Obstetrics

Common Questions

What do you need to do during your pregnancy?

Checklist:

TimingWhatWhere
Under 12 weeksDating scan if dates uncertainYour preferred radiology provider
12 weeksCombined first trimester screen
Blood test & ultrasound
Blood test at Pathology provider 9-13 weeks and scan 11-14 weeks
18-20 weeksMorphology scanYour preferred radiology provider 18- 20 weeks
20 weeksBooking in via internet or phone
Arrange antenatal classes
Mater Mother’s Hospital
26-28 weeksBlood tests diabetes, anaemia and Red cell antibodiesMater pathology
28 and 34 weeksAnti D immunoglobulin if Rhesus negativeRooms
36 weeksBlood test anaemiaMater pathology
Your ultrasound does not fit with your dates, which is right?

Generally speaking, early ultrasound scans are more accurate than those done later in pregnancy. We will usually work out your due date on the first visit comparing the dates your scan suggests and your own dates and from then on we stick with that date. Any scan you have after the early one may say something slightly different however the accuracy of estimating how pregnant you are gets less as the pregnancy progresses. For example, at 10 weeks the scan is likely to be correct to within 4 days whereas at 34 weeks it can only give a possible date which may under or overestimate the true date by as much as three weeks.

Which is the best way to have your baby?

The safest way for a mother to deliver her baby if there are not complications along the way and we are talking about a pregnancy with one baby, is vaginally. There are numerous reasons I might recommend a caesarean section and we can continue to discuss this as your pregnancy progresses. Sometimes you may hope for a vaginal birth and there will be good reasons to avoid this which we will discuss and sometimes you may hope for a caesarean section when there is no reason you should avoid a vaginal birth. In the end the decision is yours and I hope you will make it taking into consideration all the information we can make available to assist you.

Does it cost more for a caesarean section?

My fee for delivery is included within the pregnancy management fee. Whether your birth is a normal unassisted vaginal birth or a complicated birth for twins for example does not alter this. For caesarean sections and complex births however additional people must be involved including for caesarean a surgical assistant, and for caesarean and some vaginal births a neonatologist and anaesthetist. Their fees are separate from the management of pregnancy fee. You can get more information from my reception staff about this.

What is my recommendation about delivering the placenta?

There are two ways delivery of the placenta can be managed. One is called active management which involves having an injection of a drug (one of these is syntocinon) to cause the uterus to contract and the placenta to separate. This method has been clearly shown to reduce the risk of post-partum haemorrhage. I advise you to choose this method. The alternative is called physiological management which in essence means not giving the drug and waiting for the placenta to separate of its own accord. This may take up to 60 minutes and the risk of bleeding is higher with this method. There is an additional consideration these days, which is delayed cord traction and that allows additional blood to enter the baby. It is not unreasonable to wait for a minute if the baby is well for this to occur as it can increase the baby’s red blood volume and reduce the risk of needing transfusion particularly for premature babies. It can be practiced together with active third stage.

Should my baby have Vitamin K?

All newborn babies have low levels of Vitamin K and this vitamin is important for normal blood clotting. There is a risk of your baby having abnormal internal bleeding sometime after birth. This risk is higher if your baby is premature or if you have an operative birth. The disease we are trying to prevent is called haemorrhagic disease of the newborn and it can be almost completely avoided by the Vitamin K injection. There is an oral option however this requires several doses and is not as well absorbed as the injection given just after birth. There are no significant risks of giving Vitamin K and I would urge you to agree to it.

You can get more information about this by clicking here

How does the River City Obstetric Group work?

There are six female obstetricians in this group practice. All of them have been working in obstetrics for more than 10 years. The Group uses an on-call roster that delivers high quality 24-hour obstetric care at Mater Mothers’ Private Hospital (MMPH), South Brisbane. They are experienced Obstetricians and Gynaecologists who are woman-focused and evidence-based.

Using a team approach to minimise fatigue inherent in the provision of 24-hour care, the group has an Obstetrician rostered on-call for the women of all the specialists in the group. At all times one Obstetrician is dedicated to attend to the immediate needs of the Group’s expectant mothers.