I was very pleased to see Amelia (not real name) for management of her 3rd pregnancy. But there were concerns. Amelia has a history of pyelonephritis (kidney infection) in 2014 and chronic hypertension (elevated blood pressure). Her previous two pregnancies were...
Patients ask me at their postnatal visits, from time to time: ”How long should I wait before having another baby?” While there are no set rules, there are considerations that you should think about before trying again. My personal opinion is that about 18 to 24 months...
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...
Contents What can be done about Headaches During Pregnancy? Headaches during pregnancy can occur the same in pregnant women as they can at any other time, with the causes being the same as would be the case as if you were not pregnant. These usual headache triggers...
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...
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...
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...
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...
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...
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...
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...
For staff on the wards, patients, husbands / partners, visitors there is now no requirement that they wear facemasks. The hospital has gone back to the pre-Covid recommendations for use of facemasks, e.g. by a doctor when operating.
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
The Hospital has advised… Support people are ENCOURAGED to remain on hospital grounds for the entire duration. If a support person leaves the hospital grounds to go home/shopping etc. they WILL BE required to have a valid negative swab result on their phone before...
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...
Both Norwest Private Hospital and the Sydney Adventist Hospital have increased their COVID precautions because of the increasing number of COVID case in the community. There are differences between the hospitals precautions because each is a privately owned hospital...
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...
If you live in a suburb where there are COVID cases then you must have a COVID swab within 3 days of your next antenatal visit and forward to us the negative result. If you have any cold or flu like symptoms then you must have a COVID swab before your next antenatal...
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...
Another good reason for being confined at Norwest or the San and having me as your obstetrician. Your husband/partner can be with you for your antenatal visits, during labour and while you are an inpatient on the postnatal ward. This is not the case for public...
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....
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...
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...
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...
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...
RANZCOG updated advice on COVID vaccination for Australian pregnant women can be found at the link below. COVID-19 Vaccination in Pregnant and Breastfeeding Women
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.
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...
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...
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
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...
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...
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...
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...
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...
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....
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
Contents Travel insurance and pregnancy Pregnancy is a very unpredictable time Appropriate travel insurance while pregnant is not optional Read the fine print Helpful websites The insurance cost will vary because of … Make sure it is in writing If...
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....
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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....
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...
What Can Ease Sciatic Nerve Pain During Pregnancy? Sciatica pain in pregnancy is due to compression on the sciatic nerve. For pregnant women, this can be caused by the pressure of the gravid uterus, and in advanced pregnancy, by the baby pressing on the sciatic nerve....
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...
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...
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...
*Saturday morning appointments are not available for initial antenatal visit.
