APPOINTMENTS

Your first visit is usually around 8 weeks of pregnancy. We’ll have a detailed discussion of your medical history and current health.

I encourage you to bring a list of questions, so that we can talk through any concerns you have.

I’ll also perform an ultrasound scan to confirm your due date. We’ll talk about staying healthy (diet, exercise and lifestyle advice), supplements, screening for Down syndrome and any special plans for your pregnancy.

Following this, I usually see you monthly until 28 weeks, fortnightly to 37 weeks and then weekly until delivery. Of course, we’ll individualise this schedule based on your needs. At each visit, we will talk about your progress, check your blood pressure and organise any necessary tests/treatments.

I also personally perform all the ultrasound monitoring of your baby throughout the pregnancy, including specialised tests such as the nuchal translucency, 19-week morphology (anatomy) scan and fetal blood flow.

I will scan you at every visit to keep a close eye on baby’s growth and development using the latest ultrasound technology available in my rooms.

Your partner is very welcome to attend all of your appointments and I encourage you to video the ultrasounds, making your own unique collection of pregnancy mementos.

WHAT IF MY PREGNANCY IS HIGH RISK?

Some pregnancies start out high risk, others become high risk as the pregnancy progresses.

If your pregnancy is high-risk, then you have the reassurance of knowing that I am a fully accredited Maternal-Fetal Medicine (MFM) specialist.

MFM specialists are the Obstetricians who look after the most complex and high-risk pregnancies. I am also very happy to care for women with low-risk pregnancies.

I have particular expertise and experience in looking after:

• Miscarriages and multiple miscarriages.
• Medical problems in pregnancy, including high blood pressure, diabetes, thyroid disease, inflammatory bowel disease, epilepsy, lung disease, kidney disease, organ transplants, lupus and auto-immune problems, blood clots.
• Twin and triplet pregnancies. The latest evidence tells us that all twins and triplets should be managed by an experienced high-risk obstetrician and I currently manage all the multiple pregnancies in the CUMH twin clinic.
• IVF pregnancies, including for mature age, genetic disorders, donor eggs.
• Complications in a previous pregnancy such as pre-eclampsia, small baby, premature delivery, short cervix, stillbirth, 3rd and 4th degree tears, blood group antibodies.

PREVIOUS COMPLICATED DELIVERY

Many patients come to see me because they have experienced difficult births in the past and have been left with ongoing problems.

I focus on achieving excellent obstetric outcomes for all my patients, while minimising the impact of childbirth on the pelvic floor and reducing your risk of any further bad outcomes.

PREPARING FOR PREGNANCY

One of my specialist areas of interest is seeing women before they become pregnant and discussing ways to maximise the chance that both mothers and their baby will have as safe a pregnancy as possible.

If you are thinking about having a baby, this is the perfect time to see me for pre-pregnancy advice and preconception genetic testing.

I have counselled hundreds of couples preparing for pregnancy, and the best way to achieve a healthy pregnancy is to be healthy yourself at the time of conception.

There are a number of things we will discuss at your pre-pregnancy visit:

• Your medical history and any previous pregnancy issues
• Prenatal and preconception genetic screening, vaccinations, cervical screening and any other recommended tests and treatments
• Medication safety in pregnancy
• Lifestyle advice (diet, smoking cessation, healthy weight) and folic acid supplementation

IF YOU HAVE AN EXISTING MEDICAL PROBLEM…

…or you experienced complications in a previous pregnancy, then pre-pregnancy counselling is essential. An antenatal care plan tailored to your own individual circumstances will give you the best chance at a successful pregnancy.

Pre-existing medical problems such as Diabetes; High Blood Pressure and Kidney Disease; Over- and Under-Active Thyroid; Inflammatory Bowel Disease (Ulcerative Colitis and Crohn’s); Epilepsy and other Neurological problems (Multiple Sclerosis, Intra-Cranial tumours); Blood Clots and Clotting Disorders; Heart Disease; Cancer, Leukaemia and Lymphoma; Lupus (SLE) and other Autoimmune Problems; Serious Respiratory Disease.

IVF and ICSI pregnancies, including Mature Age, Donor Eggs and Families with Genetic Disorders.

Complications in a previous pregnancy such as Pre-Eclampsia; Small and Growth-Restricted Babies; Premature Birth and Short Cervix; Recurrent Miscarriage; Stillbirth; Blood Group Antibodies.

BIRTH & BEYOND

VAGINAL BIRTH
I am very supportive of vaginal birth, including Vaginal Birth After Caesarean (VBAC) and vaginal delivery of twins.

Should it be necessary, I have extensive experience in performing safe assisted deliveries. I have safely delivered more than 1,000 babies by instrumental vaginal delivery. I also have detailed knowledge of the effects of different modes of birth on the pelvic floor. The safety of you and your baby, as well as protecting your pelvic floor, are at the forefront of my mind when considering an assisted delivery.

I also perform External Cephalic Version for appropriate patients who have breech babies at term and want to have a vaginal delivery. ECV means turning the baby in the womb from breech to head-first, allowing you to try for vaginal delivery.

CAESAREAN DELIVERY (C-Section)
I am very experienced in performing Caesarean sections, including in women with previous abdominal surgery, bowel disease and other conditions where a highly skilled surgeon is required.

In addition to having performed more than 1,000 caesarean sections, I have also published articles in the medical literature on mode of delivery and the impact of Caesarean sections.

I firmly believe in informed patient choice. If, after discussing the pros and cons, you decide that your preferred birth is by Caesarean section then I am happy to support your choice.

POSTNATAL CHECK
A lot of my research focuses on the long term health implications for mothers following pregnancy. Postnatal care for mother is extremely important to prevent and, where necessary, treat infection and post-birth complications. Evidence shows that women who receive postnatal care are less likely to suffer from postnatal depression and are more likely to continue breastfeeding.

In the days after your birth, I will visit you daily in hospital to ensure you are recovering well and getting all the support you need. These initial days are also the perfect time to take advantage of the services offered by the hospital, such as new-baby classes and breastfeeding assistance. It’s important that you feel confident and ready to take your baby home.

I will see you back in my rooms as needed but always 6 weeks after your birth. The 6 week postnatal check is an opportunity for you to talk about yourself, your body and your feelings. At this visit, I will make sure you have fully recovered from the birth, talk to you about how you are coping with new motherhood, and talk through your options for contraception.