I am a specialist Obstetrician and Gynaecologist with a particular interest and extensive experience in the management of complicated pregnancies. This means the services that I offer include – but are not limited to – the following:

  • Preconception assessments and advice, including optimising medical problems prior to embarking upon pregnancy.
  • All aspects of miscarriage care including the assessment and management of recurrent miscarriages. See my website www.miscarriagecare.com for more information about my care of women with miscarriages. I well understand the anxiety that goes with a pregnancy after even one miscarriage and I am happy to support you throughout such a time and to see you (and your baby) as often as is necessary to reassure you.
  • General uncomplicated pregnancy care. I am happy to provide you with the full spectrum of birthing options from water births to caesareans. I am comfortable with managing a vaginal birth after a caesarean (VBAC) and – if you meet certain criteria (and twist my arm) – vaginal breech birth. From time to time (and usually at 3 am) I find myself delivering babies while I am lying on the delivery room floor so you can imagine what positions the mother might be in when giving birth! I am comfortable discussing your wishes for your birth and I can assist you with writing a birth plan. I work collaboratively with my midwifery colleagues in doing my best to optimise your birth experience without compromising safety.
  • Pregnancy care for women with complex medical problems, including:
    • High blood pressure or heart problems
    • Asthma
    • Kidney and bladder disorders including renal transplants
    • Anaemia, low platelets and thalassaemia
    • Thyroid and other endocrine problems
    • Liver and gastrointestinal problems including inflammatory bowel disease
    • Inflammatory conditions such as Lupus and arthritis
  • Pregnancy care for women with reproductive problems, including women with:
    • Fertility problems or those who have conceived with IVF or other reproductive technologies
    • Recurrent miscarriages
    • Cervical Incompetence (what a terrible term!)
    • Polycystic Ovarian Syndrome and Insulin Resistance
    • An increased Body Mass Index (BMI)
    • Previous preterm births
    • Previous significant pregnancy problems such as severe pre-eclampsia
    • Previous difficult or traumatic births
    • Previous stillbirths or neonatal (newborn) deaths
  • Pregnancy care for women with psychological or psychiatric conditions.
  • Pregnancy and birth care for women with previous caesarean sections including offering, supporting and managing Vaginal Births after Caesareans (VBACs).
  • Pregnancy and birth care for women with multiple pregnancies. I have extensive experience in managing twin pregnancies – including those with monochorionic twins – and triplets.
  • Pregnancy and birth care for the over 40’s. While 40 is very much the new 30 sometimes there are particular challenges for women over 40 with respect to pregnancy and childbirth. I have considerable experience at assisting you in meeting these challenges and doing my best to ensure a happy healthy outcome. (And don’t worry – you are definitely younger than your obstetrician!)

While I am capable of caring for women with very complicated pregnancies I very much enjoy looking after women with normal pregnancies and I am always thrilled to help a woman to give birth naturally (but beware – I have been known to get fathers to deliver their own children if everything is proceeding normally!). I also believe that even in the presence of significant complications it is my role to emphasise that pregnancy is always a positive, normal event.

As I now focus almost exclusively on obstetrics, I perform very little gynaecology. I believe there are a great number of highly skilled gynaecologists practicing in the Eastern Suburbs and I can refer you to them if you wish me to.

Special features of my service:

I believe there are a number of aspects of my service that are unique when compared with some other pregnancy providers. These aspects are:

  • Experience. I have nearly 20 years continuous experience of providing pregnancy care with 14 years as a specialist. I have trained in the UK and the majority of my experience was gained at Australasia’s largest obstetric hospital – National Women’s Hospital in Auckland
  • Continuity. I can look after women from before they fall pregnant for the first time until their family is complete
  • Accessibility. I give my patients my cell phone number so that they can contact me directly in the event of any significant concerns arising.
  • Time. My first (or booking) visits are one hour and standard antenatal visits are 30 minutes to ensure there is adequate time for a thorough assessment and discussion. I can perform an ultrasound scan at every visit to check on your baby (or babies!) if you wish.
  • Flexibility. The nature of my personality and clinical practice (as opposed to my politics) is conservative and the safety of you and your baby is always my first priority. However I am very keen to accommodate your wishes for your labour and birth and I am capable of stepping outside of traditional medical comfort zones as long as you and your baby are healthy.
  • Availability. I provide a continuous personal 24 hour service and I share my weekends and holidays with only one other obstetrician – Dr Natalie Shaw ( www.natalieshaw.com.au ). I do not participate in a group practice where multiple different specialists provide care out of hours and at weekends. I book my holidays and study leave nine months in advance so you will know if I am planning any leave BEFORE you book with me. Most private obstetricians personally deliver the babies of approximately 80 to 85 % of women booked with them. I deliver 95% of mine (unfortunately even I have to take time off occasionally).
  • Attentiveness. When you go into labour you will call me to discuss how things are going at home and we will make a mutual decision as to when the right time is for you to come to the hospital. I will come and see you shortly after you arrive at the hospital (although forgive me if I delay this a little if you come in at 2 – 4 am!) and I will be actively involved in your labour as well as the birth. If you are in labour during my normal office consulting hours I will cancel and reschedule my appointments (with apologies to those who are inconvenienced) so that I am focused on your care. I have a low opinion of obstetricians who simply show up to deliver the baby – usually with a flourish (if they get there on time) – at the end of labour. Some obstetricians deliver babies at different locations around Sydney whereas I only deliver at Randwick (which is also where I live so I am only three minutes from the hospital in the middle of the night).
  • Collaboration. I work collaboratively with my midwifery colleagues in my office ( www.amandabartlett.com and www.betterbeginnings.com.au ) and at the hospitals I work in. While I am experienced and capable I do not hesitate to seek the advice of my medical colleagues (including other obstetricians) in potentially difficult situations in order to optimise your care.
  • Safety. Unfortunately safety – particularly for your baby – cannot be guaranteed because of the nature of pregnancy and childbirth. However I strive to do my best to deliver your baby in good condition without compromising your own health and safety. As at November 2010 I have cared for more than six hundred – often very high risk – private patients. None of my patients have suffered a stillbirth (fingers crossed and touch wood) and the only newborn deaths have occurred in babies with preexisting severe life threatening congenital abnormalities (two babies) or extreme prematurity and low birth weight (three babies). None of my births have involved babies suffering any form of oxygen deprivation or significant physical trauma. This safety record is remarkable given the often very high risk nature of my clientele.    
  • Workload. I restrict myself to 15 private births per month. My reasons for this are:
    • To make sure that I am not caught in two places at once so that I can focus on the care of my individual patients before, during and after the births of their babies
    • In order to devote some of my time to the public service at The Royal Hospital for Women
    • To make sure I have time to keep up to date with international trends in obstetrics
    • To minimise disruption of my consulting sessions to ensure that I am only rarely running late (and if I am attending a birth I prefer to reschedule visits rather than keep women waiting)
    • To prevent exhaustion and to manage my own work / life balance