I recently met a newly appointed young obstetrician at the hospital. I asked her how she was going. She replied: “It is frightening”. 
She had finished her training four years earlier and now she was having to do things without the umbrella of the training programme and senior obstetrician support.
It took me back to when I was at her stage in private practice. But in contrast I had far more clinical experience and better senior support in my training than newly qualified obstetricians today. I was so fortunate in this regard. I did seven years of my training in the United Kingdom working in the NHS. There was so much clinical work. There was far, far more clinical work than what trainee obstetricians get in Sydney. As well the last five years of my training was in Oxford, which was regarded a ‘centre of excellence’ in obstetric research and in pregnancy care. In my time working in Oxford, I remember meeting qualified obstetricians and obstetric physicians who came to Oxford from Australia, United States, and other countries to gain extra knowledge and skills. As well there were many brief visits from senior obstetricians from around the world. I was able to meet the ‘who’s who’ of obstetrics in my time in Oxford. This level of training and experience is not what Sydney trainee obstetricians get.
Now I have been a fully qualified obstetrician for many years. I have looked after 15,000 pregnant women. That means I am one of the most experienced obstetricians in Sydney. I have supported many thousands of women in successfully achieving spontaneous vaginal deliveries, I have done thousands of operative vaginal deliveries, and I have done thousands of Caesarean section deliveries. That considerable experience and my excellent training puts me in particularly good stead for avoiding and handing pregnancy and delivery complications.
A more junior and inexperienced obstetrician is more likely to have avoidable complications and to not manage complications as well as a very experienced senior obstetrician.
You can often tell when obstetricians are lacking experience and confidence. One sign is they often do things in pairs. They are often asking another obstetrician to help them with an operative vaginal delivery or a Caesarean section delivery. But two obstetricians who are inexperienced does not equate with one obstetrician who is highly experienced.
A less experienced obstetrician will often do operative vaginal deliveries in the operating theatre, with the anaesthetist and theatre staff in attendance, even in the early hours of the morning. That suggest their lack of skills and confidence in their management. I have never done this in all my years as an obstetrician or when I was a trainee obstetrician.
Being very experienced not only gives me the clinical skills to manage complications better, but also to anticipate and take preventative action to often avoid complications happening. Through careful management I have sometimes been able to avoid emergency Caesarean sections and give women the normal vaginal deliveries, which was their plan. Midwives tell me the response of many less experience obstetricians to such adverse labour developments would be Caesarean section deliveries.
Many patients tell me they book with me because of my experience. They can de-stress and enjoy their pregnancy more. They comment if there is crisis, I am calm. I know what I am doing. They say my being calm results in them being calm and trusting in me and my care. There are so many anxious pregnant women these days. I tell such patients I want you to enjoy your pregnancy as is such a momentous time of your life. A woman cannot really enjoy her pregnancy if she is anxious. If I am not worried there is no need for you to worry.
