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
See COVID -19 Care in Maternity Women’s Health Unit
- 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.
Pathways and Visit Schedules - Routine Pregnancy, High BMI, GDM
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
For Shared Maternity Care Providers essential Documents
Routine Pregnancy Care Guideline
Contains visits schedule, routine care and investigations recommended at each visit
2020 COVID-19
Telehealth & Visit Schedules in Women’s Health Outpatients (COVID-19)
COVID -19 Care in Maternity Women’s Health Unit
Peninsula Health Maternity Service Guidelines relevant for GP Providers
In alphabetical order
Abdominal Examination Palpation
Anti-RH (D) Immunoglobulin Antenatal and Pastnatal Administration
BMI ≥ 35 in Pregnancy Management
Decreased-fetal-movements/Safer Care Victoria
Group B Streptococccus and Chorioamnionitis Womens Health
Hypertension in Pregnancy Pre Eclampsia and Eclampsia
Indications for Antenatal Ultrasound
Iron Deficiency Anemia in Paregnancy, Intrapartum and Postpartum
Management of the Small for Gestational Age or Growth Restricted Fetus
Nausea and Vomiting in Pregnancy Women’s Health
Prelabour Repture of Membranes at Term Women’s Health
Prenatal Screening Tests Women’s Health
Risk Assessment for Model of Pregnancy Care
Vaginal Birth after Caesarian Section (VBAC)
Vitamin D deficiency during pregnancy and breastfeeding Women’s Health
Other Resources
Department of Health-How to Quit smoking
National Health and Medical Research Council- Healthy Eating in Pregnancy
Safer Care Victoria – Accurate Pregnancy Dating (Estimated Due Date)
Safer Care Victoria – Table 4 Safe and effective excercise 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)
See Maternity Services Consumer Page for additional information on safe sleeping, SIDS, PND and other information about the Peninsula Health Maternity Unit
External Guidelines
Safer Care Victoria Maternity ehandbook
Pregnancy Care Guidelines – Australian Government Department of Health
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.