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You're now at week 27!
This week we include more information about Anti-D. There’s information about baby movements, your sleeping position, what to expect when you are admitted to the hospital, and baby tests and treatment offered after the birth.
Part 1: Things that are relevant to your pregnancy now
A blood test in early pregnancy gives us important information about your blood type.
As well as your blood group, another thing this test tells us is if you are Rh positive or Rh negative.
Most women (85 per cent) are Rh positive.
If you are Rh negative and your baby is Rh positive, your body may produce antibodies that fight against your baby’s blood and could lead to them developing anaemia and jaundice. This can be treated by testing your blood again later in the pregnancy and giving an Anti-D (RH immunoglobin) injection at 28 and 34 weeks.
Before you are given an Anti-D injection you must give your informed verbal consent. Your doctor or midwife will:
- explain why the Anti-D injection is recommended
- clarify when you will be given the Anti-D injections, both during your pregnancy and after the birth of your baby
- outline what the treatment involves
- describe the risks and benefits of having the injection as well as the risks or consequences of not having the injection
- give you an opportunity to ask questions
- use written information or diagrams to help you understand treatment.
Anti-D may also be recommended for other medical reasons during pregnancy. Your doctor or midwife will talk to you about these if they occur.
Part 2: Things you may want to consider
By now you will probably be quite familiar with your baby’s movements. Whether they be light flutters, a swish, a roll or starting to be stronger kicks and punches. these are all signs that your baby is well. Being aware of your baby’s movements during pregnancy is one of the simplest things you can do to help keep your baby safe and healthy. Regular and healthy movements are a good sign of wellbeing.
Your baby will continue to move about during the pregnancy, both moving position and stretching about. How often they move is different for each baby. They will have “awake” and “sleep” periods as well. All these movements continue throughout your pregnancy.
It is a myth that babies’ movements slow down or become weaker towards the end of pregnancy. When a baby is unwell, they may try to save energy by slowing down their movements. This may be the first sign of a problem and may occur at any time in a pregnancy.
How will I know if a quiet time is normal or too long?
If your baby is unusually quiet at a time when they are normally active, it might be a sign that your baby is becoming unwell.
If you notice a change in your baby’s movements that concerns you, please contact the hospital immediately. Call (03) 8345 3635 to speak with a midwife or come into the Women’s Emergency Care department located on the Lower Ground Floor, near our carpark entrance on Flemington Road.
See our Reducing the risk of stillbirth webpage for more information and links to other organisations which can also offer advice.
The importance of side sleeping during pregnancy
Sleeping in pregnancy can become difficult, due to things like heartburn and nausea, the growing size of your baby, frequent toilet visits overnight, etc. Added to that is the importance of staying off your back or stomach when sleeping.
It is recommended that you start going to sleep on your side from 28 weeks of pregnancy. While either side is okay, experts recommend that left is best.
This position helps to:
- maintain a good blood flow to your uterus and oxygen supply to baby
- prevent a slow or sluggish blood supply to the rest of your body
- make breathing easier for you
- reduce the risk of gut and abdominal problems
- decrease pressure on your growing breasts.
Don't panic if you roll from side to front or back while you sleep. Just reposition yourself and go back to sleep.
Some tips for easier positioning in bed:
- Prop a small pillow or rolled handtowel under your belly so that it’s not putting pressure on your upper side or back. This can also help you from rolling onto your stomach.
- Use a pillow between your knees.
- Buy a special extra-long pregnancy pillow if you think it might help.
- Positioning a pillow behind your back can help keep you on your side, preventing you from rolling onto your back.
If you are short of breath or have heartburn, it may help to raise the head of the bed by using pillows, placing a rolled blanket under the mattress, or raising the top end of the bed.
Research has improved our understanding of how a baby’s brain develops during the last few weeks of pregnancy. We know that a baby’s brain grows throughout a pregnancy and in most cases, it will continue to grow up until the baby is full term.
We also know that the last few weeks of a pregnancy are an important time for the development of a baby’s brain. Every week a baby is born closer to 40 weeks reduces their chance of having to spend time in a neonatal intensive or special care unit.
The time your baby spends growing inside you, can make a difference to their health outcomes. When considering the timing of your baby’s birth, it’s important to remember that a balance of the health benefits to your baby and any specific risks to you and your pregnancy should be considered.
Talk with your doctor or midwife or visit the Every Week Counts website for more information. You will find information in English and other languages on that website.
If you have contacted your doctor or midwife and they suggest that you come into hospital, there are a few things that you can expect to happen.
Your doctor or midwife will most likely ask questions about any known risk factors or issues you might have had during your pregnancy. They may do a CTG (cardiotocograph) by placing an elastic belt around your belly, to measure your baby’s heart rate. Your doctor or midwife will also feel your belly to see where your baby is positioned and to check their growth.
An ultrasound of your baby may also be done if one has not been done recently. You probably had an ultrasound scan in early pregnancy to work out your baby’s due date. Ultrasound scans can also be used to measure your baby’s heart rate and blood flow, and to check on growth. Your doctor or midwife may also do a blood test.
Part 3: Tests and treatment for your baby after their birth
After the birth, you will be asked if you wish your baby to have several tests. You have the right to consent, ask for more information, or refuse.
The following information and links will help you make an informed decision about the tests being offered.
The Apgar score is an assessment of your baby’s overall condition including breathing, heart rate and colour. This is done at one minute and at five minutes after birth. The Apgar score simply tells your carers how well your baby has made the transition from intrauterine (inside the womb) life to extrauterine (outside the womb) life.
Babies with a lower Apgar score may need additional care following their birth.
For more information about the Agpar score visit Pregnancy Birth and Baby.
We recommend that babies are given a single dose of vitamin K by injection within a few hours of birth. Newborns may be deficient in vitamin K in the first eight days of life. Vitamin K is needed to help the blood clot and to prevent bleeding.
For more information on vitamin K visit the Better Health Channel.
Hepatitis B is a disease caused by a virus that affects the liver. Hepatitis B is spread by infected blood and other body fluids such as saliva. It is recommended that babies are immunised soon after birth and during infancy. Hepatitis B vaccine will be offered to your baby before you leave hospital. To complete the immunisation, more vaccinations are given over the next four years.
If you are hepatitis B positive, we suggest that your baby be given an immunoglobulin injection while in hospital. This is to give your baby some immediate protection from hepatitis B.
For more information see the fact sheet Hepatitis B immunisation: The birth dose and your baby
Sometimes after the birth we suggest your baby is weighed. This is usually recommended after their first breastfeed. Your baby may already have passed urine and meconium (your baby’s first poo) by then. Routinely, they would be weighed again on Day 2 either in hospital or when our midwife visits you at home.
It is most likely they will have lost weight during this time but remain healthy. The midwife will inform you of the weight loss and if any treatment is required. It may take the average baby about 7-10 days to return to their birth weight – this is normal.
This routine health check is offered to your baby soon after birth. A small number of babies are born with a hearing loss that could affect their speech and language skills. Hearing loss may not be obvious in the first few weeks of life but can be detected by a hearing screen. You will be given the results as soon as the screen is completed.
Ongoing hearing tests will also be part of your care in the community through your local Maternal and Child Health Nurse.
More information about the Victorian Infant Hearing Screen program can be found on The Royal Children’s Hospital website.
The Newborn neonatal screening test is recommended for all new babies in Victoria. A blood sample is taken from your baby’s heel and sent to a specialist laboratory. It is then tested for some very rare and very serious diseases. In most cases, if the diseases are found in the newborn they can be treated, and the baby will grow and develop normally.
This test screens for:
- congenital hypothyroidism
- cystic fibrosis
- amino acid disorders such as phenylketonuria (PKU)
- fatty acid oxidation disorders
- other rare metabolic disorders.
How is the test performed?
When your baby is between 48 and 72 hours old, a midwife will do a heel prick and put four small spots of blood on a piece of blotting card. If the results are normal, you will not be contacted.
More than 99 per cent of babies have a normal test result. If your baby is found to have a medical condition, you will be contacted, and your baby will be referred to a specialist for tests and treatment.
Visit the VCGS website for more information about the Newborn Screening Test.
Vitamin D helps a baby’s growth and promotes healthy bone development. It is recommended that you give your baby vitamin D from birth until they are 12 months old, or until advised by your doctor.
For more information see our fact sheet Vitamin D supplements for babies.
We hope you have found the information interesting.
If you have any health concerns please talk to one of your health care professionals – midwife, General Practitioner (GP), hospital doctor, etc.
There will be more to read and learn next week, in week 28. Stay safe and well.