule of visits for antenatal care (PDF 362.38KB).

Group pregnancy care sessions can be beneficial to women who are keen to share and learn about pregnancy, childbirth and parenting with other pregnant women. 

During this session a midwife will attend to your antenatal checks while another midwife supports group discussion and education. Partners and support persons are welcome to attend.

Group pregnancy care takes place on Tuesday nights 6 to 8pm for each of your scheduled visits. 

Speak to your midwife for more information.

The Young Mum's Pregnancy Group is a free service for young women who are 20 years or younger.

This service offers care and education sessions in a group setting every Monday 1:30 to 3:30pm in the Education Block in Westmead Hospital. Partners and support people are welcome and encouraged to join.

What we offer

• Free of charge for young women 20 years and under
• Antenatal check-ups
• Childbirth and parenting education
• Choice to speak with social workers at the sessions.
• Meet the same midwives and social workers each time you visit
• Referrals to the doctor if more care is needed
• choice to attend as often as you like or just on your check-up days.

Topics covered

• Labour and birth
• Managing pain in labour
• Tour of the Birth Unit
• Caesarean birth
• Feeding your baby and contraception
• Caring for your baby - sleep and settling
• Baby bath

How to book

Speak to your midwife or book directly by calling (02) 9845 6005

Download the Young Mum's Pregnancy Group brochure (PDF 224.71KB)

You can choose to have antenatal (time before birth), and postnatal (time after birth) care provided by a privately practising midwife (private midwives). 

Accredited private midwives with admitting rights can:

• book women into Westmead Hospital
• provide midwifery care for those women who choose to give birth in Westmead hospital
• transfer into the hospital from a planned homebirth. 

This means that:

• your antenatal appointments can be more flexible.
• you enjoy continuity of care with one midwife.
• our Birth Unit midwives will care for you while you are in labour and birth. 

You will need to: 

• attend the booking-in visit clinic at the Women's Health Clinic at Westmead Hospital.
• ask the midwife who is booking you in for a referral to the privately practising midwife antenatal shared care program

Note: Your suitability to access a midwife through the program will depend on your health, previous obstetric history and personal factors.

Talk to our staff to provide you with a list of private practice midwives with admitting rights to our hospital, if you do not already have one.

If you are interested in the MCP for your pregnancy you should be:

• in good health, without medical conditions
• planning to have a natural birth with no unnecessary interventions
• prepared to go home with your baby between 4 to 6 hours after birth, if you are both well.

Auburn Hospital

Register your interest for MCP in Auburn by filling out our online registration form. 

Register your interest online

Blacktown Hospital

To register your interest in the MCP in Blacktown, email WSLHD-midwiferygrouppractice-blacktown@health.nsw.gov.au

Westmead Hospital  

Your local GP (General Practitioner) will refer you to the antenatal clinic, noting that you would like to be considered for MCP in Westmead. 

Register your interest online

To learn about our midwifes' role and how they work within the team, read our guidelines for care factsheet (PDF 633.59KB).

You will get to know your midwife and be able to contact them directly and learn about your pregnancy and your baby. 

Sometimes your midwife may not be available to take your call or provide all care. However, until your midwife becomes available, another known midwife will provide advice and care to help meet your needs.

Learn more about what midwives do.

You can schedule to attend your pregnancy visits at Westmead hospital or in your home. 

Your midwife will follow the recommended schedule of visits set by the NSW Ministry of Health. Learn more about the checkups, tests and scans available during your pregnancy.

View and read the schedule of visits for antenatal care (PDF 362.38KB).

Birthing your baby at home (homebirth) is a possible option for women with low-risk birth within the WCMP. 

Read our factsheets to:

• find out if you are eligible for homebirth (PDF 288.51KB)
• find out if you are able to have a home birth (PDF 613.69KB)
• learn about homebirth with the WMCP (PDF 2.85MB).

Your WMCP midwife will discuss when you should come into the hospital and will provide care and support during your labour and birth. 

If you and your baby are well, you can be discharged 4 to 6 hours after birth. 

If you have a medical concern, you will be admitted to the maternity ward. Your WMCP midwife will then help you plan for discharge.

Learn more about childbirth.

Your midwife will visit you and your baby at home after you've been discharged from the hospital. Home visits are provided for up to 2 weeks following the birth of your baby. 

Your GP or local child and family health centre will then provide care for you and your baby.

Learn about being at home with your baby after giving birth.

Auburn Hospital's MCP team offers specialist midwifery services for pregnant women who have experienced female circumcision or Female Genital Mutilation / Cutting (FGM/C). 

Our staff are training to offer confidential advice and can perform de-infibulation (a minor surgical procedure to gently open the vulval area) for comfort, health and/or childbirth.

For more information call (02) 8759 3278 or (02) 8759 3244, or email WSLHD-Auburn-WomensHealth@health.nsw.gov.au

Learn more about the NSW Education Program on FGM/C and how it is working to prevent the practice and minimise the impacts for affected women, girls and their families. 

If you are interested in the PAPOOSE program for your pregnancy you can:

• ask your doctor (GP) to write down your interest when they send in their referral to the Women's Health Clinic at Westmead Hospital.
• tell the midwife you'd like to book in when they ring you from the clinic
• ask the clinic at any time in your pregnancy
• refer yourself by registering your interest online

You will get to know your midwife and be able to contact them from 8am to 4.30pm every day. You will learn about your pregnancy and your baby. 

Sometimes your midwife may not be available to take your call or provide all care. However, until your midwife becomes available, another known midwife will provide advice and care to help meet your needs.

Learn more about what midwives do

Our Young Mum's PAPOOSE midwifery services are for women up to 22 years of age.

What we offer

• Continuity of care in the prenatal (before birth) and postnatal (after birth) period.
• You can contact your midwife from 8am to 4.30pm every day.
• If your midwife is away, another PAPOOSE midwife may answer the phone or visit you.
• During your care, you will learn what to expect during your pregnancy, labour and birth.
• The Young Mum's Group is available so you can connect with other mums. 

How to book

To book an appointment or for any questions call 0427 550 777

During your pregnancy, you will be seen in a clinic close to Westmead Hospital. There may be a time you will need to visit Westmead Hospital, your midwife will arrange this. 

Your midwife will discuss the schedule of visits with you. Learn more about the checkups, tests and scans available during your pregnancy.

View and read the schedule of visits for antenatal care (PDF 362.38KB).

You will be given the Birth Unit phone number so you can call the staff during your labour for advice on when to come to Westmead Hospital. You should also phone the Birth Unit if you have any worries.

During your labour and birth, the Birth Unit midwives will care for you. You may also have a student midwife, who you know, be there at your birth (if you wish).

After your baby is born, you can go home 4 to 6 hours after birth if everything you and your baby are well. If you wish to stay in hospital, you will be admitted to the maternity ward to recover for a couple of days before going home.

Learn more about childbirth

Your midwife will visit you and your baby after you've been discharged from the hospital. Home visits are provided for up to 2 weeks following the birth of your baby. 

Your GP or local child and family health centre will then provide care for you and your baby.

Learn about being at home with your baby after giving birth

Contact us

The best way to contact us is by registering your interest online 

Give us your feedback 

We use all feedback from our patients, carers and families to improve our patient and carer experiences. 

Take our online feedback survey

The SMILE Midwifery Clinic is a free maternity service that focuses on providing continuity of care.

• You will have the same team care for you throughout your pregnancy.
• A SMILE student midwife along with a hospital midwife will care for your during your labour and birth.
• They can provide some postnatal (after birth) care, which is optional. It also depends on the student midwife's availability.

We have 2 clinics, in Castle Hill and North Paramatta. If you need to see a doctor at Westmead Hospital, your midwife will organise it.

The SMILE Midwifery Clinic works with the medical team to provide personalised care that considers your specific needs, preferences and medical history.

Register your interest

If you are interested in the SMILE midwifery service for your pregnancy:

• register your interest online with Auburn Hospital
• Email WSLHD-midwiferygrouppractice-blacktown@health.nsw.gov.au to register with Blacktown Hospital
• register your interest online with Westmead hospital.

The COSMiC group practice is a midwifery student-led model of care offered at all hospitals in Western Sydney Local Health District. 

At all times, experienced midwives directly supervise, support, and guide the students. 

In this model of care, the midwifery students provide: 

• Antenatal care
• Labour and birth care
• Postnatal care 

This model of care helps our students to: 

• gain experience in a midwifery group practice
• become well-rounded, confident midwives. 

The COSMiC group practice works in conjunction with our partner universities: 

• Australian Catholic University
• University of Technology Sydney
• Western Sydney University

How to join

Places are limited in this model of care. If you want to see the COSMiC midwifery students, ask your midwife at your hospital or contact the outpatient nurse unit manager at:

• Auburn Hospital
  Phone: 0447 283 975
• Blacktown Hospital
  Phone: 0427 653 254
• Westmead Hospital
  Phone: 0439 068 712

Download the COSMiC Midwifery Student Group Practice factsheet (PDF 506.3KB)

You will be able to access our pregnancy care and give birth at Westmead Hospital if you live within the Westmead Hospital catchment area. Proof of address may be required.

Note: Not all streets in these suburbs marked with an asterisk are part of our catchment area. You can find out by calling the Women's Health Clinic at 02 8890 6508.

Westmead Hospital catchment area

Download the Westmead Hospital catchment area list (PDF 423.87KB)

This is for women identified as having medical or obstetric problems that require a specialist obstetrician to monitor their pregnancy.

The Doctors' clinics are located in the Women's Health Clinic in Westmead Hospital via entrance 4, G Block on level 2. The clinics are open between 8am-12.30pm and 1.30-4pm, Monday – Friday. 

Some women will choose to continue pregnancy care with their family doctor (GP) or see a private obstetrician for pregnancy and childbirth care.

Common conditions requiring specialist obstetric care include:

• Gestational diabetes (high blood sugar levels occurring during pregnancy with no previous history of diabetes)
• Pre-eclampsia (can occur after 20 weeks' gestation, a key symptom is high blood pressure)
• Placenta praevia (placenta is positioned close to or over the cervix)
• Cholestasis (flow of bile from the liver is blocked causing itching on parts of the body)
• Multiple pregnancy (twins, triplets, etc.)
• Some instances of a previous difficult pregnancy or delivery.
• specialised clinics for women who have experienced Female Genital Mutilation/Cutting (FGM/C). Learn more about the NSW Education Program on Female Genital Mutilation/Cutting (FGM/C).

Specialist clinics

As a private patient, you will need to book into the hospital so we know you will be delivering your baby with us. Women who plan to give birth at Westmead Hospital and book a private obstetrician must attend a booking-in appointment at our Pregnancy booking-in clinic.

When you come in, you will need to bring your blood tests and ultrasounds. If you do not bring copies of blood tests with you or if the midwife cannot get a copy:

• you will be asked to have the blood tests at the hospital. Additional fees above health care insurance premiums may apply for this service.
• Please contact the Patient Finance Department for advice on costs as a private patient.
• Talk to the staff to ask for a list of obstetricians available at Westmead Hospital.

Shared pregnancy care, also known as antenatal shared care, is when your pregnancy care is shared between an accredited general practitioner or family doctor (GP), or a privately practicing midwife, and your hospital. 

In addition to building a trusting relationship with your GP or midwife, they can offer additional services and supports after your baby is born. 

Shared pregnancy care is available at Auburn, Blacktown and Westmead hospitals.

Who can have shared pregnancy care?

You can choose shared pregnancy care if you're having a normal pregnancy with no specialist or complex care needs. Conditions that are usually not suitable for shared pregnancy care include:

• if you're having twins, triplets or more in a single pregnancy.
• blood pressure problems that need medication
• heart disease
• diabetes requiring insulin or diabetes in previous pregnancy (gestational diabetes)
• endocrine (hormone) problems
• mental health conditions that need medication
• mental health conditions soon after having a baby (perinatal mental illness)
• epilepsy needing medication
• severe asthma and on regular medication
• blood disorders that need medication
• history of cancer in the past 3 years
• autoimmune disorders
• HIV or Hepatitis C infections
• history or stillbirth or multiple miscarriages
• having premature babies
• obstetric complications in previous pregnancies
• babies born less than 2500 grams or more than 4500 grams
• having a Caesarean section or myomectomy (surgery to remove uterine fibroids)

Shared pregnancy care options

GP Shared Care (GPSC)

If you choose this option, you can build a relationship with your GP (general practitioner or family doctor) to have flexibility of appointments and continuity of care options. 

Any GP who is part of the GPSC program are accredited by the hospital. If your GP would like to join the GPSC program, they can arrange an accreditation by calling 02 8811 7100.

Privately practising midwives

Talk with the hospital staff for a list of private practice midwives with admitting rights to our hospital. Learn more about the private practice antenatal shared care program.

How often do I need to see the GP or private midwife or hospital?

A breech presentation is when the part of the foetus lowest in the uterus is the buttocks or feet, rather than the head. 

If you are more than 35 weeks pregnant and your baby is in a breech position, it is unlikely the baby will turn its head to the down position for birth. The clinic can offer you choices to manage the last weeks of your birth and pregnancy. 

The clinic team is made up of an obstetrician, an obstetric registrar, and a midwife who are experts in breech pregnancy and birth. If you are having a vaginal breech birth, the team will support you in the birth unit and in the maternity ward after the birth of your baby. 

Note: We do not accept appointments earlier that 35-36 weeks as there is still a chance that your baby might turn their head down.

Appointments and referrals

The Breech clinic is located on Level 2, G Block in the Women's Health Clinic at Westmead Hospital. The clinic operates between 1.30-5.30pm on Mondays (excluding public holidays). 

You will need a referral to access our service. Your doctor (GP), midwife or obstetrician can make an appointment for you. 

They can also call the Clinical Midwifery Consultant for the Breech clinic at (02) 8890 7993 or 0409 708 130.  

To change your appointment call (02) 8890 6508.

What to expect

We will work with you to plan your care options. This includes talking with you about trying to turn the baby to a cephalic (head down) position. This is called an External Cephalic Version (ECV). If you choose to have an ECV and your baby turns, you will return to your main pregnancy carer (GP or midwife) and plan for a normal vaginal delivery.

If you choose not to have an ECV or if we cannot turn the baby, we'll discuss and help you decide whether to have a vaginal breech birth or a Caesarean birth.

You can ask as many questions as you need so you are confident and informed about your choices. 

The immunisation clinic offers the whooping cough vaccination to pregnant women from 28 weeks of pregnancy and the flu vaccination in the autumn and winter months. 

It is important to stay informed with trusted and reliable information on:

• Influenza (flu)
• Respiratory syncytial virus (RSV)
• Viral gastroenteritis (gastro)
• measles
• other infectious diseases. 

Learn more about vaccinations before, during and after pregnancy. 

Book in an appointment on a day you have your scheduled antenatal (pregnancy) visit. You can ask the staff at the clinic reception to book an appointment for you. 

Speak to your GP about your concerns with your whooping cough vaccination or call the Women's Health Clinic. 

Note: If you experience any unexpected reactions to any vaccination, please advise the immunisation clinic immediately or as soon as possible. For any health emergencies always call Triple Zero (000) or go to your nearest emergency department. 

Location and contact details

The immunisation clinic is open from 8am to 4pm, Monday to Friday. It is located on Level 2, G Block in the Women's Health Clinic at Westmead Hospital. You can call the Women's Health Clinic at (02) 8890 6508.

A post-dates pregnancy, also known as prolonged pregnancy or late-term pregnancy, refers to a pregnancy continuing beyond 41 weeks of gestation (294 days). 

In order to have a care plan in place, we review women who are still pregnant at 41 weeks to:

• see how they are coping
• check the health of the baby
• discuss what happens next.

The review takes place at the post-dates clinic in the Day Assessment Unit (DAU) which is located on Level 2, G Block via entrance 4 in the Women's Health Clinic at Westmead Hospital.

What we check

Some of the examinations during a normal visit include:

• checking your blood pressure, urine and tummy
• a heart tracing and ultrasound measurement of the amniotic fluid (fluid in the uterus around the baby)
• an internal examination to check how ready your cervix (neck of the womb) is for labour.

What we discuss with you

• We discuss inducing labour and advise whether the birth should be brough on in the next few days.
• Inducing labour is considered safer than leaving the baby in the uterus, even though the risks in continuing the pregnancy are very small.
• Inducing labour only slightly lowers the chances of a Caesarean birth and only slightly increases the chance of a vaginal birth assisted by vacuum or forceps.
• If you choose to continue the pregnancy a bit longer, we discuss what follow-ups are required. 

The Westmead Institute for Maternal Fetal Medicine (maternal fetal medicine clinic) supports women with complex pregnancy needs.

Such pregnancies include:

• problems with the baby’s physical development
• problems with the placenta
• pregnancy at risk of early delivery
• women with a major medical condition or history, including organ transplant, heart and kidney disease, Type 1 diabetes, cancer and blood disorders.

Women attending this clinic may also have other medical teams involved in their care planning such as the Neonatal, cardiac, endocrine or renal teams.

Referrals

Women and families can be referred from anywhere for specialised care at our clinic.

Please make sure your correct phone number is in the referral form. We will contact you with your appointment date and time. If we do not contact you within 2 working days of receiving your referral form, please call (02) 9845 6802

Your referring doctor can contact the maternal fetal medicine clinic midwife on 0428 611 831

Interpreter services

If you need an interpreter for your appointment, please let us know when booking your appointment. If we cannot book an in-person interpreter, a telephone interpreter service will be used.

Costs

• The ultrasound scans are free for Medicare card holders.
• Non-Medicare patients will be charged $126. Please allow 30 minutes before your scan to complete the payment process at the cashiers.
• Both Medicare and non-Medicare patients having a chorionic villus sampling or amniocentesis scan, can choose to pay for a quick result, costing $175. If you choose this option, the Westmead Children's Hospital will send you a bill after the scan is completed.  

At your appointment

Appointment times are between 7.30am-3pm. When you attend your appointment:

• please bring all your scans, test results and reports with you.
• arrive 15 minutes before your appointment to complete paperwork
• if you arrive more than 10 minutes later, you may need to re-book your appointment.
• please drink one full glass of water, one hour before your scan.
• switch off all mobile devices during your scan.
• no photos or videos will be allowed. We do not provide 3D images.
• ask your questions at the end of the scan, as the sonographer needs to focus on the scanning process.
• all urgent matters will be discussed with you on the day.

Cancelling or rescheduling appointments

We have a busy service, and the timing of your appointment is very important to your care and management. We encourage you to attend the appointment you have been given.

If you need to cancel and reschedule, please contact us as early as possible to arrange a suitable appointment time.

Location and contact details

Our clinic is located on Level 2, G Block (street level) in the Women's Health Clinic at Westmead Hospital. You can call the clinic at (02) 8890 6802 between 7.30am-3.30pm, Monday to Friday.

The PEARLS provide advice and referrals for pregnant women experiencing a complex pregnancy as well for newborns that need intensive care.

Our services

The PEARLS team has specialist midwives, nurses, doctors and surgeons who provide care for you when:

• your baby requires surgery soon after birth
• your baby needs a planned admission into newborn intensive care
• you have a major medical condition
• you have a complex pregnancy
• you need additional specialist support through your pregnancy and childbirth.  

Midwifery care

A PEARLS midwife will provide you with a direct mobile phone number to:

• record your birth plan
• answer all your questions and concerns
• coordinate all your antenatal, birth and postnatal care
• complete your childbirth and parenting education
• help with breastfeeding support
• discuss about keeping your labour and birth normal
• help you familiarise yourself with the Birth Unit, Neonatal Intensive Care Unit (NICU) and the Grace Centre for Newborn Intensive Care before your baby is born.
• help you arrange accommodation close to Westmead Hospital if you are travelling from within NSW, interstate or overseas for the birth or after your baby is born.

Note: To find more information for patient and carer accommodation options near the hospital, visit the Westmead Accommodation Complex or call 02 8890 6900 between 8.30am-1.30pm, Monday to Friday.

Babies and surgery at the Children's Hospital

If your baby needs surgery in the first few weeks of life, and was born at Westmead Hospital, the care will be shared with the Grace Centre for Newborn Intensive Care at the Westmead Children's Hospital.

The PEARLS team coordinate with the Maternal and fetal medicine and Neonatal Intensive Care Unit specialists to plan for:

• your baby's birth
• the transfer to the Westmead Children's Hospital
• readying a mobile intensive care unit to move your baby between both hospitals.

videocam 15:13

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Video transcript

Parents' guide to the Grace Centre for Newborn Care | WSLHD

[Music]

[Screen text 'Grace Centre for Newborn Intensive Care - working together with families' appears over video of a male and female medical team wheeling a neonatal intensive care unit into a hospital room]

[Female voiceover]
The Grace Centre for Newborn Care welcomes you and your baby.

[Nadia Badawi, Professor and Neonatologist, Co-head Grace Centre for Newborn Care]
The Grace Centre for Newborn Care is situated at the Children's Hospital at Westmead and it's a very specialised Newborn Intensive Care Unit.

[Music]

[Female voiceover]
We hope that this DVD gives you some insight into the care your baby will receive and the support available for parents.

[Music]

[Angela Casey, Nurse Manager, Co-head Grace Centre for Newborn Care]
We see really sick babies and it is overwhelming for parents.

[Nadia Badawi]
We try to make it as comfortable and as homely for families.

[Angela Casey]
The reassuring thing for the parents is that they're in the absolute best place for their baby at that time.

[Nadia Badawi] 
Our philosophy which we really try to practice is that the family is part of the team that look after the baby and we try to practice family focused care.

[Female voiceover]
Parents are welcome to be with their babies at any time of the day or night.

[Different parents in the care unit share their experience]

[Dad 1] 
Before Lola was born we came in for a visit, and things were explained to us.

[Mother 3]
Every day they come and see me come and speak to me the nurses the doctors. We know each one by first name basis.

[Dad 1]
We've had a lot of opportunity to ask questions.

[Different scenes of medical staff working in the centre]

[Bronwyn Parkinson, Nursing Unit Manager, Grace Centre for Newborn Care]
We work right from the beginning as a team to link in with the parents and to make them as comfortable as possible.

[Couple sitting outside with food and drink]
They haven't done something without telling us and talking to us about it. It's a fantastic unit.

[A nurse explains baby's update to parents] 
Today is much better he's on still on CPAP 6cm, his tummy looks good. He's been coping and handling well.

[A woman walks toward the hospital and enters the main doors, walks to and enters an elevator]

[Female voiceover]
On arrival at the hospital go up to level 3.

[Nadia Badawi]
Your baby might have been referred because they have a surgical condition or have a heart problem or have a complex medical condition that requires all the specialist facilities that are present only at a children's hospital.

[Woman approaches the neonatal intensive care unit, and sanitises her hands outside the unit entrance. She presses the main buzzer and a female nurse answers]

[Nurse]
Hi can I help you?

[Woman]
Hi my name is Ren I came to see my daughter Nikki.

[Peter Barr, Neonatologist, Grace Centre for Newborn Care]
The parent worries about two things. First of all, they're worried that the baby's going to die and secondly, they're worried that the baby might be left with some significant disability and these are very real concerns both of them are unlikely.

[Nadia Badawi]
About 15 years ago the mortality rate in Grace was nearly 20%. Now thanks to the coordinated effort of all the doctors and nurses the mortality rate now is under 2%.

[Ren walks to the centre's reception window.]

[Ren]
Hello

[Female voiceover] 
At the reception desk you'll be greeted by our secretary.

[Secretary] 
Hi Ren, Nikki's in intensive care. Would you like me to take you down?

[Female voiceover]
Past the reception desk on the right are lockers for families we ask you to leave your belongings here.

[Peter Barr]
Because the babies who come to Grace intensive care often have problems that involve more than one system of their body there are many people involved in their care.

[Nadia Badawi] 
There is a big team who look after your baby. So that will include the neonatologist who will coordinate the care, you may have a surgeon or other sub-specialist paediatricians, we have a social worker, occupational therapist, physiotherapist, feeding specialists, and all of these people are really integral to the care that we provide.

[Screen shows Peter Barr with other team members talking to a person out of screen]
We're just waiting really on the CT result.

[Angela Casey]
There're 90 nurses here in this unit. We have nurses that are clinical managers, clinical nurse specialists who are senior nurses and then registered nurses.

[Dad 1]
It's been a very difficult, difficult time because very unsure as to what our child's needs were and it's been explained quite clearly for us and felt very supportive.

[Angela Casey]
We encourage families to be with their babies as much as they're able to, but we understand that they do have other responsibilities such as caring for siblings at home.

[Dad 2]
It's been a bit tough, running around from hospital to hospital and trying to dedicate enough time to each child.

[Dad 1] 
The level of care and professionalism of the staff helps with your nervousness of being a new parent.

[Mother 1] 
And if you're not here they can ring you or you can ring at any time as well which is fantastic.

[Music]

[Angela Casey] 
If friends or family also want to visit your baby, then that's absolutely fine.

[Mother 2]
His grandparent parents come in and see him all the time during visiting hours.

[Nadia Badawi] 
Grace has an intensive care unit as well as a high dependency unit.

[Female voiceover]
It is very important that everyone wash their hands when entering and leaving the ward including small children.

[Angela Casey] 
The Intensive Care Unit is extremely busy the babies come in and need urgent attention.

[Peter Barr walks into the unit with medical team and examines a baby on a ventilator]
35 weeks premature baby who had respiratory distress after birth for the day would be to extravert to low flow oxygen if he needs that.

[Angela Casey]
Some of the babies do require to be put on a ventilator which is a device that helps the baby breathe.

[Kaye Spence, Clinical Nurse Consultant, Neonatology, Grace Centre for Newborn Care]
When they come through that door there's a lot of equipment, a lot of lights. Sometimes you might hear an alarm going off

[Peter Barr and team continue to examine a baby]
218? yeah okay. So, the plan is tube out, wait a couple of hours. 30ml per kilo, feed third hourly...

[Nadia Badawi]
Many of the babies who come to Grace require a major surgical operation during the first few days of life. The neonatologist and the other staff in Grace will explain the procedure to you and then the surgeon will come explain the procedure in detail and then you'll be asked to sign a consent form.

[Nadia Badawi in the unit with Mother 2 and her baby]
So, Daniel as you can see is in intensive care, he's had surgery, he's fully monitored and that monitor behind. We do ward rounds twice a day.

[Nadia asks Mother 2 a question] 
Then there's always an opportunity for you to really be involved in the care?

[Mother 2]
Very much so I love it.

[Nadia Badawi]
The results in grace are excellent for surgery.

[Female voiceover]
In the Intensive Care Unit every baby is allocated a nurse who cares for the baby and parents during their shift.

[Music]

[Angela Casey] 
The staff are very conscious about explaining procedures, explaining the equipment make sure they're all right.

[Mother 3]
This is Hudson he's 5 weeks old and he has Hirschsprung's, so he wasn't the typical Hirschsprung's baby he was very hard to diagnose. Eventually we got there and had surgery and he's much better, he's doing really well.

[Peter Barr] 
We're very mindful of baby's distress and of the distress of families and we organize a unit that tries to minimize all of that.

[Dad 2]
Seeing just the magnitude of how it works it's I've been overwhelmed it's been excellent.

[Music]

[Kaye Spence]
We give the babies quiet time between 12 and 3 each day.

[Female voiceover]
During quiet time we close all the blinds and dim the lights.

[Kaye Spence] 
We reduce the activity during that time keeping it for just for the babies and their parents.

[Couple sitting outside with food and drink]
One of the nurses started a diary for him and it has photos of him, his medical attachments, what they were for.

[Female voiceover]
Every baby has a diary. It becomes a record of your baby's journey.

[Couple sitting outside with food and drink]
I've added a couple of pages to it as well.

[Female voiceover] 
We encourage parents to do as much caregiving as they would like to.

[Mother 2]
I change his nappy, and I clean his eyes his mouth.

[Nurse shows parent how to turn over their baby in the cot]
All right you can pop him over.

[Couple sitting outside with food and drink]
We're able to change his diaper and we've been taught about the tubes that are high risk tubes that you don't want to touch and then the other ones that are fine to move around.

[Dad 2] 
I had an opportunity to have a cuddle and just set in my arm the staff were fantastic shifting him with all his wires and tubes.

[Nurse picks baby and places into a mother's lap that has a large, curved pillow]
Okay hi Mom, and I'll bring that elbow in...

[Female voiceover]
Human contact is important for the well-being of any baby.

[Couple sitting outside with food and drink]
The first couple of days I just sat next to him and held his hand, and he clutched on tight.

[Screen shows Mother 2 cradling her baby on her chest. Text on the screen reads: Skin to skin cuddle is known as kangaroo care]

[Susan Clarke, Social worker, Grace Centre for Newborn Care]
Often, I talk to families around your baby knows your voice they're reassured by your presence the touch that you provide is very different to the experience that they're having with all of us that are working with their baby.

[Mother 3]
The social worker reached out to me when we first got here and I reached out to her again after his first surgery. He's doing well like as everyone expected, she was really good to motivate you and remind you you're being a good parent and doing everything right.

[Mother 2 cradles her baby and asks a nurse a question] 
How do we introduce the baby to his siblings?

[Mother 3] 
It was really helpful knowing that I can speak to her and know that she understands me.

[Nurse answers Mother 2's question]
And just going through some of the photos that you have and just saying look this is how big he was when he was born and this is where he's at now.

[Susan Clarke]
The social worker is also providing practical assistance with accommodation parking and those types of things which become quite overwhelming for families when they're under a huge amounts of pressure.

[Female voiceover]
It is important to take a break. There's a parent lounge and courtyard. You can try one of the cafes in the hospital or take a walk in the garden.

[Couple sitting outside with food and drink]
It gives you a bit of normality than being inside and seeing your child hooked up to lots of tubes and things.

[Music]

[Female voiceover]
There is also a library where parents can learn more about their baby's care and specific medical conditions.

[Music]

[Peter Barr]
A baby that needs more specialised nursing care but doesn't need the intensity is then transferred to what's called high dependency where they are cared for in a more relaxed environment but no less observant in the way that we would care for them.

[Angela Casey] 
In this unit the parents are able to interact with babies more and provide more of the care.

[Lauren Kendrick, Clinical Nurse Specialist]
Chance is in an open care bed so he's got some nesting here he's actually waking up a little bit just to support him so he pushes against it just like he would when he was in utero. He's got a feeding tube in his nose to help him feed. This is our IV pump and it's got something called TPN or total parental nutrition, fats and sugars to try and help him to grow. He's also got some supplemental oxygen which is just helping him breathe.

[Female voiceover]
Every baby is attached to a monitor, if the baby's signs go out of the normal range alarms will ring to alert staff.

[Kaye Spence]
And alarms are used to anticipate a problem not because there is a problem.

[Lauren Kendrick]
This is our monitor that most babies have. So along the top is heart rate, the yellow squiggly line that's to monitor how many breaths he breathes in a minute, and the light blue is to monitor his oxygen saturation or how much Oxygen's going around in his blood.

[Female voiceover]
We have a developmental care team here who work with the babies and their families.

[Kaye Spence]
That consists of our occupational therapist and physiotherapist, social worker, together with representatives from the nurses and the doctors and we meet regularly.

[Female voiceover]
The babies have an individualized care plan. It's kept in the green folder at the cot side.

[Kaye Spence speaks to a Dad 3]
At the moment you're giving her cuddles, have you bathed her yet?

[Dad 3]
Yeah

[Kaye Spence]
Babies are very communicative they can cry but they can also give a other behavioural cues.

[Kaye Spence speaks to Dad 3]
Our occupational therapist and physiotherapist will come around and look at her.

[Kaye Spence]
Part of developmental care is working with the families to teach them to read those babies cues.

[Music]

[Angela Casey]
Some of the babies obviously have breastfeeding or bottle fed. But some babies can't feed and they're fed through a tube and that's a way that the parents can also assist.

[Couple sitting outside with food and drink]
I'm able to breastfeed Isaiah now and they encourage that from about the fourth day.

[Female voiceover]
The lactation specialist will help mothers with breastfeeding and expressing milk for their baby.

[Helen Mercieca, Lactation specialist, Grace Centre for Newborn Care]
There are four expressing stations here. Part of my role is to support new mothers that come into the unit with breastfeeding and expressing and that can be with problems or issues they may be having.

[Mother 1]
Before Lola was born I met with the lactation consultant we sat down and we discussed what the options were and I actually expressed before she was born and stored the milk here and then it's been ongoing support once she was born.

[Peter Barr speaks to Mother 3] Is there any talk of home?

[Mother 3] 
Lisa actually said maybe Friday so depending on his antibiotics.

[Peter Barr] 
Sounds good to me

[Angela Casey]
We talk about discharge throughout the whole journey

[Mother 3] 
It's going to be strange having him at home and not 24-hour care but it'll be delightful.

[Lisa Macklin, Discharge Support Nurse, Grace Centre for Newborn Care]
My job is to help parents to go home with their baby. Benjamin has only had a short stay basically he's had his operation he stays with us for 24 hours and then we get him back to his Hospital of birth.

[Lisa talks to Mother 4 who is facing her, both stand over the baby's cot]
This surgeon wants to see you in 4 weeks' time.

[Lisa Macklin]
I've helped mom and dad on any special precautions that they need to take.

[Angela Casey]
There's a lot of planning and negotiating that is involved in discharge.

[Mother 4 asks Lisa Macklin a question]
We can take the dressing off ourselves...?

[Lisa Macklin] 
I link them in with community nurses and arrange the follow up with GPs, paediatricians.

[Lisa Macklin talking to Mother 4]
If you have any problems with the wound just give me a call

[Music]

[Lisa Macklin]
Part of my job is to help them to feel really supported and feel comfortable about taking their baby home.

[Peter Barr] 
We do have a newborn follow-up growth and development clinic and we do assess baby's progress.

[Nurse talks to Ren who is sitting with her baby] 
[Music]

[Peter Barr] 
The majority of families who come through will find the silver lining to the experience, even though it's troubling and traumatic for them

[Mother 3]
It's been a good experience considering where we are.

[Dad 2]
Just seeing him holding my wife's hand the way he does it's a great feeling.

[Female voiceover]
If you have any questions or concerns, please talk to us more.

[Music]

[Scrolling text on screen reads: Grace Parent Advisory Council is made of parents with first-hand experience of the care given at Grace. They work in partnership with the Grace team to help make your stay easier.]

[Scrolling text shows video credits: produced by Grace Centre for Newborn Intensive Care, The Children's Hospital at Westmead; video production by Art Resistance (www.artresistance.com.au); Acknowledgements - The Grace Centre would like to thank the families who took part in the making of this DVD. And thanks to the doctors, nurses, and staff who participated. Copyright 2013 Grace Centre for Newborn Intensive Care. For more information contact GCNC.SCHN@health.nsw.gov.au]

An EPAC is an outpatient facility for women under 20 weeks of pregnancy who are experiencing:

• vaginal bleeding
• lower abdominal pain
• blighted ovum (confirmed by ultrasound) - when a fertilized egg implants in the uterus but fails to develop into an embryo, leading to early miscarriage.

Our midwives will provide women experiencing a possible miscarriage or ectopic pregnancy with:

• assessment, management and referral to specialist doctors
• Anti-D injections after a miscarriage if you have a RH negative blood group.

Most public hospitals in NSW offer EPAC services. Contact your local public hospital for information and services in your area. 

EPACs in Western Sydney Local Health District

Your GP (doctor) can refer you to the EPAC by calling us directly. Please leave a detailed message, state your name, contact numbers and MRN (medical record number), if known. We will contact you to discuss a management plan and arrange an appointment.

Note: If you are experiencing heavy bleeding (soaking a pad or more per hour) or severe abdominal pain, please go straight to your nearest hospital Emergency Department (ED) or call Triple Zero (000)for an ambulance.

What to bring to your appointment

Please bring:

• valid Medicare card
• copies of any blood results and ultrasound reports taken in and during your pregnancy
• copies of any recent blood group and antibodies for an anti-D injection, if you have a Rh-Negative blood group
• any other health information
• current list of medications.

Maternity Assessment Clinics or MACs provide care for women who are more than 14-20 weeks pregnant and require closer monitoring without the need for hospital admission. 

Western Sydney Local Health District offer MACs in Auburn, Blacktown and Westmead Hospital.

You may be referred to a MAC by your care provider or birth unit; and in some cases, you may be asked to return for a follow-up visit.

MACs in Western Sydney Local Health District

Use the information from the factsheets and links to learn more about managing nausea and vomiting during pregnancy.

• Management of nausea and vomiting in pregnancy factsheet (PDF 1007.83KB)
• Nausea and vomiting in pregnancy and Hyperemesis Gravidarum - NSW Health (includes translated resources)

Use the information from the factsheets and links to learn more about the importance of fetal (baby) movements.

• Baby movements during pregnancy
• Your baby's movements matter
• Decreased fetal (baby) movements

Many women have bacteria (germs) in the vagina and in their urine, which do not cause any problems when they are not pregnant but can make them, or their baby, unwell during pregnancy and after birth. 

Use the information from the factsheets and links to learn more about the tests we do to protect you and your baby.

• Asymptomatic bacteriuria in pregnancy factsheet (PDF 242.33KB)
• Group B Streptococcus (GBS) in pregnancy factsheet (PDF 585.3KB)
• Influenza and pregnancy
• Influenza and pregnancy - guidance for clinicians' factsheet
• Transmissible diseases during pregnancy
• Protect your newborn from whooping cough

High blood pressure can happen for the first time during pregnancy (pre-eclampsia) and may cause problems for you and your baby. Women who have high blood pressure before they are pregnant are more likely to develop pre-eclampsia. 

Blood pressure in pregnancy may also have long term health consequences for some women. Regular checks with your GP and a healthy lifestyle are important to protect you. Use the information from the factsheets and links to learn more about pre-eclampsia. 

• Pre-eclampsia
• High blood pressure in pregnancy
• Preeclampsia explained by experts and women who lived it (video)

Diabetes can develop during pregnancy for the first time, called gestational diabetes, it needs to be monitored to protect you and your baby. Having diabetes before you are pregnant is also relevant, please speak with your doctor before trying for a pregnancy to make sure things go as smoothly as possible.

Having gestational diabetes may increase the chances of developing diabetes later in life for some women. Regular checks with your GP and a healthy lifestyle are important to protect you. Use the information from the factsheets and links to learn more about diabetes in pregnancy.

• Gestational diabetes
• Gestational diabetes factsheet (PDF 219.05KB)
• Pre-existing diabetes and pregnancy
• Pregnancy when you have diabetes
• Eating well with gestational diabetes (PDF 216.1KB)
• Weight gain in pregnancy
• Weight gain in pregnancy (gestational weight gain) factsheet (PDF 455.17KB)

Anaemia means having a low red blood cell count. Red cells carry oxygen around the body and having enough of these cells is essential for you and your baby. There are many causes of anaemia but in pregnancy, having low iron is a common and important one. 

We check your blood count at various stages of pregnancy to find out whether you need extra iron or other supplements. Use the information from the factsheets and links to learn more about anaemia in pregnancy.

• Anaemia in pregnancy
• Iron infusion brochure (PDF 2.4MB)
• Important nutrients in pregnancy factsheet (PDF 476.56KB)
• Iron needs in pregnancy brochure (PDF 13.77MB)

Your 'Rhesus factor' (RhD) tells you if you have a protein known as 'D antigen' on the surface of your red blood cells.

If your blood group is Rh negative (A negative, B negative, AB negative or O negative) you will need to be given anti-D injections at particular times in your pregnancy to protect your current and future babies from serious anaemia.

Use the information from the factsheets and links to learn more about RhD negative in pregnancy.

• Rhesus D negative in pregnancy - what you need to know

The placenta is the organ that feeds your baby during pregnancy and is delivered after your baby is born. Sometimes the placenta can be in the wrong position and obstruct (block) the passage of your baby through the birth canal.

Rarely, the placenta separates (comes loose) from the wall of the uterus before it is supposed to. Both of these problems can cause bleeding during the second and third trimesters (first 3 or 6 months - thirds) of pregnancy.

Use the information from the factsheets and links to learn more about the placenta and related conditions. 

• Placental abruption factsheet (PDF 470.05KB)
• Placenta accreta
• Placenta accreta factsheet (PDF 706.34KB)
• Placenta praevia
• Placenta praevia factsheet (PDF 1.24MB)
• Retained placenta

A breech presentation is when the part of the foetus lowest in the uterus is the buttocks or feet, rather than the head. This has significant meaning in terms of delivery, especially if it occurs at term (more than 37 weeks). Usually the waters (membranes) break during or just before labour starts. 

Use the information from the factsheets and links to learn about breech pregnancy, what to expect when your waters break too early or if you do not go into labour once your waters break when your baby is due.

• Breech pregnancy and safe birthing options
• Breech baby at term - information about care options
• When the waters break before 37 weeks (PPROM) factsheet (PDF 426.44KB)
• When the waters break after 37 weeks (TermPROM) factsheet (PDF 510.51KB)

Some women can experience vaginal bleeding during the first trimester (first 12 weeks of pregnancy). Sometimes this could be due to a serious cause like miscarriage or ectopic pregnancy; however, it does not mean that this is happening to you.

The known causes for vaginal bleeding include:

• miscarriage
• ectopic pregnancy (pregnancy developing outside the womb)
• molar pregnancy (gestational trophoblastic disease - GTD)
• problems with the cervix (neck of the womb)

Occasionally a reason for bleeding during pregnancy cannot be found.

Miscarriage is a very common problem of early pregnancy. At least 1 in 5 pregnancies end in a miscarriage. The reasons for most early pregnancy losses are not known. What we do know is that many of these pregnancies did not form properly, and that this is nature's way of 'starting again'. Most women who have one miscarriage will not experience another.

• Molar pregnancy
• Recurrent miscarriage factsheet (PDF 237.21KB)
• Ectopic pregnancy information sheet (PDF 309.83KB) (PDF 309.83KB)
• Pregnancy of unknown location information sheet (PDF 259.85KB)
• Miscarriage management options information sheet (PDF 665.43KB) (PDF 665.43KB)

If you experience early pregnancy bleeding it is important that you see your GP, midwife or obstetrician. If you have very heavy bleeding, pain or are feeling faint, call Triple Zero (000) for an ambulance or go to the nearest emergency department.

Early Pregnancy Assessment Clinic (EPAC)

The EPAC is for women under 20 weeks pregnant and experiencing complications, including:

• vaginal bleeding
• lower abdominal pain
• blighted ovum (confirmed by ultrasound) - when a fertilized egg implants in the uterus but fails to develop into an embryo, leading to early miscarriage.

We have EPACs at Auburn, Blacktown, and Westmead hospitals. 

Auburn Hospital

Your GP (doctor) can refer you to the Auburn Hospital EPAC by calling (02) 8759 3278

Blacktown Hospital

Your GP can refer you to the Blacktown Hospital EPAC by calling (02) 8670 5376

Westmead Hospital

Your GP can refer you to the Westmead Hospital EPAC by calling (02) 8890 9193

The EPAC is an appointment-only clinic for women who are located within the Westmead Hospital catchment area list (PDF 423.87KB). 

Learn more about our EPAC services or contact your nearest local hospital. 

Pregnancy and the six weeks after your baby's birth, called the post-partum period, are times when you are at higher risk of blood clots in the legs (deep vein thrombosis - DVT) and the lungs (pulmonary embolism - PE). 

Women who have a had a blood clot in the past or who have a genetic or inherited risk for blood clots may need special care during and after their pregnancy. Use the information from the factsheets and links to learn how to prevent blood clots and what to expect if you have had one in the past.

• Preventing blood clots in pregnancy and after birth factsheet (PDF 172.15KB)
• Reducing your risk of developing a blood clot
• Deep vein thrombosis (DVT)
• Pulmonary embolism (PE)

The hormones of pregnancy, as well as changes in your weight and posture, may cause pain in your joints and limbs. Some conditions are more common while pregnant like carpal tunnel syndrome and pelvic girdle pain. 

Use the information from the factsheets and links provided by the Westmead Hospital Physiotherapy Department to help you manage these problems. 

You can also make an appointment at the Physiotherapy Department at Westmead Public Hospital on (02) 8890 6500

• Backache in pregnancy
• Pelvic girdle pain in pregnancy
• Round ligament pain in pregnancy
• Carpal tunnel syndrome and pregnancy

Pregnant women sometimes get infections during and after birth. Use the information from the factsheets and links to learn more.

• Syphilis (includes translated resources)
• You, your baby and syphilis (includes translated resources)
• Don't fool around with syphilis (video)
• What is Cytomegalovirus (CMV)?
• Cytomegalovirus (CMV) and pregnancy
• Bowel multiple antibiotic-resistant organisms in pregnancy and newborns factsheet (PDF 831.22KB)

During pregnancy, some women may experience thyroid disorders where their thyroid becomes:

• underactive (hypothyroidism), due to too little iodine in their body, a pre-existing immune disorder or previous damage to the thyroid gland.
• overactive (hyperthyroidism), usually a result of a condition that stimulates the thyroid gland too much. An example is Graves' disease. 

Thyroid dysfunction affects 2 to 3 in every 100 pregnant women and should be monitored and treated where necessary. 

• Thyroid dysfunction and pregnancy
• Graves' disease in pregnancy factsheet (PDF 382.03KB)
• Iodine supplementation
• Thyroid dysfunction after giving birth

Deciding you would like a baby is an important time in your lives. Even before you start trying for a pregnancy there are many things you need to know and questions you may want to ask. 

Use information from the links and factsheets to help with what to consider before pregnancy.

• Planning a pregnancy
• Health advice for women who are trying for a baby (PDF 759.96KB)
• Prenatal tests for your baby (during pregnancy)
• Reproductive genetic carrier screening

Finding out that you are pregnant is wonderful and exciting. You will want to learn as much as you can about what to expect during your pregnancy and birth, and to speak with your pregnancy carers about any concerns and questions you may have. 

Use information from the links and factsheets to learn more about early pregnancy. 

• Hyperemesis gravidarum factsheet
• Managing nausea and vomiting in early pregnancy factsheet (PDF 1007.62KB)
• Ultrasound scans in early pregnancy (before 12 weeks) factsheet (PDF 627.39KB)
• Screen tests for your baby in early pregnancy brochure
• Being active during pregnancy factsheet (PDF 148.6KB)
• Discomforts and concerns during pregnancy factsheet (PDF 207.28KB)
• Exercise before and after birth factsheet (PDF 615.99KB)
• Sexuality during pregnancy and after childbirth factsheet (PDF 405.89KB)
• Keep your teeth and gums healthy during pregnancy
• Prenatal testing booklet
• Gestational weight gain factsheet (PDF 455.17KB)

Throughout your pregnancy you will need to attend the antenatal clinic regularly to have your and your baby's health checked. There are range of pregnancy care options including:

• midwife care
• shared GP care
• care by the hospital doctors

You and the hospital staff can decide which option is most suitable for you. For more information and to book in an appointment visit the women's health clinic page. 

Use information from the links and factsheets to learn more about antenatal care and clinic visits, and what to do during your pregnancy.

• Antenatal clinic visits schedule factsheet (PDF 362.38KB)
• Routine antenatal tests during pregnancy
• Ultrasound tests needed during pregnancy factsheet (PDF 584.96KB)
• Chorionic villus sampling (CVS)
• What to expect after your CVS procedure factsheet (PDF 161.69KB)
• 18-to-20-week morphology scan factsheet (PDF 245.46KB)
• Non-invasive Prenatal Testing (NIPT)
• Why your baby's movements matter
• Fetal heart rate monitoring (CTG)
• Monitoring baby's heart rate with cardiotocography (CTG) factsheet (PDF 1.19MB)
• Graves' disease
• Graves' disease factsheet (PDF 382.03KB)
• Falls prevention for mothers and newborn babies factsheet (PDF 181.79KB)
• Perineal massage (at 34 or 35 weeks) factsheet (PDF 1.14MB)
• Chromosome microarray (CMA) testing during pregnancy factsheet
• Diagnostic tests during pregnancy factsheet
• When you are having your baby
• Having a healthy pregnancy
• Every Week Counts - timing of birth
• Every Week Counts - resources in Arabic, English, Hindi, Korean and Mandarin
• Captioned video: Let's talk timing of birth

You may find a lot of confusing, and sometimes contradictory, information on what you should or should not be eating while you're pregnant. Family and friends may also add to the confusion by giving personal advice.

Use information from the links and factsheets about diet, vitamins and supplements during pregnancy, which can help guide you.

• Alcohol during pregnancy and breastfeeding
• Foods to eat or avoid when pregnant
• Nutrition advice during pregnancy
• Food safety during pregnancy and what goods to avoid factsheet (PDF 315.7KB)
• Ideal weight gain during pregnancy factsheet (PDF 114.01KB)
• Important nutrients during pregnancy factsheet (PDF 476.56KB)
• Vitamin D during pregnancy and for infants factsheet (PDF 880.51KB)
• Pregnancy supplements: folate and iodine
• Foods high in iron
• Iron needs in pregnancy brochure (PDF 13.77MB)

Use information from the links and factsheets to learn more about important vaccines recommended before and during your pregnancy and for newborn babies. 

• Vaccinations before, during and after pregnancy
• Rhesus D negative in pregnancy
• Vitamin K at birth
• Influenza information for pregnant women
• Pregnant women: Protect your newborn from whooping cough
• Hepatitis B vaccination for babies
• Whooping cough (pertussis) in pregnancy and newborns factsheet (PDF 361.25KB)
• FAQs about COVID-19 for pregnant women and new parents
• Pregnancy, parenting and COVID-19
• COVID-19 vaccination and pregnancy factsheet (PDF 424.94KB)
• Infant RSV immunisation product (nirsevimab) factsheet
• Captioned video: RSV vaccine by Dr Woods (NSW Health)

The hormones of pregnancy, as well as changes in your weight and posture, may cause pain in your joints and limbs. Some conditions are more common while pregnant like carpal tunnel syndrome and pelvic girdle pain. 

Use information from the factsheets provided by our physiotherapy department and the links to help you manage these problems. 

For appointments, call the Physiotherapy Department at Westmead Hospital on (02) 8890 6500

• Carpal tunnel syndrome and pregnancy
• Carpal tunnel syndrome in pregnancy factsheet (PDF 770.2KB)
• Physical activity and exercise for pregnancy
• Exercise before and after pregnancy factsheet (PDF 615.99KB)
• Pelvic Girdle Pain (PGP) in pregnancy factsheet (PDF 258.51KB)

​Smoking causes harm to babies even before they are born. Cigarette smoke contains more than 7,000 chemicals, (including about 70 that are known to cause cancer).

You and your baby are exposed to these chemicals when you smoke or when someone smokes around you.

Use information from the factsheets and links to learn about smoking harm during pregnancy and birth and getting support to quit.

• Tobacco smoking and pregnancy
• Smoking and pregnancy
• Carbon monoxide monitoring in pregnancy (video)
• iCanQuit - NSW Quitline
• Services to help you quit smoking
• No Butts Baby - Smoking in pregnancy Part A - Myths and facts (video)
• No Butts Baby - Smoking in pregnancy Part B - Support to quit (video)

Can I see a female member of the health care team?

Occasionally, women ask if they can see a female healthcare team member. However, this is not possible in our emergency care areas. All our male and female staff are highly trained and will look after you with care and respect.

We allocate care based on our staff's skills and experience so that you receive the best and fastest care. You could suffer harm if you decline care based on the gender of the caregiver.

If you are being cared for by a male health professional, you can ask for a female staff member also to be present. In many (but not all) situations, a family member or friend can also be present.

In our pregnancy or gynaecology clinics

In our pregnancy clinic, we will try to provide you with a female team member if it's important to you. You may have to wait longer for this. It is easier to see a woman if you are seeing a midwife, as most midwives are female.

If you are assigned to a doctor's clinic, you may be able to see a female depending on them having the right experience for your care. It will also depend on the care other pregnant women in the clinic need that day.

Our gynaecology clinic is smaller with fewer staff than our antenatal (pregnancy) clinics. Sometimes, we may not have any female staff or no one with the right experience to look after you. Learn more about our gynaecology services.

Talk to the hospital staff if you wish to see a female healthcare provider in the clinic. Please remember we will not always be able to meet your request.

In an emergency care area

Only a few staff are rostered across our emergency care areas, especially after hours. Here, care is more urgent, including treatment required by other patients. Many emergency staff are male.

For safety, it is necessary to match our staff's skills and experience with our patients' needs.

We cannot provide staff based on gender in our emergency care areas, including:

• the birth unit, antenatal and postnatal wards
• operating theatres, including for elective surgery
• Neonatal Intensive Care Unit (NICU)
• adult intensive care
• emergency department
• x-ray and ultrasound.

Our emergency care teams are well trained and will take good care of you. 

Declining care based on gender in an emergency care area may cause delays, which could lead to serious harm. Other patients may also be affected. 

The hospital will always consider the needs of every person under its care. Learn more about our emergency care services.

Find information about pregnancy and the first 5 years of your child's life, and NSW Health services that can help you along the way.​​​​

There are services and resources that offer support and will answer important questions. It’s important to look after yourself and your baby during pregnancy.

Use the information from the factsheets and links to learn more about having a healthy pregnancy.

• Airline travel during pregnancy factsheet (PDF 180.9KB)
• Ideal weight gain in pregnancy factsheet (PDF 114.01KB)
• Sexuality during pregnancy and after childbirth factsheet (PDF 405.89KB)
• Mental health help for parents and babies

Use the information from the factsheets and links to learn more about what to do immediately after baby is born.

• Skin-to-skin contact
• Your baby after birth
• The first week
• Vitamin K for newborn babies (includes in-language translated resources)

Blood clots, also known as Deep Vein Thromboses (DVT), are a leading cause of preventable death in Australia. During pregnancy and the postnatal time, you are at higher risk of blood clots. 

Most blood clots occur in the deep veins of the legs. Occasionally these clots break free and move to other parts of the body, in particular the lungs. This is called a pulmonary embolism (PE) and it can have very serious consequences.

Early detection and treatment of clots can help reduce the risk of harm. 

Read the preventing blood clots in pregnancy and after birth factsheet (PDF 172.15KB).

During pregnancy and labour your body will have undergone many changes. Post-birth recovery can take months and takes time and patience. 

Breastfeeding, gentle exercise and a healthy diet will help with gradual weight loss. Find more information on healthy lifestyle choices for new parents

Your uterus

It takes about 6 weeks for your uterus to return to pre-pregnancy size and during this time it is normal to experience period-like bleeding. 

Most women have red, moderately heavy bleeding for 2-4 days, which lessens to a lighter coloured discharge (called lochia) which may continue for up to 6 weeks. 

Note: If you notice that the blood has a bad smell, becomes heavy or bright red again, please inform your GP or midwife or go to your nearest hospital emergency department.

Afterbirth pains

During these early days you will usually feel abdominal cramping or afterbirth pains. These pains may be most noticeable when you are breastfeeding; they are part of your body’s recovery after birth.

Your first period after birth

Your first period may return after 6 weeks. If you are exclusively breastfeeding, it may take longer before you have a period.

Post-delivery constipation

Constipation can occur post-delivery particularly if you have a bruised perineum or stitches. Drinking plenty of water, eating fresh fruit, vegetables and other high fibre foods will help counteract this problem. Light exercise also helps prevent constipation. 

Use the information from the factsheets and links to learn how to care for your body after having your baby.

• Your body after having a baby
• Looking after your body after having a baby
• Recovery from birth

Just after your baby’s birth there will be minimal changes to your breasts. The first yellow milk your breasts make is called colostrum. 

When your ‘mature milk’ comes in, around day 3 or 4, your breasts will start to feel heavy and full. When your milk has come in, it is important to wear a well-supported, fitted bra and you may also wish to use breast pads to absorb any unexpected leaking.

It is helpful to read about breastfeeding before delivery. Attending breastfeeding classes and getting yourself well prepared beforehand should also help you to breastfeed successfully.

Learn more about breastfeeding your baby and breast health.

During the first days after a vaginal birth, you will experience some perineal pain and swelling. The symptoms may be worse if you have needed stitches. Regular pain relief tablets and ice packs are recommended to help with your recovery.

Once the area has started to heal it is recommended that you commence regular pelvic floor exercises. These will strengthen the muscles and decrease the risk of stress incontinence, which is losing small amounts of urine when coughing, laughing or exercising.

Speak to the staff about these exercises and try to attend the physio class in our postnatal ward, which provides information about pelvic floor exercises. The class runs Monday to Friday at 9:30am.

Use the information from the factsheets and links to learn how to care for perineum and pelvic floor.

• Caring for your perineum factsheet (PDF 367.03KB)
• Pelvic floor exercises factsheet (PDF 423.44KB)
• Pregnancy, childbirth and continence resources for expectant and new mums

Learn more about treatment options for pelvic floor problems.

What is a third- or fourth-degree tear?

Many women have tearing of the tissues between the vagina and anus (back passage) during the birth of the baby. If these tears extend into the anal sphincter muscle around the anus, they are called a third- or fourth-degree tear.  

The anal sphincter muscle helps control flatus (wind) and faeces or bowel motions, so it is very important it heals well.

Ways to assist healing

Good hygiene is important for the healing process. Keep the area clean, wash and pat dry after each visit to the toilet. Regular ice packs wrapped in a damp cloth will help reduce swelling. 

Apply the ice packs to your perineum for up to 10-20 minutes at a time and change every 2 hours. Use a sanitary pad or toilet paper to support the stiches when you open your bowels. 

Avoiding constipation

It is important to avoid constipation, as straining can cause the repair to break down. Other ways to help avoid or effectively manage constipation include:

• drinking plenty of water, at least 2 to 2.5 litres per day.
• having a high fibre diet such as fruit, vegetables, wholegrain breads and cereals.
• taking a fibre supplement such as psyllium, Fybogel, Normacol, Metamucil, or Movicol every day for at least 3 months (complete healing takes a few months).
• avoiding painkillers containing codeine (Panadeine, Codral) and oxycodone (Endone) as these can cause constipation. For more women the best painkillers to consider are paracetamol and anti-inflammatory medications like ibuprofen (Nurofen). 

Healing stiches

Once you have returned home, if you experience an increase in pain from the stitches or discharge from the anus, call the Westmead Hospital Women's Health Clinic at (02) 88906508

Review of sphincter healing

The best way to check healing of the anal sphincter is with a specialised ultrasound called an endoanal ultrasound. It is performed between 6-12 months after the birth and conducted in the Anal Ultrasound and Physiology Clinic at Westmead Hospital. 

This examination, which only takes a few minutes, places a narrow probe into the lower 2-3 cm of the anal entrance to easily assess the tissue healing. It is not painful but can be a little uncomfortable if some of your stiches have not yet dissolved.

If you have not heard back from the clinic about your appointment, please call (02) 88890 7668 to check if your referral has been received. 

Pelvic floor exercises

Pelvic floor muscle exercises are important for all women after having a baby and can be started soon after birth. Learn more about caring for your perineum and pelvic floor and read the exercise before and after birth factsheet (PDF 615.99KB).

Physiotherapy review

A physiotherapist will contact you around 6 weeks after giving birth. Always refer to the appointment details provided to you. 

If you are having difficulty controlling wind or bowel motions or with urine leakage, contact the Women's Health physiotherapist at the following locations:

• Auburn (02) 8759 3177 or (02) 8759 3176
• Blacktown (02) 9881 8302
• Westmead (02) 8890 6500

After giving birth, you may experience back ache as your body recovers from pregnancy and labour. It is important to take care when bending and lifting after delivery. 

Avoid lifting heavy objects and always bend from your knees not your back. Being conscious of your posture while sitting and breastfeeding will also limit back pain.

While in hospital try to attend physiotherapy, classes are held in the ward from Monday to Friday and starts at 9:30am.

Read the exercise before and after birth factsheet (PDF 615.99KB).

A new baby will change the dynamics of the relationship between you and your partner. This is a time of great happiness, but it can also be emotionally stressful becoming parents. 

Regular and honest communication between you and your partner is very important. Consider having time together without the baby so that you can enjoy each other’s company.

The time frame when a couple wish to become sexually intimate again after birth varies greatly. Before having intercourse (sex) again, it is generally recommended to wait for any vaginal bleeding to settle down (usually about 4 weeks) and for any stitches to dissolve (usually about 4- 6 weeks). 

It is important that you feel secure and comfortable about having sex again. The changes your body has undergone, and the hormones of breastfeeding may affect your sex drive. Be kind to yourself - some couples will need to spend time being intimate in other ways (kissing and cuddling, etc.) before recommencing sex.

Before having sex, you will also need to think about contraception. Remember that it is possible to fall pregnant as soon as 4 weeks after your baby’s birth, even before having had your first period.

You may be able to restart your previous birth control methods, or you may need to use something else. Talk to the staff before you leave hospital, or to your GP, to find out what options may be suitable for you.

Use the information from the factsheets and links to learn about sex and contraception after birth.

• Mirena® IUD insertion after birth factsheet (PDF 2.88MB)
• Sexuality during pregnancy and after birth factsheet (PDF 405.89KB)
• Contraception factsheet (PDF 291.83KB)
• Long-Acting Reversible Contraceptives after birth factsheet (PDF 499.73KB)
• Progesterone only Pill contraceptive for breastfeeding women factsheet (PDF 196.03KB)
• Translated resources for women on contraception
• Vasectomy: permanent contraception for men factsheet (PDF 415.19KB)*
• Permanent contraception for women factsheet (PDF 275.03KB)

Note: Westmead Women's Health Clinic does not offer the vasectomy service. Men will need to seek a referral from their GP. 

Use the information from the factsheets and link to learn how to register the birth of your baby.

• Register a birth
• Register a birth online form
• Register your baby's birth and get their birth certificate
• NSW Registry of Births, Deaths & Marriages

Videos on how to register your newborn

videocam 1:01

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Video transcript

BDM NSW: Registering your newborn - made easy

[Background music playing. Screen shows an animated bear waving and pointing to the video title, which reads 'Registering your newborn made easy]
Female voiceover: Congratulations on your new baby!
[Screen shows a brown teddy bear flying in a small yellow and blue airplane with a streamer attached that says 'congratulations'. Text below the streamer says 'on your new baby']
We know how busy this special time is,
[Screen shows small icons of baby items like rattle, socks, feeding bottle, a bib and a rubber duck appearing one after the other. Below text reads 'we know how busy this special time is']
so now you can register your Newborn online.
Screen shows a rabbit with a bow and dress holding a tablet device, on the screen it reads 'you can register your newborn online']
The Birth registration and Birth certificate application
[The screen of the tablet the rabbit is holding changes to show different lines to indicate a form or application. Next to tablet, text reads 'the birth registration and birth certificate application]
are combined in one easy online transaction.
[Rabbit now is standing on the left side, with text on the right that reads 'are combined in one easy online transaction'
Registering your baby’s birth is FREE,
[screen shows a bear with a bow tie holding a sign with the word 'FREE' on it. Text to the bear's right reads 'registering your baby's birth is...' the word 'FREE' on the sign grows bigger and out of the sign]
and creates their legal identity.
[Screen shows a baby holding a sign that has 'legal identity' with a tick mark on it. On the baby's right text appears which reads 'and creates their legal identity']
In New South Wales, you need to register your baby within 60 days.
[Screen shows a white shape of the state of NSW with the words 'Register within 60 days' below it. A baby elephant wearing a crown and bowtie appears next to the text]
When you register your baby, you can also purchase a Birth certificate.
[Screen shows a rabbit with a bow and a dress holding a credit card. Text above reads 'Purchase a certificate now'. A bear with a bowtie holding a piece of paper with the words 'Birth Certificate' and a ribbon appears to the right of the screen]
Or, if you wish you can apply for a certificate later.
[Text changes on the screen to read Apply for certificate later]
A standard birth certificate helps to organize your child’s education, travel, legal and other benefits.
[screen shows a baby with arms outstretched and smiling, with text to it's right that reads 'a birth certificate helps to organise'. A series of icons from the left appear, a set of alphabet blocks, a flying airplane, a medical cross and items indicating food]
Certificates are mailed safely to your home.
[Screen shows a red post box with several letters inside. Text to it's right shows certificates are mailed safely to your home.]
If you’re the parent or guardian of a Newborn, give your child the right start!
[Screen shows a baby sitting and playing with blocks, two butterflies fly around the baby in the background. Text above the baby reads as 'give your child the right start!]
Register your baby at www.bdm.nsw.gov.au
[Screen shows text www.bdm.nsw.gov.au with an arrow that hovers above to indicate a website link]
[Background music fades]

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Video transcript

Justice NSW: Indigenous Birth registration - made easy

[Screen with a white background with colourful text that reads 'our kids count']
Treena Cutmore: 
It’s really important to register your child within the first 60 days of being born.
The reason being...for enrolment into early childhood or big school...and identification
Bianca Roberts: 
Alahni was born in October 2013 out at Randwick at the Royal Women’s Hospital
She’s a very fun child... very ‘out there’ as you may have seen already. She keeps me very busy! (laughs)
Treena Cutmore: 
I’ve worked in early childhood for 34 years. With my current employment, I’ve seen a few issues with parents getting their child enrolled due to not having their child registered... and that delayed their process for them starting childcare.
Bianca Roberts: 
It was important to register Alahni because I wanted to go back to work pretty soon after she was born. I think she was about 18 months when I did. So already having her registered and having her birth certificate made the enrolment process a lot easier. 
Treena Cutmore:
If Aboriginal parents need help, they can ask the social worker at the hospital or go to the local Aboriginal Medical Service to help register their child. By registering your baby, it opens up opportunities for your child later in life.
Bianca Roberts: 
When I registered Alahni, it was all paperwork. Now they have an online registration format. 
If you need a paper form, they can provide those for you. You get everything you need when you leave the hospital, all of your forms and details. It's an easy and quick process so I found it to be good...yeah. 
Treena Cutmore: 
I think it's really important that new mums talk about registering their child because our kids need to be counted, our Aboriginal children.
Bianca Roberts: Our kids count, register your baby. 
Treena Cutmore: 
It's really important to register your child within the first 60 days. 
Bianca Roberts: 
You can register your child at any time even if you missed the 60-day period. 
Treena Cutmore: 
Just remember it is your responsibility to register your baby. 
Bianca Roberts: 
It's free to register the birth of your baby. If you need help registering your child there's help down at Births Deaths & Marriages. Go visit them or give them a call!
[Alahni's voice singing in the background]
[Screen with a black background with white text. Text reads: To find how to register your baby, visit www.bdm.gov.au/newborn or call 13 77 88]
[NSW Government logo appears in the background]

Smoking and vaping harms you and your baby. We know that smoking and vaping affects your health in the long-term by increasing your risk of lung cancer and other diseases, and can also:

• cause miscarriage and stillbirth (babies dying inside the womb before birth)
• increase the risk of premature birth
• prevent your baby from growing properly in the womb
• increase the risk of SIDS (sudden infant death syndrome) in newborns
• increase the risk of asthma in babies and young children

There are several different approaches to quitting smoking. Your doctor or midwife can provide advice and resources to help you quit and refer you for ongoing support if you wish.

• Smoking and vaping during pregnancy (includes links to translated resources)
• Passive smoking and vaping (includes links to translated resources)
• Resources for supporting psychosocial health in pregnancy
• E-cigarettes (vapes) and the facts about vaping
• Shisha (waterpipe) smoking for pregnant women and young families factsheet (PDF 181.69KB)

The NSW Quitline can help you stop smoking. 

Alcohol in pregnancy

Drinking alcohol while you are pregnant can result in long-term harm to your baby. Drinking heavily or having binge drinking sessions, can cause your baby to develop fetal alcohol spectrum disorder (FASD) which leads to some, or all, of the following:

• babies not growing properly
• abnormalities in the child's facial appearance
• learning and memory difficulties
• problems with behaviour
• eyesight and hearing difficulties
• poor coordination
• heart and kidney defects

The chance of your baby being harmed is low if you drink only occasional small amounts of alcohol. However, the truth is that we don’t know what a safe amount of alcohol intake during pregnancy is. The safest approach is not to drink alcohol at all if you are pregnant or planning a pregnancy.

Many pregnancies are unplanned and often women find they have been drinking small amounts of alcohol before they knew they were pregnant. This is unlikely to have harmed your baby, but you should stop drinking once you discover you are pregnant.

Some women find it hard to control their drinking. If you are having difficulty, please speak with our staff immediately. We are happy to provide you with help and support and refer you for help if you wish.

• Alcohol and pregnancy
• Alcohol use while pregnant
• Fermented drinks and alcohol factsheet
• Australian guidelines to reduce health risks from drinking alcohol

Alcohol and breastfeeding

Alcohol passes into breast milk and to the baby. Alcohol can affect your baby’s feeding and sleeping patterns. It takes at least one hour after a standard drink for the alcohol to leave your body completely. It is best to stop breastfeeding for this time period. 

Do not breastfeed if you are feeling tipsy or drunk. If you are planning to have a drink it is best to express and store breast milk before having alcohol and use the expressed milk to feed your baby.

• Alcohol and breastfeeding
• Alcohol, pregnancy and breastfeeding
• Alcohol during pregnancy and breastfeeding
• How alcohol affected breastfeeding (video)
• What women want to know about pregnancy and alcohol (video playlist)

Prescription medications

Many women worry that regular medications they are taking will affect their pregnancy. While some medicines may be a problem for pregnancy it is very important NOT to stop taking your regular medicines without discussing this with your doctor first. 

Abruptly stopping medications can make you very unwell, which is dangerous for you and your baby. Some prescription medications such as Buprenorphine or methadone can be continued through your pregnancy. 

Substance Use in Pregnancy and Parenting Services (SUPPS) team can liaise with you and your prescribers to ensure the right care plan is created for you and your baby.

Mothersafe provides free telephone advice concerning medications in pregnancy for all women in NSW. If you based in the Sydney Metropolitan area call (02) 9382 6539, for non-metropolitan areas call 1800 647 848

Note: While the Mothersafe service is based at Royal Hospital for Women in Randwick, you should follow-up your query at Westmead Hospital with your doctor or midwife.

• Medicines during pregnancy
• Vitamins and supplements during pregnancy

Illegal (street) drugs

Illegal drugs can be harmful for both you and your unborn baby. If you are a regular drug user, we encourage you discuss this with your doctor or midwife. Simply stopping drugs can be dangerous for you and your baby. 

We can advise safe ways to stop using and refer you for help with quitting. If you use heroin, we can help you change to methadone which is safer for you and your baby. Using drugs in pregnancy can be harmful and include:

• increased chances of miscarriage, stillbirth (the baby dying in the womb) and increased risk of sudden infant death syndrome
• causing your baby to not grow properly
• causing problems with the placenta (the afterbirth which feeds the baby during pregnancy)
• causing birth defects
• causing withdrawal symptoms after baby is born leading to babies being irritable, feeding poorly or having fits.
• if you share syringes and catch Hepatitis or HIV these viruses can pass into the baby’s blood in the womb and infect your baby.

The NSW Health Your Room website provides information on many different street drugs and how they affect pregnancy. You can access further resources and support at:

• ADIS (Alcohol and Drug Information Service) - in Sydney call (02) 9361 8000 or regional 1800 422 599
• our Alcohol and other drugs service - call (02) 8860 2565
• CRACKS in the ICE

Neonatal Abstinence Syndrome (NAS)

Your newborn may experience symptoms of drug withdrawal if you have been using certain prescribed or non-prescribed drugs, and/or alcohol. This is called Neonatal Abstinence Syndrome (NAS) and can cause irritability, poor feeding and sleeping, and even fits (convulsions).

The SUPPS Drug Health team will talk with you about what you can expect for your baby after birth. Your baby will be monitored for signs of withdrawal and may require admission to the Newborn Intensive Care Unit’s nursery rooms for management of any withdrawal symptoms.

You will also be able to talk with the Neonatologist about the care for your baby.