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Guidelines for Shared Maternity Care Affiliates Guidelines for Shared Maternity Care Affiliates 2010 The Shared Maternity Care Collaborative 1 GUIDELINES FOR SHARED MATERNITY CARE AFFILIATES 2010 Mercy Hospital for Women The Royal Women’s Hospital Western Health Northern Health Copyright State of Victoria 2010 This work is copyright and if reproduced reference must be cited as follows: Guidelines for Shared Maternity Care Affiliates, Mercy Hospital for Women, The Royal Women’s Hospital, Western Health and Northern Health 2010. Published by Mercy Hospital for Women, The Royal Women’s Hospital, Western Health and Northern Health, Melbourne, Victoria. All rights reserved. Except for the purposes of education, fair dealing and use within the intended environment, no portion of this document should be reproduced or copied for any purposes, including general exhibition, lending, resale and hire. November 2010 Published on the web, at the four Hospitals’ websites: www.thewomens.org.au, www.mercy.com.au, www.wh.org.au, www.nh.org.au DISCLAIMER These guidelines have been developed for the provision of shared maternity care between Mercy Hospital for Women, The Royal Women’s Hospital, Western Health and Northern Health (The Hospitals) and shared maternity care affiliates accredited at these Hospitals. Irrespective of these Guidelines, every health service provider and health professional must individually exercise the standard of professional judgment and conduct expected of them in selecting the most appropriate care for a pregnant woman and in the management of her pregnancy. Any representation implied or expressed concerning the efficacy, appropriateness or suitability of any treatment or service is expressly negatived. The Hospitals cannot and do not warrant that the information contained in these guidelines is in every respect accurate, complete or indeed appropriate for every woman and her pregnancy. Accordingly, the Hospitals will not be held responsible or liable for any errors or omissions that may be found in any of the information set out in these guidelines. These guidelines contain links to websites (“linked third party sites”) not under the direct control of the Hospitals. These links are provided as a convenience and the inclusion of any link does not imply endorsement or approval of the linked website. The Hospitals make no warranty regarding the quality, accuracy or fitness for purpose of the content or services available through linked third party sites. 2 ACKNOWLEGEMENTS Project Leads Madeleine Whinney Shared Maternity Care Guidelines Project Officer Dr Ines Rio Head General Practice Liaison Unit, The Royal Women’s Hospital Management Group Dr Leonie Griffiths General Practice Liaison Officer, Northern Health Dr Mary Anne McLean General Practice Liaison Medical Advisor, Mercy Hospital for Women Dr Ines Rio Head General Practice Liaison Unit, The Royal Women’s Hospital Dr Jo Silva General Practice Advisor, Western Health Bianca Bell General Practice Liaison Coordinator, Western Health Merran Mackie General Practice Liaison Project Officer, Mercy Hospital for Women Sue Vallance General Practice Liaison Project Officer, Northern Health Madeleine Whinney Project Officer, The Royal Women’s Hospital Steering Committee Dr Louise Kornman Clinical Director, Maternity Services, The Royal Women’s Hospital Dr Bernadette White Clinical Director, Obstetric & Maternity Services, Mercy Hospital for Women Dr Alex Teare Clinical Services Director Women’s & Children’s Health, Northern Health Dr Michael Sedgley Clinical Services Director, Division of Women’s and Children’s Services, Western Health Tanya Farrell Director Maternity Services, The Royal Women’s Hospital Theresa Bowditch Deputy Director Nursing, Maternity and Neonatal Services, Mercy Hospital for Women Susan Gannon Divisional Director Women's & Children's, Western Health Dr John Scopel Shared Maternity Care Affiliate GP representative Dr Fiona Broderick Shared Maternity Care Affiliate GP representative Dr Judy Smith Shared Maternity Care Affiliate Midwife representative Carol Lawson Shared Maternity Care Affiliate GP, Royal Australian College of General Practice representative Dr Jennifer Anderson Shared Maternity Care Affiliate GP, General Practice Victoria representative Dr Leonie Griffiths General Practice Liaison Officer, Northern Health Dr Mary Anne McLean General Practice Liaison Medical Advisor, Mercy Hospital for Women Dr Ines Rio Head General Practice Liaison Unit, The Royal Women’s Hospital Dr Jo Silva General Practice Advisor, Western Health Bianca Bell General Practice Liaison Coordinator, Western Health Merran Mackie General Practice Liaison Project Officer, Mercy Hospital for Women Sue Vallance General Practice Liaison Project Officer, Northern Health Madeleine Whinney Project Officer, The Royal Women’s Hospital Karen Irving Senior Program Advisor, Maternity Services, Department of Health (to February 2010) Melissa Brown Senior Program Advisor, Maternity Services, Department of Health (from February 2010) Special Thanks Shared Maternity Care Coordinators at the four hospitals: Jane De Marco, Sue Herlihy, Julie Brook and Francis Sweeney Other hospital staff who informed these guidelines Shared Maternity Care Affiliates and women involved in focus groups Department of Health Royal Australian College of General Practitioners Three Centres Collaboration 3 CONTENTS INTRODUCTION ....................................................................................................................................... 6 THE SHARED MATERNITY CARE MODEL .................................................................................................. 8 Definition ............................................................................................................................................. 8 Responsibilities in Shared Maternity Care .......................................................................................... 8 The Hand Held Pregnancy Record ....................................................................................................... 9 The Shared Maternity Care Coordinator ........................................................................................... 10 Accreditation and Reaccreditation of Shared Maternity Care Affiliates ........................................... 11 THE PRE-PREGNANCY CONSULTATION ................................................................................................. 13 Preventive Activities before Pregnancy ............................................................................................ 13 Pre-pregnancy Consultation Checklist .............................................................................................. 17 ANTENATAL VISITS ................................................................................................................................ 24 Confirmation of Pregnancy ............................................................................................................... 24 Shared Maternity Care at Our Hospitals ........................................................................................... 26 Hospital location maps .................................................................................................................. 27 How to Refer for Shared Maternity Care .......................................................................................... 28 Satellite Clinics ............................................................................................................................... 28 Hospital Tours ................................................................................................................................ 28 Support Services ................................................................................................................................ 29 Schedule of Visits .............................................................................................................................. 29 Shared Maternity Care Affiliate Discussion Points and Patient Information .................................... 37 ANTENATAL INVESTIGATIONS ............................................................................................................... 49 Initial Routine Investigations ............................................................................................................. 49 Initial Investigations to Consider ....................................................................................................... 50 Second Trimester Investigations ....................................................................................................... 55 Third Trimester Investigations .......................................................................................................... 55 TESTING IN PREGNANCY FOR FETAL ABNORMALITIES ......................................................................... 60 Screening versus Diagnostic Tests ..................................................................................................... 60 4 Counselling ........................................................................................................................................ 60 Down Syndrome and other Chromosomal Abnormalities ................................................................ 61 Fetal Morphology Ultrasound (18-20 weeks) ................................................................................... 67 MANAGEMENT AND REFERRAL OF ABNORMAL FINDINGS .................................................................
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