Dr Alexander's long term experience allows him to look after both low risk and high risk pregnancies. That is why he only delivers babies at The Mater Mothers Hospital.
When you call our office, all newly pregnant patients meet with Dr Alexander to review your medical history and provide you with important information about having a healthy pregnancy. We perform an ultrasound on all our patients at approximately eight to 10 weeks to help establish your baby's due date and to check on the health of the pregnancy. The first visit involves a full exam and review of available prenatal testing, planning for further antenatal testing as required and draw a brief plan for the second trimester. The routine follow up antenatal visits will be every 4 weeks up till 28 weeks, every 2 weeks between 28-36 weeks and weekly afterwards until delivery. Delivery mode and management is discussed throughout the third trimester.
Dr Alexander respects a woman’s right to choose the method of her delivery. If you wish to aim for a vaginal birth then he will support you fully in this choice. Similarly, if you choose to have an elective Caesarean Section he will also support you your choice.
It is important to recognize the signs of labour so that you will know when you are experiencing the “real thing.” If this is your first baby, you will most likely experience lightening (the descent of the baby’s head into your pelvis) sooner than women who have already had other children. Typically, the signs of labour include uterine contractions, tightening of your stomach, and cramps in your low back. About two thirds of women experience these tightening before their waters break. About one third will notice fluid leaking out first. If you are unsure about what is happening, don’t forget that the Mater Mothers’ Private Midwives are available 24 hours a day on 3163 7000 to answer any questions.
Dr Alexander has chosen to deliver babies at the Mater Mothers’ Private Hospital because he feels that the the Mater Mothers’ offer a safe environment for both Mother and Baby. If all is going well then you should be able to experience labour the way you wish. You can have a very “low-tech” birth if you wish, knowing that all the best equipment, services and staff are immediately available, if required. Mater Mothers’hospitals have operating theatres close by, Anaesthetists on standby and Paediatrician available. Mater Mothers’ Hospital is considered a tertiary hospital and therefore has a Level 3 (the highest level) Intensive Care Nursery, if required.
You may also be interested in taking childbirth preparation classes, which teach coping methods for labour and delivery, and helps guide new parents in the many decisions they will make before and during the birth process. One of the things you may be most concerned with is the amount of pain you may experience during labour. Childbirth is different for all women, and no one can predict how much pain you will have. During the labour process, your midwife or Dr Alexander will ask you if you need pain relief, and will help you decide what option is the best for you. Your options may include a local or intravenous analgesic (pain relieving drug), an epidural (injection which blocks pain in the lower part of your body), spinal anaesthesia (used when the delivery will require forceps), or a pudendal block (numbs the vulva, vagina and anus during the second stage of labour and during delivery).
High-Risk Pregnancy Management
We take care of many high risk pregnancies at “My OBGYN”. There are a variety of different conditions that qualify as a high-risk pregnancy. Some of these are twins, high blood pressure in pregnancy, diabetes in pregnancy, poor fetal growth and thyroid disease in pregnancy.
Our practice is unique in that we have different protocols to guide management of high risk pregnancies. A protocol is a list of specific blood tests, ultrasounds, frequency of visits, etc. that we follow for each high risk condition. The protocols are evidence based, which means that they are derived from the best available medical research.
Packing for Your Hospital Stay
Most women who deliver naturally or by C-section usually need similar packing bag. Be sure to pack a bag with enough comfortable clothes for your hospital stay (pack shirts and tops that have zip or buttoned fronts if you plan to try breastfeeding). Look for soft clothes with loose elastic or adjustable waistbands, warm socks, and even a couple of zippered sweatshirts or cardigan sweaters for those cool hospital rooms. Also include toiletries such as toothpaste and toothbrush, lotion, brush, makeup, and soap.
A nice-smelling bath soap, your favorite lip gloss, brand new slippers, or extra special hand cream can provide just the pick-me-up you may need while recovering from your surgery.
Your due date and labour day
Labour may start at full term or sometimes pre-term. Your labour may start by having irregular contraction that may pick up in duration and intensity, then is the time when you need to call the labour ward at the Mater Hospital on 07-3163-7000.
You may have gush of fluid ( ruptured membranes ), this sometimes can precede contractions, please ring the labour ward and proceed to hospital. Dr Alexander prefers you to be in hospital for further assessment and management as needed, as there is increased risk of infection if that happens.
Preparing for Surgery
You would have discussed with Dr Alexander the date and time of the procedure. Dr Alexander will discuss with you any special preparations if needed depending on the course of your pregnancy. You will also be reminded to refrain from eating or drinking for eight before your surgery.
Checking into the Hospital
Present to the Mater Mothers Hospital 5th floor reception desk the morning of your surgery, usually two hours before the operation time.
Once you’ve arrived at the hospital, you’ll check in and be shown to your room, where you’ll change into a hospital gown. Once in your room you will be admitted and assessed by the midwife including physical assessment (which includes checking vital signs and reviewing your medical history), the hairline 3 cm above pubic bone might be shaved down.
When the time comes, a nurse will bring you and your partner to the operating complex. You will meet with an anesthetist to discuss your options for anesthesia, and also meet the midwife, and Paediatrician.
Your partner is allowed to sit at your side during your operation, he will be given hospital scrubs to wear during your surgery. During the operation, your partner will be prohibited from videotaping, however still photos is allowed.
After an anesthetic is administered, you will lie down on an operating table and a catheter will be inserted to drain urine during your C-section and until you can attend to your own bathroom needs. Your doctor or attending nurse will then set up a curtain above your chest to separate you from your surgical team (giving you both some privacy during your operation). Your arms may be secured to keep you from accidentally reaching into the sterile surgical area. If you have regional anesthesia ( epidural or spinal ), the method generally preferred by doctors and hospitals, you’ll be awake during the operation. You won’t feel pain, but if you’ve had an epidural, you will probably feel pressure and pulling throughout the procedure. You should be able to talk to your partner and your doctor during the procedure.
Post-Op: Moments after Surgery
Once your baby is born, he or she will be examined by the paediatrician in the same operating room and that takes 5-10 minutes. The baby then is brought to your arms until the procedure is finished. You will then be moved to a post-op recovery room where you’ll be closely monitored, usually for the next one hours.
A lot of what you’ll experience is based on the type of anesthesia. Women who’ve had general anesthesia will feel more groggy and sleepy. While those who had a spinal or epidural, may be experiencing “the shakes.”
This uncontrollable shivering is harmless and is caused by a combination of the birth process and the medications you received in your spinal or epidural. If you received morphine through your spinal or epidural towards the end of surgery, you may also have an all-over itchy feeling—a common side effect. There are medicines which will help control the itching, should it become unbearable.
If all is going well, you’ll be moved to your hospital room.
You will still be closely monitored by nurses. Throughout your first day after delivery, you can expect checks of your vital signs, your incision, and your vaginal discharge. Your nurse will check the amount of urine you’re passing and will use a stethoscope to listen for bowel sounds. Your nurse will also assess your pain and help with pain management.
You can have water after 4 hours, and if you feel well and nauseous will be allowed to have free fluids after 6 hours, and diet as tolerated the day after. The bladder catheter will stay for at least 12 hours, that is usually removed the second morning after the procedure and you will have what we call Trial Of Void. The nurse will measure the volume of urine that is left in the bladder after you urinate. That practice was put in place to insure the proper functioning of the bladder after spinal or epidural anaesthesia.
If you had a Cesarean due to a complicated pregnancy or delivery, or if you or your newborn are ill, it may take longer to begin nursing, But if you and baby are both feeling well, you may have started nursing in the recovery room. Expect to need help with breastfeeding, especially at first. Your hospital’s lactation nurse can help you. Always remember that there are many techniques and many opinions, please do not get confused, you might need to try all and settle on one that suits best your baby and yourself.
On Your Feet: Day Two
You’ll probably be free of the catheter on your second day after delivery. And if you are feeling well enough, you’ll begin eating and drinking again.
Around this time, your nurse may also help you take those first post-op steps and will help you have a shower, you will also be visited by a physiotherapist who will teach you few bracing techniques, and exercises.
Dr Alexander will come to check on you the second day, discuss your concerns if any with him, the paediatrician will also come to check on the baby.
Pain control usually, oral medicine, is ordered for you by Dr Alexander and the Anaesthetist, some are given regularly and some as required. Take your pain relief, and keep on the top of it. Use the time that you spend in the hospital, obviously to recover but also to get to know your baby and gain confidence in preparation to discharge home.
You will be going home from the hospital on Day 5 if all is good. The first week or two you are home, don’t push yourself.
You can also ease your recovery by continuing to be gently active and remembering not to lift anything heavier than your newborn.
Having a pillow on hand can help tremendously during these days after surgery. Press it gently against your belly to help soften pain when walking or sneezing, and tuck it behind your back to help you feel more comfortable when sitting. Try to have sleep whenever you can, you and your partner should take “shifts”, when you feel tired frustrated and “nothing working” take a break and have couple of hours sleep. With each day that goes by in the first two weeks, you typically feel a little better.”
Your Postpartum Checkup: Six to Eight Weeks Later
Most women will be on track by week 3-4, You’ll have your final postpartum checkup with Dr Alexander. Take that opportunity to discuss your concerns if any and clarify various issues as the need arises. Discussion regarding contraception and pap smear will also be done.
By six weeks, you should have stopped bleeding, pain free and back to normal everyday life. You will have some numbness still typically above the scar as the superficial nerves that were cut will regenerate not before 6 months.
It’s not uncommon for some women who deliver via Cesarean, especially the unplanned ones, to feel guilty about the procedure, but even those with planned operations. Discussing the issue with Dr Alexander and explaining the reasons for the unplanned emergency C-Sections tend to alleviate those feelings.
The most important thing that you should remember is that you and your baby are healthy.
Though planned Cesareans aren’t foolproof, it can be reassuring to know that, for the most part, you have the ability to prepare for one of the most exciting events in your life. Armed with knowledge, many mothers find that delivering via C-section is less stressful than they expected. With a good birth plan and open communication between your doctor and your birthing team, you’ll be able to fully enjoy the birth of your child.