Westmead pregnancy services

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  

We understand that you may prefer to have your care provided by a female staff member however, it is important to be aware that our team includes male midwives, doctors, anaesthetists, paediatricians and students.

Your health and safety is our priority. We provide the most appropriate person for your care. We cannot promise that you will only have care provided by female staff. If care with only female staff is important to you, you may need to arrange a female private doctor for your pregnancy or gynaecological care.

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.

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.

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 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 Westmead Hospital
on 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.

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. 

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?

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. 

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

The breech clinic is for women whose babies are in a ‘bottom first’, also called ‘breech’ position. 

Towards the end of pregnancy, if your baby is in a breech position when you are more than 35 weeks pregnant,  it is unlikely to turn into a head down position for birth.

There are a number of choices that can be offered to you by the team at the Westmead Breech clinic to manage the last weeks of your birth and pregnancy. 

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

You need to be referred to the breech clinic by your local doctor (GP), your midwife or your obstetrician, they can make an appointment for you. 

If you need to change the appointment you can telephone 8890-6508. Your GP, midwife or obstetrician can also call the Clinical Midwifery Consultant for Breech Clinic on 8890-7993 or 0409 708 130. 

A referral letter (PDF 200.49KB) will need to be completed by your provider and emailed to WSLHD-WestmeadPregnancyBookings@health.nsw.gov.au

Your GP, midwife or obstetrician needs to order an ultrasound scan of your baby before you come to the clinic if you do not already have a recent one.

The ultrasound looks at the amount of fluid around your baby, how big your baby is and where the placenta (afterbirth) is. 

This helps us to decide how best to manage your pregnancy and birth. An information factsheet about External Cephalic Version (turning the baby) will be given to you so that you will have an idea of what we will be discussing appointment.

The breech clinic team consists of an obstetrician, an obstetric registrar and a midwife. 

The team are experts in breech pregnancy and birth and safety is our main concern. 

We will also see you in Birth Unit if you are having a vaginal breech birth and on the Maternity Ward after the birth of your baby.

At your appointment you will be able to plan your care with our team. You may think that you have no choice but to have a caesarean section, this is not the case. At your appointment we will talk with you about trying to turn the baby to a “head down” or cephalic position. This is called an External Cephalic Version (ECV) (PDF 536.18KB). 

If you choose to have an ECV and your baby turns you will return to your main pregnancy carer (Midwife or Doctor) and plan for a normal vaginal delivery. If you choose not to have an ECV or we cannot turn the baby, we will then talk about your birth options with you so that you can decide whether to have a vaginal breech birth or a caesarean birth (PDF 615.98KB).

If you choose to have a vaginal breech birth sometimes we need to send you for extra tests, such as a CT scan or another ultrasound scan. You will be able to talk about all of your options at your visit. 

After birth your baby's hips will need an ultrasound scan at 6 weeks of age due to the way they were positioned in the uterus. All breech babies will be offered this ultrasound scan after birth whether they were born vaginally or by caesarean section. 

The maternity ward will give you the ultrasound referral form for this ultrasound scan. This is a routine test to check your baby's hips are normal and do not require any other treatment. At your appointment you can ask as many questions as you need so that you are confident and informed about your choices  

You will find the breech clinic in the Women’s Health Clinic, level 2, G Block at Westmead Hospital. 

You will find the breech clinic in Women’s Health Clinic which is to the left of the Information Desk at entrance 4. 

When you arrive please see the Women’s Health Clinic receptionist. 

The breech clinic takes place every Monday between 1:30pm - 5:30pm (excluding public holidays).

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.