Highly Experience Obstetrician in East Melbourne

Whether this is your first, second, third, or thirteenth baby (!?), each pregnancy is a brand-new experience. With each baby, you become a new parent. Throughout your pregnancy, you will notice many changes to:

• Your body;
• Your emotions;
• Your activities;
• Even your clothes.

Share this information with the people close to you. You, your baby, and your family will all benefit from this special time in your life.

After your first appointment, the hospital will send confirmation of your booking. You should also receive information about antenatal classes. I strongly suggest you and your partner attend these or similar classes. The pregnancy and labour will be more satisfying the more you understand them. 

I am always available for urgent problems. Please contact me at 9418 8210 during office hours or at home after hours if you have any concerns about the pregnancy. If you have difficulty reaching me, please ring the call service on 03 9387 1000, and they will page me immediately. I am on call 24 hours a day. When I am on leave or at a conference, another experienced obstetrician will cover for me. 

At your first visit, I will speak to you at some length, examine you, often perform an ultrasound, and order some routine tests.

These include:

• A Pap smear if not performed recently.
• A full blood examination, iron stores, vitamin D levels, blood glucose and thyroid function. I will tell you whether you need to take iron and vitamin D by e-mail or at the second visit.
• Blood group and antibody screen.
• Rubella and varicella (chicken pox) antibody level.
• Hepatitis B, HIV, and syphilis serology.
• Thyroid function test
• Random glucose level
• Midstream urine for culture.
• Ultrasound examination combined with a blood test at 12 weeks to screen for Down syndrome if you want this test – see Should I have a screening test for Down Syndrome?
• Another ultrasound at 19 weeks to examine the foetus more closely.

Some additional tests will be done later in pregnancy. At about 26 weeks, I will order a blood test to see if you have developed gestational diabetes and check your haemoglobin and iron levels. If you are Rh–negative, you will have antibody levels checked at 26 weeks, and will receive injections of Anti-D at 28 and 34 weeks. At about 36 weeks, you will have a swab from the vagina to see if you carry group B strep, as this can affect the baby during labour and delivery.

I strongly recommend that if you are pregnant during the influenza season, you should be vaccinated against the 'flu. I will arrange this for you. Your partner, and anybody else who will be in regular close contact with the newborn baby, should be vaccinated against whooping cough (pertussis). You will be vaccinated in the hospital soon after the baby is born.

There are many interesting sites about pregnancy on the internet. Some that I recommend are MedlinePlus, UpToDate, Royal College of Obstetricians and Gynaecologists (UK), Center for Disease Control and Society of Obstetrics and Gynaecology of Canada. Be aware that these are overseas sites, and the information may differ slightly for Australia.

Many symptoms are common in pregnancy, although they do not usually indicate any major problems.

Nausea and vomiting trouble up to 50% of pregnant women. These symptoms usually resolve by about 12 weeks. Try to eat small frequent meals and drink lots of fluids. Pyridoxine (Vitamin B6) has been shown to be effective for morning sickness, at a dose of 100 mg/day. Ginger tablets 3 times a day may also help. These are available in combination as Blackmore's Morning Sickness Formula®. "Sea Bands", available from pharmacies, press on an acupuncture point (Nei Guan), and may also help. Finally, Restavit® is an over-the-counter sedative that is safe in pregnancy and very effective for nausea - take 1/2 - 1 at night. If, despite all these measures, the problem persists, please contact me. 

Mild abdominal pains are very common throughout pregnancy. Paracetamol (e.g., Panadol) is safe in pregnancy. Dizziness, fainting, nose bleeds, vaginal discharge and "stabbing"   vaginal pains are also common and usually not cause for concern. 

Leg cramps, especially at night, sometimes occur in late pregnancy. The only treatment that has been shown to have any effect is magnesium (e.g.  Magmin® 3 times per day). 

If back pain troubles you, physiotherapy can be very helpful. 

Indigestion will usually respond to Mylanta or other antacids. Ranitidine is available over the counter for severe problems.

Bleeding at any stage of pregnancy is always worrying. In early pregnancy, a small amount of bleeding (less than a period) usually does not lead to miscarriage. It is also normal to have a "show" of blood and mucus just before the start of labour. However, if you have any bleeding that concerns you at any time, please contact me immediately.

Please feel free to discuss your plans for labour with me during the pregnancy. Learn here what you need to know about normal childbirth. You may wish to have a birth plan – here is a suggested format for you to download. 

Please contact the hospital when you start to have contractions or when your waters break. The midwives will advise you when to come into the hospital and let me know when you arrive. I will then come to see you and will usually perform an internal examination to assess your progress. When in labour, you are free to find the most comfortable position and to have pain relief as necessary.

For delivery, I am happy to deliver you in most positions. An episiotomy will only be cut, if necessary, subsequent to consultation with you. After the baby is delivered, I recommend you have an injection to reduce blood loss with the delivery of the placenta. I also strongly advise that the baby receives intramuscular vitamin K.

Neonatal circumcision is a highly emotive topic. There is no doubt that it has definite, though small, benefits, as well as definite, but very small risk. I am happy to discuss this with you during the pregnancy and, if you wish, to perform a non-religious circumcision for your son before you both leave the hospital (this is not available at Frances Perry House).