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Obstetrics

Continuous care, from preconception to postpartum. Whether you are planning, already pregnant, need closer monitoring, or have just had your baby.

OUR APPROACH

Every pregnancy has its own plan of care

The appointments and tests follow the stage you are at and whatever comes up along the way.

The essentials of obstetrics, in one place.

Appointments, ultrasound, prenatal screening and diagnosis, with a Grupo Germano de Sousa sample collection point at the clinic. The clinical team follows you from before conception through to after the birth, bringing in other clinical areas at any point along the way.

REASONS TO BOOK

When to see an obstetrician

Planning a pregnancy, following one already under way, preparing for parenthood and recovering after the birth. We start by understanding where you are.

Not sure where to start?

01

WHEN YOU WANT TO CONCEIVE

  • Coming off contraception
  • Blood tests, supplements and vaccinations
  • A family history of genetic conditions
  • A condition or medication review
  • Difficulty conceiving
  • A previous pregnancy loss
  • Pregnancy after 40

02

WHEN YOU ARE PREGNANT, OR SUSPECT YOU MIGHT BE

  • Confirming and dating the pregnancy
  • The anomaly scan, blood tests and screening in each trimester
  • Your baby’s growth and wellbeing
  • Vaccinations and everyday care in pregnancy
  • Symptoms that worry you between appointments
  • Preparing for birth, parenthood and breastfeeding

03

AFTER THE BIRTH

  • Your postnatal check
  • Caesarean or perineal scar
  • Urinary leakage or pelvic heaviness
  • Breastfeeding support
  • Changes in mood and sleep
  • Reassessment if you had gestational diabetes
  • Contraception and resuming sex

04

WHEN CLOSER MONITORING IS NEEDED

  • Advanced maternal age
  • Twin pregnancy
  • Recurrent pregnancy loss or a previous ectopic pregnancy
  • High blood pressure, pre-eclampsia or gestational diabetes
  • Autoimmune, thyroid, cardiac or oncological conditions
  • An abnormal or inconclusive screening result
  • An abnormality on ultrasound or fetal growth restriction
  • Suspected fetal heart condition
  • A short cervix or risk of preterm birth

AREAS OF CARE

General obstetrics and high-risk pregnancy

General obstetrics follows a pregnancy that runs without complications: appointments, scans and the screening for each trimester. When something about you, your baby or the pregnancy itself calls for closer monitoring, care moves to the high-risk pathway. The level of risk can change over the months, in either direction.

Preconception and fertility

Before pregnancy: assessment of your general health, blood tests, recommended supplements, vaccinations and a review of your regular medication. Initial fertility assessment if conception is taking longer or after a pregnancy loss.

Pregnancy monitoring

Appointments paced to each stage of pregnancy: your own health, your baby's growth, the blood tests and screening for each trimester, and a support scan during the appointment whenever it is needed.

Ultrasound and prenatal diagnosis

Advanced ultrasound at each trimester, screening for chromosomal abnormalities and, if indicated, invasive diagnosis such as amniocentesis or chorionic villus sampling.

High-risk pregnancy

Twin pregnancy or pregnancy after 40, high blood pressure and pre-eclampsia, gestational diabetes, pre-existing maternal conditions (cardiac, autoimmune, thyroid or oncological), risk of preterm birth and changes in your baby’s growth or heart.
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Preparing for birth

In the final weeks, your baby’s position and wellbeing, and your own health before the birth. And preparation for breastfeeding, the first days and parenthood, with a specialist maternal and obstetric health nurse.

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Programa Nascimento+

Postpartum care and recovery

Recovery after birth, usually reviewed within the first six weeks: healing, the pelvic floor, contraception and resuming sex, emotional health, breastfeeding and metabolic reassessment if you had gestational diabetes.
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SERVICES

Consultations, tests and prenatal diagnosis

Routine monitoring and high-risk pregnancy take place in the same clinic, with ultrasound, screening and blood tests on site. Care is adjusted to the level of monitoring each pregnancy calls for, and prenatal diagnosis is carried out here from start to finish.

  • Early pregnancy and dating scan

    The first scan of the pregnancy: it confirms the location of the pregnancy, the viability of the embryo and gestational age.

  • First-trimester scan

    Also known as the nuchal translucency scan. It assesses early fetal development and the markers used in combined screening.

  • Second-trimester anomaly scan

    A detailed assessment of fetal anatomy, the placenta and the amniotic fluid.

  • Third-trimester scan

    The growth scan: estimated weight, the baby’s position, the placenta and the amniotic fluid.

  • 3D/4D Ultrasound

    Three-dimensional and real-time imaging, with AI support, as a complement to a clinically indicated obstetric scan.

  • Cervical length assessment

    Measurement of cervical length to assess the risk of preterm birth.

  • Cardiotocography (CTG)

    Recording of the fetal heart rate and uterine activity in specific stages or clinical situations during pregnancy.

  • Fetal echocardiography

    Detailed assessment of the baby's heart, when the anomaly scan raises a concern or there is an increased risk of congenital heart disease.

  • Prenatal diagnosis

    Assessment for genetic or structural conditions in the baby. It brings together the screening in each trimester, ultrasound and, if indicated, invasive diagnosis.

  • Pregnancy blood tests

    Blood tests and screening for each trimester, including serology, gestational diabetes screening and non-invasive prenatal testing when indicated. Samples are taken at Clínica Mulher by Grupo Germano de Sousa.

  • Newborn screening test

    Newborn screening, known as the heel prick test, carried out at the clinic in the baby's first days of life by a specialist nurse.

  • Amniocentesis

    Ultrasound-guided sampling of amniotic fluid, usually from 15 weeks, for genetic diagnosis. Carried out in the consulting room, with the procedure and its risks explained beforehand.

  • Chorionic villus sampling (CVS)

    Ultrasound-guided sampling of placental tissue in the first trimester, for genetic diagnosis when the result cannot wait until 15 weeks.

  • Nascimento+ Programme

    Eight in-person sessions with experts involved in pregnancy and postpartum care at Clínica Mulher: Obstetrics, Specialist Maternal and Obstetric Health Nursing, Pelvic Floor Physiotherapy, Nutrition, Psychology, Human Sexuality and IBCLC-certified Lactation Consultancy. A practical programme designed to prepare you for birth, returning home, maternal recovery, breastfeeding and the transition to a new family routine. Groups of six couples.

WHAT TO EXPECT

How your prenatal care
appointment works

1

Your pregnancy

Gestational age, symptoms, test results, any change in your health and what brought you here this time.

2

Your health

Blood pressure, weight and whatever this stage of pregnancy calls for. An obstetric examination is carried out when it is needed, explained before it starts, and only goes ahead with your consent.

3

Your baby's wellbeing

The assessment follows your gestational age and the reason for the appointment, with a support scan if needed. The trimester scans have their own appointment.

4

Where things stand

How your pregnancy is progressing, the results available, any changes to your care plan and what will be monitored until your next appointment.

5

You leave knowing what comes next

Your next appointment, tests and screening can be booked before you leave the clinic. Until then, you can book a follow-up video consultation.

CLINICAL TEAM

Obstetricians and specialist nurses

A team with expertise in maternal-fetal medicine, specialist ultrasound, prenatal diagnosis, fertility support and maternal and obstetric health.

SHARED CARE

When other clinical areas come in

Sometimes an obstetric situation calls in another clinical area: when gestational diabetes is not controlled by diet, when blood pressure rises in pregnancy, when urinary leakage continues after the birth, when the baby keeps turning the head to the same side.

Endocrinology

Gestational diabetes that diet alone does not control, thyroid disease and pre-existing diabetes needing medication adjustment in pregnancy

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Pelvic Floor Physiotherapy

Pelvic pain, incontinence, abdominal diastasis, functional preparation for birth and pelvic floor recovery after delivery.

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Nutrition

Persistent nausea, anemia, gestational diabetes, weight gain above or below what is expected, and adapting how you eat through each trimester and while breastfeeding.

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Psychology

Anxiety, depressive symptoms, fear of childbirth, grief after pregnancy loss, and adjusting to parenthood when it turns out harder than expected.

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Osteopathy

Lower back, pelvic or pubic symphysis pain and postural changes in pregnancy and after birth. And for the newborn: colic, a preferred head position and difficulty latching.

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Cardiology

Heart disease diagnosed before or during pregnancy, high blood pressure, palpitations and other cardiovascular changes in pregnancy and postpartum.

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Exercise and Women’s Health

Assessment and prescription of exercise adapted to each stage of pregnancy and to resuming activity after birth, including after a caesarean.

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Human Sexuality

Pain during sex, changes in desire and vaginal dryness, in pregnancy and on returning to intimacy after birth.

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Dermatology

Melasma, itching, pregnancy-specific dermatoses and changes in moles or pigmented lesions that appear or shift over these months.

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Rheumatology

Lupus, antiphospholipid syndrome and other autoimmune conditions that call for a medication review before conceiving and closer monitoring through pregnancy.

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Medical Oncology

Cancer diagnosed before or during pregnancy, with shared decisions on systemic treatment and obstetric monitoring.

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QUESTIONS AND ANSWERS

Frequently asked questions

The questions we are asked most about pregnancy monitoring, screening and the signs that warrant assessment. The answers are for guidance and do not replace a medical consultation.

Should I have an appointment before trying to conceive?

Ideally, yes: a preconception appointment allows us to review your general health, any chronic conditions and regular medication, check your vaccination status, discuss your personal and family history, and start any recommended supplements. It is also an opportunity to identify risk factors that can be addressed or better controlled before pregnancy.

How many ultrasound scans are performed during pregnancy?

In a low-risk pregnancy, three main ultrasound scans are usually planned, one in each trimester. Additional scans may be needed, for example to assess the cervix, fetal growth or the placenta. In the appointment itself, a support scan is carried out whenever the assessment calls for one, without replacing the trimester scans.

What is non-invasive prenatal testing (NIPT)?

NIPT, or screening using cell-free fetal DNA in the mother’s blood, estimates the risk of certain chromosomal conditions from a maternal blood sample. It has a high detection rate for some trisomies, but remains a screening test. Whether it is appropriate should be discussed in the context of the ultrasound findings and the screening strategy for each pregnancy.

What care is recommended for pregnancy after 40?

Pregnancy after 40 is associated with a higher likelihood of certain complications, including chromosomal conditions, hypertension and gestational diabetes. Care ideally begins before conception and includes an individualised discussion about prenatal screening and the level of monitoring that is right for you. Many pregnancies after 40 progress well with appropriate assessment and follow-up.

I have had a previous pregnancy loss. What care might I need in a future pregnancy?

A previous pregnancy loss does not mean that your next pregnancy will have complications. It may, however, be appropriate to have a preconception appointment and closer monitoring, particularly during the first trimester. If you have experienced recurrent losses, specific previous complications or other risk factors, further investigation may be recommended before or during a new pregnancy.

I have a heart condition. Can I be cared for during pregnancy?

Yes: in most cases a known heart condition does not rule out pregnancy, but it calls for assessment before conception whenever possible and a monitoring plan agreed between Cardiology and Obstetrics — the field known as cardio-obstetrics. More complex situations may require coordination with a hospital referral centre, decided case by case.

When is fetal echocardiography indicated?

Fetal echocardiography is indicated where there is a family history of congenital heart disease, a concern raised by the anomaly scan, maternal diabetes or another risk factor. At Clínica Mulher it is performed by a pediatric cardiologist specialising in fetal cardiology.

Which symptoms during pregnancy require urgent medical assessment?

Some symptoms require medical assessment without delay, including:

  • Heavy bleeding or leaking fluid
  • Reduced fetal movements
  • Severe abdominal pain
  • Regular contractions before term
  • A severe or persistent headache, particularly with visual changes
  • Sudden shortness of breath
  • Significant pain or swelling in one leg
  • A high or persistent fever
  • Vomiting that prevents you from keeping down fluids

If you have any of these, seek medical assessment immediately — at an obstetric emergency department if the clinic is closed.

Does Clínica Mulher provide pregnancy care through to birth?

Yes: pregnancy care continues to the end of the third trimester, and we help you prepare for birth. The birth itself takes place at a maternity unit or hospital. Whether your Clínica Mulher obstetrician can attend the birth depends on the doctor, the maternity unit you choose and what has been agreed in advance.

I have breast pain and a lump while breastfeeding. What should I do?

Localised pain, redness, a firm lump and fever in the first weeks of breastfeeding may suggest mastitis. You should always be assessed by a professional, and the sooner the better: the assessment determines the treatment and prevents it progressing to an abscess. At Clínica Mulher, certified IBCLC lactation consultancy assesses the latch and drainage pattern, and works with the medical consultation when antibiotics or a breast ultrasound are needed.

BOOKING

Book your appointment

Obstetric, fertility support or specialist nursing appointments. Also available as video consultations.

Need guidance? Our concierge can help you choose the right consultation.