Pregnancy Care

Holistic, evidence-based care from early pregnancy to complex reproductive challenges.

Becoming pregnant, whether naturally or through fertility treatment - is an extraordinary milestone. Dr Rebecca Mackenzie-Proctor’s practice supports individuals and couples from the first positive pregnancy test through early pregnancy, and provides comprehensive care for recurrent pregnancy loss, recurrent implantation failure, and miscarriage management. Her approach is grounded in compassion, personalised medicine, advanced reproductive endocrinology, and collaborative multidisciplinary support.

Early Pregnancy Care

Comprehensive, evidence-based support from the moment you see a positive test

Early pregnancy (0–12 weeks gestation) is a critical period marked by rapid fetal development, significant hormonal shifts, and important health decisions that influence the rest of the pregnancy. My early pregnancy care combines specialist reproductive endocrinology, holistic support, and personalised monitoring—particularly for women conceiving through IVF, frozen embryo transfer (FET), ovulation induction, donor conception, or those with a complicated reproductive history.

What to Expect in Early Pregnancy Care

• Confirmation of pregnancy with serial β-hCG when clinically appropriate

• Early pregnancy ultrasound (typically 6–8 weeks) to confirm location, viability, number of embryos, and dating

• Hormonal monitoring for women who have undergone IVF, FET, ovulation induction, or have luteal phase concerns

• Thorough review of medical, reproductive, and lifestyle factors

• Education and reassurance based on current RANZCOG and international guidelines

Understanding Early Pregnancy: What’s Happening in Your Body?

Hormonal Changes

• hCG rises rapidly and supports the corpus luteum until the placenta takes over progesterone production (usually around 10-12 weeks).

• Progesterone and estrogen stabilise the uterine lining, support placental development, and reduce uterine contractility.

• Thyroid hormones often increase by 30-50%; mild adjustments in thyroid medication may be needed in women with hypothyroidism.

• Metabolic changes increase insulin resistance, making nutritional foundations important from the beginning.

Embryonic Development Milestones

• Week 4-5: Gestational sac visible on ultrasound

• Week 5-6: Yolk sac and early fetal pole appear

• Week 6-7: Cardiac activity detectable

• Week 7-8: Limb buds and early brain development

• Week 10-12: Placenta begins to take over hormonal support

These developmental windows can help guide timing of scans, management of complications, and reassurance during normal variations.

Clinical Pathway for Early Pregnancy

Pregnancy Confirmation

• Serial β-hCG testing when clinically indicated:

• Post-fertility treatment

• Past ectopic pregnancy

• Previous miscarriage

• Uncertain ovulation

• Expected rise is minimum 53% increase over 48 hours, but rising patterns vary.

Early Ultrasound

Performed around 6–8 weeks to:

• Confirm a uterine (not ectopic) pregnancy

• Verify viability and heartbeat

• Exclude molar pregnancy

• Assess number of embryos

• Confirm accurate gestational dating

• Review presence of subchorionic haematoma if symptomatic

Luteal and Early Placental Support

Depending on mode of conception:

• IVF/FET programmed cycles: continued progesterone until 10–12 weeks

• Natural or modified natural FET cycles: progesterone support only when indicated

• Ovulation Induction/IUI: luteal support tailored to cycle characteristics

Dose adjustments are based on:

• Clinical symptoms

• Progesterone levels (if monitored)

• Mode of FET and window of implantation timings

Screening & Risk Assessment

We address:

• Antenatal bloods - hepatitis B,C. HIV, rubella immunity, blood group and antibody screen

• Vitamin D

• Blood pressure and metabolic risk (assess HbA1c)

• Iron status (ferritin), B12, folate

• Genetic carrier status and early pregnancy NIPT planning

• Lifestyle factors: smoking, alcohol, medications, supplements

Supporting Your Symptoms: What’s Normal?

Common Symptoms

• Nausea and vomiting

• Fatigue

• Mild cramping

• Breast tenderness

• Light spotting

• Heightened smell or taste sensitivity

Red Flag Symptoms

Urgent review is required if you have:

• Heavy bleeding

• Severe abdominal pain or shoulder pain

• Dizziness, fainting

• Persistent vomiting and dehydration

• No pregnancy symptoms after previously strong symptoms (case-dependent)

Nutrition, Supplements & Food Safety in Early Pregnancy

Core Supplements

• Folic acid 400–800 µg/day, or 5 mg/day for high-risk groups

• Iodine 150 µg/day

• Vitamin D supplementation based on levels and local guidelines

• Iron if ferritin <30 µg/L or symptomatic

• Omega-3 DHA, particularly for women with low fish intake

Food Safety Guidelines (Australia)

Pregnancy increases susceptibility to foodborne illness such as Listeria.
Guidelines include avoiding:

• Soft cheeses, deli meats, pâté

• Pre-prepared salads

• Undercooked eggs

• Unpasteurised dairy

• Raw seafood

Exercise, Movement & Pelvic Floor Health

Regular exercise improves maternal wellbeing and reduces risks of:

• Excessive gestational weight gain

• Gestational diabetes

• Hypertensive disorders

• Back and pelvic pain

Most women can continue their pre-pregnancy activity level, adjusting intensity as needed.

Recommended activities:

• Walking, swimming, Pilates, yoga

• Light–moderate strength training

• Pelvic floor exercises

Avoid:

• High-fall risk sports

• Contact sports

• Heavy lifting if unaccustomed

• Activities causing overheating (hot yoga, saunas)

Medication & Safety Review

We review all:

• Prescription medications

• Supplements

• Herbal products

• Topical agents, acne medications

• Mental health medications

Mental Health & Emotional Support

Hormonal changes and early pregnancy uncertainty can heighten anxiety. Dr Rebecca Mackenzie-Proctor aims to support emotional wellbeing through:

• Reassurance and early access to appointments

• Mind–body strategies (mindfulness, breathwork, sleep support)

• Referral to psychologists specialising in fertility and pregnancy

• Planning support for previous pregnancy loss anxiety

Continuity of Care Into Second Trimester

With Dr Rebecca Mackenzie-Proctor you will be supported through:

• Early viability

• NIPT planning

• First-trimester screening

• Transition to obstetric care

• Specific planning if at higher risk (thyroid, PCOS, endometriosis, IVF pregnancy, previous loss)

Dr Rebecca Mackenzie-Proctor focuses on empowering you with clear guidance, evidence-based recommendations, and timely monitoring so you feel supported and confident during these early weeks. I integrate your fertility history, medical background, and personal goals to create a holistic plan that keeps both you and your developing baby safe.