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Pregnancy checklist

Find a lead maternity carer (LMC)

Your LMC will support you during your pregnancy, labour and the first few weeks after your baby is born.

See our downloadable list of midwives in Wellington, Porirua and Kapiti or you can contact us for more information.

You can also read more about how to find a midwife here.

In early pregnancy there is the option of seeing your GP for scripts for folic acid and iodine, antenatal blood test forms and scans. 

Blood tests can be done at one of the Wellington SCL locations: https://www.wellingtonscl.co.nz/  

If you have a scan form from a Doctor or Midwife then you can book the scan at either:  

Pacific Radiology https://pacificradiology.com/ 

Horizon Radiology https://wellingtonradiology.co.nz/ 

or Wellington Ultrasound https://www.wus.co.nz/  

Folic acid and iodine

These are essential nutrients for you and your baby.

Folic acid

Folic acid helps the body to make new cells. Folic acid is important because it can help to prevent birth defects of a baby’s brain and spine, such as spina bifida. Spina bifida can cause walking, bladder and bowel problems.

Take a folic acid tablet (0.8 milligram [mg]) every day for 4 weeks (1 month) before you might become pregnant through to 12 weeks after becoming pregnant.

If you find out that you are pregnant and you haven’t been taking a folic acid tablet, start taking tablets straight away. Keep taking them until the 12th week of your pregnancy.

You can buy folic acid tablets from pharmacies (or at a lower cost when prescribed by your midwife, medical practitioner)

Iodine

Iodine helps the body to grow and develop, especially the brain. Because babies get iodine from their mothers, pregnant and breastfeeding women need more iodine.

During pregnancy and while breastfeeding, choose foods that are high in iodine and take an iodine tablet every day. Foods that are high in iodine are well cooked seafood, milk, eggs, some cereals and bread.

Take one 0.150 milligram (mg)/150 micrograms (mcg or μg) iodine-only tablet every day when pregnant and breastfeeding. You can buy iodine tablets at pharmacies (or at a lower cost when prescribed by your midwife, medical practitioner)

Read more about folic acid and iodine here.

Vitamin D

Vitamin D is needed for strong bones and joints as well as healthy muscle and nerve activity. If you don’t have enough vitamin D during pregnancy, your baby may be born with low vitamin D levels. This can affect how your baby develops.

The sun is the main source of vitamin D. Small amounts of vitamin D can also be found in foods such as oily fish (tuna, sardines and salmon), eggs and some margarines, milks and yoghurts.

Some time in the sun is recommended so that your body can make vitamin D. Try to get outside before 10 am or after 4 pm between September and April, and around the middle of the day between May and August. The lighter your skin, the less time you need to be in the sun to make enough vitamin D. Don’t get sunburnt.

Some people have low levels of vitamin D – called vitamin D deficiency. If you have darker skin, spend most of your time inside, have liver or kidney disease or are taking certain medicines (eg, anticonvulsants), you are at a higher risk of vitamin D deficiency. If you live south of Nelson-Marlborough in winter, you’re also more likely to have low vitamin D levels in late winter and early spring.

If you are worried that you don’t get enough vitamin D, or you have a higher risk of vitamin D deficiency, talk to your midwife, medical practitioner or nurse practitioner.

Make a decision about screening tests

A number of screening tests are offered for pregnant people and their babies. It is your choice whether to have these done or not. The first tests should happen in the first 10 to 14 weeks of your pregnancy.

Antenatal blood tests

Seven different tests are currently offered. These are usually carried out at the same time so you only have one set of blood taken. These tests are:

  • Blood group and rhesus factor
  • Full blood count
  • Rubella
  • Syphilis
  • Hepatitis B
  • HIV
  • Diabetes - HbA1c

For further information about any of your antenatal blood tests please talk to your Lead Maternity Carer (LMC) or GP.

Download a flyer about antenatal blood tests from the National Screening Unit. (PDF)

HIV testing in pregnancy

Pregnant people should be offered an HIV test along with their first antenatal blood tests. You have the option to decline the test. Most pregnant people with HIV are unaware they have the infection; an HIV test is the only way to tell. HIV virus can be passed onto others, including your unborn baby. Treatment in pregnancy reduces the risk of the HIV virus being passed to the baby from 30 percent to less than 1 percent.

Download leaflets about HIV testing in pregnancy from the HealthEd website.

Downloads for HIV Testing in Pregnancy Leaflets - Ministry of Health are in the following languages:

Diabetes testing

Diabetes testing is offered twice in pregnancy: as part of the first antenatal blood test and again when you are 24 to 28 weeks pregnant. Read more about diabetes testing during pregnancy on the Ministry of Health

Screening for Down syndrome and other conditions

Antenatal screening for Down syndrome and other conditions can be done either before 14 weeks or between 14 and 20 weeks of pregnancy. Read more about this on the National Screening Unit website.

Give your baby the best possible start

Avoid smoking, alcohol and recreational drugs.

You may find the following resources useful:

Quitline F Aukati Kai Paipa

Quitline is a free national service to support smoking cessation

Contact is via phone, Ph: 0800 778 778  online https://quit.org.nz/register

and text 4006.  If your language preference is Māori Quitline can send you texts in Te Reo

For more information on the programme offered by Quitline see the Help to Quit section of the website

Quitline also has a range of quality smoking cessation resources, available for you to order free of charge through the Ministry of Health’s HealthEd catalogue. Additional resources are also available to download from our Info Resources page. 

More information about alcohol, drugs and support to quit smoking:

Find out more about 'I Quit Smoking for Baby and Me'

Find out more about quitting smoking

Find out more about why you shouldn't drink alcohol while you're pregnant

Read more about the risks of smoking, drugs and alcohol if you're pregnant

    Eat well and stay active

    Eating well and doing moderate physical activity during pregnancy are important for you and your baby. Nutritional needs are higher when you are pregnant. Meeting these needs helps protect the long-term health of both you and your baby.

    Immunisations for pregnant people - whooping cough, influenza and COVID-19

    Whooping Cough and inflenza

    Immunisation against influenza, whooping cough and Covid during pregnancy is recommended by the Ministry of Health, and free. Talk to your doctor or practice nurse, or your midwife to find out how to protect you and your child.

    Mothers pass some of their immunity along to their babies during pregnancy. This provides some protection to newborn babies.

    Find out more about immunisations during pregnancy.

    COVID-19 (coronavirus)

    For Covid-19 changes to services see https://www.ccdhb.org.nz/our-services/covid-19-changes-to-our-services/

    Information for pregnant people is available on the Ministry of Health Website https://www.health.govt.nz/our-work/diseases-and-conditions/covid-19-novel-coronavirus/covid-19-information-specific-audiences/covid-19-information-pregnant-women-and-those-who-have-recently-given-birth

    For information for hapū māmā, pregnant people about getting vaccinated against COVID-19.

    see https://www.health.govt.nz/covid-19-novel-coronavirus/covid-19-vaccines/covid-19-vaccine-pregnancy-and-breastfeeding 

    and https://covid.immune.org.nz

     

     

    Pregnancy Health

    Ministry of Health

    The Ministry of Education's HealthEd website has extensive information and resources related to pregnancy.

    Visit the HealthEd website here.

    Services and support during pregnancy.

    Find out about the services and support available to you while you are pregnant.

    Your pregnancy booklet 

    This provides information on being pregnant, giving birth, the first few weeks after the birth, and the roles and responsibilities of LMCs (Lead Maternity Carers). You can access the free booklet online here or ask for a copy from your GP, midwife/LMC or by contacting us.

    Pregnancy video weeks 0 to 14 weeks of pregnancy

    Find out about keeping healthy and well during the first 14 weeks of pregnancy.

    Find out more on the Ministry of Health website.

    Alert signs – when to call your midwife (or specialist doctor)

    Contact your midwife (or specialist doctor) straight away if you have concerns about your or your babies health. See the list of danger signs during pregnancy here.

    Contact your midwife (or specialist doctor) straight away if you have any of the following listed below.

    • You have bleeding from your vagina, or you have vaginal discharge that is unusual for you.
    • Your ‘waters’ leak or break before labour starts or, once they have broken, the fluid is dirty-looking, greenish or brown.
    • If, once you are regularly feeling your baby move, your baby moves less than usual or you cannot feel your baby move at all.
    • If, after the first few weeks of your pregnancy, you have pains or cramps in your abdomen (tummy).
    • Your hands, feet or face suddenly swell.
    • You have pain or burning when you wee/mimi – especially if you also have a fever and a sore back.
    • You have a very bad headache and this lasts for more than a few hours.
    • You can’t see well – you have blurry vision or you start to see white lights, flashes or dots in front of your eyes or you have double vision. 
    • You have a fever of over 38°C – you may have a virus, so check with your midwife (or specialist doctor) or pharmacist before you take any medicines. If your fever lasts for longer than a day, check with your midwife (or specialist doctor), or doctor or nurse.
    • You fall on or hurt your abdomen (tummy) – get this checked, even if you don’t feel hurt or sore.
    • You are very thirsty but you can’t wee/mimi.
    • You start feeling sick and throwing up in late pregnancy – especially if you have pain and a fever.
    • You itch all over – especially if you have dark-coloured wee/mimi and pale poo/tuutae.

    Zika virus

    Pregnant people who become infected with Zika can transmit the disease to their unborn babies, with potentially serious consequences. Reports from several countries, including Brazil, indicate an increase in severe birth defects (microcephaly in particular) in babies whose mothers were infected while pregnant.

    Zika virus is mainly transmitted by mosquitoes and may be present in any country that has the mosquitoes able to spread it. To date, the virus has been found in parts of Africa, southern Asia, the Pacific Islands, and the Americas. The mosquitoes that can spread Zika virus are not normally found in New Zealand.

    Rare instances of sexual transmission (mainly male to sex partner) have also been documented.

    For more information about Zika from the Ministry of Health

    see https://www.health.govt.nz/your-health/conditions-and-treatments/diseases-and-illnesses/zika-virus 

    Pregnancy classes

    Antenatal classes

    Antenatal childbirth classes provide information on pregnancy, labour, birth and postnatal care.

    Speak to your LMC midwife or consultant about booking into classes.

    Hapū Wānanga Te Raukura ō te Aroha

    Hapū Wānanga Te Raukura ō te Aroha is a kaupapa Māori approach to providing antenatal education and support for whānau. It aims to help empower Māmā to be able to make their own informed decisions throughout their hapūtanga journey, as well as providing whanau with opportunities to link in with practices like taonga puoro and muka.

    Location is Porirua. 

    Whanau can book through this link https://forms.gle/F24ZfKEjRKmbNpMZ9 

    Find us on social media here https://www.facebook.com/HapuWa/

    Tu Ora Compass Health Childbirth and breastfeeding free classes 

    Tu Ora Compass Health is a not -for profit organisation, supported by Te Whatu Ora Health NZ,  Capital, Coast, and Hutt Valley Hospitals 

    Attend the full series of 3-4 classes or pick and choose, different dates and different locations. They offer in person or zoom classes. 

    Classes are run by childbirth educators who have worked as midwives.

    In-person classes venues are in Newtown. Porirua and Kapiti

    Locations:

    Cancer Society Newtown;

    Tu Ora Compass Health, Porirua, level 3 ( up the lift), City Fitness Building, 1 Walton Leigh Ave, Porirua;

    Kapiti Health Centre, Warrimoo St Paraparaumu ( by Paraparaumu Maternity)

    Zoom to Wellington, Porirua, Kapiti, and Hutt Valley

    Book into a free class via https://www.childbirthclasses.co.nz/ 

     

    Birth Wise

    Promotes wellness in pregnancy, natural birth and holistic parenting by empowering people to make informed choices.

    For more information see http://www.birthwise.org.nz/

    Parent Centre Childbirth Education

    Led by qualified childbirth educators. They are private classes so there is a cost.

    For more information see www.wgtnparents.org.nz

    Dental health, healthy eating and exercise

    Dental health

    Looking after your dental health is particularly important during pregnancy. Read 5 tips to keep your smile healthy on the Bee Healthy Regional Dental Service website.

    Healthy eating

    Eating well and doing moderate physical activity during pregnancy are important for you and your baby. Nutritional needs are higher when you are pregnant. Meeting these needs helps protect the long-term health of both you and your baby

    The same site also has a resource about avoiding listeria for vulnerable people, including pregnant women.

    Eating safely in pregnancy

    Links to information about food safety

    Find out more about eating well during pregnancy from Ministry of Health

    Find out more about eating safely from Ministry of Primary Industries

    Maternal Green Prescription (MGRx)

    Provides a free programme managed by Sport Wellington to promote the health and well-being of pregnant people through improved nutrition and increased levels of physical activity. Sport Wellington Healthy Lifestyle Co-Ordinators work with women to encourage positive healthy lifestyle changes that will benefit their growing baby and whole whānau.

    Find out more about the Maternal Green Prescription programme.

    If you are pregnant and would like to make a positive change for you and your whānau, speak to your lead maternity carer, CCDHB community midwife or General Practitioner to see if a Maternal Green Prescription is right for you. Please use the following links to access referral information regarding green prescriptions.

    Fill out a self referral form here.

    See here for referral criteria. 

    Being active during pregnancy

    Find out more about how to stay active during pregnancy and breastfeeding.

    Sleep on side when baby's inside from 28 weeks of pregnancy

    It is recommended that pregnant people sleep on their side from 28 weeks of pregnancy this aims to reduce the risk of late stillbirth.

    Clinics and ultrasound

    Women's Clinics - Acute Assessment

    The Acute Assessment Unit acts as a front door to the Women's Health Service for pregnant people requiring acute assessment for obstetric and gynaecological conditions. Women seen in this unit are referred by their primary healthcare provider e.g. GP, LMC. Women's Health provides acute assessment services 24 hours a day, 7 days a week. During the hours of 8am - 6pm Monday to Friday (excluding Public Holidays) people are seen at the Women's Clinics - Acute Assessment. Outside these hours the Obstetric and Gynaecology Registrar can be contacted by the primary healthcare provider and arrangements made to see the woman in the appropriate inpatient area.

    Clinics - Ultrasound

    Ultrasound provides a comprehensive scanning service for obstetrics, prenatal diagnosis and treatment, and gynaecological scanning.

    We do not provide a community scanning service. Please contact your primary healthcare provider for community scanning.

    Contact details for Community Scanning:

    Wellington Ultrasound

    https://www.wus.co.nz/contact-us

    38 Riddiford St  Newtown, Wellington, 6021

    Pacific Radiology Wellington

    https://www.pacificradiology.com/#/other/contact-us

    Horizon Radiology

    https://wellingtonradiology.co.nz/

    Level 1/61-63 Taranaki Street, Te Aro, Wellington 6011 and 

    Suite 408 Level 4, 2 Titahi Bay Road, Porirua 5022

    Amniocentesis

    This is a procedure used to evaluate the health of your unborn baby and identify any problems that may exist. Using ultrasound as a guide, a thin needle is inserted through your stomach into your uterus (womb). A small sample of the amniotic fluid that surrounds your baby is then taken. This fluid contains cells from the baby, which are then studied in the laboratory.

    The best time to perform amniocentesis is in the 16th week of pregnancy.

    Chorionic Villus Sampling

    Chorionic villus sampling (CVS) is used to test for genetic disorders, such as Down’s syndrome, and involves taking a small sample of the chorionic villi, which are the tiny units that make up the placenta. The placenta is the organ that grows on the inner lining of your uterus (womb) through which nourishment and oxygen pass to your foetus (unborn baby). The chorionic villi have the same chromosomes as your foetus and DNA analysis will determine if your unborn child has any genetic abnormalities. 

    Using ultrasound as a guide, the sample is obtained by inserting a cannula up through the vagina and cervix (transcervical) or by inserting a needle in through your stomach (transabdominal). 

    Intrauterine Growth Restriction (IUGR)

    In a very small number of pregnancies, the baby may not grow as well as in a normal pregnancy. This is called intrauterine growth restriction (IUGR) and the unborn baby will be described as being “small for gestational age” (SGA). This means that the baby is smaller than expected for the length of time that the woman has been pregnant. An unborn baby with IUGR should be carefully managed during pregnancy and delivery but will usually be healthy at birth. 

    Obstetric Ultrasound

    Ultrasound imaging, also called ultrasound scanning, is a method of obtaining pictures from inside the human body through the use of high frequency sound waves. 

    Obstetric ultrasound refers to the specialised use of this technique to produce a picture of your unborn baby while it is inside your uterus (womb). The sound waves are emitted from a hand-held transducer, which is placed on your stomach, and reflection of these sound waves is displayed as a picture of the moving foetus (unborn baby) on a monitor screen. No x-rays are involved in ultrasound imaging.

    Measurements of the image of the foetus help in the assessment of its size and growth as well as confirming the due date of delivery.

    Anti-D Immunoglobulin

    Anti-D immunoglobulin for Rh negative people who have miscarried or have had a sensitising event is prescribed and ordered by the GP or LMC from the Blood Centre during working hours Monday to Friday. You can collect the Anti-D yourself and take it back to your GP or LMC to be administered. There is no charge to the client.

    Health conditions

    Pre-eclampsia

    Pre-eclampsia is a serious condition that occurs in some people during the second half of pregnancy. It is characterised by high blood pressure, swelling that doesn't go away and large amounts of protein in the urine. If left untreated it can stop the placenta, which provides nourishment to the baby, from getting enough blood and thus slows the baby’s growth. The condition can also be dangerous for the mother. In the early stages, simple measures such as bed rest may control the symptoms but, if not, it may be necessary to deliver the baby a week or two early.

    Gestational diabetes 

    Gestation is the length of a pregnancy from conception to birth (usually 40 weeks in humans). Gestational diabetes is a type of diabetes (glucose intolerance) that occurs in some women during pregnancy. Pregnant people with gestational diabetes have a high level of glucose (or sugar) in their blood because they do not have enough of the hormone insulin to cope with the extra demands of the growing foetus (unborn baby). In most cases, gestational diabetes is managed by diet and exercise and will usually disappear after the baby is born

    Support for hearing impaired

    Support for pregnant deaf and hard of hearing people and their whānau

    International research suggests the Deaf community has poorer health outcomes compared to the general population. We know effective communication in healthcare settings contributes to good patient outcomes and this requires recognition of linguistic and cultural differences. For the Deaf community this means adequate use of NZSL interpreters.

    Can I have a NZSL interpreter?

    Yes, qualified NZSL interpreters should be used in all ‘high consequence’ circumstances 24/7.E.g., health consultations, including assessment, treatment and discussions around medication.

    1. Ask the Deaf person if they want a NZSL interpreter?
    2. If yes, do they have a preferred interpreter?

    For appointments with my independent midwife, GP, Plunket, ultrasound appointments, antenatal classes:

    iSign pays for the interpreter, contact iSign at:

    For appointments based at the hospital the hospital will pay the cost (delivery, woman’s health etc.)

      Who’s responsible for booking the interpreter?

      The organisation (not the Deaf person) is responsible for booking the interpreter.However, if there are any problems getting an interpreter the Deaf person can text iSign on 3359.

      What should I do if no NZSL interpreters are available?

      Discuss with the Deaf person the best way to communicate, some options include:

      • Using the Video Relay Interpreting service (available between 8am-8pm, Mon-Fri, 10am-5pm Saturday and 12pm-5pm Sunday). The service is also available during these hours on public holidays.
      • Postpone the appointment until you can get an interpreter
      • Use note writing, online videos, gesture, lip reading, family/friend to interpret (NB: these options are risky and should be considered as a last resort)
      • Check out these videos.

      What is the Video Interpreting Service (VIS)?

      • VIS uses a qualified NZSL interpreter via skype through the screen names NZVIS01 - NZVIS07
      • A hearing person can also call a deaf person who uses skype via VIS by calling 0800 4877 877.
      • VIS should usually be a backup option
      • ED at Wellington Regional Hospital and Kenepuru Community Hospital have iPads set up ready to use VIS
      • For more information, check out www.nzvis.co.nz.

      If you have any questions, you can call or text the disability team (during working hours):

      Miscarriage

      The most common symptoms of a miscarriage are cramping and/or bleeding. If you are concerned, contact your LMC or doctor for advice. If you become unwell and the bleeding is heavy or you have pain contact your LMC or the emergency department.

      Most people recover physically soon after a miscarriage, but it can be very upsetting and grieving is normal.

      For support following a miscarriage contact the Miscarriage Support Group www.miscarriage.org.nz or for information about the pregnancy grief and loss counselling service see 

      https://www.ccdhb.org.nz/our-services/maternity/information-sheets/specialist-pregnancygrief-and-loss-counselling-service.pdf

      Last updated 27 February 2023.