30 Apr 2013

Hydration for Pregnancy, Labour and Birth

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I have been thinking about drinks and hydration in pregnancy lately. There don’t seem to be many healthy options out there for pregnant women so in my spare time (ha ha) I have been working on a healthy hydration drink for pregnant women. It is called Aqua Mamma and its coming very soon – watch this space!

30 Apr 2013

Assistance

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I’m well aware that having a baby in the private system is an expensive exercise, even with Medicare and Health Insurance. As I have explained previously neither organisation contributes a great deal to doctors’ fees in maternity (and given the prospective size of the Federal Budget Deficit I wouldn’t hold out any hope of an improvement).

A few patients have been surprised and disappointed to receive an invoice from a surgical assistant if they have a caesarean at Prince of Wales Private Hospital. Unfortunately it is compulsory for me to contract a surgical assistant when you have a Caesar at Prince of Wales and unfortunately they do send you a bill and your Health Fund doesn’t cover a great deal  of it.  You can avoid this expense by having your baby at The royal Hospital for Women. If you have a Caesar there I press gang one of the junior doctors to assist and they cannot bill you (I bought a plasma TV and a couch for the junior doctors lounge at The Royal in recognition of their ongoing support).

31 Jan 2013

Your Baby’s movements

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I have had a couple of women ring the office asking Rebekah to move their appointments forward because of a reduction in their baby’s movements.

I cannot emphasise strongly enough that a reduction in your baby’s movements is a potential emergency and that you must call or text me on my mobile phone if you are concerned – and that you must not go to bed worried about your baby’s movements.

Please read Your Baby’s Movements on my website. This information is also found in the booklet I gave you at your booking visits.

19 Dec 2012

Watch out – Listeria is about

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I was reading my usual source of up to date medical information this morning – The Sydney Morning Herald – and I came across a piece about a listeria outbreak in Melbourne. The source of the infections appear to have been Australian – made soft cheeses (Brie and Camembert). This just highlighted the need to be very careful about potential sources of listeria when you are pregnant as the infection can be very harmful to unborn babies.

For more information about food and Listeria you can check out www.foodauthority.nsw.gov.au/consumers/life-events-and-food/pregnancy/

(And before many of you ask the Christmas Ham is NOT safe unless it is freshly cooked and served hot – so throw some on the barbie and cook the crap out of it if you are desperate)

05 Oct 2012

Next Year’s Break

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This year is passing by so quickly – I just can’t believe it. Of course the nature of my business is such that I need to organise study leave and holidays 8 months or so in advance so that you are fully informed of my availability (or lack thereof). Accordingly I will be off on study leave and holiday for the first three weeks of June 2013, returning to work on Monday 24th June. I know my partner Dr Natalie Shaw is then having three weeks off for the same reason (through to mid July).

Both Natalie and I have decided to engage a locum to cover our respective practices over June and July (the last time I was away for two weeks poor Natalie delivered the babies of seven of my patients as well as looking after her own patients!). The locum will be Dr Lynn Townsend. Both Natalie and I have worked with Lynn for many years at the Royal Hospital and regard her very much as an assiduous, caring, safe obstetrician – so we think she fits in very well with the way we practice. Lynn’s other job is in Obstetric ultrasound – she works at Ultrasound Care so some of you may meet her when you have your routine ultrasound scans (such as the Nuchal Translucency).

10 Oct 2011

Epidural and Caesarean Evening Seminars at Rob Buist Obstetrics

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I am finally making good on a previous promise (and thanks for your patience) to provide seminars on important topics around childbirth. The first of these will be combined evening seminars covering epidural anaesthaesia and caesarean childbirth. These seminars will be monthly and they will be facilitated by myself and my specialist anaesthetic colleague Dr Alec Harris (morpheuspaddo@gmail.com). Alec and I work together at Prince of Wales Private Hospital and he is a skilled and experienced obstetric anaesthetist (I once watched him insert an epidural into a woman who was sitting on a Swiss ball but that, as they say, is another story).

The first two seminars will be from 6.30 pm to 8.30 pm on 25th October and 29th November (both are Tuesday evenings). Alec will kick off for the first hour about epidurals then I will cover caesarean childbirth.

Of course I recognise that most women don’t wish to have either an epidural or a caesarean but sometimes these things become necessary so there is value in being as well informed as possible just in case.

As always couples who are cared for by other maternity providers are welcome although the seminars are free for my patients and cost $50 for couples not booked with me.

Please contact Melanie Shilbury to book into these seminars – melanie@robbuist.com

10 Oct 2011

New Pregnancy Education Centre at Rob Buist Obstetrics

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Our birthing classes have started to become quite popular – in fact so popular that my waiting room is too small to accommodate all of the couples coming to the classes. Rather than unduly limiting the size of the classes (although we keep the numbers to less than ten couples in order to facilitate interaction and encourage you to answer questions) we have acquired Suite 1701 in Westfield Tower One (it’s on the 17th floor of the same building as my office). We are setting this space up as a centre dedicated to pregnancy education and birthing classes. Given a little time we will add as many educational resources as we can in order to provide a “one stop” pregnancy education centre for you.

Accordingly from now all of our birthing classes and seminars will take place in Suite 1701 on the 17th floor of Westfield Tower One (the same building as my office).

09 Aug 2011

Hospital Tours with Rob Buist Obstetrics…

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Hospital Tours with Rob Buist Obstetrics…

…are not as much fun as wine tours of France or culinary tours of Italy. Nonetheless they are an important part of having a baby in the eastern suburbs.

A hospital tour is a really good idea if you are yet to make up your mind which hospital you want to give birth in or if you have already decided and would like to check out the hospital of your choice.

Every two months – labours and births permitting – I personally conduct a tour of the relevant parts of The Royal Hospital for Women and The Prince of Wales Private Hospital.

For both hospitals the tour includes:
Coming to the hospital, parking and checking in,
The Delivery Unit,
The Postnatal Wards, and
The premature baby unit

These tours are free and you are welcome to join them even if you are not one of my patients (or I suppose its an inexpensive way of checking me out if you haven’t chosen your obstetrician yet). However you do need to book for the tours and you can do so by contacting Melanie at melanie@robbuist.com

The tours will always be at 10.30 am Saturday and the next tour will begin at 10.30 am on Saturday 27th August 2011

14 Jun 2011

Coming out the right way for a change – Vaginal Birth after Caesarean.

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The great majority of women who fall pregnant plan to give birth naturally. However for a number of reasons many women wind up having their first baby by caesarean section. Many women who give birth by caesarean are extremely disappointed to have done so – even if they understand and accept the reasons for their caesarean.

Such women should consider the option of planning to have their next baby vaginally. We call this approach planning a Vaginal Birth After Caesarean or VBAC for short.

VBAC has been around for almost as long as caesarean sections have. Like a number of aspects of obstetric care, VBAC has been in and out of fashion over the years. For the vast majority of last century the dictum “Once a caesarean, always a caesarean” held true in the USA. By contrast, hospitals under British influence (including those in Australia) have always viewed VBAC as being a valid option for women with a previous caesarean.

The reason for the conservative approach in the USA was the – reasonable – fear that contractions of the uterus might cause the uterus to rupture, with potentially catastrophic consequences for the mother and the baby. This risk was greatest with the now vary rare “up and down” – or classical – incision in the uterus. Caesareans have usually been performed by a low “side to side” – or lower segment – incision for a number of decades.

Perhaps surprisingly VBAC was the subject of very little scientific study over the vast majority of the twentieth century so traditional forms of management held sway on both sides of the Atlantic Ocean.

The 1980′s – a time of change

Following the rise of feminism in the 1970′s the women’s movement challenged many norms including the absolute “always a caesarean” approach. A number of scientific studies began to be published in the 1980′s that suggested that many women with a previous caesarean could give birth vaginally safely. These studies suggested that women who had previously undergone a lower segment caesarean had a more than 70 percent chance of giving birth vaginally if they attempted labour. The risk of the uterus rupturing in labour was comparatively low – 0.5 to 1 percent (one in 100 to 200 women) –  with adverse consequences for either the mother or the baby being extremely rare.

With the benefit of hindsight a number of these studies were perhaps over optimistic mainly because they included women who had previously given birth vaginally as well as having had a caesarean. We now know that women who have had both a vaginal birth and a caesarean have a higher success rate and lower complications when they have a VBAC compared to women who have only ever given birth by caesarean. Read more

20 Oct 2010

Financial advice from your Obstetrician!

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Financial advice from your Obstetrician!

In these difficult post safety-net-for-obstetrics days I am acutely aware of the need to reduce the out of pocket expenses associated with having a baby. Regular readers of my website along with all of my patients will be well aware of the dim view I hold regarding the current level of Medicare / Insurance support for obstetrics.

Anyway I was discussing all of this with my accountant – Victor Manauzzi of Platinum Associates in Bondi Junction (02 9386 2688) – over a coffee when he reminded me that there is a tax rebate available for out of pocket medical expenses which can be claimed when preparing your tax return.

Victor tells me for the year ended 30 June 2010 the Australian Taxation Office (ATO) allows a 20% tax offset for net medical expenses over $1,500 ($2,000 after July 1 2010) after deducting reimbursements paid by Medicare and your private health fund. Read more