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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 for 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...

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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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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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Differences between Braxton Hicks and Labour Contractions

Differences between Braxton Hicks and Labour Contractions

Braxton Hicks contractions are named after the English doctor John Braxton Hicks who first described them in 1872. He reported many women felt contractions without being near confinement. He said this process was usually painless, but caused women confusion as to...

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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

I am often asked questions about epidural and spinal anaesthetics. I have compiled the information below with these questions in mind. An epidural anaesthetic is a regional (not general) anaesthetic whether local anaesthetic medication is injected into the epidural...

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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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“I have itchy hands and itchy feet”

“I have itchy hands and itchy feet”

Bronwyn presented at 10 weeks pregnancy for management of her second ongoing pregnancy. Her first ongoing pregnancy had been complicated by preeclampsia (requiring medication to control her blood pressure) and intrauterine foetal growth retardation. She had a...

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Caesarean section delivery needed in second stage labour

Caesarean section delivery needed in second stage labour

  The first time I met Fozia was at 12 weeks gestation in her second pregnancy. She told me she delivered her first baby in 2006. She told me she went into spontaneous labour at 40 weeks gestation and after 17-hr labour had a spontaneous vaginal delivery of a...

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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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Two recent cases of placenta praevia

Two recent cases of placenta praevia

Two recent cases of placenta praevia It was a Thursday afternoon. I took a patient to theatre for a Caesarean section delivery because of placenta praevia. Placenta praevia is when the placenta develops in the lower aspect of the uterus and in close relation to 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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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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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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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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A patient’s birth plan – an elective Caesarean section

A patient’s birth plan – an elective Caesarean section

A patient who is 29 weeks pregnant in her second pregnancy saw me yesterday for a scheduled antenatal visit. She said she had decided on her ‘birth plan’ and wanted to discuss it with me. In her first pregnancy she was managed as a public patient as a major Sydney...

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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

Caesarean section closure

A patient at her postnatal visit today complimented me on how much better her Caesarean section delivery experience had been with me. I had not looked after her in her previous pregnancy. She also said she had much less postoperative pain, needed fewer painkillers,...

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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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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 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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  • 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.