Labour & Delivery

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Pain relief in labour

Pain relief in labour

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

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A good labour and childbirth story

A good labour and childbirth story

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

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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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