While I am available to be contacted by phone (business day hours), by email and by social media messaging you can also contact the Birth Unit 24 hours per day and if she is concerned the midwife will contact me. If you think the matter is an emergence then phone the...
Australia’s ethnicity mix has been changing. This is having an impact on pregnancy management. In the past there were very few people of Asian and South Asian ethnicity living in Australia. Over more recent years there has been considerable immigration from Asian and...
Patients often ask me : “Will I have normal delivery?” I had thought, and Suzie had thought, she would have a normal delivery. It was her third pregnancy. She had had vaginal deliveries with the first two. Her second labour was only 2.5 hrs duration. This pregnancy...
Caesarean section is either an emergency or elective operation. An emergency Caesarean section is done when there is an urgent complication in pregnancy or labour which significantly compromises your or your baby’s wellbeing (or both). This implies that continuing the...
Jennifer (not real name) booked with me for management of her first pregnancy. She and her husband are a delightful couple, and they were very excited about having a baby. Jennifer was planning to have vaginal delivery. Her baby measured about 1 week larger than her...
Emily was in labour for her first baby. Her pregnancy had been uneventful. At 5cm cervical dilatation the midwife who was looking after Emily contacted me to say the baby’s heart rate pattern had become very abnormal and that she was concerned about baby’s wellbeing....
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....
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...
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...
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...
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...
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...
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...
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...
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...
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,...
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...
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...
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...
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...
I recently wrote an article titled ‘Caesarean section changes during my time as an obstetrician’ in which I mentioned that there had been an increase in the Caesarean section rate over more recent times. One reason for this is that there has been a corresponding...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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....
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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....
*Saturday morning appointments are not available for initial antenatal visit.
