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Shared Maternity Care Guidelines and Visit Schedules

Welcome to the Peninsula Health Shared Maternity Care Guidelines 

These guidelines have been provided by the Peninsula Health GP Liaison Unit and Peninsula Health Women’s Services as a general guide to the management of Pregnant Women booked for birth at Peninsula Health. The Guidelines describe what to do for a woman whilst providing Shared Maternity Care in a normal pregnancy, high BMI pregnancy or Gestational Diabetes Mellitus pregnancy.

These guidelines can be helpful particularly in the first trimester for any GP, not just those accredited with the Shared Maternity Care Program.

General public who are accessing this information are encouraged to speak to their doctor or midwife and are reminded that the information shown here may not be appropriate in every situation, and should not replace clinical discussion. 

Antenatal Triage and Models of Care

Antenatal Risk Assessment for Models of Care

Decisions about appropriate models of care should be guided by the Peninsula Health Risk Assessment for Model of Care document and made in consultation with patients.

Women with NO risk factors (Group A) are considered LOW risk and suitable for GP Shared Maternity Care.  Women with MEDIUM risk (Group B) are suitable for GP Shared Care AFTER Obstetric review and HIGHER risk (Group C) women should be for Obstetric care only.

See Risk-Assessment-for-Model-of-Pregnancy-Care

Models of Care at Peninsula Health

  • Models of care may change according to need during pregnancy and/or labour
  • For urgent clinical advice please contact the Obstetric Registrar on duty via switch on 9784 7777 

GP Health Check

Women who are in group A with no known risk factors are advised to see their GP, if they have not already done so, for a health check. The purpose of this is to ensure that women who are having midwifery led care have a medical review and examination to exclude any obvious morbidity. For more information see Risk Assessment for Model of Pregnancy Care Women’s health CPG.

 The health check should comprise:

  • Review of any medical history if not already done
  • General health and wellbeing
  • Confirm estimated date of birth (EDB)
  • Provide smoking cessation and substance use advice if applicable

 

  • Systemic examination to include (if not already done at first visit):
    • Blood Pressure and Pulse Rate
    • Body Mass Index
    • Cardiovascular examination (exclude murmurs)
    • Respiratory examination
    • Breast examination (only if indicated from symptoms)
    • Thyroid examination
    • Abdominal examination (exclude masses)
    • Speculum examination only if indicated from symptoms (HVS, chlamydia testing if indicated ant already done at firts visit
    • Cervical screening test if indicated (opportunistic screening)

 

It should be noted that this health is not to allocate a level of risk or a model of care. Allocation of the model of care is conducted at the booking visit and in conjunction with the obstetric planning visit. If the GP identifies any issues that may alter the allocation of risk, they should refer the woman back to the antenatal clinic for a clear plan of care to be made.

 

 

 

Pregnancy Assessment - When and How to Refer

Use this chart to determine when and how to refer for

  • emergency treatment
  • assessment and/or admission to the Women’s Health Unit
  • early pregnancy, fetal or postnatal wellbeing assessment, or
  • women who require non-emergency specialist obstetric consultation

Pregnancy and Postnatal Assessment- When and How to Refer 2019

 

Clinical Practice Guidelines

Pregnancy Care Guidelines – Australian Government Department of Health

Pregnancy and Postnatal Assessment- When and How to Refer 2019 to Peninsula Health

WOMEN’S HEALTH SERVICE PROMPT GUIDELINES

These are Peninsula Health guidelines with relevant information for GPs

Risk Assessment for Model of Pregnancy Care

Routine Pregnancy Care

Antepartum Haemorrhage (APH)

Post-Partum Haemorrhage

Management of Women with a BMI ≥ 35 in Pregnancy

Shared Maternity Care GP  Pathways including what to do at each visit

Routine Pregnancy Care Pathway

High BMI Patients Pregnancy Pathway

Gestational Diabetes Pregnancy Pathway

Shared Maternity Care GP  Guidelines

Antenatal Ultrasound Guideline

Anti-D Pathway in the Community 2019

Decreased Fetal Movements Guideline 2018

Estimated Due Date Calculation

Exercise and Pregnancy

Gestational Diabetes- Safer Care Victoria

Foods to Avoid and Healthy Eating during your Pregnancy   patient flyer

Fundal Height, Abdominal Palpation and Auscultation Guideline

Hypertension in Pregnancy-Safer Care Victoria

Iron Deficiency Anemia in Pregnancy Guideline for GPs 2019

Healthy Eating and expected weight gain during pregnancy – NHMRC

Nausea and Vomiting in Pregnancy Guideline for GPs 2018

Obesity during Pregnancy-Safer Care Victoria

Prenatal Screening 2017

Pre-labour Rupture of Membranes Guideline-2018

Vaccinations in Pregnancy

  • Influenza – Recommended for all pregnant women at any stage of pregnancy, particularly those who will be in the 2nd or 3rd trimester during the influenza season
  • dTpa(diphtheria-tetanus-acellular pertussis) – Recommended as a single dose between mid 2nd trimester and early 3rd trimester of each pregnancy (ideally at 20–32 weeks)

 

Disclaimer

These guidelines have been developed by the Peninsula Health GP Liaison Unit and the Peninsula Health Women's Services as a general guide to the management of women participating in the Peninsula Health Shared Maternity Care Program. They may not be applicable in every clinical case. They should not replace thorough clinical assessment and judgement.

Care should be taken when printing any information or Clinical Guidelines. Updates to these guidelines will take place as necessary. It is therefore advised that regular visits to this Website will be needed to access the most current information.