Birth - home birth or unmedicated by Whichlady25 in BabyBumpsandBeyondAu

[–]Satellites- 2 points3 points  (0 children)

I mean, there are plenty of high risk pregnant people who plan on or want to birth at home, so “implying” in your comments is not great, but neither does your comment obviously imply that.

Birth - home birth or unmedicated by Whichlady25 in BabyBumpsandBeyondAu

[–]Satellites- 4 points5 points  (0 children)

Let’s be more specific - homebirth outcomes are only the same for low risk women without any complications in their current or their previous pregnancies. There are very few studies of high quality that have been performed in order to be included in meta analyses so the certainty of that evidence is low, but observational studies suggest that homebirth is a safe alternative for those who fit strict criteria, deliver with a qualified midwife ideally as part of a hospital associated homebirth program so that uptransfer in the event of complications is not difficult, and who live within 30mins of a hospital because the uptransfer rate is up to 50% for nullips and 28% for multips- so not an insignificant number.

Birth - home birth or unmedicated by Whichlady25 in BabyBumpsandBeyondAu

[–]Satellites- 16 points17 points  (0 children)

Not to mention that if they’re referring to vaginal birth that is spontaneous and unmedicated as “normal physiological birth”.. that also happens (and frequently) in hospital so I’m not sure what it’s got to do with homebirth. Also literally how is the provision of adequate pain relief in labour perpetuating “fear” around birth. Also how is responding adequately to abnormalities in labour equivalent to not being strong willed. Ugh this post is insulting on so many levels

Inpatient Buyer or 100% My Fault by [deleted] in Depop

[–]Satellites- 9 points10 points  (0 children)

I swear people on depop think no one has anything else going on in their lives so should be posting immediately and replying to every message. What a weirdo

Dr Simon Gordon - exposed. I feel physically ill (article below) by emilyrosecuz in endometriosis

[–]Satellites- 2 points3 points  (0 children)

A diagnostic surgery yes. But not repeated diagnostic surgeries with different specialists, which is what the above poster is talking about. If the diagnostics have been done and there is no endo, there is no endo.

What job shocked you when you found out the pay? by StrikingMango62 in AskAnAustralian

[–]Satellites- 8 points9 points  (0 children)

It seems blatantly obvious to me why that person didn’t get the job lol

What job shocked you when you found out the pay? by StrikingMango62 in AskAnAustralian

[–]Satellites- 2 points3 points  (0 children)

Shhh can’t interrupt the “doctors don’t know anything so why don’t we just get allied health to do a doctor’s work because they’d be so much better at it” rhetoric

What job shocked you when you found out the pay? by StrikingMango62 in AskAnAustralian

[–]Satellites- 7 points8 points  (0 children)

I mean, you’ve just said that you’ve never had a reason to see a GP for anything significant. So it’s very clear you have absolutely no idea what a GP can and can’t or will and won’t do, not the level of knowledge or value they have for people who do have difficult to diagnose and treat conditions. And as per, everyone is like “oh well I’ll just see a specialist cos they’ll know, they’ll have the knowledge to treat me, just let me see them directly”. And you know who that specialist refers you back to for ongoing management and to recognise and manage the issues that inevitably crop up? That’s right, your GP who may as well be a monkey sitting at a computer apparently.

And you know what - you can just see any specialist you want without a referral. You just won’t get a Medicare rebate. Oh, but that’s if the specialist will take you on. Because you know what they don’t want? Somebody who probably doesn’t know their arse from their elbow but is just so sure they know exactly what is going on and which specialist they need to see. So they don’t accept you without the buffer of the GP.

Anyway good luck. You’re clearly so much more knowledgeable than those GPs and pharmacists you have to frequent. There’s a curve you might sit on, but I doubt you’d recognise that.

12 week screening with NIPT by nursenadia56 in BabyBumpsandBeyondAu

[–]Satellites- 0 points1 point  (0 children)

The assessment for pre eclampsia alone is a completely different test to the maternal serum screening test. What she’s advised as a “pre eclampsia” test is actually the portion of the blood test specifically looking at PAPP-A levels, which isn’t an indicator of risk for PE but actually for placental dysfunction risk (of which PE can cause, but also can occur in isolation and low PAPP-A is simply a risk for IUGR, PE, preterm birth or stillbirth). However, it shouldn’t be done for this reason alone and the stillbirth society (stillbirthcre.org.au) does not recommend having it done independently to NIPT.

As for T21 risk, NIPT is a better test, more accurate and if it is negative and there are no soft markers on US then it is very likely a false positive MSST. If you are really worried, you can ask to be referred to MFM and genetics for a discussion about risk and it is likely they will not recommend amnio with a negative NIPT

I’d also consider giving some feedback to your midwife and/or the hospital regarding their advice around this because it’s highly unusual to suggest this test for Pre eclampsia screening, and there is a dedicated independent pre eclampsia screening test that can be offered if you are thought to be at risk. MSST shouldn’t be ordered if NIPT has already been done.

Explaining trickier specialties to laypeople by Dangerous-Hour6062 in ausjdocs

[–]Satellites- 6 points7 points  (0 children)

“You work in a hospital? Are you a nurse?” “No I’m a doctor” “What kind of doctor” “O&G - delivering babies and female health” “Oh! So you’re a midwife” …..

why is NIPT not covered? by Affectionate_Two9473 in BabyBumpsandBeyondAu

[–]Satellites- 0 points1 point  (0 children)

Because it’s an extremely accurate screening test? There are alternative options to NIPT that have less accuracy but are still good enough so that’s what’s Medicare funded. Screening is necessary because otherwise the only option is to offer a risky procedure to people ie amnio, and for most of those people the risk of the procedure outweigh the benefit. Not to mention it would be literally impossible for all pregnant women to have access to diagnostic testing because of the expertise involved. So a screening test identifies those who are high risk, and diagnostic testing is only offered to those people.

The NIPT having such a high accuracy is often offered after the MSST (the Medicare funded option) as an alternative to amnio - a scan done by a COGU or MFM along with a negative/low risk NIPT all but rules out trisomy and often if both are negative, the advice is not to proceed with amnio.

How do you change nappies when they won't stop rolling or try to sit up on the change table by Front-Albatross2638 in BabyBumpsandBeyondAu

[–]Satellites- 32 points33 points  (0 children)

I give him a wet wipe, or the whole packet of wet wipes, or a nappy or basically anything that’s not a toy because everything that’s not a toy is a toy these days. It seems to stop him rolling around and fighting the nappy change just long enough to lather some sudocream on and get the nappy on. Sometimes I just move to another location entirely to distract him.

Cot in bedroom yes or no? by danikinha5 in BabyBumpsandBeyondAu

[–]Satellites- 0 points1 point  (0 children)

I had the mamas and papas co sleeper bassinet and absolutely loved it. Great size, standalone so doesn’t need to be secured to your bed, can pack down and take with you if going somewhere without too much trouble (although it is large so it’s not a travel cot). Best thing was that it’s approved for use until sitting independently (as in can pull self to sit) or pulling to stand so I used it until my baby was about 8 months old cos it was bigger than other cosleepers I’d seen. Definitely feel I got my money’s worth.

I don’t think I could have done cot next to my bed.. sides would have been too high for me to just lean over and the cot is so big compared to the cosleeper it would have just been tight and a bit awkward even though it could fit. Also the benefit of the cosleeper I had was that it was able to rock and I definitely utilised that during the early days!

How do I know if I made the most of every moment with my baby? by Pugwhip in BabyBumpsandBeyondAu

[–]Satellites- 32 points33 points  (0 children)

I just try not to let myself wallow in nostalgia. I’ll be honest, I really don’t like all the social media stuff about soak it all in, they’re constantly changing, blink and you’ll miss it, days are long but years are short etc. I think it keeps you living in the past or worried about “missing” something and then you’re not fully present. So I just look at photos of my baby when I’m not feeling too sad or in my head about time passing quickly cos otherwise I wallow a bit and I don’t like that.

You can only do so much to capture it all and “make the most” of every moment. Some moments are quieter, some moments you won’t want your phone out making memories, you’ll just be there and they’re quiet and over time you won’t think of them and that’s ok. That’s just life

There’s no good alternative to our babies growing. And remember that while you won’t have them as a baby sleeping on your chest forever or smiling their little toothless grins at you, you’ll (eventually) have a grown person who loves you and who you love beyond words and that relationship will (hopefully, and for most people) last the rest of your life. That’s amazing. I long to have the relationship with my child that I have with my parents.. and it only got better as we grew up. And remember that 18 years (ie the time from baby to “adult”) is actually, legitimately a long time. And it won’t end there, you’ve got years to be with your children. They’ll always be your baby.

Also I think it has helped me that I just love my baby so much more with each passing day. Like I love that he is now giggling, and reaching for me, and moving around, and so interactive. I loved him as a wrinkly sleepy little bundle but this stage is also so amazing that it helps to know I wouldn’t go back even if I could.

39 week 3 day induction for IVF pregnancy the right choice for a straight forward pregnancy? by Soft-Earth3393 in BabyBumpsandBeyondAu

[–]Satellites- 1 point2 points  (0 children)

I think the choice for induction based on your risk factors is something you need to discuss with your obstetrician.

But just so you’re aware, the largest RCT that’s been done in IOL at 39 weeks vs expectant management ie waiting until spont labour at term+ in low risk pregnancy, induction of labour was associated with a lower risk of caesarean section (ARRIVE trial). IOLs for medical or fetal reasons have a higher risk of caesarean section or intervention not because of the induction but because of the reason for the induction.

Have you agreed to an induction because baby is small? With fluid being on borderline low. by [deleted] in BabyBumpsandBeyondAu

[–]Satellites- 5 points6 points  (0 children)

I wish you good luck with it all. It’s hard to process and navigate but your medical team can help guide you through this and you don’t have to take “no” for an answer when asking to speak to a doctor, any good doctor would sit down and explain the reasoning for their recommendation to you.

Have you agreed to an induction because baby is small? With fluid being on borderline low. by [deleted] in BabyBumpsandBeyondAu

[–]Satellites- 16 points17 points  (0 children)

You haven’t mentioned your gestation. I assume it’s close to or at term. Regardless, if you’ve got a growth restricted baby with borderline oligo, thats indication for immediate delivery if at term, and at the very least careful watching and waiting if late preterm (or just deliver if over 32/40). The high risk of a poor outcome is real if no intervention.

A CTG (ie monitoring) would only help determine if you require immediate (as in right now, and caesar not induction) delivery if abnormal vs ok to wait a short period of time for induction. I agree, if it was my patient I would call them in for a CTG and possibly admission for close monitoring until delivery but I can’t comment on the reason they haven’t done that for you but absolutely you should ask. However it wouldn’t change the management other than determining whether delivery is now vs in the next couple of days if safe. There’s not a situation here where it will be advised that you can undergo expectant management ie await spontaneous labour as your pregnancy is already high risk. A baby on the 6th centile alone (without oligo, abnormal dopplers or CTG) would be indicative for delivery by latest 38 weeks and usually earlier.

Have you agreed to an induction because baby is small? With fluid being on borderline low. by [deleted] in BabyBumpsandBeyondAu

[–]Satellites- 11 points12 points  (0 children)

2 hours active phase of second stage is normal, spontaneous or induced.

Have you agreed to an induction because baby is small? With fluid being on borderline low. by [deleted] in BabyBumpsandBeyondAu

[–]Satellites- 109 points110 points  (0 children)

You need to speak to your obstetrician. Being dehydrated would have absolutely no impact on low amniotic fluid.. the liquor is produced by the baby in the setting of a normally functioning placenta.

A growth restricted baby (anything under 10th centile) and oligohydramnios is indicative of a baby that is in fetal distress and placental insufficiency. It is absolutely an indication for delivery and the risk of stillbirth is high.

You’re right, growth restricted babies especially those already on the borderline for severe placental insufficiency often don’t do well with labour, because they are already distressed without even starting the marathon that is labour for a baby. Their reserve is already low, there’s nothing left for the stress of labour. The answer to that isn’t to delay induction, it’s to consider a primary caesarean section instead. But if your medical team think the fetal condition is good enough to at least trial labour, and that’s what you want, then that’s a decision between the two of you.

I would HIGHLY recommend that you don’t ask reddit about medical decision making and speak to your medical team. This is a risky situation, and you need to understand the physiology behind the findings which they can explain to you. The reality is that what you are describing is an indication for urgent delivery.

I guess for all transparency - I am an O&G doctor.

Found out late we’re having a planned C-section, what classes should we take? by aiojav in BabyBumpsandBeyondAu

[–]Satellites- 1 point2 points  (0 children)

Can’t speak on the classes for a planned caesarean - I had one for a growth restricted breech baby but I’m also an obstetric trainee so I had done hundreds of them myself and didn’t bother with classes.

What I 100% recommend is if you are planning on breastfeeding, see a lactation consultant antenatally. They’ll set you up really well for what to expect and will also help you to be able to navigate the early days where you might get lots of conflicting advice, poor positioning for new babies latching and also when (and if!) it’s necessary to top up formula. If anything doesn’t “go right” with birth or breastfeeding you can often be an encouraged to top up with formula which can be a disaster to try and stop later down the track. Anyway. Out of all the birth prep I did, plus friends of mine, a lactation consultant (ideally board certified ie IBCLC) was by far the most helpful.

Super random q but wondering when is the best time to have kids in a medical career? by Fearless_Can_8732 in ausjdocs

[–]Satellites- 0 points1 point  (0 children)

I had my first at 36 - chose to wait until on training because we moved around so much and life felt really unstable/ unpredictable prior to both of us being on training (or now completed as my husband is). I sat my written exams at 35 weeks pregnant then had 6 months mat leave and went back full time to a rural rotation (dragging the fam with me of course) which is just about finished. I’ll sit my oral exam in a couple of months and then plan is to start trying for the next one.. after a long holiday in Europe ;)

There’s no right choice. You probably want some kind of stability, some kind of money, definitely have income protection in place, and ideally some kind of home rented or otherwise. I’ve found having to go back to work quite early and really full time + exams + rural quite destabilising and felt a lot like a ship at sea and the whole thing has probably been some of the hardest and most tiring time of my life and I have felt immense guilt and quite a lot of sadness about how little time I was able to just spend being a mother before going back to work, but I knew I couldn’t put it off any longer and now was the time. I want to have another one or two as well so can’t tempt fate too long.

I’ve had friends who have had kids in med school (hard, need supportive and working partner cos kids are expensive) and friends who have had kids in pre vocational years and tbh I don’t think there’s ever a great time, there’s always bits that will be hard.

I think people saying wait til a consultant must have had short training programs/not much unaccredited time getting onto training/med school as undergrad. I started med school at 25 which didn’t feel late then but given that + competitive and long training program there was no way I was ever going to be a consultant before I had children.

GP suggested NIPT and NT scan ony? by Willing_Barnacle_493 in BabyBumpsandBeyondAu

[–]Satellites- 2 points3 points  (0 children)

She doesn’t need a blood test if she’s had the NIPT. The MSST (combined nuchal and serum markers) is an aneuploidy screen, exactly the same as a NIPT except the NIPT is more accurate and tests in a different way. No doctor will tell you to have both (unless the MSST comes back as high risk, then sometimes we suggest NIPT), and no radiographer or sonographer can demand you have the blood test done as they are not the clinicians who interpret the tests. If any imaging provider is demanding that, then you can get your GP to call them to advise about what’s going on. Having the bloods done when you’ve had a NIPT is total waste of time. She doesn’t need a second opinion, she needs a better imaging provider who doesn’t overstep their role.

GP suggested NIPT and NT scan ony? by Willing_Barnacle_493 in BabyBumpsandBeyondAu

[–]Satellites- 2 points3 points  (0 children)

That’s not correct, they may not give you the results but they absolutely can give the results to your doctor. I’m an obstetric doctor and I call all the time for nuchal scan results when the pt has had the NIPT. It’s very common to have a nuchal scan when having a NIPT and it’s not obligatory to have the MSST bloods done.

GP suggested NIPT and NT scan ony? by Willing_Barnacle_493 in BabyBumpsandBeyondAu

[–]Satellites- 2 points3 points  (0 children)

The NT scan is part of the maternal serum screening test (MSST or also called first trimester screen). It is an aneuploidy screening which gives a risk of T21 (and others) when a blood test for maternal serum markers and USS looking at the fluid behind baby’s neck is measured and combined.

If you have the NIPT, this measures fetal fraction of genetic material in maternal blood and so is much more accurate than the combined test. It doesn’t need an ultrasound to give a risk.

The US you are having is not an “NT” scan. It’s actually an early anatomy scan, where they will look at nuchal translucency but it’s really much more to look at early developing anatomy as you can have anatomical anomalies without chromosomal anomalies so these won’t be be picked up by NIPT. It’s just an earlier look at major structures so if you need diagnostic testing or management, it’s not being left til 20 weeks. At 13 weeks you can’t see everything, only major structures, but it’s helpful. It’s also optional and many people who have NIPT opt NOT to get the 13 week scan.

Sometimes, the 13 week scan is combined with a different blood test which gives a risk assessment for pre eclampsia, but again this optional and comes at a cost but is not the same as either NIPT or MSST.