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Government of Western Australia
North Metropolitan Health Service Have this book
with you at your
appointments
and when you
have your baby
Pregnancy,
Birth and your Baby
A guide to your care with
King Edward Memorial Hospital | Family Birth Centre | Community Midwifery Program
WNHS
Community
Advisory Council
your
voice 1Pregnancy, Birth and your Baby Pregnancy, Birth and your Baby
Table of Contents
Important Information and Contacts............................4
About this book............................................................4
3 Taking care of yourself 5 Giving birth 7 Breastfeeding
Nutrition for you and your baby.................................19 Preparing for labour...................................................59 Benefits of breastfeeding...........................................96
Morning Sickness......................................................21 What to bring to hospital............................................59 Getting started...........................................................96
1 Pregnancy care options Food safety and hygiene...........................................22 Medications...............................................................60 The first few days......................................................97
Exercise.....................................................................23 What to pack for your stay.........................................60 Feeding cues.............................................................99
Welcome......................................................................6
Managing common aches and pains.........................24 Your birth plan...........................................................61 How breastfeeding works..........................................99
Pregnancy care options...............................................7
Medications and alternative medicines.....................26 Support in labour.......................................................61 Signs your milk is flowing........................................100
Community Midwifery Program................................7
Midwifery Group Practice.........................................7 Common concerns in pregnancy...............................27 How do I know I’m in labour?....................................62 How long to feed your baby.....................................100
Hospital Antenatal Clinic Midwives..........................7 Drugs and alcohol in pregnancy............................27 When labour begins..................................................62 Signs baby is getting enough..................................101
Shared Care.............................................................7 Smoking.................................................................27 Stages of labour........................................................64 Helping your baby to breastfeed.............................101
GP Shared Care.......................................................7 Dental care................................................................28 Delivering your placenta after the birth of your baby.....65 Nipple care..............................................................102
Private Practicing Midwife........................................7 Cytomegalovirus (CMV) and pregnancy...................28 Keeping your placenta...............................................65 Hand expressing.....................................................102
Antenatal Clinic – Obstetric Doctor Care ................8 Immunisations and vaccines ....................................29 Pain management in labour......................................66 Expressing with an electric breast pump.................103
Private Obstetric Care..............................................8 Work and pregnancy.................................................29 Pain relief..................................................................66 Storage of breast milk.............................................105
Family Birth Centre......................................................8
Air travel ...................................................................29 Monitoring your baby during labour...........................68 Thawing and warming of breast milk.......................105
Wearing seat belts.....................................................29 Assisted birth.............................................................68 Engorgement...........................................................106
2 Services and support Emotional ‘ups and downs’........................................30 Water birth.................................................................70 Blocked ducts..........................................................107
Depression and anxiety.............................................30 Mastitis....................................................................108
Visiting Hours............................................................10 Emotional health and wellbeing.................................31 Dummy use while breastfeeding.............................108
Aboriginal Liaison Officer at KEMH...........................10 Your partner’s feelings...............................................31 6 After the birth
Agnes Walsh House Lodge.......................................10 Abuse........................................................................32 Immediately after birth...............................................74
Crèche.......................................................................10 Sex during pregnancy ..............................................32 Your baby...............................................................74 8 Unexpected outcomes
Interpreters – Language Services.............................10 Coping alone.............................................................32 You.........................................................................74 Bleeding during pregnancy......................................110
Outpatient Pharmacy.................................................11 Preventing falls after you have had your baby..........75 Miscarriage..............................................................110
Pastoral Care Services..............................................11 Tests and medications for your baby during the first
Women and Newborn Health Library........................11 4 Your visits few weeks of life........................................................76
Problems with the placenta ....................................110
Breech baby............................................................110
Are you or your baby of Aboriginal or Torres Strait Newborn blood spot screening test...........................77
What is a routine check up?......................................34 High blood pressure................................................110
Islander origin?..........................................................11 Hearing screen..........................................................77
Tests available in pregnancy.....................................34 Pre-eclampsia.........................................................110
Department of Psychological Medicine.....................12 Pain relief after the birth of your baby.......................77
Screening tests..........................................................34 Gestational diabetes................................................ 111
Violence and sexual assault......................................12 Going home...............................................................78
Diagnostic tests.........................................................35 Premature labour and birth...................................... 111
Providing feedback....................................................12 Discharge medications at KEMH...............................78
Gestational Diabetes screening................................35 Non-elective caesarean...........................................112
Social Work Department............................................12 Support at home........................................................79
Your first appointment................................................35 Jaundice..................................................................112
Women living with a disability ...................................12 Postnatal care and the first six weeks.......................79
What happens at the first visit? .............................35 Intensive and Special Care.....................................112
Privacy of your personal information.........................13 After pains..............................................................79
Rhesus D negative in pregnancy..............................36
Public or private admission at KEMH only................13 When a baby dies....................................................112
Between 12 and 20 weeks........................................37 Bleeding.................................................................79
If you don’t have a Medicare card.............................13 Pelvic floor exercises.................................................81 Women and Infants Research Foundation..............112
Thinking about breastfeeding....................................38
Student health professionals.....................................13 Caesarean wound care.............................................81 Find out more..........................................................114
What is the placenta?............................................38
Community Advisory Council.....................................13 Contraception............................................................82 Women and Newborn Health Service contact details.....114
Braxton Hicks contractions....................................39
Parent Education.......................................................14 Ultrasound booking................................................39 Sexual intercourse.....................................................82 Websites about pregnancy and parenting...............115
Obstetric Medicines Information Service...................14 Between 21 and 33 weeks........................................41 Six week postnatal check..........................................82 Glossary..................................................................116
Breastfeeding Support and Information.....................15 At 26 weeks...........................................................42 Contraceptive Methods.............................................84 Find out more..........................................................118
Ten Steps to Successful Breastfeeding.................15 At 30 weeks...........................................................42 Sexuality and Childbirth.............................................86 Are you worried?.....................................................119
King Edward Memorial Hospital (KEMH) special Preparing you for your hospital stay......................42 Physical factors.........................................................86
services.....................................................................16 Diabetes in pregnancy...........................................43
Emotional factors:......................................................86
Parent Education...................................................16 Between 33 and 40 weeks........................................48
When is it okay to start having sex?..........................86
Antenatal classes...................................................16 At 36 weeks...........................................................48
Hospital tours.........................................................16 Postnatal depression and anxiety.............................88
Group B Streptococcus (GBS)................................48
Childbirth and Parenting Courses..........................16 Monitoring your baby during your pregnancy.........50 Community Child Health Nurse.................................89
Breastfeeding workshop........................................17 Things to talk about with your midwife or doctor....51 All About Me - Personal Health Record
Physiotherapy classes...........................................17 Between 40 and 42 weeks........................................52 (the purple book).......................................................90
Vaginal birth after caesarean (VBAC) class...........17 Management of Prolonged Pregnancy .................54 Settling your baby......................................................90
Planning a positive caesarean birth class..............17 Induction of labour.................................................55 Financial support and benefits..................................91
Multiple birth class.................................................17 Safe Infant Sleeping..................................................92
Family Birth Centre....................................................17 Sudden Unexpected Death in Infants (SUDI)............94
Community Midwifery Program.................................17
2 3Pregnancy, Birth and your Baby
Pregnancy, Birth and your Baby
Important Information and Contacts
Outpatient Clinics:
To change your appointment or check on the progress of your referral, please phone Outpatient Direct
(OPD) 1300 855 275.
Community Midwifery Program (CMP) or Midwifery Group Practice (MGP), phone your midwife on
his/her mobile.
In the first 20 weeks After 20 weeks
If you are in your first 20 weeks of pregnancy and If you need urgent care contact the
you experience pain or bleeding you can contact Maternal Fetal Assessment Unit (MFAU) on
the King Edward Memorial Hospital Emergency (08) 6458 2199 anytime day or night.
Centre on (08) 6458 1431 anytime day or night.
When to contact us: King Edward Parking
Memorial Hospital
Call your midwife, doctor or MFAU Two hour parking is
(24-hours-a-day) if you experience KEMH is located at permitted on a number of
any of the following. Do not wait 374 Bagot Road, Subiaco. streets surrounding the
until your next appointment. Hospital. It is recommended
How to get here you park your car in the
• Unusually strong headaches patient/visitor carpark
• Vision problems Public transport located on Hensman Road
• Stomach pain Bus Route 27 stops right or one of the Subiaco City
outside the front door of the Council’s carparks, as your
• Swollen hands and/or face hospital on Bagot Road. appointment or visit may
• Nausea and vomiting with or take longer than the parking
without diarrhoea The closest train stations
time allows.
to KEMH are at Daglish
• You think you are in labour (670 metres) and There are two ACROD/
• Very itchy skin Subiaco (1 km). disabled parking bays
• Fever located at the front of the
Planning your trip by
Hospital and two in the
• Urinary problems public transport is made
Hensman Road carpark.
• Watery and/or greenish vaginal easy by using the website
discharge www.transperth.com.au Please be aware, not
or calling 13 62 13 for following parking signs at
• Reduced baby movements information on bus/train KEMH and/or in the City of
1
• Any concerns or worries routes and timetables. Subiaco may result in a fine.
About this book
The information provided in this book has been supplied with the aim of providing you with health
information and information about the choices you have once pregnant. If you read this book and decide
you need further information on any topic please talk to your doctor or midwife or visit us at:
Pregnancy care
www.kemh.health.wa.gov.au and www.healthywa.wa.gov.au
Please note that if you wish to contact King Edward Memorial Hospital via telephone our switchboard
number is (08) 6458 2222.
Fact sheets and brochures
More information can be found at: www.kemh.health.wa.gov.au
KEMH Family Birth Centre Community Midwifery Program
options
(08) 6458 2222 (08) 6458 1800 (08) 9301 9227
4 51
Pregnancy, Birth and your Baby
Pregnancy care options
This first section outlines the types of care and birthing locations available to you with the
Women and Newborn Health Service (WNHS). Depending on the reasons for your referral
Welcome you may have the opportunity to choose pregnancy care options at King Edward Memorial
Hospital, The Family Birth Centre (FBC) or with the Community Midwifery Program (CMP).
Congratulations on your pregnancy and welcome to
The Women and Newborn Women and Newborn Health Service, incorporating King King Edward Memorial Hospital Midwifery Group Practice
Health Service respectfully Edward Memorial Hospital, the Family Birth Centre and King Edward Memorial Hospital (KEMH) Midwifery Group Practice (MGP) provides
acknowledges the Noongar the Community Midwifery Program. offers world-class care and wide-ranging women with pregnancy care from the same
people, both past and present, support services to WA women with small group of midwives.
the traditional owners of the This booklet is designed to give you information about complicated pregnancies, infants born
Women are cared for by the same midwives
land on which we work. the care you will receive with us. Keep it with you prematurely and those who live locally.
for the duration of their pregnancy, labour
throughout your pregnancy and following the birth of your Women experiencing a complex or and birth and in the postnatal period.
The Women and Newborn baby as it contains lots of information and advice you ‘high-risk’ pregnancy may be referred to
Health Service also might find useful.
Women choosing this model of care
KEMH for their pregnancy care. Women may birth in the Family Birth Centre
recognises, respects and
We encourage you, your partner and support people who are not high-risk but want to receive (FBC) for low risk pregnancies, or in the
values Aboriginal & Torres care at KEMH must live within specific
Strait Islander cultures as we to be involved in your care. We want to give you the main hospital.
postcodes. To view a current list visit
walk a new path together. support, information and care you need to feel confident healthywa.wa.gov.au
and ready for your baby’s birth. Hospital Antenatal Clinic Midwives
Depending on your individual needs Women with uncomplicated pregnancies
Every birth is a special and unique event and you should
and where you wish to give birth may choose to have their care with
receive care that meets your needs throughout pregnancy, midwives at the Antenatal Clinic and
WNHS has a variety of pregnancy
birth and in the days after you and your baby go home. deliver in the hospital.
care options available:
Clinic appointments are available Monday
Community Midwifery Program to Saturday including Wednesday evening.
The Community Midwifery Program (CMP)
can support you to have your baby in a public Shared Care
hospital, at the Family Birth Centre or in your This option enables you to continue
own home within the metropolitan area. appointments with your General
The CMP offers a unique service available Practitioner (GP) or an eligible privately
to Perth women experiencing a low risk practicing midwife (EPPM) during
pregnancy. The CMP provides safe, your pregnancy.
evidence-based, continuity of care from
known midwives throughout pregnancy, GP Shared Care
labour, birth and for two to four weeks in After seeing the midwife/doctor at KEMH
the post natal period. for your hospital booking visit, you are
The CMP midwives hold antenatal/ then seen by a GP of your choice who is
postnatal clinics and classes in various eligible to participate in shared care until
locations across Perth in order to keep approximately 36-38 weeks. A list of GP
your care within the community. These Shared Care providers is available on the
locations include Joondalup, Kalamunda, KEMH website.
Subiaco, Cockburn and Rockingham.
Private Practicing Midwife
The CMP pride themselves in protecting,
promoting and supporting natural birth with Alternatively you may wish to consider
a high percentage of clients choosing to a privately practicing midwife who is self
give birth in water. employed and can admit pregnant women
under their care.
For more information about the Community
Midwifery Program, visit our website at
www.kemh.health.wa.gov.au
6 71
Pregnancy, Birth and your Baby
Pregnancy care options
Antenatal Clinic – Family Birth Centre
More information? Obstetric Doctor Care The Family Birth Centre (FBC)
This type of antenatal care is only provides care for healthy women for
A range of online fact available to women who have: whom a straight forward, low-risk
sheets, brochures pregnancy and birth is anticipated.
and booklets about • A complicated medical history
pregnancy and birth • Had a previous pregnancy The Centre is a home-like
are available. requiring specialist care environment, care is midwifery
and/or hospitalisation led only and available to women
Ask your midwife
• A pregnancy that is not from anywhere in the Perth
or doctor if there is
progressing normally metropolitan area.
more information
available about • A multiple pregnancy e.g. twins Due to high demand, it is
your care or visit recommended women book early as
Some women are transferred from
www.kemh.health. places at the FBC are limited.
midwifery or shared care to obstetric
wa.gov.au and view
doctor care if problems occur. Certain health issues may preclude
the brochures and
information online. some women from attending the FBC.
Private Obstetric Care If you’re unsure about whether you
You can also contact
the Women and Women who wish to be cared for by can attend please check with the FBC
Newborn Health an obstetrician with private admission midwives. For further information call
Library for further rights at KEMH can be admitted as the FBC or visit the KEMH website.
information and a private patient. More information is
resources on available on page 13.
(08) 6458 1100.
National Women
Held Pregnancy
Record (NWHPR)
You will be given a
NWHPR at your first
appointment. You
2
must bring it with
you to ALL your
visits to the hospital,
your midwife or
doctor, your local GP
and when you come
to have your baby.
You are encouraged
Services and
to read this record
and ask questions
during your
support
pregnancy.
8 92
Pregnancy, Birth and your Baby
Services and Support
The services listed below are available to women birthing with the Outpatient Pharmacy Are you or your baby of Aboriginal or
Visiting Hours Women and Newborn Health Service (WNHS), whether it be at Lower Ground Floor, B Block, Torres Strait Islander origin?
King Edward Memorial Hospital, the Family Birth Centre or with the 374 Bagot Road, SUBIACO WA 6008 You will be asked this question when you attend
King Edward Community Midwifery Program (with KEMH as their nominated hospital). Tel: (08) 6458 2722 King Edward Memorial Hospital (KEMH).
Memorial Hospital
Monday to Friday Why will I be asked?
Visitors are welcome Aboriginal Liaison Officer Agnes Walsh House Lodge is located
8.30am - 5pm
to visit maternity next door to the main hospital and
wards 3, 4, and 5
at KEMH provides single rooms with shared
The four main reasons are:
each day from: Aboriginal Liaison Officer kitchen and bathroom facilities. Pastoral Care Services 1. Deciding the origin of a person based on their looks
Tel: (08) 6458 2777 Tel: (08) 6458 1036 or (08) 6458 1726 is not reliable, the only way to find out is by asking.
3pm – 8pm Speak to your midwife if you need
(Wednesday, Thursday, Friday) support with accommodation. 2. The WA Department of Health collects data on the
Visitors outside these This is a free confidential service offering
Coming to a large hospital, especially Aboriginal and Torres Strait Islander status of every
hours will not be emotional and spiritual support to all women,
permitted on the wards. from a rural or remote area, can be a Crèche their family and friends.
person attending any health service in WA.
difficult experience. We want to make www.kemh.health.wa.gov.au/ 3. The answer provides information on the health
One nominated After hours pastoral support is available to status of all Australians and helps improve health
sure your time with us is positive and services/facilities/
support person, such all inpatients in cases of emergency and care for everyone.
culturally respectful. bereavement. You do not have to be a
as a partner, is able to Tel: (08) 6458 1370
KEMH has an Aboriginal Liaison churchgoer or have any religious beliefs to 4. If there are culturally specific services available
visit any time between The King Edward Crèche is a free
Officer (ALO) available to provide receive pastoral or spiritual support. Speak such as an Aboriginal Liaison Officer, they can
8am and 8pm. child-minding service based at
to your midwife or doctor or contact Pastoral be offered.
Partners are unable support to you during your stay KEMH, next door to the East Wing
at KEMH. Our ALO can assist by Care directly.
to stay overnight at Clinic, on the Hensman Road side of Respecting your privacy
KEMH. talking to staff, including doctors the Hospital.
and midwives, on your behalf if you Women and Newborn KEMH has the responsibility to protect any information
Family Birth Centre wish. They can also assist you in The crèche accepts children of Health Library you provide and is bound to privacy rules which protect
Visitors are welcome to linking up with other services that parents/guardians who: a person’s identity. If you are unsure, please ask about
This is a free library service which provides
visit at any time during might be able to help you when you the privacy policy before answering the question.
• Have an outpatient appointment health information from published sources
your stay in the FBC. are ready to go home. before 2pm, or to WNHS patients, their families and carers, You may also be asked other important
• have a baby in the special care health professionals and the general public of questions such as:
Ngalla Mia and Moort Mandja Mia
nursery/neonatal intensive Western Australia. The collection specialises
at KEMH • Your age
care unit. in women’s health, pregnancy, childbirth,
Asking for a Ngalla Mia is a meeting place for and infant care. As well as books, the library • where you were born
Aboriginal women and is located Interpreters has an extensive range of DVDs and health
female doctor • where you live
on the lower ground floor of Agnes pamphlets including many specifically written
In order to provide Walsh House at KEMH.
– Language Services for Aboriginal clients. • your state of health
the best possible Tel: (08) 6458 2802 • your GP details.
Moort Mandja Mia is an outdoor Items can be borrowed for a two week period
care, staff are Professional interpreters who and the library service can be accessed These questions are not discriminatory and do not mean
allocated on the basis family gathering place, located
on Hensman Rd, designed to are accredited through National online even once you have returned home. you will be treated differently. Australian state and territory
of skills required to Australian Authority for translators The library also provides free Wi-Fi. governments and Aboriginal and Torres Strait Islander
care for our patients. acknowledge the traditional
custodians of this land, the Noongar and interpreters can be provided The service does not provide medical organisations need to know all they can about the health
We are unable to (Whadjuk) people and welcome to patients and their families who or counselling advice, but can provide of people in WA to assist with planning and providing
provide doctors, women and their families to KEMH. are non-English speaking or have a contact details for appropriate services and appropriate health services. The information you provide
midwives or nurses hearing impairment. support groups. enables policies to be created, funds to be allocated and
on the basis of race, Agnes Walsh House Lodge If you would like an interpreter, The library is located on the ground floor
services to be developed in areas of most need.
gender or religion. WNHS provides short-term temporary please call the Language Services Your answers may also help KEMH refer you to
in the main corridor of KEMH next door to
accommodation for women from Department before your appointment. the café. appropriate services when you are discharged.
regional or remote areas who are The aim of asking these questions is to work together to
Opening hours are 9am -12noon Monday to achieve better health for everyone.
required to be in Perth for care
Friday excluding public holidays.
at KEMH.
10 112
Pregnancy, Birth and your Baby
Services and Support
Department of Psychological Social Work Department Privacy of your personal student observes or participates in your
care and you have the right to say no. Your
More information? Medicine Tel: (08) 6458 2777 information wishes will be respected at all times and
Tel: (08) 6458 1521 Pregnancy and childbirth can be WNHS protects privacy by keeping this will not affect your care.
The HEALTHY WA
8.30am – 5pm a very challenging time. You may your personal information secure from
website provides
families with information The Department of Psychological be feeling overwhelmed, isolated, unauthorised access, use or loss. All Community Advisory Council
Medicine provide expertise in the anxious or stressed. Perhaps you staff employed by WNHS have a duty to The WNHS Community Advisory
on pregnancy, birth and
field of women’s mental health. We are experiencing problems with protect your personal information. Strict Council (CAC) is a group of community
beyond and general
assess, treat and assist patients of relationships, childcare, immigration, policies and guidelines are in place for the representatives, from all walks of life, who
health information.
King Edward Memorial Hospital whose money or housing. collection, use, release and disposal of provide feedback on ways to improve
www.healthywa.wa.gov.au
medical condition is affecting their We can provide support, advice and your information. services from a consumer’s perspective.
The Pregnancy, Birth & emotional health, or whose emotional referrals to services in your local area If you would like to join our Community
Baby helpline is a free health is affecting their medical to help you manage these issues. Public or private admission at Advisory Council (CAC) please contact the
national 24-hour helpline condition. Please contact us directly or ask to KEMH only Customer Service Unit to register your interest.
for women and families. see a social worker when you attend
You must be a patient of KEMH to Under the requirements of the Medicare
Tel: 1800 882 436 qualify for access to services. Services the clinic. We are always willing to talk
about issues that may be worrying Agreement, all eligible patients, regardless
are available for up to six months of insurance status, being admitted to a
after discharge or clinic attendance you and affecting your pregnancy
public hospital, have the right to choose
and for up to one year for parents of experience.
whether to be admitted as a public or The Community Advisory Council
babies hospitalised in the Special Care private patient. There are no out-of-pocket
Nursery. Women living with a disability expenses if you elect to use your private The Community Advisory Council (CAC) represents the
Did you know? Tel: (08) 6458 2870 interests of patients, their support people and carers
Concerns about mental health in health insurance.
Suggestion boxes (Occupational Therapy) who use services at KEMH, the Family Birth Centre or
pregnancy and in the early postnatal Patients with private health insurance can Community Midwifery Program. Membership of the CAC is
and feedback forms period can be discussed and a referral WNHS is committed to ensuring that contact the Private Patient Liaison Officer broadly based.
are found around to Psychological Medicine services people with disabilities, their families on (08) 6458 1066 or email
the hospital or ask made by your health care provider, and carers are not discriminated Members of the CAC are interested in receiving feedback
kemhpplo@health.wa.gov.au
a staff member midwife or doctor. against in any way and that they have about services from people of all ages, cultures and
about how you can regions of Western Australia. They meet regularly to
the same opportunities as other people If you don’t have a provide information to WNHS’s Executive on ways to
provide feedback. Violence and sexual assault to access the hospital’s facilities,
The Sexual Assault Resource Centre receive the same level of care and Medicare card improve services.
(SARC) 24-hour Emergency Line information. More about disability KEMH, FBC and CMP are public health The role of the CAC is to:
(08) 6458 1828 or Freecall access is available on the KEMH services. All patients must have a Medicare 1. Advise and facilitate to WNHS on ways to increase
1800 199 888 website www.kemh.health.wa.gov.au card to receive free health care. Patients community participation
not eligible for Medicare benefits will need 2. Assist WNHS in monitoring quality of service and
Domestic violence and sexual assault, Women living with a disability or to organise payment before receiving care
chronic health condition who need accessibility
whether they are past experiences or and services.
current, can make pregnancy and birth extra support may be referred to 3. To advocate on behalf of consumers, carers and
a traumatic time. KEMH can provide the KEMH Occupational Therapy If you are a resident of a country that has community
you with support and assistance that is Department. Occupational Therapy a health care agreement with Australia 4. To provide a consumer perspective on activities,
private and respectful of your situation. may include help to adapt your home (known as a Reciprocal Health Care initiatives and projects that impact on WNHS services.
Talk to your doctor or midwife, the environment, advice about assistive Agreement) you are entitled to limited
There are many different ways to contact the CAC.
Social Work Department or the SARC. equipment and modifying everyday subsidised health services for ‘necessary
These include:
activities during pregnancy and the treatment’ while visiting Australia.
• In a letter, explain your issue and address the letter to
Providing feedback early months following birth. Please call Medicare on 13 20 11 for more
CAC Chairperson
Tel: (08) 6458 1444 Occupational Therapists also have information. Customer Service Unit
(Customer Service Unit) resources to help carers understand the Women and Newborn Health Service
practical challenges associated with a Student health professionals PO Box 134,
Feedback is valuable in improving
disability and ways to assist. They can WNHS has a major teaching focus and Subiaco WA 6904
services and ensuring we are providing
also link you to Carers WA for advice provides important training opportunities
a high quality service. We encourage • Send an email to kemhcsu@health.wa.gov.au and put
and support. for health care providers. Students are
you to contact the customer service ‘CAC issue’ as the subject heading.
always under the direct supervision of an
unit if you have any concerns or wish to • Telephone the Customer Service Unit on (08) 6458 1444
experienced practitioner.
compliment a staff member.
You will be asked permission before a
12 132
Pregnancy, Birth and your Baby
Services and Support
No Smoking at KEMH Parent Education Obstetric Medicines Breastfeeding Support Benefits of breastfeeding • Breastfeeding reduces risk of
Sudden Unexpected Death of
Patients are able to Tel: (08) 6458 1368 Information Service and Information There are many emotional and
an Infant (SUDI/SIDS).
access support to The KEMH Parent Education Tel: (08) 6458 2723 physical benefits for both you and
manage their smoking
Breastfeeding Centre of WA your baby from breastfeeding. Health benefits for you
department offers a wide range of For expert, current practice
when they are admitted classes, both in person and online, Tel: (08) 6458 1844 Some of these are listed below. • Breastfeeding will make your
information on:
to hospital. Pamphlets plus our KEMH Parent Education uterus (womb) contract, which
• Medicine use during pregnancy Following the birth of your baby,
on the Quit Program are website has links to online Health benefits for your baby helps reduce the risk and
available from hospital your midwife will assist you
resources and the KEMH Library. • Medicine effects on the amount of bleeding after birth.
staff or visit with breastfeeding advice and • Breast milk has all the nutrients
These resources will help prepare fetus and neonate
www.quitwa.com or support. There are also lactation for growth and development.
women and their support person for • Neonatal medicine therapy Importance of skin-to-skin
contact Quit on 13 78 48. consultants available at KEMH to
the birth of their baby, ongoing care and infant doses • Breast milk helps prevent contact after birth
and the transition to parenthood. advise hospital patients on how
respiratory and intestinal
In the interest of your • FAQs on medicine and to manage any breastfeeding Keeping your baby with you
The Parent Education department is infections, and allergies.
own health and the breastfeeding. difficulties you may experience. promotes a feeling of closeness,
health of others in the located on the first floor of A Block. • Babies fed only breast milk which produces a strong hormonal
hospital, smoking is Student midwives are allocated to are less likely to develop response for both you and your
NOT PERMITTED inside Parent Education as part of their inflammatory bowel disease baby that is linked to greater
the buildings or on midwifery training. and diabetes.
breastfeeding success as close
the grounds of KEMH. Had previous contact stimulates your baby’s
There are no designated breastfeeding instincts to breastfeed.
smoking areas and on-
challenges or concerns?
the-spot fines may be
Ten Steps to Successful Breastfeeding
issued. Ask your midwife to refer you
KEMH is a Baby Friendly Health Initiative (BFHI) Accredited Hospital where a mothers informed
to the Breastfeeding Centre choice of feeding is encouraged, respected and supported. BFHI accredited hospitals follow the
for advice and support. Ten Steps to Successful Breastfeeding.
a Comply fully with the International Code of Marketing of Breast-Milk Substitutes
and relevant World Health Assembly Resolutions.
1 b Have a written infant feeding policy that is routinely communicated to staff and parents.
c Establish ongoing monitoring and data-management systems.
2 Ensure that staff have sufficient knowledge, competence and skills to support breastfeeding.
Discuss the importance and Facilitate immediate and uninterrupted skin-
3 management of breastfeeding with
pregnant women and their families.
4 to-skin contact and support mothers to initiate
breastfeeding as soon as possible after birth.
Support mothers to initiate and Do not provide breastfed newborns any
5 maintain breastfeeding and manage
common difficulties.
6 food or fluids other than breast milk, unless
medically indicated.
Enable mothers and their infants
Support mothers to recognise and respond to
7 to remain together and to practice
rooming-in 24 hours a day.
8 their infants’ cues for feeding.
Foster the establishment of breastfeeding
Counsel mothers on the use and risk
9 of feeding bottles, teats and pacifiers. 10 support groups and refer mothers to them
on discharge.
If you have any questions or concerns about breastfeeding, talk about them now with your midwife
or doctor. It is very helpful to attend an antenatal breastfeeding class, so speak to your midwife or
book in with the KEMH Parent Education department if you are having your baby at KEMH. This
booklet contains more information on breastfeeding on page 96.
14 152
Pregnancy, Birth and your Baby
Don’t forget: Occasionally skin to skin contact may be The Parent Education department is Topics include: Planning a positive caesarean
delayed for medical reasons. In these located on the first floor of A Block in • When to come to hospital, normal birth class
Bookings with the circumstances you will be supported to the hospital and is staffed by clinical labour and active birth. For women and their support person who
Parent Education commence skin to skin contact as soon midwives. Student midwives are
• Methods of pain relief, induction of are booked for a caesarean birth.
Department are as possible. allocated to Parent Education as part
labour and assisted birth.
essential so call of their midwifery training.
If you are having breastfeeding problems • Introduction to breastfeeding. Multiple birth class
(08) 6458 1368 to following discharge from hospital, please Please book early to avoid
disappointment. • Parenting and postnatal issues. An evening specifically designed
book your place. call the Breastfeeding Centre of WA.
It is recommended that you attend the for women and their support person
Lactation consultants can help women
Breastfeeding and Physiotherapy expecting twins or triplets.
who are having breastfeeding problems.
Antenatal classes classes also. Please ring the Parent Education
Appointments are essential (see contact
Healthy pregnancy discussion for Department on (08) 6458 1368 for details.
details in the back of this booklet). Breastfeeding workshop
Antenatal classes pregnant women between 12 and Bookings are essential for classes and
The following services & support 20 weeks The breastfeeding workshop provides hospital tours.
TO BOOK - Please the opportunity for all pregnant women
use the QR code are available specifically for An enjoyable evening for women and to practise positioning and attachment of Family Birth Centre
provided, use the patients at: their partner or support person about the baby at the breast in a small group
link on the KEMH understanding the physical changes setting. In this women-only environment, The Family Birth Centre and Midwifery
– Parent Education King Edward Memorial pregnancy brings. This session involves open discussion of breastfeeding is Group Practice midwives hold their own
web page or ring the Hospital (KEMH) discussion with the midwife, dietitian and supported and encouraged. parent information sessions.
Parent Education physiotherapist.
special services The FBC sessions will cover:
team on
(08) 6458 1368. Parent Education Hospital tours Physiotherapy classes • Preparation for parenthood.
During COVID hospital tours are provided • Breastfeeding.
The KEMH Parent Education department Skills for birth and beyond.
as an online video and can be found • Preparation of labour and birth.
offers a wide range of classes to help This class involves learning about
under Parent Education on our website.
prepare and assist women for the birth relaxation, breathing awareness, • Discussion forums.
of their baby, ongoing care and the massage and positioning to improve your
Childbirth and Parenting Courses Women who have their babies with the
transition to parenthood. Your partner or comfort during pregnancy and childbirth.
support person are welcome. Courses are offered to first time mothers FBC can also access the Antenatal
and their partner or support person. Each Sessions are held in the Physiotherapy Breastfeeding Classes through the
Please book Bookings are essential so please Department.
early to avoid weekly session lasts for two hours or as a Breastfeeding Centre. All the KEMH
contact the Parent Education team on specific services are available to the
disappointment. condensed two-day workshop. To book, please use the QR code
(08) 6458 1368 between Monday and FBC women on request.
provided, use the link on the KEMH
Friday, 8am - 9am, or 3pm - 4pm (except Parent Education web page or ring
Wednesdays) to book your place. the Parent Education team on Community Midwifery Program
(08) 6458 1368. The Community Midwifery Program
classes are designed to inspire and inform
expectant couples for the birth and to
assist new parents during the first few
weeks and months of their baby’s life.
Classes are for all women and their
Vaginal birth after caesarean
partners or support person and
(VBAC) class workshops are conducted by midwives or
For women and their support person trained childbirth educators experienced
planning a vaginal birth after a previous in all types of birth.
caesarean birth. Please note that only women who have
Tel: (08) 6458 1368 for details. KEMH as their supporting hospital can
access the KEMH specific services.
16 173
Pregnancy, Birth and your Baby Pregnancy, Birth and your Baby
Taking care of yourself
The following information is about the things you can do to help you
and your baby stay healthy during pregnancy.
Nutrition for you These drinks are not recommended
during pregnancy.
and your baby Helpful hints
Eating well Do I need extra vitamins Good sources of
During pregnancy it is important for both
or minerals? folate include green
leafy vegetables,
you and your baby that you eat well. You Folate-rich foods oranges and nuts.
need more nutrients but not necessarily
more calories. This means you need to Folate (or folic acid) is a vitamin found Folate is added
focus on the quality and variety of foods in a variety of foods. It is recommended to some breakfast
you eat. that you take a folate supplement for cereals, juices
two months before you get pregnant and and bread.
If you eat regular meals and include for the first three months of pregnancy,
fruit and vegetables, wholegrain breads to reduce the risk of your baby having Iron is found in red
and cereals, dairy foods and lean meats neural tube defects such as spina bifida meat, chicken and
(or other protein alternatives), you will (a type of birth defect). As well as eating fish with smaller
be getting most of the nutrients that foods such as leafy vegetables and amounts in beans,
you need. beans, a daily supplement containing pulses, nuts and
During pregnancy your body needs 500mcg folic acid is recommended. seeds and green
folate, iron, calcium, vitamin D and leafy vegetables,
iodine. Sometimes these need to be Iron wholemeal breads
taken as additional supplements. and cereals.
It is important to eat a healthy and
A vegetarian diet can be very healthy well-balanced diet during pregnancy to Calcium is present
if care is taken to replace meat with ensure an adequate supply of iron. Iron in dairy foods
another protein. If you do not eat any is needed to make red blood cells that like milk, cheese,
meat, eggs or dairy you may need a carry oxygen around the body. During yoghurt and most
Vitamin B12 supplement while you are pregnancy you need more iron because
soy milks.
pregnant and breastfeeding. Vitamin the volume of your blood increases and
B12 is an important vitamin for brain your baby’s blood is also developing. Vitamin D is mostly
development in your baby. Healthy iron levels are important made in the skin
Advice about food, diet, nutrition, during pregnancy and may reduce from exposure to
supplements and weight during pregnancy complications, like anaemia. If a woman sunlight, but a small
is available from your midwife, doctor becomes anaemic while pregnant, it will amount comes
or a dietitian. Dietitians have specialist make her even more tired than expected. from diet, such as
knowledge about nutrition during oily fish, egg yolks,
3
Your Doctor or Midwife will guide you if
pregnancy and can provide expert advice margarine and some
additional iron is required in the form of
about any problems with your diet. You brands of milk.
tablets or liquid. It is important to take
can see a dietitian any time during your your iron supplements as instructed and
pregnancy. (See back of this booklet for inform your Doctor or Midwife if you are
contact details). unable to take them due to side effects.
Caffeine Iron is normally absorbed by your
body from the food you eat. For an
Taking care
Tea, coffee, cola drinks, iced coffee and
energy drinks all contain caffeine. iron rich diet:
• include at least two serves of meat,
There is mixed evidence about the
chicken, fish, eggs, legumes or nuts
effects of large amounts of caffeine on
of yourself
every day, and
the developing baby, however moderate
amounts appear safe. This is up to three • eat wholegrain breads, cereals and
cups of coffee or five cups of tea per day. green leafy vegetables regularly.
Guarana is a caffeine substance used in
many brands of energy drinks.
18 193
Pregnancy, Birth and your Baby
Taking care of yourself
The iron in animal-based foods is Always speak to your doctor, If you are worried about your weight Things that can make nausea and
easier to absorb than the iron in plant- midwife, dietitian or pharmacist if and diet, talk to your midwife or vomiting worse could include: rich or Helpful hints
Remember based foods. If you are a vegetarian you are unsure about taking your contact the dietitian (see page fatty food, strong food smells, spicy
• Eat a range of foods: or vegan, you will need to take extra supplements, if you have stopped 114 for contact details). If your food, chocolate, cigarettes, coffee, Morning sickness
grains, vegetables, care with your diet to get enough iron. taking any medicine or are still having Body Mass Index (BMI) is more tea, cola and iron tablets.
fruit, dairy, meats and Tips for relief:
problems taking it. than 40 you will be referred to a There is some evidence that ginger
pulses. Some women can’t get enough iron • Eat small meals and
dietitian. Ask your midwife or doctor helps settle pregnancy nausea.
from food. Blood tests are performed snacks frequently
• Quality not quantity. at different stages throughout
Calcium at your appointment. Ginger can be taken as:
your pregnancy to check for iron Calcium is important for developing • Drink plenty of water
• Make sure your hands, • Half a teaspoon of powdered ginger
food and utensils are deficiency. Your doctor, midwife your baby’s bones. If you don’t eat Morning Sickness dissolved in herbal tea • Get plenty of rest
well washed to avoid or dietitian will let you know if you calcium rich foods regularly you may Pregnancy nausea and vomiting (or • Grated ginger root in hot water (can • Avoid triggers like
contamination. need an iron supplement and advise need a calcium supplement. Morning Sickness) is common, and strain and serve cold with honey) rich foods and strong
you on the recommended form normally occurs early in pregnancy
• Talk to you doctor, • Ginger beer (non-alcoholic) check smells
of iron supplement. Iodine and improves by the second trimester.
dietitian or midwife the ingredients label to see it If nothing works see
about supplements. It is important to remember that some Iodine is needed for normal mental It does not impact your chances of contains ginger root
having a healthy pregnancy. It can your midwife or doctor.
foods help your body absorb iron and development of your baby. The There are medications
• Fish is a good source occur at any time of the day, and • Crystallised or glace ginger
some have the opposite effect. amount of iodine needed increases available for controlling
of omega 3 but some during pregnancy, but only small for some women it can continue • Ginger biscuits
types should be Supplements (if advised by your morning sickness
amounts are found in most foods. The throughout the whole pregnancy.
limited. doctor or midwife) should be taken Other helpful tips: that are safe during
NHMRC recommends that all women Although we are uncertain about the pregnancy.
one hour prior to food. cause, we know that changing your • Cold food is better tolerated than
take a daily pregnancy vitamin that
contains 150μg of iodine. diet may relieve your discomfort. Here hot food, because there is less
are some great tips. odour
Fish If you are vomiting continuously it is • Space out food and drinks so
very important to drinks fluids to avoid you’re not overfilling
Fish is a good source of omega 3 fatty
acids, which your baby needs for brain dehydration. Drinks that contain some • Avoid skipping meals and snacks Take care!
Australian Guide to Healthy Eating
Enjoy a wide variety of nutritious foods
and nervous system development.
Eating fish is encouraged during
sugar are better tolerated. Try to sip
something every 15 minutes. The
as an empty stomach can increase
nausea These foods
from these five food groups every day.
Vegetables and
pregnancy, however some types best drinks for this are: electrolyte or • Eat slowly and sit upright may upset your
sports drinks (Hydralyte, Gastrolyte,
Drink plenty of water.
legumes/beans
should be restricted as they may • Practice relaxation techniques stomach:
contain higher levels of mercury. You Powerade, Gatorade), lemonade,
• Wear loose clothing • Fatty or fried foods
Grain (cereal) foods,
ginger beer, mineral water, juices
mostly wholegrain
and/or high cereal
fibre varieties Muesli may eat one to three serves per week
Polenta
of any fish or seafood not listed below (diluted) or cordial. You could also try • Get fresh air – try eating outside • Thick, creamy
Quinoa
(an average serve is 150 grams). ice cubes or icy poles. • Rest after meals but avoid lying flat gravies or soups
Penne
Fettuccine
Red kidney Fish with high mercury levels Aim to eat small and often, e.g. • Chew foods well • Overly sweet foods
something every 30 minutes. like chocolate, rich
beans
Limit shark (flake), broadbill, swordfish, • Keep something next to your bed
Wheat flakes
and eat something before you get desserts, cakes and
marlin, orange roughy (sea perch) or Try the following foods:
Red lentils Chickpeas
catfish as all contain higher levels of up in the morning pastries
mercury. You can eat one serve of • Crackers or bread or dry toast • Strong smelling
• Cook and freeze meals when
Red kidney
beans
these per fortnight, provided you do not • Jelly you’re feeling well, ready for when foods
eat any other fish that week. you’re having a bad day • Coffee, tea, cocoa,
Lentils
Chickpeas
Mixed nuts
• Popcorn or dry breakfast cereal
• Fruit – fresh or tinned cola drinks
Weight A small number of women may
experience more severe nausea and • Spicy or rich foods
• Plain rice, pasta,
Weight gain varies between women
Fruit
Lean meats and potatoes or noodles prolonged vomiting that requires • Wholemeal / high
poultry, fish, eggs,
tofu, nuts and seeds and may depend on your pre- medical attention. Contact your fibre bread
and legumes/beans
Milk, yoghurt, cheese and/or
pregnant weight. Weight gain in • Soups – fresh, tinned midwife or doctor if you experience
alternatives, mostly reduced fat
pregnancy averages from 10 to 16 or cup-a-soups signs of dehydration (dark urine or
Use small amounts Only sometimes and in small amounts
kilos. If you were underweight at the • Dairy foods – milk, yoghurt, dizziness with standing), repeated
start of your pregnancy you can afford cheese, smoothies or custard vomiting throughout the day
to gain more than the average. If you (especially if you see blood in the
• Nuts or a trail mix
were overweight you should aim to vomit), pain or cramping, or weight
gain 5-9kg; however, strict dieting is loss over 2-3kg.
20 Source: National Health and Medical Research Council not recommended.
213
Pregnancy, Birth and your Baby
Taking care of yourself
Food safety and hygiene • soft serve ice cream and Exercise Pelvic floor exercises
Helpful hint thick shakes
Exercise can help you physically and • Sit with an upright posture. As
There are two infections of particular
• tofu, both soft and hard types, mentally during pregnancy and the you become better you can
Avoid high risk concern during pregnancy. Although
and tempeh (cooked tofu is period after birth. It is best to check progress to standing.
foods such as soft these infection are extremely rare, they
considered safe) with your doctor or midwife before
cheeses like brie or can harm your developing baby. you commence exercise as there are • “Squeeze and lift” – close your front
feta, cold meats, pate, • unpasteurised milk and certain conditions where exercise is and back passages and gently
uncooked or smoked Toxoplasmosis unpasteurised milk products not suitable and others where you draw them up inside you. Imagine
seafood, pre-prepared need to be cautious. that you are trying to stop urine
Toxoplasmosis is caused by a parasite Refrigerate leftover food as soon as it
salads and soft-serve midstream or trying to hold in wind.
ice-cream.
found in raw meat and in cat faeces. has stopped producing steam and eat
within 24 hours. When you reheat food Staying fit • Try to hold this contraction for
To reduce the risk of toxoplasmosis:
make sure it is piping hot, as heat kills • Choose exercises such as walking, approximately five seconds whilst
• Wash your hands well after handling Listeria. swimming (not frog kick), low impact you breathe normally.
pets or gardening aerobics and yoga.
To prevent infections including • Relax and feel your muscles let go.
• Wash salad vegetables listeria infection: • Avoid hot temperatures (spas and • Rest for 10 seconds.
• Cook meat thoroughly saunas) and don’t do vigorous
• Thoroughly wash your hands,
• Avoid contact with cat faeces, wear cooking utensils and chopping exercise in crowded rooms or hot/ • Repeat this exercise 5-10 times
gloves to dispose of cat litter boards humid conditions (over 37 degrees) (one set).
as this can affect your baby. • Aim for two or three sets per day.
Listeria • Wash raw vegetables and fruit
• Drink plenty of fluids, especially
• Refrigerate all food, including Do your pelvic floor exercises anytime
Listeria is a bacteria that can water.
leftovers, as soon as the food is cool of the day and during everyday
contaminate food and cause infection. You can still play sport during activities such as watching TV,
Although listeria infection is rare, it is enough to touch
pregnancy if it is not too strenuous, cooking or standing in a queue.
very dangerous for pregnant women • Throw out food left at room but avoid contact sports or excessive
and their unborn babies. temperature for long periods twisting, jumping and bouncing
Listeria bacteria can survive and (more than four hours), movements.
grow at low temperatures. Keep your especially in summer
fridge as cold as possible (below 5ºC) • Defrost frozen food in your fridge or Pelvic floor muscles
without freezing the food. Many ready- microwave, rather than on the bench Your Pelvic Floor muscles are a
to-eat foods are considered high risk group of muscles that form a sling
foods for Listeria infection. Excess Vitamin A across the floor of your pelvis.
People at risk of Listeria infection Too much Vitamin A can be harmful to They have a number of important
should avoid the following foods: your developing baby. As liver contains functions:
very large amounts of Vitamin A, limit • Prevent urgency and leakage
• paté
your intake to small amounts (50g per of urine
• cold ready-to-eat chicken week at most). There is no danger of
excessive Vitamin A intake from other • Maintain bowel control
• manufactured ready-to-eat meats,
foods. However, it is often present in • Better sexual function
including polony, ham and salami
multivitamin supplements so before • Prevent or reduce prolapse
• soft cheeses, including brie, buying them ask the pharmacist if the
camembert, fetta and ricotta supplements are recommended for • Back support
pregnancy. • Strengthen core muscles
• pre-packed, pre-prepared or self-
serve fruit or vegetable salads It is important to maintain good
• freshly squeezed fruit and strength and control of your pelvic
vegetable juices floor muscles. These muscles
stretch during the 2nd stage of
• ready-to-eat cold, smoked or raw labour as they relax to allow the
seafood, including smoked salmon, delivery of your baby.
oysters, sashimi and cooked prawns
• sushi
22 23You can also read
