We are very sorry to hear about your loss and understand that these questions may be difficult for you to answer. However it is important that we know your full history so that be can provide you with the best possible care.
Please complete the details for three of your previous pregnancies and the midwife will help complete the remaining prior pregnancy details.
If you had your baby at the Mater Mothers' we will have the details on record. You therefore don't need to enter them again here. Please go back to the previous screen and review your selection.
Whilst most pregnancies fortunately end with the birth of a healthy baby we realise that this sadly is not always the case. If you would prefer not to complete the details of the birth of your baby online please tick the box below and a midwife can help you with this.
Thank you for providing us with the details about this pregnancy
A midwife will talk to you about your previous pregnancies at your first appointment. Please click on the button below to continue providing us with information about your current pregnancy.
Please bring a copy of the scan report with you to your first appointment.
If you have a scan between now and your appointment with us please bring a copy of the report with you.
Have you ever had any health problems affecting your:
If you have an advanced health directive please bring a copy with you to your first appointment.
What types of operations have you had?
Fluvax is recommended for pregnant women. Please see your GP to discuss vaccination
The whooping cough vaccine is recommended for pregnant women in the last trimester of your pregnancy (28 weeks onwards). Please see your GP to discuss vaccination
click here for a brochure on staying comfortable during pregnancy and afterwards
Please note the information you provide here is confidential
EDINBURGH POSTNATAL DEPRESSION SCALE
The following scale is used across the world to screen for pregnancy and postnatal depression.
Please select the circle for each question that is the closest to how you have felt in the PAST SEVEN DAYS.
Click here for some useful information about emotional changes during pregnancy and for new parents
If you have any thoughts of harming yourself please contact:
1300 MH CALL (1300 64 22 55) – this is a 24/7 service for anyone with questions or concerns
13 11 14 Lifeline Australia
Online chat
https://www.beyondblue.org.au/get-support/get-immediate-support
Or
Present to your closest hospital emergency department
Thank you for taking the time to complete this form.
Please click on the below 'Submit' button to finish.