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Australia Prenatal Care Schedule

This is a general overview of the prenatal visits many people in Australia are offered during pregnancy, drawn from public guidance by RANZCOG and the WHO. Every pregnancy is different — your own care provider decides which checks and timing are right for you. It's here for reference and orientation, not as medical advice.

Disclaimer: BabyBerry is for general information and self-tracking. It is not a medical device and does not provide medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider.
  1. First Antenatal (Booking) Visit — Weeks 8–10
  2. First Trimester Screening (Combined Screen / NIPT) — Weeks 11–13
  3. Mid-Trimester Check-in — Weeks 16–18
  4. Morphology Ultrasound (Detailed Fetal Scan) — Weeks 19–20
  5. GDM Screening Visit (75 g OGTT) — Weeks 24–28
  6. Anti-D, dTpa, and Safer Baby Bundle — Week 28
  7. Growth Check and Birth Plan — Week 32
  8. Second Anti-D and Preparation — Week 34
  9. GBS Swab and Presentation Confirmation — Weeks 36–37
  10. Post-Dates Review and Induction Planning — Weeks 40–41

First Antenatal (Booking) Visit

First prenatal visit · Weeks 8–10 · Fasting may be needed

Pregnancy confirmation, full booking blood panel, dating ultrasound, Medicare enrolment, and choice of care model (public hospital, GP shared care, private obstetrician, or Midwifery Group Practice)

Good to know: In Australia, the booking visit is where you lock in your care model. The four common options are: public hospital antenatal clinic (bulk-billed via Medicare, usually midwife-led for low-risk pregnancies), GP shared care (your GP co-manages visits with the hospital), private obstetrician (continuity with one OB, with out-of-pocket fees above the Medicare rebate), and Midwifery Group Practice (MGP) / birth centre / planned homebirth (continuity-of-midwife model in many public hospitals). All models include a Medicare rebate, and public options are generally bulk-billed at no cost.

Common checks

  • Dating Ultrasound — A dating ultrasound is typically performed between 8 and 12 weeks to confirm a viable intrauterine pregnancy, rule out ectopic pregnancy, measure the embryo, and confirm the estimated due date (EDD). In Australia the first-trimester dating scan attracts a Medicare rebate when referred by your GP or obstetrician and is considered the most accurate method for determining gestational age.
  • Complete Blood Count (CBC) — A CBC (or FBC — full blood count, as it is usually called in Australia) measures red and white blood cells and platelets, establishing a baseline for anaemia, infection, and clotting. Haemoglobin is tracked throughout pregnancy because iron demand rises in the second and third trimesters.
  • Blood Group and Antibody Screen (ABO/Rh(D)) — Identifies ABO blood group and Rh(D) status, plus screens for red-cell antibodies. Rh(D)-negative patients in Australia receive Anti-D immunoglobulin (Rh(D)-Ig, supplied as Rhophylac or CSL Rh(D)-Ig) at both 28 and 34 weeks, and again after delivery if the baby is Rh(D)-positive — a NBA/RANZCOG recommendation to prevent haemolytic disease of the newborn.
  • Infectious Disease Panel (HIV, Hepatitis B, Hepatitis C, Syphilis, Rubella, Varicella) — RANZCOG recommends universal screening at the first visit for HIV, hepatitis B surface antigen, hepatitis C antibody, syphilis, rubella immunity, and varicella immunity. Early detection lets the care team prevent mother-to-baby transmission (HIV antiretrovirals, hepatitis B immunoglobulin and vaccination at birth) and flag non-immune patients for postpartum MMR and varicella vaccines.
  • Urinalysis and MSU Culture — A mid-stream urine (MSU) sample screens for asymptomatic bacteriuria, urinary tract infection, protein, and glucose. Untreated bacteriuria is a known risk factor for pyelonephritis and preterm labour, so treatment with pregnancy-safe antibiotics is standard if an MSU culture is positive.
  • Cervical Screening Test (CST) if due — If your Cervical Screening Test (HPV-based, every 5 years under the National Cervical Screening Program) is overdue, it may be done at the booking visit. CST is safe throughout pregnancy and does not increase miscarriage risk.
  • Blood Pressure and Weight — Baseline measurements are recorded and repeated at every visit. A sustained rise in blood pressure after 20 weeks is the key screen for pre-eclampsia, and weight trajectory informs nutritional counselling per the Australian Pregnancy Care Guidelines.
  • Medical and Obstetric History — Your care provider reviews menstrual history (LMP), previous pregnancies, surgeries, chronic conditions, medications, allergies, family genetic history, and psychosocial factors. This establishes risk stratification (low-risk vs. high-risk) and determines whether referral to an obstetrician or maternal-fetal medicine specialist is needed.

How to prepare

  • Come fasting (no food or non-water drinks for 8-12 hours) — the booking bloods may include fasting glucose and lipid panel.
  • Bring your Medicare card (and private health fund card if applicable). If you are new to Australia, ask your GP about reciprocal Medicare agreements or private cover.
  • Note the first day of your last menstrual period (LMP) — this is the starting point for dating your pregnancy.
  • Prepare a list of medications, vitamins, and supplements, plus any chronic conditions and past surgeries.
  • Gather both sides of family medical history — genetic conditions, birth defects, diabetes, high blood pressure, and mental health history.

Tips

  • Start taking a pregnancy multivitamin with 500 mcg folic acid and 150 mcg iodine daily — the NHMRC recommends starting at least one month before conception and continuing through the first trimester (folic acid) and the entire pregnancy and breastfeeding (iodine). Higher folic acid (5 mg) is prescribed for specific risk factors such as diabetes, obesity, or a previous neural tube defect.
  • If you want GP shared care, confirm your GP is registered for antenatal shared care with your local hospital. If you want MGP or a private obstetrician, self-refer or ask your GP for a referral early — MGP and popular private OBs book out quickly.
  • Expect this visit to take 45-90 minutes. Bring a snack for after the bloodwork and your partner or support person if you have questions about decisions ahead.
  • Follow Food Standards Australia New Zealand (FSANZ) listeria advice: avoid soft cheeses, pâté, pre-prepared salads, raw or undercooked meat/fish/eggs, and unpasteurised dairy. Limit caffeine to under 200 mg per day (about 1-2 cups of coffee) and avoid alcohol completely.

First Trimester Screening (Combined Screen / NIPT)

Visit 1 · Weeks 11–13

Nuchal translucency (NT) ultrasound plus maternal serum markers (PAPP-A, β-hCG) — the Combined First Trimester Screen — and the option to discuss self-funded NIPT (~$400-600 AUD, not Medicare rebated) as an alternative

Good to know: Prenatal screening in Australia is opt-in and decision-making should feel informed, not rushed. The two main pathways are the Combined First Trimester Screen (NT + bloods, Medicare rebated) and NIPT (self-funded around $400-600 AUD). You can choose one, both, or decline screening altogether. No test is perfect — screening estimates probability, while diagnostic tests (CVS at 10-13 weeks, amniocentesis from 15 weeks) confirm a diagnosis with approximately 0.1-0.3% procedure-related pregnancy loss risk. Free genetic counselling is available through public genetics services in every state if any result is outside the expected range.

Common checks

  • Nuchal Translucency (NT) Ultrasound — A specialised ultrasound between 11 weeks 2 days and 13 weeks 6 days measuring fluid behind the baby's neck. Combined with maternal blood markers and maternal age it screens for trisomy 21 (Down syndrome), trisomy 18, and trisomy 13. NT measurement must be done by a sonographer credentialled through the Fetal Medicine Foundation (FMF), and the scan attracts a Medicare rebate.
  • First Trimester Maternal Serum Screen (PAPP-A, β-hCG) — A maternal blood test measuring pregnancy-associated plasma protein A (PAPP-A) and free β-hCG. Combined with NT and maternal age, the Combined First Trimester Screen gives a personalised risk estimate for chromosomal conditions with approximately 90% detection and a 3-5% false-positive rate. It is Medicare rebated when referred appropriately.
  • Non-Invasive Prenatal Testing (NIPT) — self-funded — NIPT analyses fetal DNA in maternal blood and has >99% sensitivity for trisomy 21. In Australia NIPT is self-funded (approximately $400-600 AUD) and is NOT Medicare rebated for average-risk pregnancies — this is a significant cost difference from some other countries. A positive NIPT still requires diagnostic testing (CVS at 10-13 weeks or amniocentesis from 15 weeks) for confirmation.
  • Fetal Heart Rate (Doppler) — Handheld Doppler is used from 10-12 weeks onward to confirm a reassuring fetal heart rate (typically 110-160 bpm). If the heart rate cannot be found, an ultrasound is done to confirm viability rather than assuming a problem.
  • Blood Pressure and Weight — Routine recording continues at every visit. The Australian Pregnancy Care Guidelines target weight gain based on pre-pregnancy BMI — your provider will share a personalised range.

How to prepare

  • You do not need to fast for NT ultrasound or Combined FTS bloodwork. Hydration helps — drink a glass of water an hour beforehand for clearer imaging.
  • Bring your referral from the booking visit — NT scans must be done at an FMF-accredited imaging centre, and this appointment is usually separate from your provider visit.
  • If you choose NIPT, organise it with your GP or obstetrician this week — most labs process samples within 5-10 business days. Consider discussing which microdeletion panels (if any) you want included.
  • Talk with your partner about what you would do with screening results before doing the test. Thinking through your values ahead of time makes decision-making less stressful if a higher-risk result comes back.

Tips

  • Combined FTS results typically arrive 1-2 weeks after bloodwork. If your risk estimate is higher than 1 in 300, your provider will offer NIPT or diagnostic testing and free public genetic counselling.
  • Morning sickness usually peaks around 9-11 weeks and eases by the end of the first trimester. Small frequent meals, ginger, and vitamin B6 (25 mg up to 3x daily) are evidence-based first-line strategies. Talk to your provider about doxylamine-pyridoxine if symptoms are severe.
  • If you are working, you can start looking into Paid Parental Leave (PPL) through Services Australia — currently up to 22 weeks of government-funded leave at the national minimum wage, plus your employer's paid parental leave if offered. You must claim through myGov before the baby is 1 year old.

Mid-Trimester Check-in

Visit 2 · Weeks 16–18

Review of Combined FTS/NIPT results, listening to fetal heart, blood pressure and weight trend, birthing hospital enrolment forms, and preparation for the 19-20 week morphology scan

Good to know: Around 16-18 weeks many pregnant people feel their first quickening — those early flutters of fetal movement. First-time parents tend to notice it later (18-22 weeks) than those who have been pregnant before (14-18 weeks). In Australia, movement advice follows the Safer Baby Bundle: from 28 weeks onward, contact your hospital or midwife immediately if you notice any change in your baby's movements — do not wait until the next day.

Common checks

  • Screening Result Review — Your provider walks through Combined FTS or NIPT results and answers questions. If results are in the lower-risk range no further action is needed; higher-risk results trigger a free referral to public genetic counselling and discussion of diagnostic options.
  • Fetal Heart Rate (Doppler) — The reassurance of hearing the heartbeat is now routine at each visit — expect a rate of 120-160 bpm at this gestation.
  • Blood Pressure, Weight, Urinalysis — A dipstick urine check at each visit screens for protein (pre-eclampsia), glucose (gestational diabetes), and leukocytes (urinary tract infection). Combined with blood pressure, it forms the basis of antenatal surveillance under the Australian Pregnancy Care Guidelines.
  • Hospital Booking / Birth Centre Enrolment — If you are in GP shared care, this is often when the hospital booking paperwork and first hospital midwife appointment are organised. Public hospital booking forms include birth preferences, support person details, and anaesthetic/analgesia preferences.
  • Mental Health Screening (EPDS) — The Edinburgh Postnatal Depression Scale (EPDS) is used antenatally in Australia per RANZCOG and the COPE Perinatal Mental Health Guidelines. A score ≥13 triggers a conversation about extra support, referral to a perinatal mental-health service, or a Medicare-rebated mental health care plan through your GP.

How to prepare

  • Bring the referral for your 19-20 week morphology ultrasound — these imaging centres book out 2-3 weeks ahead, so schedule at this visit.
  • Write down any questions about your screening results before the appointment — it is easy to forget once you are in the room.
  • If you are Rh(D)-negative, remember Anti-D is coming at 28 and 34 weeks — your provider may mention it now so you are prepared.

Tips

  • Start kick counting awareness by 28 weeks — but from 20 weeks onward, get to know your baby's usual patterns of wake and rest. The Safer Baby Bundle movement advice is: know your baby, and speak up early if anything changes.
  • Consider enrolling in childbirth and early parenting classes now — public hospital classes are often free or low-cost, and many fill up months ahead. Private options like Calmbirth or hypnobirthing are also widely available in all capital cities.
  • Second-trimester wellbeing: the 2nd trimester is often when energy returns. Light exercise (walking, pregnancy yoga, swimming) is safe and recommended per the Australian Physical Activity Guidelines for pregnancy — aim for 150 minutes per week of moderate activity.

Morphology Ultrasound (Detailed Fetal Scan)

Visit 3 · Weeks 19–20

Comprehensive fetal anatomy survey (the "morphology scan"), placental location, amniotic fluid volume, and transvaginal cervical length assessment — a Medicare-rebated routine scan in Australia

Good to know: The morphology scan is the most detailed structural ultrasound of the whole pregnancy. Most findings are reassuring, but if the sonographer identifies a soft marker or structural finding, your provider will arrange follow-up — this may include a targeted ultrasound at a tertiary centre, genetic counselling (free through public services), fetal echocardiography, or diagnostic amniocentesis. Remember: most soft markers are not clinically significant on their own, and most structural findings have good outcomes with appropriate planning.

Common checks

  • Morphology Ultrasound (19-20 weeks) — In Australia this scan is called the morphology scan (not the anatomy scan or anomaly scan). Over 30-60 minutes the sonographer systematically examines the brain, face, spine, heart (four-chamber view and outflow tracts), lungs, abdomen, kidneys, bladder, limbs, and genitalia, and measures biparietal diameter, head circumference, abdominal circumference, and femur length. RANZCOG and ASUM recommend this scan for every pregnancy.
  • Placental Location and Cord Insertion — The sonographer identifies where the placenta is relative to the cervix. A low-lying placenta or placenta praevia flagged at this scan is rechecked at 32 weeks — about 90% resolve as the uterus grows. Cord insertion is checked to rule out velamentous insertion or vasa praevia, which affect delivery planning.
  • Amniotic Fluid Volume — Measured as the amniotic fluid index (AFI) or deepest vertical pocket. Too little (oligohydramnios) or too much (polyhydramnios) prompts additional investigation for fetal kidney issues, growth restriction, or gestational diabetes.
  • Cervical Length Measurement (Transvaginal) — A transvaginal measurement of cervical length is part of the morphology scan. A cervix shorter than 25 mm before 24 weeks is a significant preterm birth risk and triggers discussion of vaginal progesterone or cervical cerclage per RANZCOG preterm birth prevention guidelines.
  • Fetal Sex Determination (if desired) — Unlike some countries, there are no legal restrictions on disclosing fetal sex in Australia. Most morphology sonographers can identify fetal sex with ~95-99% accuracy at 19-20 weeks — let the centre know in advance if you want to know, prefer not to know, or want the information sealed in an envelope for a gender reveal.

How to prepare

  • Drink 500-750 mL of water in the hour before the scan — a moderately full bladder helps visualise the lower uterus and cervix. Most Australian imaging centres will tell you their preferred prep on booking.
  • Wear a two-piece outfit for easy abdominal access. Expect the scan to take 30-60 minutes; longer if the baby is in an awkward position.
  • Check fees in advance. Public hospital-based morphology scans are usually bulk-billed; private imaging centres may charge a gap above the Medicare rebate ($50-150 AUD).

Tips

  • Bring your partner if possible — seeing the baby move in such detail is often a highlight of pregnancy. Most Australian imaging centres include a USB or printouts with key images as part of the scan.
  • Take the opportunity to ask the sonographer to explain what they are seeing on the screen — most are happy to talk you through the heart, brain, and face views.
  • Start thinking about the "big three" decisions ahead: where you will birth, who will be in the room, and what your preferences are for pain relief. Australian public hospitals generally offer nitrous oxide ("gas and air"), morphine injections, and epidural at no out-of-pocket cost.

GDM Screening Visit (75 g OGTT)

Visit 4 · Weeks 24–28 · Fasting may be needed

75 g 2-hour oral glucose tolerance test (fasting) per ADIPS/RANZCOG — the Australian one-step approach, not the US/Canada 50 g GCT — plus full blood count, antibody screen, and pre-Anti-D bloods for Rh(D)-negative patients

Good to know: GDM affects 12-15% of Australian pregnancies and is more common in women with South Asian, East Asian, Pacific Islander, or Aboriginal and Torres Strait Islander backgrounds. Diagnosis is not a cause for alarm — most people manage GDM with diet, exercise, and home blood glucose monitoring, and only a subset need metformin or insulin. If you are diagnosed, you will be referred to a diabetes educator and dietitian (covered by Medicare through a Chronic Disease Management plan), and extra growth scans may be added at 32-36 weeks.

Common checks

  • 75 g 2-hour Oral Glucose Tolerance Test (OGTT) — Australia follows the ADIPS (Australasian Diabetes in Pregnancy Society) and RANZCOG one-step diagnostic approach: after an overnight fast, a fasting blood glucose is drawn, you drink a 75 g glucose solution, and blood is drawn again at 1 hour and 2 hours. A positive result at any time point diagnoses gestational diabetes (GDM). Diagnostic thresholds are fasting ≥5.1 mmol/L, 1 h ≥10.0 mmol/L, or 2 h ≥8.5 mmol/L. This is different from the US/Canada two-step 50 g GCT approach.
  • Full Blood Count and Iron Studies — FBC is repeated around 28 weeks to check for anaemia, which becomes more common as blood volume increases. Iron studies (ferritin, transferrin saturation) are often ordered if haemoglobin trends down — oral iron or, in some cases, iron infusion (e.g., Ferinject) may be recommended.
  • Red Cell Antibody Screen (Rh(D)-negative patients) — Rh(D)-negative patients have a repeat antibody screen drawn before the 28-week Anti-D immunoglobulin dose. If new antibodies have developed, a referral to a maternal-fetal medicine specialist is made before Anti-D is given.
  • Fetal Heart Rate, Fundal Height, Blood Pressure — From 24 weeks onward, fundal height (symphysis-fundal height, SFH) measurement in centimetres is added to routine checks — it should roughly match the gestational age in weeks, with more than ±3 cm deviation triggering a growth ultrasound. Fetal heart and blood pressure continue as before.
  • Pre-eclampsia Risk Reassessment — Blood pressure, urine dipstick protein, and symptoms (headache, visual changes, right upper quadrant pain, swelling) are reviewed for early pre-eclampsia. Patients at moderate-to-high risk per SOMANZ/RANZCOG criteria are usually already on low-dose aspirin (100-150 mg at night) started before 16 weeks.

How to prepare

  • Fast for 8-14 hours before the OGTT — water only. Schedule the appointment for early morning so fasting is easier.
  • Eat normally (not low-carb) for at least 3 days before the test — severe carb restriction can give a falsely abnormal result.
  • Plan to stay at the pathology collection centre for 2-2.5 hours — you cannot leave between draws. Bring a book, phone charger, or work laptop, and a healthy snack for after the 2-hour sample.
  • The glucose drink is very sweet and many people feel nauseous after it. Sip slowly, and tell the collector if you vomit — the test will need rescheduling.

Tips

  • If you are Rh(D)-negative, your first Anti-D immunoglobulin (Rh(D)-Ig, 625 IU) is scheduled around now (28 weeks). It is an intramuscular injection in the arm or buttock and takes only a minute. Post-injection observation is usually 15-20 minutes for rare reactions.
  • Free antenatal breastfeeding education classes are offered by most public hospitals and the Australian Breastfeeding Association (ABA) in every state. Starting early makes the first feed easier — it is the ABA helpline (1800 686 268) that supports parents 24/7 after birth.
  • Start planning your paid parental leave dates. You can apply for government PPL through myGov up to 3 months before your due date, but must be on leave to receive payments. Also confirm any employer-paid parental leave entitlements with HR.

Anti-D, dTpa, and Safer Baby Bundle

Visit 5 · Week 28

First dose of Anti-D for Rh(D)-negative patients, dTpa (whooping cough) vaccination at optimal 28 weeks per ATAGI, kick-counting education, and transition to fortnightly visits

Good to know: The 28-week visit is the busiest single visit of pregnancy in Australia — Anti-D (if Rh(D)-negative), dTpa, flu, potentially RSV, GDM-related discussion if OGTT was positive, and a shift in visit frequency and focus. The vaccines are all given in the arm and are not associated with any increased miscarriage, preterm birth, or fetal abnormality risk — the safety data is extensive. Skipping them is a bigger risk to your baby than the vaccine side effects (sore arm for a day or two).

Common checks

  • Anti-D Immunoglobulin — First Dose (28 weeks) — Rh(D)-negative pregnant people in Australia receive 625 IU of Anti-D (Rh(D)-Ig, supplied as Rhophylac or CSL Rh(D)-Ig) at 28 weeks AND again at 34 weeks, a two-dose protocol per NBA and RANZCOG guidelines — different from the single 28-week dose used in some other countries. A third dose is given within 72 hours after birth if the baby is Rh(D)-positive. Anti-D is a blood product derived from pooled plasma and is supplied free through Australian Red Cross Lifeblood.
  • dTpa (Whooping Cough) Vaccination — ATAGI and NHMRC recommend dTpa vaccination between 20 and 32 weeks, with the optimal window being around 28 weeks to maximise antibody transfer to the baby. Whooping cough (pertussis) is most dangerous in the first months of life before the baby has their own 6-week immunisation. dTpa is provided free under the National Immunisation Program for every pregnancy, regardless of prior vaccination history.
  • Influenza Vaccine (any trimester) — Flu vaccine is funded free under the National Immunisation Program for pregnant people in any trimester, including during flu season. If you have not yet received this year's flu shot, it can be given at the same visit as dTpa.
  • RSV Vaccine (Abrysvo) — 28-36 weeks — From early 2025, the Australian NIP funds maternal RSV vaccination (Abrysvo) between 28-36 weeks to protect the newborn from RSV bronchiolitis in the first months of life. Ask your provider at this visit; in some states it is given at the 28-week visit alongside dTpa.
  • Kick-Counting and Movement Advice — The Safer Baby Bundle (Stillbirth CRE Australia) teaches parents from 28 weeks: get to know your baby's pattern of movements, and if there is any change — fewer, weaker, or a different pattern — contact your hospital or midwife immediately, day or night. Do not use cold drinks, sugar, or lying down as self-tests; these are no longer recommended.
  • Fetal Heart, Fundal Height, BP, Urine — Routine surveillance continues. From 28 weeks visits become fortnightly until 36 weeks, then weekly from 36 weeks in most Australian care models.

How to prepare

  • Take paracetamol ready at home for possible post-vaccine arm soreness. Avoid prophylactic paracetamol before the shot — it may slightly reduce the immune response.
  • Confirm your OGTT result before this visit if possible — the appointment will be more productive if a GDM conversation (if needed) is ready to go.
  • Wear a short-sleeved top — you may be getting dTpa, flu, RSV, and Anti-D all in one visit.
  • Your care provider will offer a referral to the hospital's antenatal class program and breastfeeding class if you have not already enrolled. Book early — popular classes fill up.

Tips

  • Save the 24/7 pregnancy phone line for your hospital or midwifery service on your phone now. In most Australian public hospitals you can ring directly any time for concerns — decreased movements, unusual pain, bleeding, possible labour signs.
  • Third trimester sleep: left-side sleeping from 28 weeks is recommended by the Safer Baby Bundle — it improves blood flow to the placenta and is linked to lower stillbirth risk. Use a pregnancy pillow for comfort.
  • If you have not already, start car-seat (baby capsule) research. Under Australian law, newborns must travel home in a rear-facing, properly-fitted child restraint meeting AS/NZS 1754. Kidsafe and many state-based auto clubs offer professional fitting appointments.

Growth Check and Birth Plan

Visit 6 · Week 32

Fundal height trend, fetal position assessment, growth ultrasound if clinically indicated, birth plan discussion, and review of low-lying placenta if flagged at morphology scan

Good to know: Reduced fetal movements from 28 weeks onward are the most important warning sign in the third trimester. In Australia, "perception of reduced movement" is a direct indication for same-day assessment at the hospital Pregnancy Assessment Unit (PAU) or Birth Suite — you do not need a GP referral or appointment. Assessment usually includes a cardiotocograph (CTG) for 20-40 minutes and, if any concerns, a growth/Doppler ultrasound. Trust your instincts.

Common checks

  • Symphysis-Fundal Height (SFH) and Growth Assessment — SFH is measured in centimetres at every visit from 24 weeks. If the fundal height plateaus, drops, or is more than 3 cm less than the gestational age, your provider refers you for a growth ultrasound to check fetal weight (estimated fetal weight, EFW), amniotic fluid, and umbilical artery Doppler per RANZCOG small-for-gestational-age guidelines.
  • Fetal Position (Leopold's Manoeuvres) — Your provider palpates your abdomen to assess fetal lie and presentation. At 32 weeks most babies are head-down (cephalic), but breech or transverse lie at this gestation is still common and usually resolves by 36 weeks. If your baby is breech at 36 weeks, RANZCOG recommends discussing external cephalic version (ECV) at 37 weeks.
  • Low-Lying Placenta Follow-Up (if previously flagged) — If the morphology scan found a low-lying placenta, a transvaginal ultrasound at 32 weeks rechecks placental position. About 90% migrate clear of the cervix as the uterus grows; persistent placenta praevia triggers a discussion of planned caesarean and hospital admission planning.
  • Blood Pressure, Urine, Fetal Heart Rate — Blood pressure and urine dipstick continue to screen for pre-eclampsia, which is most likely to develop between 32 and 37 weeks. Contact your hospital immediately for severe headache, visual disturbance, upper abdominal pain, or sudden swelling.
  • Birth Plan Conversation — Your midwife or GP starts a structured conversation about birth preferences: pain relief options (non-pharmacological, nitrous oxide, opioid, epidural), position and movement, continuous vs intermittent monitoring, support people, water birth if available, and preferences for placenta delivery and skin-to-skin. Public hospitals in Australia encourage written birth plans but remain flexible to clinical circumstances.

How to prepare

  • Write down your birth preferences before this visit — even a simple list of 5-10 points helps structure the conversation. The Raising Children Network and COPE both have free Australian birth plan templates.
  • Pack your hospital bag starting this week — you do not want to be packing at 4 am in labour. Include items for you (toiletries, labour clothes, snacks, phone charger), baby (newborn onesies, nappies, swaddle), and home (post-birth pads, breast pads).
  • Note the address and parking information for the maternity entrance of your hospital — in early labour you will be glad to have it written down.

Tips

  • Consider enrolling in an antenatal breastfeeding workshop — public hospitals, community health centres, and the Australian Breastfeeding Association all run free or low-cost sessions. A single 2-3 hour class dramatically improves first-feed success.
  • Perineal massage from 34 weeks (5-10 minutes daily) is supported by Cochrane evidence for reducing perineal trauma in first-time birthers. Use a neutral oil (e.g., sweet almond or olive) and gentle pressure.
  • Book a professional car-seat fitting for 36-38 weeks. Kidsafe, RACV (VIC), NRMA (NSW), RACQ (QLD), and RAA (SA) all offer fittings for around $60-80 AUD, or in some states bulk-billed for concession card holders.

Second Anti-D and Preparation

Visit 7 · Week 34

Second Anti-D dose for Rh(D)-negative patients, confirmation of fetal presentation, hospital tour booking, and early warning-sign education

Good to know: A Rh(D)-negative pregnancy in Australia is very well protected by the two-dose Anti-D schedule. The blood product is sourced from screened volunteer donors through Australian Red Cross Lifeblood and has an outstanding safety record over decades of use. Side effects are usually limited to a sore injection site. Because Anti-D is a plasma-derived product some patients have personal preferences to discuss — your provider can outline the alternatives and risks of declining.

Common checks

  • Anti-D Immunoglobulin — Second Dose (34 weeks) — The second routine antenatal Anti-D (625 IU) dose is given at 34 weeks for Rh(D)-negative patients. This differs from countries that give only one antenatal dose at 28 weeks. The two-dose Australian protocol (28 + 34 weeks, plus postpartum if needed) is recommended by the NBA (National Blood Authority) and RANZCOG and provides ongoing antibody protection through the third trimester.
  • Fetal Presentation Re-Check — Your provider palpates the abdomen again to check position. By 34 weeks most babies settle into a head-down (cephalic) position. If the baby is breech at this visit and not yet turning, you will be offered a confirmatory ultrasound at 36 weeks and a discussion of External Cephalic Version (ECV) at 36-37 weeks or planned caesarean.
  • Fundal Height, Fetal Heart Rate, BP, Urine — Routine third-trimester surveillance continues. Watch for the triple combo that suggests pre-eclampsia: new hypertension (≥140/90 on two occasions 4 hours apart), proteinuria on dipstick, and symptoms such as visual changes, severe headache, or upper abdominal pain.
  • Early Warning Signs Education — Your midwife or GP reviews when to contact the hospital: reduced or changed movements, vaginal bleeding (any amount), leaking fluid, regular painful contractions before 37 weeks, severe headache or visual changes, persistent upper abdominal pain, and unusual itching (which can signal obstetric cholestasis). The message is always: when in doubt, call — do not wait until morning.

How to prepare

  • Book your hospital tour (or virtual hospital tour) for the next 2-3 weeks if you have not already — knowing the layout and where to park makes labour day less stressful.
  • Check that your hospital bag is mostly packed. A common Australian public-hospital packing list is available on most hospital websites — labour clothes, post-birth change, phone charger, baby going-home outfit, safe-sleep swaddle.
  • Keep your Medicare number, private health fund details (if applicable), and a copy of your hand-held pregnancy record in your bag or glove box.

Tips

  • From 34 weeks, start counting baby movements twice daily — after a meal and before bed. You are looking for at least 10 movements in 2 hours, but more importantly you are looking for your baby's own normal pattern.
  • Continue perineal massage 5-10 minutes daily if you have started. Evidence supports a small but meaningful reduction in perineal trauma for first-time birthers.
  • Confirm post-birth support: who can bring meals the first week? Who can hold the baby so you can shower? Australian paid parental leave helps, but local support (family, friends, meal trains) makes the biggest day-to-day difference. Many councils also offer free maternal and child health nurse home visits after discharge.

GBS Swab and Presentation Confirmation

Visit 8 · Weeks 36–37

Universal Group B Streptococcus (GBS) swab at 35-37 weeks per RANZCOG 2019, presentation ultrasound if clinically needed, External Cephalic Version (ECV) discussion if breech, and shift to weekly visits

Good to know: From 37 weeks your pregnancy is considered term in Australia, meaning the baby is fully developed and spontaneous labour is welcomed. Most Australian hospitals and midwives favour waiting for spontaneous labour up to 41 weeks in uncomplicated pregnancies. This is supported by RANZCOG evidence that induction-versus-expectant-management trade-offs shift at 41-42 weeks. You may hear terms like "early term" (37+0 to 38+6), "full term" (39+0 to 40+6), "late term" (41+0 to 41+6), and "post-term" (≥42+0).

Common checks

  • Group B Streptococcus (GBS) Swab — RANZCOG 2019 guidelines recommend universal GBS screening with a single combined low vaginal and rectal swab at 35-37 weeks. GBS is a bacterium colonising around 15-25% of Australian pregnant people; it is usually harmless but can cause serious early-onset neonatal infection. Positive GBS status means you receive intravenous benzylpenicillin (or clindamycin for penicillin allergy) during labour, which reduces neonatal GBS disease by ~90%.
  • Presentation Ultrasound (if malpresentation suspected) — If clinical palpation at 36 weeks suggests breech, transverse, or uncertain presentation, a quick bedside or formal ultrasound confirms. In breech presentation, the PROMPT/RANZCOG pathway is to offer External Cephalic Version (ECV) at 36-37 weeks (~50% success rate, done under monitoring in the birthing unit) or plan a caesarean at 39 weeks.
  • Fundal Height, Fetal Heart Rate, BP, Urine — Routine surveillance continues. From 36 weeks onward, most Australian care models move to weekly visits.
  • Cervical Exam (if indicated) — Routine cervical examinations at 36-37 weeks are NOT recommended in Australia — they provide limited predictive value and are uncomfortable. An exam may be offered if you request one, if membrane sweep is being discussed, or if there are clinical concerns.

How to prepare

  • Before this visit, review the GBS information sheet your care team provides. If you are penicillin-allergic, discuss that today — it changes which antibiotic would be used in labour.
  • The swab takes under a minute and is done by you or the midwife. No special preparation is needed — you can shower normally beforehand.
  • Keep a weather eye on three things this week: any bleeding, leaking fluid, or regular painful contractions. From 37 weeks these may signal labour; before 37 weeks they need urgent assessment.

Tips

  • Start thinking about birth registration. Every Australian state and territory requires registration of the birth with the state Birth, Deaths and Marriages (BDM) within 60 days. Your hospital will provide a registration pack in the maternity bag — you can register online through your state's BDM website. Registration is required before you can apply for Medicare enrolment, newborn bloodspot claim, Centrelink family payments, or a passport.
  • Pre-register for Medicare for the baby and set up your myGov "Medicare for my child" so that enrolment is faster in the first weeks. Also confirm Child Care Subsidy (CCS) registration if you plan to return to work.
  • Practise breathing and relaxation techniques from your antenatal classes daily. Even 10 minutes a day rewires the stress response and makes labour easier to ride.

Post-Dates Review and Induction Planning

Visit 9 · Weeks 40–41

Post-dates surveillance with CTG and ultrasound, membrane sweep discussion, and induction of labour booking at 41 weeks per RANZCOG

Good to know: Once you pass your due date, your provider moves to close surveillance — typically CTG and amniotic fluid checks every 2-3 days, plus a booked induction date no later than 41+3 to 42 weeks. This is not a failure of your body: about 50% of first-time birthers go past 40+0 and it is completely normal. Induction itself at 41 weeks has been shown in Australian randomised trial data (including the ARRIVE and RCOG-aligned evidence) to have outcomes at least as good as, and often better than, expectant management past 41 weeks.

Common checks

  • Post-Dates Cardiotocograph (CTG) — From 40-41 weeks, most Australian hospitals offer a CTG (20-40 minutes of continuous fetal heart and uterine activity monitoring) to confirm fetal wellbeing. A reactive CTG with accelerations and no concerning decelerations is reassuring. Abnormal CTG findings prompt admission for further assessment.
  • Amniotic Fluid Ultrasound — A focused ultrasound measures amniotic fluid index (AFI) or single deepest pocket. Oligohydramnios (AFI < 5 cm or deepest pocket < 2 cm) is a common reason to recommend induction in late-term pregnancies even if the CTG is reassuring, because fluid volume declines as the placenta ages.
  • Cervical Assessment and Bishop Score — A vaginal examination (with consent) assesses cervical dilation, effacement, position, consistency, and fetal station — together the Bishop score. A favourable Bishop score (≥6) predicts higher success with artificial rupture of membranes and oxytocin; an unfavourable score prompts cervical ripening with balloon catheter or prostaglandin gel/tablet before induction.
  • Membrane Sweep (Stretch and Sweep) — If your cervix allows and you consent, your provider can perform a membrane sweep — a finger movement at the internal cervical os to separate the membranes from the lower uterine segment. RANZCOG supports membrane sweep from 40+3 weeks as it modestly reduces the need for formal induction. Expect cramping and possibly some spotting afterward.
  • Induction of Labour Booking (41 weeks) — Per RANZCOG, if spontaneous labour has not begun by 41+0 to 41+3 weeks, induction is recommended — beyond 42 weeks, the risk of stillbirth, meconium aspiration, and caesarean rises. Your provider books you into the hospital induction list at this visit and explains the three-stage process: cervical ripening (balloon catheter or prostaglandin) → artificial rupture of membranes → oxytocin infusion if needed.

How to prepare

  • Pack for a longer admission — induction can take 24-48 hours from start to delivery. Bring phone chargers, snacks for your support person (you may be on a light diet), lip balm (hospital air is dry), and comfortable clothes for labour.
  • Discuss your preferences: do you want to try a membrane sweep? Would you prefer balloon catheter or prostaglandin for ripening? Do you want to labour at home as long as possible after an outpatient sweep? Your provider will work through options with you.
  • Review signs of active labour and when to come in: regular contractions every 3-5 minutes lasting 60+ seconds for an hour, waters breaking (note colour and smell), any bleeding beyond a show, or reduced movements — always call, regardless of your induction booking.

Tips

  • Eat well, rest, and stay hydrated — these are the only evidence-based natural labour-prep methods. Dates from 36-40 weeks have modest evidence of shortening labour, and Cochrane supports nipple stimulation to ripen the cervix. Castor oil, acupuncture, spicy food, and pineapple have limited or no evidence.
  • Prepare the going-home outfit, car seat (install now if not already), and the coming-home space (bassinet, nappy station, somewhere comfortable for you to sit while feeding). Your maternal and child health nurse will visit in the first 1-2 weeks after discharge — their number will be on your discharge paperwork.
  • After birth, register the baby with your state's Birth, Deaths and Marriages within 60 days, enrol in Medicare (usually done with the hospital midwife), apply for PPL through myGov if eligible, and book the 6-week postnatal check with your GP or obstetrician. The Maternal and Child Health Service (free in all states) will see you and baby at 1-2 weeks, then at 4 weeks, 8 weeks, and beyond.

Sources

This overview references public guidance from:

Prenatal Care Schedules by Country