Dr Gary Sykes

Holiday

Holiday

I will be on holidays with my wife on an Antarctica Cruises from tomorrow, 21st February, until Monday 18th March. I have an excellent obstetrician colleague covering if needed. The office is open while I am away. My secretaries Kylee and Lauren will be available to...

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Whooping Cough and Pregnancy

Whooping Cough and Pregnancy

Whooping Cough and Pregnancy Pertussis (whooping cough) is caused by the bacterium Bordetella pertussis. There is no evidence that if you develop whooping cough in pregnancy your baby will be harmed while it is inside you. The risk to your baby has to do with once...

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Headaches in pregnancy

Headaches in pregnancy

Sadly, headaches can be common in early pregnancy. Why this is so is not known for certain. It is thought it may be because of hormone changes and increased blood volume in pregnancy. As well though pregnancy can be a time of anxiety and stress, fatigue, poor sleep,...

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My daughter Mandy

My daughter Mandy

My daughter Mandy Witt is a therapist. I have given her use of an office in my rooms to see clients. Her business is called Mandy Witt Therapy. Information is at  https://mandywitt.com. So, if you see someone you don’t know working in my rooms or non-pregnant people...

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Miscarriage

Miscarriage

What is a miscarriage? Miscarriage which is also called spontaneous abortion is defined as the loss of a pregnancy before 20 weeks of gestation. In the first third of pregnancy, a miscarriage is called a first-trimester miscarriage. A miscarriage that occurs in the...

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Dad During The Pregnancy – What Is Your Role?

Dad During The Pregnancy – What Is Your Role?

What is my role in the pregnancy? You are a very important person! During pregnancy the mother of your baby is likely to be more tired, uncomfortable and emotional than usual. You can give her the extra support, attention, understanding, encouragement and love that...

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Travel in Pregnancy

Travel in Pregnancy

When is it good to travel? The best time to travel is when you are between 20th to 32nd weeks of your pregnancy. At this time of your pregnancy, you should out the other end of all the initial pregnancy concerns with miscarriage, nausea, etc and have completed all the...

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How do I stay healthy during my pregnancy?

How do I stay healthy during my pregnancy?

Pregnancy is an exciting time when you have new life (your baby) developing and growing in your uterus. I am regularly asked “what can I do?”, “what can’t I do?”, “what can I eat?”, “what can’t I eat?” etc. A mother-to-be wants to look after her precious cargo in her...

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Can I exercise in pregnancy?

Can I exercise in pregnancy?

Exercise and Activity Walking is an excellent idea. As well, antenatal exercise classes are available through the hospital and privately. You can inquire about the hospital classes when you book. See also in link section exercise in pregnancy. Working Normally I am...

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Having A Healthy Diet In Pregnancy

Having A Healthy Diet In Pregnancy

A healthy diet It is very important to endeavour to be in optimal nutritional health before you conceive and in pregnancy. When you are pregnant you are feeding two not one! Because of chemical additives in the food you buy in the supermarket, etc. it is very had to...

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No Gap private pregnancy care

No Gap private pregnancy care

My previous blog “The cost-of-living crisis is prompting many women to defer having a baby.” has prompted comments and discussion about how women are deferring pregnancies because of current cost of living pressures. That is very sad. When it is on woman’s heart to...

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Rectal bleeding after pregnancy

Rectal bleeding after pregnancy

I have bleeding from my rectum. Is that ok? This is not an infrequent question at the 6-week postnatal visit It is usually due to an anal fissure. An anal fissure results from tearing the anal mucosa with passage of hard large stools. What can be done about it? You...

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Vacuum cup and forceps

Vacuum cup and forceps

When are vacuum cups and forceps used when delivering a baby? For an operative vaginal delivery and sometimes with a Caesarean section delivery. Will I need an operative vaginal delivery? Hopefully not. Only about 12% of my patients need operative vaginal deliveries....

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Mirena IUCD

Mirena IUCD

The Mirena intrauterine contraceptive device (IUCD) is very popular method of contraception, including for postnatal women who are breast feeding. It is good ‘spacer’ between pregnancies and good for long term contraception when the family is complete. Mirena consists...

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Looking and feeling good after pregnancy

Looking and feeling good after pregnancy

During pregnancy and vaginal childbirth there are lots of body changes. Commonest changes include enlarged abdomen, stretched abdominal wall skin, weight gain, breast enlargement, nipple and areola changes, fluid retention and swelling, stretch marks, acne, red skin...

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When will my baby turn head down?

When will my baby turn head down?

As you progress through pregnancy the baby’s position becomes a more important consideration. At about 30 weeks about 25% of babies are not in a “cephalic” (head down) position. It is normal for the baby to turn head down even by about 34 weeks. So don’t worry! It is...

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Do pregnancy hormones cause anxiety?

Do pregnancy hormones cause anxiety?

A patient recently asked me: “Do pregnancy hormones cause anxiety?”. The answer is no. Pregnancy hormones do not cause anxiety. This patient, who is 11 weeks pregnant, had an extra reason for pregnancy anxiety. She had required progesterone pessary support to maintain...

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“No idea about labour”

“No idea about labour”

A midwife said to me recently that often women today have “no idea about labour.” She said they often have no idea how painful labour contractions will be and have almost romantic ideas about what will happen. The attitude of some women is comparable to their attitude...

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Avoiding stitches with a vaginal delivery

Avoiding stitches with a vaginal delivery

A patient asked me this week: “How can I avoid stitches with my delivery?” It is the wish of every woman who is planning a vaginal delivery to have no stitches. There are many factors that relevant in determining the likelihood of this. These are considered in this...

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Hope

Hope

Marelle had first trimester miscarriages in 2018 and 2019. Later in 2019 she had a pregnancy loss at  22weeks because of spontaneous rupture of membranes with umbilical cord prolapse. In 2021, Marelle had a successful pregnancy. Her pregnancy was complicated by...

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Ransomware attack

Ransomware attack

I have a new patient who told be at her first antenatal visit that she works in cyber security. Cyber security is of increasing importance.  Cyber security protects an organisation and its employees and assets against cyber threats. I told her that my computer system...

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How Are We Different?

How Are We Different?

It is very important for you and your unborn baby that you choose the right pregnancy and childbirth support. Many pregnant women and their husbands/partners assume pregnancy care is the same irrespective of who provides it. This is certainly not the case. There are...

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Which hospital should I book to have my baby?

Which hospital should I book to have my baby?

I am often asked: Which hospital should I book to have my baby? I will start answering this question by writing about my personal experiences as an obstetrician in private practice. When I started in private practice, I had appointments at the San Hospital (Sydney...

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An unusual presentation of HELLP Syndrome

An unusual presentation of HELLP Syndrome

Emma presented to the Birthing Unit at 9.00pm with epigastric pain. She was 39 weeks 1 day gestation in her first pregnancy. There was no uterine tenderness of pain, no uterine contractions, and no vaginal bleeding. She was otherwise well.  Her baby’s heart rate...

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Financially planning for your pregnancy

Financially planning for your pregnancy

We are getting an increasing number of calls from uninsured women asking how much it will cost to have their babies as private patients. This was expected. More people are dropping out of health funds or not taking up health insurance because of increasing financial...

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Baby’s head did not engage until in 2nd stage labour

Baby’s head did not engage until in 2nd stage labour

A common question in advanced pregnancy is: “Has my baby’s head engaged?” Patients are often of the belief that baby’s head must be engaged before they go into labour. That is not true. Engagement of baby’s head means the widest diameter of baby’s head (biparietal...

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Our phones are down

Our phones are down

Our phones are down Please contact the office by email office@obstetricexcellence.com.au Sorry for the inconvenience Thank you

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Preparing for pregnancy

Preparing for pregnancy

Below are some useful guides for when you are deciding to have baby. Decide if you will be private or public patient. There are huge differences between private and public pregnancy and childbirth care, with public being the inferior quality, poor cousin of private...

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I will be vlogging soon.

I will be vlogging soon.

I have always been keen for my patients to have good quality, accurate information about pregnancy and childbirth. As well, I have always been keen to help my patients avoid believing nonsense on pregnancy topics. Before the internet incorrect information was conveyed...

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What can I do to bring on labour?

What can I do to bring on labour?

Towards the end of pregnancy, a woman is typically very excited to meet her baby, but also she is very uncomfortable because of pregnancy changes and her baby being a good size. She is usually very keen to go into labour sooner rather than later. As well most women...

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When will my baby come?

When will my baby come?

This is a popular question as a woman approaches her due date. It can be prompted by her excitement and being very keen to meet her baby. It is sometimes triggered by her increasing pregnancy discomfort and her adverse symptoms. Sometimes it is because family members...

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My ultrasound scanning accuracy.

My ultrasound scanning accuracy.

I compared my baby weight estimate from ultrasound scan measurements at the last antenatal visit for patients over a 3-month period with actual birth weights. My scan estimates of weight averaged only 8.14% variation from actual birth weights. In 89% of cases my scan...

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We can’t afford to have a baby.

We can’t afford to have a baby.

The cost of essentials has been increasing dramatically. That is putting considerable financial pressure on couples. So many are now struggling to pay their mortgage, rent, electricity and gas bills, food, other essential household goods, etc. It is very difficult...

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No need for facemasks

No need for facemasks

As it is no longer mandated by NSW Health that face masks must be worn for patients and doctors for consultations in private practice we have decided to cease advising patients and their husbands/ partners that’s face masks must be worn for consultations. I have for a...

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Mum’s diet shapes child’s future

Mum’s diet shapes child’s future

Below is an article by Ellen Connolly of the Sunday Telegraph January 27, 2008 I had it saved on my computer. I could not find the original online. But as it is has very information and has already been in the public domain I have decided to share it on my website....

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Engagement of your baby’s head

Engagement of your baby’s head

What does engagement of my baby’s head mean? Your baby’s head is engaged when the widest diameter of the head passes through the brim of your pelvis. A pregnant woman will often know this because of a very intense feeling of fullness in her pelvis. Some women have...

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My holiday away time 2024

My holiday away time 2024

I will be away overseas between Thursday 22nd February 2024 and Sunday 17th March 2024. That means I will not be available to deliver your baby between those dates. You will not be able to book with me for pregnancy care if your EDC is in this away time period....

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Why my waiting room is often empty

Why my waiting room is often empty

I have a busy obstetric practice. I endeavour to keep to appointment times and so patients are usually not having to wait to see me.  Because of this, I usually have an empty waiting room. The origins of keeping to appointment times this go back to when my wife,...

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Shop around

Shop around

Yesterday a Westmead Public Hospital nurse who I know was telling me her brother’s partner recently had a baby at Westmead Private Hospital. She was not insured. She said she was charged $4000 for her management fee and another $4000 for her delivery fee. The...

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The short cervix dilemma

The short cervix dilemma

Paula’s first pregnancy was managed as a public patient. She told the first time we met my management of her second pregnancy that a short cervix had been diagnosed in her first pregnancy at 23 weeks gestation. She said she was kept in hospital on bed rest for 5...

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Can a pregnant woman eat sushi?

Can a pregnant woman eat sushi?

Sushi has become a very popular healthy meal option over recent years. I am often asked by a pregnant patient can she still eat sushi while pregnant? It depends on what is in the sushi. Any sushi with raw or undercooked seafood should be avoided. Eating raw or...

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Don’t quit

Don’t quit

I have recently had several uninsured patients deliver where ‘out of pocket’ expenses were far more than they anticipated because of pregnancy complications or adverse health developments not related to pregnancy. While out of pocket expenses in pregnancy are usually...

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Having a safe happy Christmas when pregnant

Having a safe happy Christmas when pregnant

Christmas is a wonderful time of celebration. We celebrate the birth of Jesus Christ, we sing carols at carol services, we attend Christmas church services, we meet with family, friends and neighbours, we chare meals and drinks, we exchange gifts, and many take a...

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Can pregnant women eat pineapples and papayas?

Can pregnant women eat pineapples and papayas?

While many say eating pineapples and papaya should be avoided in pregnancy because they can trigger miscarriage and the onset of premature labour, this opinion are based on theoretical consideration and some laboratory animal studies. I am not aware of any clinical...

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Pregnancy care checklist

Pregnancy care checklist

Pregnancy care checklist We are often asked about ‘what happens when’ with pregnancy care. With that question on mind I have put together the table below as a guide. 8 Weeks First visit with me for most patients I will give you a referral for routine pregnancy...

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Being Overweight and Pregnant

Being Overweight and Pregnant

Management of childbirth in the excessively overweight patient was a topic of discussion at a recent department meeting at one of the hospitals I attend. Obesity is increasing in incidence in the community. Now approximately 50 per cent of women who become pregnant...

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HELLP Syndrome in first pregnancy. What to do this time?

HELLP Syndrome in first pregnancy. What to do this time?

Cassandra and her husband saw me at 13 weeks gestation in her second pregnancy. Cassandra was anxious about continuing the unplanned, but now wanted, pregnancy because of what she had been told after her previous pregnancy in 2013. That pregnancy was complicated by...

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Perineum trauma with childbirth

Perineum trauma with childbirth

All women who have a vaginal delivery have the wish that their perineum will remain intact with the delivery of their baby. This is not always the case. Many women experience perineal trauma with childbirth, either perineal tearing or an episiotomy or both. The most...

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Is the umbilical cord around my baby’s neck?

Is the umbilical cord around my baby’s neck?

It is not unusual for a patient to ask: “Is the umbilical cord around my baby’s neck?” The reason for the question is the patient is anxious about this and is concerned the umbilical cord being around baby’s neck (nuchal cord) will adversely affect baby’s wellbeing....

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Swaddle is ending

Swaddle is ending

Sadly the very popular Swaddle program is ending. The last day for bookings for the HCF - San Swaddle program is 31 January, 2023. That means you must be pregnant and have registered through the San for the Swaddle program before the 1st February 2023. So if you are...

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Covid – should you be concerned?

Covid – should you be concerned?

Today a nurse from a public hospital attended for routine antenatal visit. I asked about Covid cases at her hospital and whether see had to nurse these patients. She said there were many in-patients with Covid and that she did have to nurse patients with Covid. She...

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My holiday away time 2023

My holiday away time 2023

I will be away overseas on holidays between Tuesday 20th June 2023 and Monday 17th July 2023. That means I will not be available to deliver your baby between those dates. You will not be able to book with me for pregnancy care if your EDC is in this away time period....

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Ultrasound scans in pregnancy

Ultrasound scans in pregnancy

This week a patient saw me for routine visit at 15 weeks pregnancy.  I did an office ultrasound scan and sadly diagnosed her baby had anencephaly (absence of development a major portion of the brain, skull, and scalp). I had the findings confirmed by a specialist...

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I want to have a baby

I want to have a baby

It is common for woman to be thinking about becoming a mother from a very young age. When she is playing with her dolls, when she is helping her mother with other siblings, the seed of becoming a mother one day is being planted. So having a baby is the fulfilment of a...

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Anxiety and pregnancy

Anxiety and pregnancy

Many more women have anxiety in pregnancy today than in the past. This is not only my personal observation but also the opinion of midwives with whom I work and medical studies findings. This is not because pregnancy and childbirth are more dangerous today than in the...

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The joy of pregnancy

The joy of pregnancy

For many women having a baby is the fulfilment of a lifelong dream When a little girl is playing with her dolls, she is starting to dream of becoming a mummy. She is typically very keen to help her mummy with the care of younger siblings. She is typically keen to...

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“I don’t enjoy being pregnant”

“I don’t enjoy being pregnant”

This is a comment made to me by many pregnant patients. It is not that they don’t want to be pregnant. It is that they are struggling because of adverse symptoms of pregnancy that they are experiencing. There are many adverse symptoms that a woman can experience in...

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Will I need another Caesarean section?

Will I need another Caesarean section?

This is a common question. When I was training to become an obstetrician most women who had a Caesarean section had a vaginal delivery next pregnancy. This has changed. Now most women who had a Caesarean section have a Caesarean section next pregnancy. There are...

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Proud parent baby photos

Proud parent baby photos

Patients frequently send me photos and sometime videos of their newborn baby that they have taken. Sometimes they share photos of themselves while pregnant and sometimes photos of their baby at it get older as an infant or child. I am very grateful and it gives me...

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Three adverse pregnancy developments

Three adverse pregnancy developments

Suzi booked with me for management of her first pregnancy. She was 30-year-old and had no significant medical history and surgical history. Her initial routine pregnancy blood test results were normal, including her platelet count which was 190 x 10^9/L. Suzi had the...

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Internet and social media use in my medical practice

Internet and social media use in my medical practice

Before the popular use of the internet had I was giving patients at their antenatal first visit with me several pages of the most popular pregnancy questions and answers. This was motivated by a desire for my patients to have correct pregnancy knowledge, rather than...

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Will I need an episiotomy?

Will I need an episiotomy?

On Friday I had four deliveries. In the afternoon at Norwest Hospital a patient in her first pregnancy had a normal delivery with an intact perineum. That evening at the San Hospital a patient in her first pregnancy had a normal delivery but needed an episiotomy. A...

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Perineal tearing

Perineal tearing

Perineal tearing The goal with a vaginal delivery is an intact perineum. This does not always happen. There can be tearing, the commonest area of tearing is the perineum. Hopefully it is only minor tearing. Sometimes an episiotomy is needed. This could be to avoid a...

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Cervical stretch and membrane sweep

Cervical stretch and membrane sweep

Contents Cervical stretch and membrane sweep What happens in a cervical stretch and membrane sweep? Is a cervical stretch and membrane sweep uncomfortable? Does a cervical stretch and membrane sweep always work? What to expect after the procedure,...

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Omicron – should you be concerned?

Omicron – should you be concerned?

Many patients are asking me about Covid and should they be concerned. I suspect this is because of the increasing number of Omicron cases (22,577 new cases today in NSW) and the often-conflicting messages from politicians, journalists, and doctors and nonsense...

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CHANGES TO COVID checking OF PREGNANT WOMEN 31st Dec 2021

CHANGES TO COVID checking OF PREGNANT WOMEN 31st Dec 2021

Both hospitals have updates their COVID check policies for pregnant women and their husbands/partners. SYDNEY ADVENTIST HOSPITAL (SAN) There have been some changes announced to the management of pregnant women which will take effect at the San, from today. Routine PCR...

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Supporting your partner in labour

Supporting your partner in labour

As the husband/partner you have a very important role in supporting your wife/partner during labour and childbirth. There is huge excitement and anticipation that you both have for meeting your new baby. But as well there is...

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Travel insurance and pregnancy

Travel insurance and pregnancy

Patients frequently ask for my permission to travel overseas during pregnancy. I usually make the comment, “Make sure you have appropriate travel insurance cover for pregnancy”. I had never thought more about travel insurance in pregnancy until recently when I read a...

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Swaddle eligibility rules change on 1st December

Swaddle eligibility rules change on 1st December

“New eligibility criteria starting 1 December 2021 require HCF members to have held pregnancy and birth related cover with HCF for 12 months by the date of the baby's birth.” If you are pregnant or planning to get pregnant very soon and planning to take advantage of...

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COVID vaccination hesitation in pregnancy

COVID vaccination hesitation in pregnancy

The large majority of patients tell me at their antenatal visit how they are fully COVID vaccinated, had their first shot or have their appointment for their first shot. CONGRATULATIONS! There is a small minority who have decided not to be vaccinated while pregnant or...

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SAN Swaddle update

SAN Swaddle update

The Hospital advises… After 1 December 2021, patients must have held obstetrics cover exclusively with HCF for 12 months prior to their baby's birth to qualify for the Swaddle program. Previously, patients have been able to switch from a different health fund into HCF...

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Increased risk of COVID infection in pregnancy

Increased risk of COVID infection in pregnancy

While most patients are either already vaccinated against COVID or keen to be vaccinated ASAP, there are some patients who are hesitant. My understanding, after discussion with hesitant patients, is this hesitancy has a lot to do with believing nonsense negative...

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I strongly encourage you to get vaccinated against COVID

An increasing number of patients are asking me about COVID vaccination in pregnancy. I strongly suggest you arrange to be vaccinated against COVID. Safety of COVID vaccination in pregnancy Some patients are saying they are worried about safety especially for their...

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From tragedy to triumph

From tragedy to triumph

When I first met Lauren, my heart went out to her because of her tragic pregnancy history. With her first she miscarried at 9 weeks She lost her second baby at 17 weeks. A boy. She presented to hospital with ruptured membranes. In view of the presentation, she agreed...

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COVID vaccination now recommended for pregnant women

RANZCOG statement extract: "RANZCOG and ATAGI recommend that pregnant women are routinely offered Pfizer mRNA vaccine at any stage of pregnancy. This is because the risk of severe outcomes from COVID-19 is significantly higher for pregnant women and their unborn baby....

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Baby Orlando is born

Baby Orlando is born

Last Monday evening Emily, our second daughter, gave birth to a beautiful baby boy who she and her husband Jeremy have named Orlando. Orlando is their second and has an older brother Hudson. Orlando is our 10th grandchild. All went well with Orlando’s birth. Mother...

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Berry holiday

Berry holiday

Each two years we take the family on a family holiday. We recently did this. We stayed at a large home just outside Berry. It was found by our daughter-in-law, Tanya. There were enough rooms / beds for everyone. There was enough space for the grandchildren to play...

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Avoiding significant perineal trauma with childbirth

Avoiding significant perineal trauma with childbirth

Rosemarie saw me for management of her first pregnancy. The pregnancy was uneventful. She was admitted to hospital in spontaneous labour when she was 39 weeks gestation. She had an epidural for pain relief in labour. In second stage labour there was slow progress with...

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Norwest Hospital Maternity feeding room now open

Norwest Hospital Maternity feeding room now open

Norwest Private Maternity is excited to announce that the Feeding Room (formerly the Well Baby Nursery) is now open and ready to welcome mothers. It will be a place where new mums can go to relax, get support and feeding advice. The Feeding Room will not just be for...

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“I have itchy hands and itchy feet”

“I have itchy hands and itchy feet”

Contents Labour pain relief Caesarean section deliveries Who administers the spinal and epidural anaesthetics? Effectiveness How are regional spinal or epidural anaesthetics given? What are the benefits of regional epidural anaesthetics? What are the...

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Norwest Hospital news

Norwest Hospital news

More midwives are being appointed so that there is a higher staff to patient ratio and better support of new mums. Dedicated Postnatal Lactation Consultant Service commencing 10 May. Breastfeeding room reopened. Maternity / Birth Unit tours have recommenced. Tours are...

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Happy Easter

Happy Easter

We wish you and your family a very happy Easter. It is a hugely different Easter compared to Easter 2020, which was soon after the start of the COVID pandemic. Last year my wife Robyn and I watched Good Friday and Easter Sunday church services online via Facebook in...

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Determination

Determination

I was pleased to see Marelle again for pregnancy care. She was understandably nervous at her initial visit for this pregnancy because of her obstetric history. She had first trimester miscarriages in 2018 and 2019. Later in 2019 she had another unsuccessful pregnancy....

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Diabetes in pregnancy

Diabetes in pregnancy

There are two types of diabetes encountered in pregnancy. On most occasions it is gestational (pregnancy induced) diabetes. This is diabetes that has its onset in pregnancy and usually resolves after delivery. Gestational diabetes is a relatively common adverse...

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COVID-19 vaccination in pregnancy. 

Last week a pregnant nurse patient and a pregnant GP patient asked me whether they could have the COVID-19 vaccine while pregnant. In the vaccine rollout they are category 1b because of their professions. I advised them, with there being no local COVID-19 cases for so...

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Perseverance

Perseverance

I first met Alison for management of her most recent pregnancy. I took a past obstetric history from her… 2003 14wks MC D&C 2003 12wks MC D&C 2004 36wks Bleeding in pregnancy, spontaneous onset of labour, SVD*, healthy boy Birth weight 3515gms. 2005 8wks MC no...

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Antenatal visits COVID update

Antenatal visits COVID update

In view of the AMBER alert reintroduced by the NSW Government only your husband/ partner can accompany you for your antenatal visit. Children, other family members and friends are not allowed to be in the office including in the waiting room.

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Thank you

Thank you

It is essential I have the support of other people in making my busy obstetric practice successful and providing patients with quality, caring pregnancy care. In this post I would like to acknowledge and thank the wonderful people who have supported me. Secretarial...

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Northern Beaches COVID outbreak

Northern Beaches COVID outbreak

This has resulted in new restrictions at Norwest Private and Sydney Adventist Hospitals. These include: Both have reintroduced mask wearing Screening on entry to both hospital, social distancing and hand hygiene practices will continue As well at the San Maternity...

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Coffs Harbour holiday

Coffs Harbour holiday

Because of COVID international border closures my wife Robyn and I had to cancel our holiday next February. Instead we are taking a shorter break at Coffs Harbour. I will be back on duty on the 5th December. Kylee and Emily are still working at the office if you have...

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Low platelet count (thrombocytopenia) in pregnancy

Low platelet count (thrombocytopenia) in pregnancy

Ede recently saw me for management of her second pregnancy. Her pregnancy was progressing well. She had her routine blood testing at 27 weeks. The results were normal except her platelet count was  below the normal range  at 131 x10^9/L  (normal range  150 – 450). Her...

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My professional opinion

My professional opinion

I arrived at the office on a recent Friday morning. My secretary told me there was a message left on the answering machine the night before from a solicitor in the United Kingdom. He did not give any details except he wanted my email address as he wanted to send me an...

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Norwest Private Hospital COVID update

Norwest Private Hospital COVID update

Norwest Hospital COVID update Norwest announced today the Hospital will again allow siblings to visit Maternity for one hour once a day, The San Hospital had not changed their policy - Partner only and no children

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COVID and baby photos with me

COVID and baby photos with me

It is popular for patients to ask for a photo of me with baby, mum, and dad immediately after birth, or while in hospital postnatally or at the 6-week postnatal visit. Sadly, for the present unless I am wearing a face mask, this is not possible. Social distancing is...

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NSW COVID-19 alert now amber

NSW COVID-19 alert now amber

NSW Health on 24th July has upgraded NSW COVID-19 alert to amber (moderate transmission risk) Consequently… In hospital… All staff must wear a surgical mask if social distancing not possible (viz. within 1.5m of patients). Husbands/partners must bring and wear their...

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COVID -19 outbreak in NSW in July 2020

COVID -19 outbreak in NSW in July 2020

Sadly, there are now more COVID -19 infections in NSW. These are community spread cases and so pose a risk to the general community. It is reported the origins of the outbreak are in Melbourne. It is reported this has happened because of gross quarantine mismanagement...

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My HOLIDAY 2021

My HOLIDAY 2021

In view of the ongoing COVID concerns and associated challenges my wife and I have decided not to book a holiday in 2021 for the time being. Rather we plan to take a couple of short breaks for a few days at times when there are no patients due.

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Pain relief in labour

Pain relief in labour

There are a variety of options for pain relief in labour.  Which one a woman chooses depends on variables such as her background wishes, expectations, labour and childbirth history, her fears, how quickly her labour progresses and developments in the labour. There is...

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Holiday 2021

Holiday 2021

The COVID-19 pandemic has meant we have had to change our holiday plans in 2021. I will now be away from Saturday 6th March 2021 to Monday 22nd March 2021. That means if you conceive with your LMP between 30th  May 2020 and 15th June 2020 I will not be available to...

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Wonderful outcomes after tragedy in the first pregnancy

Wonderful outcomes after tragedy in the first pregnancy

I first met Annie for management of her second pregnancy. Her first pregnancy had an incredibly sad outcome. She delivered at 25 weeks a little boy named Aiden who died soon after birth. I asked Annie to provide me with details of what had happened in her first...

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It is safe to fall pregnant

It is safe to fall pregnant

There has been a lot of fear in the community about conceiving doing the COVID-19 (coronavirus) pandemic. I am pleased to advise as a specialist obstetrician doctor that I consider it is safe to conceive and embark on that very wanted pregnancy. Each day there is...

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Happy Easter

Happy Easter

We wish you and your family a very happy Easter. It has been very different and very quiet Easter for us this year because of coronavirus. Besides visiting postnatal patients in hospital and delivering a baby on Easter Sunday I have been at home with my wife Robyn. We...

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Keep calm and stay at home

Keep calm and stay at home

There is so much anxiety and fear in the community, including amongst my patients, about COVID-19 (coronavirus). It is impossible to turn on the radio, TV or social media without being confronted with negative COVID-19 information. My daughter refuses to watch the...

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A good labour and childbirth story

A good labour and childbirth story

Many pregnant women are fearful of labour and childbirth. I asked Adele to share her experience to encourage especially these women. Adele wrote: “Monday 17th February - 2 days after my due date. On this day, I was working through a list of jobs around the house that...

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Coronavirus statistics interpretation

Coronavirus statistics interpretation

When I went to the Birth Unit yesterday morning one of the midwives told me she had been distressed by what the on-call anaesthetist had told her was the predicted death rate from coronavirus for people of her age. I told her that I did not agree with what he said....

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Never quit

Never quit

Catherine saw me at nine weeks gestation for management of her fifth pregnancy. Her first three pregnancies had been unsuccessful. I had not known her then. She saw me for the first time for management of her fourth pregnancy, which was successful. She told me in her...

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Some of my thoughts about the coronavirus pandemic

Some of my thoughts about the coronavirus pandemic

Some of my thoughts about the coronavirus pandemic Every patient who attended for an antenatal visit quizzed me about coronavirus. They were all anxious, especially being pregnant. This was just a small sampling of the bigger Australian community. There is so much...

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How to minimise your risk of getting coronavirus

How to minimise your risk of getting coronavirus

How to minimise your risk of getting coronavirus Washing your hands often especially before eating, drinking and touching your face. Soap and water washing for 20 seconds and thorough drying is best. Otherwise use a hand sanitiser with at least 70% alcohol.* Cover...

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Office coronavirus precautions

Office coronavirus precautions

You can only attend your appointment if you do not have now or have not had within the last 2 weeks a cold or flu-like symptoms (such as fever, sore throat, nasal congestion, cough, shortness of breath). You can only attend for your appointment if you have not been in...

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My holiday time

My holiday time

I will be away on holidays between Tuesday 23rd February 2021 and Tuesday 23rd March 2021. That means I will not be available to deliver your baby between those dates. You will not be able to book with me for pregnancy care if your EDC is in this time period. Working...

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Coronavirus and pregnancy

Coronavirus and pregnancy

Is a pregnant woman more at risk of being infected with coronavirus? In pregnancy a woman’s body has immunologic and physiologic changes which might make her more susceptible to viral respiratory infections. This logically would include coronavirus (COVID-19). But...

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San – HCF Swaddle celebration evening

San – HCF Swaddle celebration evening

Last Thursday evening the Sydney Adventist (San) Hospital and HCF had an exciting evening to which I was invited. The meeting was to celebrate the launch of the new Swaddle Maternity Package. Swaddle (San Baby Bundle Maternity Package) is an Australian first. ‘No gap’...

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Was the cervical suture necessary?

Was the cervical suture necessary?

Stephanie’s first antenatal visit with me was at 7 weeks and 6 days gestation. It was her second pregnancy, but first ongoing pregnancy. She had had a miscarriage in 2016. She advised me she had had a cervical LLETZ operation and two cone biopsies for management of...

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Using social media in my medical practice

Using social media in my medical practice

I have recently been invited to participate in a survey about doctors’ business use of social media to communicate with patients. The same people who contacted me did a similar survey of doctors five years ago and concluded ‘most Australian doctors didn't have the...

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I want an iron infusion

I want an iron infusion

It is becoming more popular for pregnant women to request an iron infusion because of tiredness in pregnancy. The iron infusion will only benefit if there is an iron deficiency, which can be checked by a blood test. Most tiredness in pregnancy is not due to iron...

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Trust

Trust

I was listening to a radio journalist in the car on the way home from the hospital. He said that he and his wife were very nervous with her first labour and childbirth experience as they didn’t really know what was going to happen. He said they were ‘way out of their...

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I want to be a mummy

I want to be a mummy

Many patients have told me they started thinking about what it will be like to be a mummy when they were young girls cuddling dolls and pretending their dolls were real babies. Becoming a mother has a very special place in a woman’s heart and for so many women is the...

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How soon can I have my baby?

How soon can I have my baby?

“How soon can I have my baby?” is a question I frequently get asked in advanced pregnancy. The question is asked because the pregnant woman who asks it is struggling to cope with the impact of advanced pregnancy on her body. I am happy to arrange induction of her...

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Public vs private pregnancy care

Public vs private pregnancy care

A patient returned to see me for pregnancy management. Because she had discontinued her health fund membership, she told me this time I will not be delivering her baby, and she will be confined as a public patient. She will continue to see me throughout the pregnancy...

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Solo vs group obstetric practices

Solo vs group obstetric practices

I am a solo obstetrician practitioner. By that comment I mean I have my own rooms (office), my own secretarial staff, I see all patients who book with me for pregnancy at each antenatal visit myself, I manage all patients who book with me in labour (with the support...

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Another reason why not to go public for pregnancy care

Another reason why not to go public for pregnancy care

Wendy had her first baby at a major public hospital as a public patient. She needed an emergency Caesarean section. She said the operation was done by a young female doctor who she had never met. She never saw this doctor again after the operation. Wendy said she had...

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Urinary incontinence and pregnancy

Urinary incontinence and pregnancy

Urinary incontinence is a common and distressing pregnancy and postpartum problem. It is usually urinary stress incontinence. Stress incontinence happens when the bladder sphincter muscle does not function well enough to hold in urine in the bladder. Recently I was...

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Eight pregnancies, two babies

Eight pregnancies, two babies

I first met Laura in 2013. She saw me for management of her third pregnancy. Her first two pregnancies had been unsuccessful. She had had two early first trimester miscarriages. She was not aware of a reason why she miscarried. Her third pregnancy was also not...

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Caesarean section by choice

Caesarean section by choice

When asked: “Can I have a Caesarean section?” I always answer: “YES”. There is an increasing number of women who choose to have an elective Caesarean section as the mode of delivery, rather than a vaginal delivery. The request is usually made at the first antenatal...

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Taking time off

Taking time off

My last blog It is good to be back prompted a Facebook comment from an old patient who moved overseas to live after her first pregnancy. I have Donna’s permission to repost her comment: “I love how dedicated you are Gary and it makes a huge difference to people. I...

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It is good to be back

It is good to be back

My wife Robyn and I arrived home on Saturday night after a wonderful four-week holiday. We spent two weeks cruising in France and then almost two weeks visiting old friends in the United Kingdom. These friendships were kindled when we lived in the United Kingdom (two...

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Severe diabetes and pregnancy

Severe diabetes and pregnancy

Desiree saw me initially for management of her first pregnancy in 2015. She had been an insulin dependent diabetic since she was five years old and was requiring 30 units of insulin per day when I saw her for her first antenatal visit. She also had a history of...

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Resuming work this weekend

Resuming work this weekend

I have decided I am well enough to resume deliveries from Saturday 9th February and office consultations from Monday 11th February. I have made a faster recovery from my severe pneumonia than anticipated. My respiratory physician is very pleased with my recovery and...

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My recent health

My recent health

On Tuesday 8th January I was admitted to ICU with a very severe and unusual type of pneumonia. Through God’s grace, the excellent care of the doctors and nurses looking after me and the right medications I am on the road to a full recovery. My recovery so far has been...

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Christmas and New Year holiday season office open days

Christmas and New Year holiday season office open days

Because of the Christmas and New Year holiday season our office will only be open on Friday 28th December and Monday 31st December. Normal opening days will resume on Wednesday 2nd January. I (Dr Gary Sykes) am working during the entire Christmas and New Year holiday...

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Was it cervical incompetence?

Was it cervical incompetence?

Trish saw me with her husband for the management of her second pregnancy. Sadly, her first pregnancy ended at 20 weeks gestation (pregnancy). She said she had spontaneous rupture of membranes and light contractions before delivering a stillborn little girl. I had not...

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History of Caesarean section delivery

History of Caesarean section delivery

There are references to Caesarean section operations in ancient Hindu, Egyptian, Greek, Roman, Chinese and European stories, photos and ancient historical records. While it is commonly believed the name ‘Caesarean’ is from the surgical birth of Julius Caesar, this is...

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Preeclampsia presenting as liver pain and tenderness

Preeclampsia presenting as liver pain and tenderness

Carolyn had an uncomplicated first pregnancy until she was 35 weeks 6 days gestation (pregnancy). She phoned the Birth Unit as she had pain in her right upper abdomen.  She was asked to come in to be assessed. I attended to see her. She was slightly tender in the...

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I have an unpredictable life

I have an unpredictable life

Last week was very busy. So, my wife Robyn and I decided to relax and see a movie on Sunday afternoon. We decided to see ‘Mission: Impossible – Fallout’. In case a patient went into labour, I didn’t book the tickets until 10.00am on Sunday. I had to do an online...

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New ultrasound machine

New ultrasound machine

On Friday I took ownership of a new GE Voluson P8 ultrasound machine. Besides all the features of my previous GE ultrasound machine there is greater clarity in photos and now I can export to your USB 3D video clips of your baby moving and sound video clips of your...

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Please avoid getting pregnant in the next month

Please avoid getting pregnant in the next month

I will be away on holidays between Saturday 4th May 2019 and Saturday 1st June 2019.  That means I will not be available to deliver your baby between those dates. You will not be able to book with me for pregnancy care if your EDC is in this time period. Working back...

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A sudden turn of events

A sudden turn of events

A patient booked with me for management of her 4th pregnancy management. The pregnancy progressed well until 38 weeks and 3 days gestation. That evening she became aware of painful vein swelling in her left thigh. Her GP arranged a doppler ultrasound scan the next...

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Planning is important

Planning is important

Pregnancy and childbirth complications can happen irrespective of who is managing your pregnancy. But with considerable professional clinical experience that is consequence of having managed many thousands of pregnant women and with personalised patient care the...

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Do I look ok?

Do I look ok?

Physical appearance is an important matter to many women and being pregnant can cause major concern because of the associated changes in body shape. There are some pregnant women who enjoy the physical appearance changes that come with being pregnant, while others...

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I am an obstetrician

I am an obstetrician

My business/practice focus is now pregnancy and childbirth management. Over 90% of patients see me because they are pregnant and want me to be their obstetrician. Women phone my office to make appointments to see me about gynaecology problems. My secretary will say is...

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Choosing public can be very costly

Choosing public can be very costly

It is that time of year when health funds are about to increase their premiums. This year’s increase thankfully is quite modest. It is the least increase in nearly two decades. The average private health insurance premium will increase by 3.95% from 1st April 2018....

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Choosing your baby’s name

Choosing your baby’s name

I was chatting with a patient and her husband about whether they had thought of a name for their soon to be born baby. This lead to the husband telling me of a friend who knew of a child with the first name ‘Abcde’. The parents of Abcde obviously thought this was a...

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A very challenging pregnancy with a wonderful outcome

A very challenging pregnancy with a wonderful outcome

Catherine saw me at eight weeks gestation for management of her 4th pregnancy. Her first three pregnancies had been unsuccessful. She told me in her first pregnancy she had a placental abruption with threatened preterm labour at 23 weeks. At 24 weeks her membranes...

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Epidural and spinal anaesthetics

Epidural and spinal anaesthetics

Contents Labour pain relief Caesarean section deliveries Who administers the spinal and epidural anaesthetics? Effectiveness How are regional spinal or epidural anaesthetics given? What are the benefits of regional epidural anaesthetics? What are the...

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When do I need my diabetes check in pregnancy?

When do I need my diabetes check in pregnancy?

I am often asked early in the pregnancy about when to have gestational diabetes mellitus (GDM) screening, with the patient under the impression that is should be done as soon as possible. This is not the case. GDM screening is usually done at 26 to 28 weeks pregnancy....

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Do Epidurals Prolong Labour?

Do Epidurals Prolong Labour?

This popular question does not have a simple answer as there are different circumstances that need to be considered. First stage labour There is no reason an epidural block should prolong first stage labour. To the contrary epidural can result in a shorter first stage...

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When Less is Better than More

When Less is Better than More

It was Louise’s second pregnancy. In her first pregnancy, she went into spontaneous labour at 40 weeks and 6 days. She had a spontaneous vaginal delivery of a baby girl weighing 3662gms. This second pregnancy was progressing well except her baby started measuring...

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Checklist for when baby is almost due

Checklist for when baby is almost due

I am asked from time to time in advanced pregnancy: “Baby is almost due - what do I need to do?" Pack Your Bag. By about 36 weeks pregnant have your hospital bags packed. Make a written note of last minute items you will need to add. It is better if you should have...

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Pregnancy care checklist

Pregnancy care checklist

Pregnancy care checklist We are often asked about 'what happens when' with pregnancy care. With that question on mind I have put together the table below as a guide. 8 Weeks First visit with me for most patients I will give you a referral for routine pregnancy tests,...

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Checklist for when deciding to have a baby

Checklist for when deciding to have a baby

I am asked from time to time: “How can I prepare to have a baby?” So, I have put this checklist together which covers the points that are relevant before you start trying. Health fund. Make sure you have appropriate health fund cover that covers you for confinement in...

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Her uterus was adherent to her anterior abdominal wall!

Her uterus was adherent to her anterior abdominal wall!

A new patient saw me for management of her third pregnancy. Her first delivery had been in Pakistan. It was an emergency Caesarean section at 36 weeks because of foetal distress. Her second delivery was in the United Kingdom. It was an emergency Caesarean section at...

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Why you should not quit your health fund

Why you should not quit your health fund

At this time of year, there is a lot of media attention given to private health insurance and premiums going up. While the media ads are trying to encourage you to join /change to a fund the ads and media attention can have the opposite impact and some people will...

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Foetal distress in first stage labour

Foetal distress in first stage labour

I have had two patients recently where despite foetal distress in first stage pregnancy were able to have vaginal deliveries. The first patient was in her second pregnancy with the first pregnancy ending as a miscarriage because of the baby having a chromosomal...

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Management of an occipito-posterior positioned baby

Management of an occipito-posterior positioned baby

It was Shannon’s third pregnancy. Her first was in 2015. That pregnancy had been uneventful. She ruptured her membranes at 40 weeks. As she did not go into labour a Syntocinon infusion was commenced. She had a vaginal delivery of a healthy girl weighing 3.1Kg. Her...

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Just in time

Just in time

Vanessa saw me for her first antenatal visit of her second pregnancy when she was 8 weeks pregnant. She told me her first pregnancy was uneventful. She went into spontaneous labour at 37 weeks. Labour lasted about 15 hours. There was a lack of progress in the second...

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Repeat Caesarean section had unexpected surprises

Repeat Caesarean section had unexpected surprises

A patient said to me at her first antenatal visit of her second pregnancy that she wanted an attempt at a VBAC (Vaginal Birth After Caesarean section). She was ten weeks pregnant at the time. I had not met her prior and I was not the obstetrician for her first...

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Pregnancy and young drivers

Pregnancy and young drivers

On December 1st 2016 driving rules in NSW changed for learner, P1 and P2 licence holders. Learner, P1 and P2 licence holders are now not permitted to use a mobile phone at all while driving. “These laws encourage learner and provisional drivers and riders to...

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Face presentation

Face presentation

I was woken by the midwife at 12.30am. A patient had arrived in labour at 6cm cervical dilatation. She was 39 weeks’ gestation and she had had two uncomplicated vaginal deliveries. She still had intact membranes. The midwife asked me to come as she was starting to get...

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Reduced growth of baby with good pregnancy outcome

Reduced growth of baby with good pregnancy outcome

Hannah saw me for management of her first ongoing pregnancy. She had two miscarriages in the past. There was no relevant history except she was hypothyroid and was taking thyroxine. The pregnancy started well. The first visit with me was at 10 weeks and there were no...

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Challenging pregnancy with a good outcome

Challenging pregnancy with a good outcome

I was very excited to see a wonderful patient for the first antenatal visit of her second pregnancy. Sadly, her first pregnancy had not worked out as she had a mid-trimester loss. She has been diabetic since as she was five years old. She has an insulin pump and is...

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Last Sunday afternoon

Last Sunday afternoon

Last Sunday afternoon my wife and I went to see the movie ‘The Accountant’. Nothing was happening so I thought it was safe. I always sit by the aisle just in case. Two-thirds of the way through the movie I had a call. I left my wife in the cinema and attended quickly...

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Testimonials are not permitted on medical websites

Testimonials are not permitted on medical websites

I wish to thank so many of you who have given me such wonderful feedback about the care I have provided for you and your unborn baby during your pregnancy. It warms my heart and gives me such great joy. I do my very best to provide the best medical care I can possibly...

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Health insurance premiums USA vs. Aus

Health insurance premiums USA vs. Aus

My wife read a Facebook post from a lady we know from the USA about the increase in their monthly private health insurance premium. It read “Opened my mail today. $2,069.03. What my "covers nothing until $6,300 a person is spent, not even meds" but costs right now...

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Posterior Placenta Position – Placenta Praevia

Posterior Placenta Position – Placenta Praevia

Posterior Placenta Position - Placenta Praevia It was a Thursday afternoon. I took a patient to theatre for a Caesarean section delivery because of the Posterior Placenta Position which is called placenta praevia. Placenta praevia is when the placenta develops in the...

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Fully dilated and baby’s head not engaged

Fully dilated and baby’s head not engaged

I was woken at about 12.30am by a midwife working in the Birth Unit. A patient had arrived in spontaneous labour and her cervix was now fully dilated. But the baby’s head was very high. The midwife told me the head was still at the level the brim of the pelvis....

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What is an obstetrician?

What is an obstetrician?

I am asked from time to time: What is an obstetrician? What is the difference between an obstetrician and a gynaecologist? What is the difference between an obstetrician and a midwife? What is an obstetrician? An obstetrician is a specialist medical doctor. An...

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How to avoid tearing with delivery.

How to avoid tearing with delivery.

Last night a patient had an intact perineum after a spontaneous vaginal delivery. It was her first baby. There was some minor vaginal tearing only. I said to her she can expect to have a much better recovery because her perineum was intact. I often get asked by...

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Breast cancer in pregnancy

Breast cancer in pregnancy

It was Monday afternoon last week. Rebecca attended with her husband Russell for her antenatal visit at 38 weeks 6 days gestation. She had had a right breast biopsy the previous Thursday and was anxious to find out the result. The result had just come through. I had...

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“I have been having hypo’s more often.”

“I have been having hypo’s more often.”

Sherree saw me for management of her first pregnancy. She had been a diabetic for five years before her pregnancy. Before her first visit with me, she had an appointment with her endocrinologist. Prior to being pregnant, he had managed her diabetes with oral...

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Never quit

Never quit

This is an amazing and wonderful story of a fabulous couple who after 15 years of trying to have to baby and despite a very challenging high-risk pregnancy because of severe preeclampsia have been blessed with was a beautiful baby boy. Irene and her husband married in...

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Baby had no heart beat at birth

Baby had no heart beat at birth

It was Lydia’s first pregnancy. It had been totally uncomplicated. I saw her at 39 weeks and 0 days for a routine check and there were no concerns. During the early evening of the next day Lydia fainted at home whilst sitting on the couch. Her mother-in-law was with...

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Obstetric Excellence website has a new look

Obstetric Excellence website has a new look

I am so often getting positive feedback about my Obstetric Excellence website. Patients frequently tell me how informative it is, how easy to navigate it is, how interesting the articles are to read. Thank you. A key aim in providing such a comprehensive pregnancy...

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Is my baby the right size?

Is my baby the right size?

I am frequently asked: “Is my baby the right size?”, “When does my baby put on the most weight?” and “How big is my baby likely to be at birth?” At each antenatal visit, I do ultrasound scanning of the unborn baby. There is no patient expense for this service. As well...

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Please don’t ‘Dr Google’

Please don’t ‘Dr Google’

An anxious patient contacted me on Thursday evening. She had a pregnancy-related discomfort and decided to search on Google for the reason. She became concerned about what she read. She came to the conclusion from what she read that she had a particularly serious...

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Baby stopped growing

Baby stopped growing

A 25-year-old patient attended at eight weeks pregnancy for her first antenatal visit of her first pregnancy. Initially, the pregnancy progressed normally and without any concerns. There started to be a slight fall-off in baby’s growth, first detected by ultrasound...

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Baby’s hand below head in labour

Baby’s hand below head in labour

Towards the end of her third pregnancy, a patient asked me if her labour could be induced. She had requested the same in the previous two pregnancies. In her first pregnancy delivery took place at 39 weeks gestation and in the second at 38 weeks gestation. All worked...

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Never quit

Never quit

A patient recently saw me for her postnatal visit. A postnatal visit is always a wonderful visit of celebration - the end of a successful pregnancy and the birth of a new baby. This was a very special postnatal visit because of this patient’s obstetric history. In...

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Time was of the essence

Time was of the essence

It was Monday morning. Amie’s husband Mitch had gone to work. Amie woke at 7am and “spent the morning lying in bed practising my calm birth breathing from the calm birth course we did two weeks earlier”. Amie was 33 weeks pregnant in her first pregnancy. Her pregnancy...

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End of year –  A time to review and plan

End of year – A time to review and plan

The end of December is the time of the year when people reflect on the year that has happened and plan for the year about to start. During this holiday season, I have been doing just that. 2015 has been a wonderful year for me with lots of positives. It has been an...

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Social media is a great asset to my obstetric practice

Social media is a great asset to my obstetric practice

Patients often compliment me on how well I have l embraced social media in my obstetric practice. I appreciate very much this positive feedback. I feel very comfortable with using social media. As well, I recognise that social media is popularly used by most of my...

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Exercise and sport in pregnancy

Exercise and sport in pregnancy

Chantell saw me for her postnatal visit this week. Chantell is a first-time mum who is also a group fitness instructor. Prior to her pregnancy, she took lots of group fitness classes at the gym, with her favourite being combat classes. When she saw me for her first...

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Pregnancy care management fee

Pregnancy care management fee

Why am I charged a pregnancy care management fee? From time to time patients ask why they need to pay the pregnancy care management fee when they pay for each antenatal visit. The Medicare management fee item number was introduced by the Federal Government when the...

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Why doesn’t Dr Sykes bulk bill for antenatal visits?

Why doesn’t Dr Sykes bulk bill for antenatal visits?

My secretaries are asked this question from time to time especially by someone who is in early pregnancy and is trying to work out which obstetrician she should book with. Superficially, it would appear if you were bulk billed for antenatal (AN) visits you would pay...

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A unique job

A unique job

Recently Samantha wrote a wonderful post on my personal Facebook page. The words and photo gave me such joy and led me to reflect on what a wonderful job I have. It is quite a unique job. As an obstetrician, I am supporting a woman and her husband/partner during one...

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Protecting your new baby from infection

Protecting your new baby from infection

Recently after church, I was chatting with a new mum whose baby daughter I had delivered eight days earlier and I was very pleased to see she had her baby in a protective sling. Not only was this very convenient for her and took up minimal space in the car (c.f. a...

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Saturday afternoon had unexpected developments

Saturday afternoon had unexpected developments

Saturday afternoon had unexpected developments. After a busy morning of visiting postnatal patients in hospital and then seeing antenatal patients for consultations in my office, I returned home. My wife and I had a major appliance at home that needed to be replaced....

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The Non-Invasive Prenatal Test (NIPT) post updated

The Non-Invasive Prenatal Test (NIPT) post updated

I have updated information on the Non-Invasive Prenatal Test (NIPT) in the Questions & Answers section of my website. Since I published on this topic there have been lots of positive developments, especially recently: There are more test-provider options and more...

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The lifestyle of an obstetrician

The lifestyle of an obstetrician

Patients often ask me what it is like to be an obstetrician I answer: “It is a fantastic career. I love being an obstetrician. It is wonderful to be able to support a patient on her pregnancy-and-delivery journey and to celebrate with her and her husband/partner the...

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Pre-eclampsia

Pre-eclampsia

I was in the special care nursery to visit the babies of two patients I recently delivered. Both patients needed delivery at 35-weeks pregnancy because of pre-eclampsia. Pre-eclampsia is one of the commonest complications of pregnancy. While in most patients it is...

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What is an obstetrician?

What is an obstetrician?

What is an obstetrician? It is not unusual to be asked: “What is an obstetrician?” An obstetrician is a specialist medical doctor who looks after (manages) women who are pregnant. An obstetrician also manages a woman and her unborn baby in labour and delivers her baby...

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How can I get myself into labour?

How can I get myself into labour?

How can I get myself into labour? This is a common question asked by a patient when she approaches her expected date of confinement (EDC), and especially if she goes past her EDC. EDC and onset of labour The first point to understand is that an EDC is an artificial...

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VBAC attempt went horribly wrong

VBAC attempt went horribly wrong

A 23-year-old woman saw me for a gynaecology consultation in the hope I could explain to her what went wrong with her last delivery eight months earlier when she had a ruptured uterus. Also, she wanted my management of abdominal pain she has had since then. I was very...

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A better delivery experience

A better delivery experience

I recently delivered the third baby of a patient who is a Pacific Islander and is a resident of her home country. She flew to Australia to meet me for the first time when she was 27-weeks' pregnant. She told me about the very traumatic delivery of her second baby at...

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Being Overweight And Pregnant

Being Overweight And Pregnant

Management of childbirth in the excessively overweight patient was a topic of discussion at a recent department meeting at one of the hospitals I attend. Obesity is increasing in incidence in the community. Now approximately 50 per cent of women who become pregnant...

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Early pregnancy diabetes detection

Early pregnancy diabetes detection

I recently introduced to my obstetric practice the new RANZCOG criteria for screening for diabetes in pregnancy. There is information about this in the Questions & Answers section of my website under the topic 'Diabetes screening in pregnancy'. Recently a...

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Last childbirth experience

Last childbirth experience

A new patient saw me this week to talk through her last childbirth experience. She also wanted to discuss having another baby. She had been managed as public patient in her last pregnancy. It was her first pregnancy. There were no pregnancy problems except for...

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Childbirth positions

Childbirth positions

I recently had two patients who wanted to deliver on “all fours” as it was a more comfortable position. One baby’s heart rate slowed every time the mother adopted the “all fours” position but was normal when she was in another position. As a consequence, we had to...

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“Please don’t let me die”

“Please don’t let me die”

It was S’s first pregnancy. S and her husband are a delightful couple who were very excited about the pregnancy. The pregnancy was uneventful. At 39 weeks, S was admitted to hospital with spontaneous rupture of membranes. After hours of waiting for spontaneous labour...

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“Inductions are better than people make out”

“Inductions are better than people make out”

A patient asked me to do a blog titled “inductions are better than people make out”. This patient delivered two days ago. It was this patient’s third pregnancy. Because of developments with the second delivery, we agreed that induction of labour was a safer option...

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Mothers Day

Mothers Day

It was Mother’s Day. The plan was to have a celebration breakfast wife my wife Robyn, give Robyn her Mothers Days gifts, then go to church with Robyn, then lunch and then take Robyn to our daughter’s home for a Mothers Day celebration afternoon tea with all the...

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Nuchal Translucency scan got it wrong

Nuchal Translucency scan got it wrong

A 29 year old patient in her second pregnancy had a Nuchal Translucency ultrasound scan (NTS) to check whether her baby has Down syndrome (Trisomy 21). The serum test maternal serum screening (PAPP-A and beta HCG levels) was also done to increase the accuracy of the...

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Sunday had its own surprises

Sunday had its own surprises

On Sunday I planned to attend my wife Robyn’s great nephew’s christening. Robyn was overseas. I had not gone overseas with her as the trip had been organised at short notice and I had too many patients due. So, at the christening I was also representing Robyn. The...

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From despair to excitement

From despair to excitement

Last week was a very busy week. Wonderful patients had successful pregnancy outcomes of beautiful babies. I saw lots of antenatal patients for mid-pregnancy routine checks. I saw patients for their first pregnancy visit who were both excited and nervous. I saw...

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Why I am an obstetrician

Why I am an obstetrician

I am often asked why I am an obstetrician The decision to become an obstetrician goes back to medical school when I was doing a term in obstetrics. One of the students in our tutorial group asked the obstetrician tutor why he was an obstetrician. His replied: "it’s a...

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Comparing Health Funds

Comparing Health Funds

A patient attended today for her first antenatal visit of her second pregnancy. She wasn’t planning a second pregnancy just yet. So, to save money, she had dropped pregnancy care cover with her health fund. She said she was going to take it up again in the future when...

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Avoiding tearing with childbirth

Avoiding tearing with childbirth

On Sunday morning at about 1.00am a patient delivered a beautiful baby girl weighing 3512gms. It was her first baby and she delivered her baby without even a graze of trauma to her vagina or perineum. She adopted the position of being on ’all fours’ to push and...

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Professional behaviour amongst professionals

Professional behaviour amongst professionals

For a number of weeks I have been ‘covering’ an obstetrician colleague. Initially it was because he was on holidays and more recently it is because he has been unwell. This ‘cover’ has included confining his patients who go into labour, seeing his patients for...

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Your baby will prefer your music and your food!

Your baby will prefer your music and your food!

In the excellent video clip titled ‘Importance of the early years’ by Professor Glover of Imperial College London UK which I mentioned in my previous blog ‘Foundations of childhood behaviour’ Professor Glover also states “We now know that towards the end of pregnancy...

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Foundations of childhood behaviour

Foundations of childhood behaviour

Last weekend my wife and I spent time with old friends from our time living in Oxford UK, Dave and Di Nutt. Dave is now a psychiatrist and neuropsychopharmacologist working at Imperial College London UK and is a world authority on brain function specialising in the...

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Nuchal Translucency scan – consider carefully first

Nuchal Translucency scan – consider carefully first

Three patients recently had nuchal translucency scans with serum checking to reassure that baby was at low risk of Down syndrome (Trisomy 21). All had high risk results. One baby has a 1 in 8 risk of Down syndrome, the second 1 in 38 and the third 1 in 138 risk of...

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The fish that got away

The fish that got away

The husband of a pregnant patient who attended with his wife today for an antenatal visit commented after a question from his wife: “You must have to spend a lot of time reassuring your patients because of old wives tales told to them.” The answer is: “Yes”. It is...

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An episiotomy that went wrong

An episiotomy that went wrong

I recently saw a new patient eight days after her confinement. She had been managed in her recent and first pregnancy as a public patient in a local large teaching hospital through its midwives clinic. She wanted a water birth. Thirteen days overdue her labour was...

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Miscarriage – Karyotype checking

Miscarriage – Karyotype checking

I saw a couple today for follow up after her third miscarriage. I met her for the first time for her first antenatal visit of this most recent pregnancy. She was nine weeks pregnant by dates at the time of her first antenatal visit. She was well and excited. All was...

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Having A Healthy Diet In Pregnancy

Having A Healthy Diet In Pregnancy

A healthy diet It is very important to endeavour to be in optimal nutritional health before you conceive and in pregnancy. When you are pregnant you are feeding two not one! Because of chemical additives in the food you buy in the supermarket, etc. it is very had to...

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Iodine and Pregnancy

Iodine and Pregnancy

Iodine deficiency has become more common in the community. It is thought due to most households (more than 80 per cent) not using iodised edible salt and also the food industry rarely uses iodised salt. As well in the dairy industry iodine-containing sanitisers...

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VBAC vs elective Caesarean section

VBAC vs elective Caesarean section

A question and my answer on a health matter advise website where I am a Heath Professional 'expert contributor'. Question to the health advise website from an anonymous person (not my patient) who I don't know and who lives somewhere in Australia: "I have had 2...

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Supplements

Supplements

There is increasing concern about the quality of most people's diet. Healthy eating today is much more difficult than in the past because of modern farming and food preparation procedures. This even has had an impact on the nutritional value of fresh fruit and...

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Medicines

Medicines

Any medicine is to be avoided unless it is absolutely necessary. If you have any queries please ask your general practitioner or me. As a general rule medical preparations that you can buy 'over the counter' (not on prescription) in a pharmacy or supermarket are safe...

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Exercise and Activity

Exercise and Activity

Walking is an excellent idea. As well, antenatal exercise classes are available through the hospital and privately. You can inquire about the hospital classes when you book. See also in link section exercise in pregnancy. Working Normally I am not concerned about...

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How do I stay healthy during my pregnancy?

How do I stay healthy during my pregnancy?

Pregnancy is an exciting time when you have new life (your baby) developing and growing in your uterus. I am regularly asked "what can I do?", "what can't I do?", "what can I eat?", "what can't I eat?" etc. A mother-to-be wants to look after her precious cargo in her...

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Expect the unexpected with childbirth

Expect the unexpected with childbirth

Today I induced the labour of a patient who was 39 weeks pregnant because it was her personal request. It had been an uncomplicated pregnancy. It was her second pregnancy. With her first pregnancy her labour had been induced at 39 weeks by me at her personal request....

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Will the grieving stop?

Will the grieving stop?

A patient sent me a Facebook message the other day. Her son had tragically died in utero at 37 weeks gestation 7 years ago. After delivery, the cause for his death was very apparent. The umbilical cord was tightly tied around his neck twice. There was so much...

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Can I stop getting stretch marks?

Can I stop getting stretch marks?

Stretch marks are due to tearing of the deeper (dermis) layer of the skin. Usually stretch marks appear as angry red lines While common in pregnancy, not every pregnant woman gets them. As well they can occur at other times when not pregnant such as with rapid growth...

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Can I stop the swelling of my hands and feet?

Can I stop the swelling of my hands and feet?

Swelling of hands and feet is common in pregnancy. Swelling is due to pregnancy hormones resulting in fluid retention in the body. It usually occurs in the feet/ankles and hands/wrists. It can also be noticed in the vulval area, in the face and in the general body....

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How do I figure out the date of conception?

How do I figure out the date of conception?

That is not an easy question to answer. The reason why we use the first date of the last menstrual period (LMP) in calculating the expected date of confinement (EDC) is because most women know their LMP date. But most women don’t know the actual date of ovulation. The...

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Grieving after a miscarriage

Grieving after a miscarriage

In a health topics Q & A website where I was invited to be a health expert I was asked the question: “How do you recover from a miscarriage? My family thinks I should "be over" my miscarriage by now, but I'm still grieving. Is this normal?” This is a very relevant...

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Caesarean section closure technique

Caesarean section closure technique

My goal is not only for you to have an enjoyable Caesarean section delivery experience but also for you to have the least postoperative discomfort possible and an excellent long to recovery with excellent healing. While there are many variables that can account for...

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How might osteoporosis affect pregnancy?

How might osteoporosis affect pregnancy?

In osteoporosis there is reduced bone mineral density which predisposes to increased risk of bone fracture. Osteoporosis leading to fracture can occur during pregnancy, though it is very uncommon. There is likely to be a background condition such as such as coeliac...

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Sciatica pain in pregnancy

Sciatica pain in pregnancy

Sciatica pain is due to compression sciatic nerve In pregnancy this can be caused by the pressure of the gravid uterus and in advanced pregnancy of the baby on the sciatic nerve. I once had a gynaecology patient who had severe sciatica and a large fibroid uterus...

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Can pregnancy increase the risk of breast cancer?

Can pregnancy increase the risk of breast cancer?

Pregnancy is the most significant modifiable factor known for breast cancer risk in women. Although an initial increase in risk occurs immediately after parturition in women older than 25 years, the overall lifetime risk of breast cancer decreases after pregnancy. The...

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Can pregnant women eat pineapples and papayas?

Can pregnant women eat pineapples and papayas?

While many say eating pineapples and papaya should be avoided in pregnancy because they can trigger miscarriage and the onset of premature labour, this opinion are based on theoretical consideration and some laboratory animal studies. I am not aware of any clinical...

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Folate and folic acid – What’s the difference?

Folate and folic acid – What’s the difference?

Folate is a water-soluble B vitamin that is found naturally in a variety of foods. Excellent food sources of folate include asparagus, bran flakes, broccoli, Brussels sprouts, chickpeas, dried beans, lentils and spinach. Folic acid is the synthetic form of folate that...

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Is there such a thing as a fear of being pregnant?

Is there such a thing as a fear of being pregnant?

I find that most women, to some extent, have a fear of being pregnant. This is often because pregnancy is something new, they have no experience and they are not in control over it to a large extent. So fear can be regarded as a normal reaction. But as well a woman’s...

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Mother’s Day treat

Mother’s Day treat

It’s Mother’s Day tomorrow. “Happy Mother’s Day” to all mums and mums-to-be. A patient and her husband brought both grandmothers-to-be to the antenatal visit today to watch their future grandchild on the ultrasound screen. They said it was a Mother’s Day treat. Junior...

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Dad did the delivery!

Dad did the delivery!

Yesterday a wonderful patient delivered her beautiful baby. It was her first. After delivering the baby’s head and anterior shoulder I turned to Dad and asked if he wanted to take over. He nervously said, “what do I do?" I showed him where to put his hands and...

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Coping with grief

Coping with grief

It was 4.00pm Monday afternoon. I was in consultation with a gynaecology patient in my office when my mobile phone rang. It was a call from the Birth Unit midwife. A patient who was 32 weeks pregnant was attending a routine antenatal class at the hospital and...

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The first antenatal visit

The first antenatal visit

It is so exciting to have the first antenatal visit with a couple during their first pregnancy. By their expressions and their words, you can tell their incredible excitement and expectation that it is such a joyful time. But they have never been on this incredible...

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More about me

More about me

I am a fully accredited specialist Obstetrician and Gynaecologist based in Sydney,  Australia. My consulting rooms are in Norwest, a subdivision of Baulkham Hills which is the next to Castle Hill. I have admitting rights to the Norwest Private Hospital, Bella Vista...

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About me

About me

This Blog site is all about pregnancy, pregnancy care, childbirth, and the joy of having a baby. Conceiving, carrying and delivering a baby remains one of life's greatest miracles. While childbirth is a highly personal experience, it is one that is shared with others....

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This is my first blog!

This is my first blog!

This is my first blog! Blogging is an excellent way for me, a passionate obstetrician gynaecologist doctor, to communicate. I am very excited about technological enhancements to how we communicate and can see a huge future for them in medicine. To enhance my obstetric...

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Drinking Water

Drinking Water

It is recommended you drink 1- 2 litres of good quality water per day during pregnancy. While there are filtration and chemical treatment of tap water, there is an increasing concern in the community about its quality. There is no guarantee of the quality of water in...

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Do I need to see the dentist?

Do I need to see the dentist?

Yes. It is a good idea to get a dental checkup now you are pregnant unless you have had one recently. Pregnant women are more at risk. Pregnancy hormone results in increased blood flow in the mucous membranes, including around the teeth. This can result in bleeding...

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Book an appointment now

  • Monday all day 9.00am to 4.30pm
  • Tuesday all day 9.00am to 4.30pm
  • Wednesday all day 9.00am to 4.30pm
  • Thursday morning 9.00am to 12.30pm
  • Thursday alternate afternoons 2.00pm to 4.30pm
  • Friday alternate mornings 9.00am to 1.00pm
  • Friday afternoon 2.00pm to 4.30pm
  • Saturday mornings 9.30am to 12.00 midday*

*Saturday morning appointments are not available for initial antenatal visit.