03 Aug 2010

Goodbye, medicare safety net

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News reports out today (including on the front page of the Sydney Morning Herald) seem to confirm what many of us have expected for some time – that obstetric services will be removed from the Medicare Safety net in next tueday’s budget.

It would have been political suicide for the Federal Government to renege on their election promise to maintain the safety net and there is growing resistance out there to the current trend of means testing pretty much everything. Read more

03 Aug 2010

Private obstetricians – not so evil after all!

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I don’t exactly run to the mailbox when the Medical Journal of Australia arrives early each month and so it was today. Anyway while thumbing through today’s edition I came across an article and an accompanying editorial examining outcomes for women and babies in Australia.

Of course you will have noticed many articles in the press recently decrying the bad habits of private obstetricians – most particularly our high obstetric intervention rates. The Sydney Morning Heraldin particular seems only too happy to devote front page real estate to any story illustrating the evils of caesareans and obstetricians (and of course the two go together) notwithstanding the more than occasional flimsiness of the science involved. Read more

03 Aug 2010

Homebirth…again

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Well its 5 45 am on Good Friday and I can’t sleep. The reason is I’ve just attended a wonderful birth. One of my patients began her first labour at about 2 this morning and then had a perfectly natural birth at about 5 am.

No complications, no stitches, all perfectly natural with the father virtually doing the delivery himself. (I have told her that many women will be very envious of her experience).

Read more

03 Aug 2010

Your baby’s movements

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From around 20 weeks of pregnancy you will begin to feel your baby moving inside you. Some women begin to feel movements a week or so earlier than 20 weeks and some a week or so later.

The time at which you begin to feel movements depends upon whether you have previously had a baby and the location of your placenta (afterbirth). Your baby’s movements are important because they are a significant sign of your baby’s wellbeing – indeed a more important sign than, say, a strong sounding heart beat. Babies are like children and adults – if they are sick they are less active. Tragically every year we see one or two women whose baby has become unwell inside them and the baby has died. Often such stillbirths are sudden and unpreventable but sometimes a baby can begin to slow down a day or more prior to dying – thus a theoretical opportunity might exist to save such a baby by delivering it urgently if it is mature enough to survive outside the womb. Read more

03 Aug 2010

Medical matters relating to twin pregnancies

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Types of twins
There are two types of twins – identical and non-identical. There are two membranes surrounding all babies when they are inside the womb

– the outer membrane, which is continuous with the placenta, is called the chorion and the inner membrane is the amnion. In most pregnancies the two are so close together they are indistinguishable from each other. Read more

03 Aug 2010

Premature labour and birth

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Full term for pregnancy is defined as 37 – 42 weeks from the beginning of the last menstrual period. Premature birth is a very important condition, being the leading cause of death and disability of babies.

Despite many advances in obstetric and neonatal care, premature birth still occurs in approximately 10% of pregnancies and significantly premature babies are far more likely to die or become disabled than babies born at full term. Read more

03 Aug 2010

New cover arrangements

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You will no doubt be aware that I practice by myself and I have avoided the increasingly popular trend whereby obstetricians practice in groups of up to six with any of the doctors being “on call” for births at any particular time.

This has meant that I have literally personally delivered more than 99% of my own patients’ babies when many other obstetricians expect to deliver approximately 85% of their own babies. In fact since February 2008 I have not missed one birth. Read more

03 Aug 2010

Nausea and vomiting in early pregnancy

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Nausea and Vomiting (N and V) are common symptoms of early pregnancy affecting 60 to 70 percent of all pregnant women. They usually settle down by 12 weeks gestation.

While most women are not unduly troubled by N and V (although vomiting is never pleasant) about one third of all women have to alter their daily activities and at least 25 percent lose time from their paid work or household tasks. A small proportion of women (around 3 percent) suffer severe N and V characterised by a number of features: Read more

03 Aug 2010

Leg cramps in pregnancy

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Many women – almost half, in fact – suffer from leg cramps in pregnancy. These involuntary spasms usually begin to cause trouble at night during the second half of pregnancy.

The cramps mostly affect the calves. Some women find it difficult to sleep because of the pain from these leg cramps.

Considering leg cramps are so common in pregnancy you would expect there to be a well studied effective treatment. In fact there is surprisingly little research into this common problem. However the strongest evidence for any particular treatment relates to magnesium supplements. A Swedish study reported in 1995 found that magnesium tablets taken twice a day for three weeks were more effective than no treatment in reducing the frequency and severity of leg cramps. Women who had suffered from cramps every second night only got them once or twice a week after taking magnesium. Read more

03 Aug 2010

GP information

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Making a referral

Please write me a referral and either give it to your patient or send it to me at:

Suite 26
Level 7
Prince of Wales Private Hospital
Barker St
Locked Bag 2
Randwick NSW 2031

Or fax it to:
(02) 9650 4898

Or email me at rbuist@gmail.com Read more