Your first pregnancy check-up

Whether you are a private or a public patient you may wish to have your first pregnancy appointment with your local GP.

There are many reasons for this, you may feel more comfortable seeing your own doctor to begin with, you may want your doctor to advise you about your maternity care options, it might be more affordable to see your GP in the first instance or it may be a number of weeks before you can get an appointment with your preferred provider or carer.

Your local doctor (GP) can do early routine visits and organise your first tests and investigations.

A GP can:

• do a pregnancy urine or blood test
• talk with you about any concerns you might have about your pregnancy or general health
• discuss and organise early tests and ultrasounds
• talk with you about diet and exercise
• help you to give up smoking and discuss alcohol and drug issues if necessary
• make sure any medications you are taking are safe in pregnancy, including any natural or alternative medicines
• talk with you about your pregnancy care options.

Tests your GP can organise

Your GP can order blood tests to check the following:

• blood group and iron levels
• immunity to rubella (German measles)
• whether you have been exposed to hepatitis (a disease of the liver)
• sexually transmitted diseases such as syphilis and HIV (this test is offered with pre and post-test counselling)
• Thalassaemia (an inherited disorder that affects the production of haemoglobin).
• your risk for having a baby with Down syndrome and other genetic disorders

For women who are at risk a blood test is also offered to check for:

• vitamin D (deficiency that can occur from lack of exposure to sunlight)

• hepatitis C.

Your GP can also do or organise the following tests:

Urine test - to check for infection.

Cervical Screening Test - if you are due, this can be done safely in pregnancy.

Genetic tests

Ultrasound – which can look for a number of problems in your baby like spina bifida, heart and limb defects and to check your due date.

RhD factor and anti-D antibodies

On average, for every 100 people:

• 83 will have the RhD protein - their blood type is called RhD positive
• 17 will not have the RhD protein - their blood type is called RhD negative.

There is a chance that - even if you are RhD negative - your baby will be RhD positive. We call this a blood type mismatch.

During pregnancy or birth, blood cells from your baby can enter your blood stream. If there is a blood type mismatch, your immune system may produce antibodies against your baby’s red blood cells. This is not normally a problem in this pregnancy. However, if a baby is RhD positive in a future pregnancy, your immune system can attack the baby’s red blood cells and make them sick. This disease is called haemolytic disease of the fetus and newborn (HDFN). It can cause severe anaemia (a lack of red blood cells to carry oxygen), brain damage, or even death.

Your GP will order a test to determine your blood group and RhD group. If the results show that you are RhD negative, you will be offered injections of a product known as RhD immunoglobulin, or ‘anti-D’. Anti-D reduces your chance of developing antibodies against your baby’s blood cells (if they are RhD positive). Anti-D is made from plasma collected from human blood donors. It is treated so that it is safe for both you and your baby. Your GP can also order a blood test for you that predicts your baby's RhD group, called the RHD NIPT. This test is covered by medicare and can be done from 15 weeks of pregnancy. 

You can find more information in our factsheet: Fetal blood group testing - for pregnant people with a RhD negative blood type.

Things to discuss with your GP

• When your baby is due.
• Information that may affect your pregnancy such as your family’s health.
• Whether you are likely to have a straightforward pregnancy or whether you have  more complex pregnancy needs.

You will also be asked about your family’s medical history, which might include factors such as diabetes, blood pressure issues, heart problems or a history of twins.

Aside from medical issues, the doctor may also ask about your circumstances such as:

• whether you might be at risk of violence
• whether you have support from family  and friends
• previous miscarriages or abortions and how you are feeling about them.

This is to make sure that all women are offered appropriate information, support and referral.

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