Pregnancy care

For outpatient services: this is a non-exhaustive guideline. Clinical judgement needs to be used when assessing clinical urgency with consideration to clinician, parental and/or family concerns.

For patients: it is strongly encouraged to book an appointment with a general practitioner (GP) for assessment, confirmation of pregnancy and referral to a maternity service. If you experience challenges with accessing a GP or otherwise choose to seek maternity care independently, you may self-refer to a public maternity service.

For referring health professionals: refer as early as possible and provide as much information as possible in accordance with this guideline to assist with timely assessment of clinical urgency.

​​​​​​​​​​​​​​​​Emergency

If any of the following are suspected please seek emergency medical advice or refer the patient to the emergency department (via ambulance if necessary)

  • Abdominal pain or back pain
  • Any concerns of high blood pressure
  • Chest pain and/or shortness of breath
  • Deteriorating mental state including suicidality, thoughts of harm to baby or psychosis
  • First trimester pain and bleeding
  • Headaches
  • Hyperemesis
  • Leg swelling and tenderness
  • Preterm labour
  • Preterm, pre labour rupture of membranes
  • Reduced or no fetal movement
  • Sudden swelling of the hands, face and feet
  • Symptoms and signs suggesting abnormal vaginal discharge, fever, pain, rigors and/or sepsis
  • Vaginal bleeding at any gestation

When public outpatient services are not routinely provided

  • Nil

Criteria to access public outpatient services

CategoryCriteria
Category 1
Recommended to be seen within 7 calendar days.

  • Current gestation > 13 weeks irrespective of risk factors
  • Pregnancy at any gestation with any of the following medical conditions, but not limited to:
    • Alcohol, illicit or prescribed drug dependency
    • Cardiac concerns (e.g. cardiomyopathy, congenital heart disease, ischaemic heart disease, pulmonary hypertension, recurrent or persistent arrhythmias, rheumatic heart disease, untreated hypertension, valvular heart disease)
    • Complex psychosocial situation (e.g. consideration of housing, maternal age, current supports, life stability, seeking adoption, intimate partner violence and/or living with multiple co-morbidities)
    • Current infectious disease in pregnancy (e.g. positive syphilis serology, human immunodeficiency virus (HIV) positive, parvovirus, cytomegalovirus, toxoplasmosis, rubella, chicken pox, primary herpes genitalis)
    • Endocrine concerns (e.g. type 1 diabetes, type 2 diabetes, unstable endocrine disease)
    • Haematological concerns (e.g. acute or current deep vein thrombosis or pulmonary embolism, antiphospholipid syndrome)
    • Intrauterine contraceptive device (IUCD) in situ
    • Medications with a high risk of teratogenicity or other embryo–fetal risk
      Note: if any concerns with medication, consider contacting MotherSafe
    • Organ transplant
    • Parent or family member with a known genetic condition (or carrier of same), not known to any genetic service
    • Pregnancy concerns
      • Any care through Early Pregnancy Assessment Service (EPAS) in the current pregnancy
      • History of 2nd trimester loss
      • History of cervical cerclage
      • Hyperemesis gravidarum
      • Multiple pregnancy
      • Recurrent miscarriage
    • Poorly controlled epilepsy
    • Poorly controlled inflammatory bowel disease
    • Renal concerns (e.g. renal dialysis, stage 1 or higher renal failure)
  • Seeking to discuss termination of pregnancy and unable to access services outside NSW Health
    Note: specific service location may need to be determined in collaboration with the local Primary Health Network​
Category 2​
Recommended to be seen within 14 calendar days.
  • ​​Current gestation between 10 weeks and 12 weeks + 6 days irrespective of risk factors
  • Current gestation < 10 weeks with any of the following risk factors:
    • Active blood incompatibility (e.g. anti-red cell antibodies, anti-platelet antibodies (i.e. Neonatal Alloimmune Thrombocytopenia – NAIT))
    • Anaemia
      Note: consider risks of thalassemia
    • Complex birth history (e.g. perinatal loss, preterm birth, adverse birth experience, pre-eclampsia)
    • Depression and/or anxiety requiring ongoing psychiatrist and/or multidisciplinary input
    • Living with a disability or neurodiverse condition​
    • ​Smoking or vaping
  • ​Current gestation < 10 weeks with any of the following priority considerations:
    • Identifies as Aboriginal and/or Torres Strait Islander 
    • Identifies that their baby will be identified as Aboriginal and/or Torres Strait Islander
    • Non-English speaking

Category 3
Recommended to be seen within 30 calendar days.

  • ​Current gestation < 10 weeks with no risk factors listed in Category 1 or 2

Information to include within a referral

Required

  • Reason for referral​​
  • Provisional diagnosis
  • Patient health summary (such as relevant medical history, relevant investigations, current medications and dosages, immunisations, allergies and/or adverse reactions), including specifically:​
    • Current pregnancy
      • Confirmation of pregnancy (positive urine or serum ßhCG)
      • Method of conception (either spontaneous or assisted)
      • Gravidity and parity
      • Last normal menstrual period (LNMP)
      • Estimated Date of Birth (EDB)
      • If planned or unplanned pregnancy
      • If single or multiple pregnancy
      • If seeking termination of pregnancy
      • Body mass index (BMI)
    • Obstetric history (if known) – for each previous pregnancy, provide details of outcome:
      • Date of birth, gestation, mode of birth, birth weight, place of birth
      • Any pregnancy complications (e.g. gestational diabetes mellitus, fetal growth restriction, hypertensive disorders of pregnancy, antepartum haemorrhage)
      • Any birth complications (e.g. postpartum haemorrhage, preterm birth, perinatal loss, pre-existing adverse birth experience)
      • Previous neonatal admission to special care nursery or neonatal intensive care unit (NICU) and reason
      • Miscarriage
      • Ectopic pregnancy
    • Medical, oncology, surgical and psychological history
      • Details of any risk factors or co-morbidities (e.g. cardiac, renal or liver disease, diabetes, hypertension, venous thromboembolism, autoimmune disease, asthma, epilepsy, obesity, bariatric surgery, eating disorders, mental health concerns)
    • Medication history
      • Psychotropic drugs (e.g. sodium valproate, lithium)
      • Other medications with recognised fetal implications
    • Social history
      • Drug, alcohol and smoking history
​​​Note: in the absence of the referral requirements above, clinical urgency will be unable to be accurately assessed

If available

  • ​Environmental exposure
  • Lack of Gillick competence and intellectual capacity (where appropriate)
  • Patient's preferred model of care
  • Immunisations (e.g. influenza, COVID vaccination status, recommendation of Pertussis or respiratory syncytial virus; RSV during pregnancy)
  • Investigations (completed this pregnancy)
    • Complete First Trimester Screen (FTS) including biochemistry
    • Non-invasive prenatal testing (NIPT) results
    • Blood group (BG) and blood group antibodies (BGA) tests
    • Full blood count (FBC)
    • Hepatitis B
    • Hepatits C
    • Syphilis serology
    • Human immunodeficiency virus (HIV)
    • Rubella
    • M/C/S on Midstream urine (MSU) result
    • Chlamydia and gonorrhea screening < 30 years old (first pass urine)
    • HbA1c
    • Haemoglobin electrophoresis (HbEPG)
    • Thyroid function test (TFT) result
    • Ferritin
    • Any obstetric ultrasounds or screening for PET risk
    • Any other investigations related to medical conditions​

Important information for referring health professionals

If there is a change to a patient’s condition while waiting for their appointment, referring health professionals may further investigate and manage the situation, or send an updated referral to the outpatient service. Where there are significant concerns about a patient's condition, referring health professionals may check HealthPathways for urgent/same day advice or contact the relevant clinical team.​

Additional maternity services

Current as at: Monday 30 March 2026
Contact page owner: System Purchasing