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

03 Aug 2010

Induction of labour – pressing the “eject” button

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The term “Induction of labour” (or IOL for short) means medically intervening to start your labour before natural labour begins. Generally we induce labour when we consider the risk to the mother and / or the baby to be less with IOL than with waiting for spontaneous labour to occur. That said some women choose to have their labour induced because of the significant discomfort that goes with late pregnancy and rarely women have their labours induced for social reasons (ever wondered why those footy players’ wives miraculously give birth a few days before the Grand Final?). Read more

03 Aug 2010

Instrumental delivery – the sink plunger or the salad servers

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Although most vaginal deliveries result in the delivery of a healthy baby without any significant intervention by your obstetrician, there are some circumstances in which we need to deliver your baby before you can push it out without assistance. Generally speaking if we need to deliver your baby before your cervix is fully open we do so by caesarean. However if your cervix is open and your baby is well down the birth canal we can deliver your baby more safely (both for you and your baby) via the vagina than by caesarean. If we do intervene to deliver your baby vaginally we use either: Read more

03 Aug 2010

A word about iron in pregnancy

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I am seeing a lot of iron deficiency in pregnancy these days. It seems now to be a rare event to find a woman with normal iron levels when we do her routine twenty six week blood tests. Possible reasons for these low iron levels are: Read more

03 Aug 2010

Medicare safety net update

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And so it seems that the Government will go ahead and remove obstetrics from the Medicare Safety Net – in order to curb the “exorbitant” fees of private obstetricians – as Ms Roxon calls them. After December 30th it will not be possible to claim obstetric fees under the safety net. Read more

03 Aug 2010

Watch out, toxoplasma is about!

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I have become aware of a couple of recent cases of toxoplasmosis. We normally regard this infection as being extremely rare. Toxoplasmosis is an infection that causes minimal or no symptoms in the mother but – without going into details – can be devastating if it crosses the placenta and affects the baby. Read more