Having a child can be a life changing and enriching experience, and having the right healthcare provider by your side can be an extremely important source of support and information. An Obstetrician is a doctor that specialises in providing medical care and advice before, during and after birth, to ensure that you experience a smooth, healthy pregnancy. Some of the important functions that Obstetricians perform include:
Antenatal Care
Antenatal care is a series of appointments that begin once your pregnancy is confirmed and continue until you give birth. They are conducted by an Obstetrician and are intended as check-up appointments to ensure that you and your baby stay healthy. These appointments are focused on three key areas:
- Identifying your stage of pregnancy and the growth of your baby.
- Examining your overall mental and physical health, and recognising any risks you might be facing.
- To discuss anything you wish to know more about or any problems you might be experiencing.
These antenatal appointments are vital to ensuring that everything runs smoothly and can be a really positive experience, allowing you to educate yourself on anything you might need and helping you alleviate any worries or concerns.
Ultrasound Scans
As part of antenatal care, Obstetricians will perform a number of routine ultrasound scans throughout your pregnancy to check on your baby’s growth and health. These scans include:
- Dating scan: An early scan to identify your due date and observe the overall health of the child.
- Nuchal translucency scan: This is an optional scan that is performed to determine whether your baby might be at risk of having a chromosomal abnormality.
- Morphology scan: Is performed in the later stages of your pregnancy to create a detailed picture of your placenta, umbilical cord, amniotic fluid, cervix and uterus. It also examines the health of your baby and its position.
Nutritional Advice
Nutrition in pregnancy is vital to both the health of the baby and the health of the mother before and after birth. An Obstetrician is a healthcare professional that can help guide your dietary choices and ensure that you are eating healthy and nutrient packed meals.
They can help educate you on what vitamins and minerals are important during pregnancy, what foods you should be avoiding and how to track your meals to ensure that you are eating the correct amounts. You will discuss important nutrients like folic acid, iron, calcium and vitamin D and ensure that you are eating the correct foods to satisfy you and your child’s needs.
Childbirth and High Risk Pregnancies
As the healthcare partner that has been with you from the very beginning of your pregnancy your Obstetrician is a wealth of information about you and your child. Having them present during your birth is important to ensure that everything is properly taken care of and that you receive the correct medical support for your needs.
If you are at risk of experiencing a high-risk pregnancy then the Obstetrician will also play a vital role in adjusting your prenatal care and advising on the delivery of your child.
Postnatal Care
Giving birth is just the beginning of the journey, so an Obstetrician will perform a postnatal check-up to discuss your pregnancy and any considerations you should take if you wish to have more children. They will also discuss your physical and mental health and ensure that you have the right support to continue to live a happy and healthy life with your child.
Pregnancy can be an incredibly emotional and turbulent time for women and their families, so having the right medical partner by your side is vital to a happy, healthy nine months. An obstetrician is a doctor who specialises in providing advice and medical care throughout, during and after your pregnancy. They are there for every step of your journey to ensure that your birth is stress free and successful.
With an obstetrician being such an important partner throughout the period of pregnancy and beyond it is vital to choose the right doctor for you. Here are five tips to guarantee you’ve picked the right option:
Ensure that they are an experienced obstetrician:
It might seem like a bit of a no-brainer but choosing an obstetrician that has been around the block a few times can make a real difference. It is a good idea to do some research online to see how long they have been in obstetrics, what types of births they are experienced with and any reviews from other moms. If you are still in doubt you might ask for an initial consultation where you will get the opportunity to ask them about their medical background and experience.
Establish that they will they be available throughout your journey:
An obstetrician is meant to be there with you from the time you get your first scans to when you are giving birth to your child, so establishing that they will be available throughout this period is important. Ask what times they commit themselves too and particularly if they be available for the birth. If they will be away for a key moment then ask them what their plan will be to ensure that you remain properly cared for.
Get to know their team:
Because obstetrics is all about continuity of care, any good obstetrician doesn’t work alone. They work with midwives, hospitals and other doctors to ensure that you get the right level of care throughout your pregnancy. Their team will be there when the obstetrician can’t be, so looking into their team and who they surround themselves by is just as important as knowing your main doctor.
Understand their cost:
Obstetricians can vary significantly in price, so understanding their pricing, what can be covered by insurance and medicare, and what can’t, is vital to ensuring that you understand the cost of your care.
Make sure they are a good fit for you:
Finally you should ensure that your obstetrician is a good fit for you emotionally. In an initial consultation you should see whether you feel comfortable around them, how open they are to answering your questions and how confident you feel in their judgement and advice. If they aren’t willing to answer your queries or become irritated, then you know that they won’t be much better throughout the stressful stages of your pregnancy.
This is an individual who will be your key point of contact and medical support throughout your pregnancy, so feeling like they are a good fit for you emotionally, who will provide you with the help and advice that you need is vital.
Between nausea, the worry about listeria and the need to ensure a high-quality diet lunchtime choices can be difficult! If you usually bring your lunch to work it is likely you will need to make some changes from your usual options- but is what you are choosing now a healthy option? Hot chips may be ‘safe’ but are they a nutritious choice? Let’s look at some of the better takeaway choices you could make and what to steer clear of most of the time!
Remember a decent lunch also makes it far less likely you’ll be reaching for that chocolate bar at 4 pm!
Toasted sandwiches/sandwiches/wraps:
Choose wholemeal, multigrain or rye bread or rolls and fill with lots of salad and some cheese, tuna or egg. If you are toasting your sandwich, you could add chicken/ham/turkey/beef. Make sure it is heated right through! Salamis and other processed meats should be avoided entirely. If your sandwich is super-sized try leaving half of it for later. Steer clear of focaccias and Turkish bread as these options are very high in energy.
Soups:
A great way of getting a whole lot of veggies in in the middle of the day! Choose options such as lentil and sweet potato, pumpkin, chicken and corn, minestrone or barley and vegetable! A gazpacho is a great option in summer. Add some toast or a bread roll if you’re feeling extra hungry.
Asian cuisine:
Skip the Laksa and deep fried items and give sushi a miss but there are still many great options to choose from- Vietnamese spring rolls, Stir-fries (add tofu/chicken/seafood/beef), a short or long or Pho noodle soup. If you get a stir-fry ask for more veggies and less rice (or choose noodles) to ensure you are filling up on the nutritious part of the meal.
Salads:
These can be a bit tricky as it is recommended that pre-made salads are avoided when you’re pregnant. Ultimately it is your decision as to what you choose to eat. Some women are happy enough with the turnover rate and hygiene practices of some establishments and will consume salads. All salads should be well washed and dried. If you are consuming salads, then take the opportunity to add in some legumes such as chickpeas or 4 bean mix or some sweet potato or corn and skip the heavy cream dressings.
A roast:
The meat carvery can be a danger but if you skip the fatty lamb or the pork crackling and go for leaner beef or chicken (skin off!) and stock up on the roast veggies (think less potato, more onion, pumpkin, peas, etc.) you can still end up with a nutritious and satisfying lunch. A grilled piece of fish with greens is also an excellent choice!
Still not sure what should you eat when you are pregnant?
Contact Dr Rahul Sen's dietitian and discuss your pregnancy diet plan.
Unless you are vegetarian, it’s ideal to have seafood feature in your diet regularly! This may include white fish, pink/oily fish and shellfish such as prawns, lobster, bugs as well as scallops and mussels.
Seafood gives you a valuable source of protein, B vitamins, iron, zinc and especially iodine and omega-3 fatty acids. The iodine and fatty acids are particularly important for your baby’s growing brain, which is actually made up of around 70% fat. Studies are ongoing about the many important benefits both iodine and fatty acids may provide-especially surrounding neural development and future intellect.
Many women are confused about the guidelines for including seafood in their diet due to concerns regarding food safety. The main issue is surrounding mercury, which is a heavy metal that can build up in the tissues of bigger fish when they eat the smaller fish. In Australia however there are very few fish that present this concern. Tinned fish is also considered safe, and often a very convenient way of getting your intake up!
Below is a table from our national Food Authority (FSANZ) that outlines the guidelines for you in pregnancy:
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Safe levels of fish/seafood consumption in pregnancy (1 serve = 150g) |
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2-3 serves per week of any fish/ seafood (this includes canned fish) not listed below |
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OR |
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1 serve per week of Sea Perch (Orange Roughy) or Catfish AND no other fish that week |
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OR |
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1 serve per fortnight of Shark (Flake) or Swordfish/Broadbill/Marlin AND no other fish that fortnight |
Keep in mind a small tin of salmon, sardines or tuna may only provide just over half of this serving size, so having tuna most days of the week as a lunch option is not a concern-though variety is always advised!
It is preferable to include seafood in your diet several times a week rather than taking fish oil supplements.
It is important that when you consume seafood in pregnancy that you ensure it is well cooked-that means no sashimi but also items such as chilled prawns (even though they are pre-cooked) should be avoided. Hot prawns or shellfish are safe as part of a hot dish. I advise women to avoid all oysters in pregnancy, just in case of hepatitis infection.
What is iron and why do I need it?
Iron is a mineral that is involved in making red blood cells, carrying oxygen and producing energy. It is therefore important to ensure you’re eating enough of it!
What is different in pregnancy nutrition?
In pregnancy your iron requirements rise greatly so you can provide for your baby’s blood supply and build up their stores. If you eat meat you should aim to include red meat at least 3 times per week as well as choosing white meats, eggs, wholegrain breads and fortified cereals, legumes and vegetables regularly. Vegetarian women will need to rely more heavily on plant sources of iron, which aren’t as well absorbed by the body.
Why does my iron level matter?
Iron deficiency can lead to complications for you and your baby. Women who are low in iron have a higher risk of small for gestational age babies as well as premature delivery. Women themselves usually feel quite fatigued and may become short of breath.
How do I know if I’m getting enough iron?
Even if you do eat red meat it is often difficult to consume the amount of iron that is needed in the last trimester of pregnancy. However, not all women will become iron deficient (anaemic), even those that follow vegetarian diets. It will depend in part on how well you absorb iron and on your body’s initial store.
Dr Sen will check your ferritin (body store) level, usually when you are around 26-28 weeks. Your haemoglobin level (amount of iron in your blood) is also checked but as your blood supply doubles during your pregnancy this level drops due to a ‘dilution’ effect and therefore isn’t reliable as a measure of iron deficiency.
Pregnancy nutrition - Supplements
If your ferritin level is low increasing your intake of red meat will not be enough to increase your stores. You will need to begin taking a high dose iron supplement formula (usually FerroGrad + C or Maltofer or Ferrotabs) 1-2/day depending on your result. Iron supplements may cause tummy upset including constipation or diarrhoea, especially in higher doses. If you suffer any discomfort, try taking it every 2nd day rather than stopping it all together. Low dose iron or the iron in your multivitamin (if you’re taking) is not sufficient. It is normal that your stool colour can change to very dark/black. This is not dangerous. Dr Sen may also discuss the possibility of an iron infusion with you.
Iron supplements should be continued until 6 weeks after delivery, though if you’ve been taking more than 1/day you can decrease to just 1/day from when you have your baby. Iron supplements are best consumed away from dairy products or calcium supplements.
It is not advised that women take a high dose iron supplement unless they have been shown to have iron deficiency.
For more information about pregnancy nutrition, click HERE
Gestational diabetes is the type of diabetes that can happen during pregnancy. Treating gestational diabetes helps reduce the risk of complications during pregnancy and improve your baby’s health in the future.
What causes gestational diabetes?
Gestational diabetes is a condition affecting around 15% of pregnant women. It causes a woman’s blood glucose to be high. The placenta produces hormones to help the unborn baby develop and grow and these hormones stop insulin hormone working so well. Insulin is the hormone needed to keep blood glucose normal. If a woman can’t meet the demand for extra insulin her blood glucose will rise.
How can gestational diabetes be avoided?
The best way to reduce the risk of gestational diabetes is to be fit and healthy before becoming pregnant. Being overweight will increase your risk, as does having a baby after 30 years of age. Gestational diabetes can still occur in healthy people - risk factors you can’t change include your family history of type 2 diabetes, gestational diabetes in a previous pregnancy and being certain ethnic backgrounds (diabetes is much more common in women of an Asian, indigenous, Islander, Mediterranean or Middle Eastern background).
Symptoms of gestational diabetes:
Gestational diabetes usually has no obvious symptoms. If symptoms do occur, they can include:
- Excessive urination
- Unusual thirst
- Extreme tiredness
- Frequent yeast infections
Unfortunately, these are often common symptoms of pregnancy, so generally, gestational diabetes is picked up when you have a routine blood glucose test between the 24th and 28th week of your pregnancy.
Morning sickness is a common symptom of early pregnancy and in many cases, goes away by the end of the first trimester. It is caused in part by changes in hormones during pregnancy and may make eating difficult.
Although it is called ‘morning sickness’, nausea can happen at any time of the day.
Morning sickness does not usually cause any problems for the unborn baby. However, if a pregnant woman experiences severe ongoing vomiting, she should see a doctor.
Please have a look at some food and eating suggestions that may help manage symptoms of morning sickness.
- Eat smaller meals more often. Missing meals can make nausea worse.
- Avoid large drinks. Have frequent small drinks between meals.
- Cut down on fatty, fried or spicy food.
- Try eating a dry biscuit before you get out of bed in the morning.
- Eat a healthy snack before you go to sleep at night. This might include fruit or yoghurt.
- Avoid foods if their taste, smell or appearance makes you feel sick.
If you vomit, it is important to not become dehydrated. It may be easier to have lots of small drinks rather than drinking a large amount in one go and Hydralyte drinks/ice blocks (or similar products) may be easier to manage.
Please be mindful that the stomach acids in vomiting can soften tooth enamel. It is best not to use a toothbrush to clean the teeth straight after vomiting as this may damage them. Have a drink of water to rinse your mouth.
If the nausea is affecting your life or your diet a lot there are several medications you can take to help- you should discuss this with your doctor. There are also some suggestions regarding nausea management:
For all other enquiries visit our website:
Dr Rahul Sen the best obstetrician in Sydney
Many pregnant women take supplements during their pregnancy but are they actually necessary?
You may have been told by your healthcare provider that if you eat a well-balanced diet, then a multivitamin in pregnancy is not usually required. However, we know that often a woman’s diet is not always ideal and in fact, one recent Australian survey showed not a single woman who participated consumed the recommended daily dietary intake of food group serves for pregnancy!
Certainly, pregnancy is a time where your nutritional needs increase in order to provide support for the baby’s optimal growth. However, your body also has an amazing capacity to adapt to different situations, and in some cases, although the requirement for a nutrient is greater in pregnancy, your body adjusts its processing of this nutrient so that increased intake from the diet is not actually required. Things are further complicated by the fact that it isn’t always easy to measure certain vitamin and minerals either and different genetic influences may contribute individual variability as well. So just what do you need to take?
Pregnancy nutrition -Folate
Without a doubt, we know that folate is critical for its role in reducing neural tube defects (NTD). All women of childbearing age should take a folate supplement of 400mcg daily for one month before and throughout the first trimester. Those with a family history of an NTD or who have pre-existing diabetes are recommended to take a higher 5mg daily dose.
If you need an advice regarding your pregnancy nutrition, Contact Dr Rahul Sen dietary advisor.
Snacks often get a bad wrap for being unhealthy…which, of course, they can be, but not if you choose wisely! Snacks can be an important part of your pregnancy diet for several reasons. Usually, when you are pregnant, you will notice you become hungry every few hours at least. This is a result of the baby ‘siphoning’ glucose (and other nutrients) from you. Ensuring a regular intake with mid-meal snacks tends to make you feel better and also makes it less likely that you’ll get super hungry for your meals. Have you noticed that once you’re excessively hungry, it’s much harder to try to control the amount you consume as well as the speed at which you eat?
You’ll often also find you can no longer fit in as much volume at a meal, especially as your pregnancy progresses. Snacks are therefore a good way to fit in your fruit and dairy requirements, as you may no longer be able to eat them together with your main meals. And often small and frequent intake also helps with other common problems in pregnancy such as nausea and heartburn/reflux.
If you’re working or at home with little kids or just aren’t used to including mid-meal snacks, it’s often hard to adjust to remembering to eat. So planning and preparation is the key! When you’re out and about you’ll probably find it challenging to find something that is both nutritious but not calorie excessive. So it pays to have a working list of options you know you can grab when you need!
Some simple examples are:
A piece of fruit
A tub of yoghurt
A glass of milk
A small fruit smoothie
Whole grain crackers or high fibre toast with cheese, peanut butter or hummus. Vege sticks with salsa
A small handful of nuts
There are just a few of dozens and dozens of other options to meet all your sweet and savoury cravings and which still consider the overall balance in your diet!
If of course you are happy eating just three meals per day and are meeting your nutritional requirements and not feeling hungry then there is no need to start adding in extra snacks either! Everyone is different, and our diets would be so boring if it were any other way!