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Clinical practice guidelines -- pregnancy care
Anonymous [Australian Department of Health]
practice guideline

Antenatal care is a usual part of pregnancy for most women who give birth in Australia. Women receive antenatal care in community and hospital-based settings and see a range of health professionals. Effective models of antenatal care have a focus on the individual woman's needs and preferences, collaboration and continuity of care. These national Clinical Practice Guidelines on Pregnancy Care provide evidence-based recommendations to support high quality, safe antenatal care in all settings. This document combines Module I, published in 2012 and Module II, published in 2014. Some chapters were reviewed and updated in 2016 to 2017. Within the diversity of women that make up the Australian population, some face greater disadvantage, experience difficulties in accessing health services and may experience poorer outcomes. The broader context of a woman's life should be considered in planning and providing pregnancy care. Taking a woman-centred approach also ensures that a woman's social, emotional, physical, psychological, spiritual and cultural needs and expectations are considered and respected. Throughout the pregnancy, women should be given information in an appropriate form to support them to make choices about their care. This document highlights specific approaches to pregnancy care for a range of groups, with a focus on improving the experience of antenatal care for Aboriginal and Torres Strait Islander women, migrant and refugee women and women with severe mental illness. The topics covered in these guidelines cover core practices in antenatal care that are relevant to antenatal care for healthy pregnant women (ie, those who do not have identified pre-existing conditions or are at higher risk of complications such as in multiple pregnancy). This includes: discussing health and wellbeing during pregnancy (eg, nutrition, physical activity); providing information to support parents to prepare for the rest of pregnancy, childbirth and parenthood; promoting and supporting breastfeeding assessing fetal wellbeing (eg, offering an 18 to 20 week ultrasound scan, discussing fetal movements and assessing fetal growth); assessing the health of the woman, in particular factors indicating that additional care may be required (eg, for women at increased risk of preterm birth or pre-eclampsia); assessing for any condition that may affect the health of the woman or the unborn baby (eg, anaemia, diabetes, sexually transmitted infections, mental health disorders); providing advice on symptoms that are common during pregnancy (eg, reflux and haemorrhoids); discussing and offering testing for chromosomal anomalies providing opportunities for women to raise any issues they wish to discuss providing ongoing support enabling consultation and referral when required. A planned schedule of antenatal visits should be agreed early in pregnancy, based on the individual woman's needs. Assessment of a woman's risk and any requirement for additional care continues throughout pregnancy. These guidelines are not intended as a textbook of antenatal care but rather. A process of prioritisation was used to decide which topics were relevant to the Australian context. While many of these topics involve clinical assessment and maternal health testing, the management of any conditions identified is not generally discussed. Health professionals are directed to appropriate resources or other relevant guidelines where available. The guidelines provide a reliable and standard reference for health professionals providing antenatal care. By providing a summary of the currently available evidence on many aspects of antenatal care, they aim to promote consistency of care and improve the experience and outcomes of pregnancy care for all families.

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