Obstetric and maternity care is the field of medicine and healthcare dedicated to the management of pregnancy and includes:

• Pre-pregnancy counselling and planning;

• Antenatal care and support;

• Delivery management;

• Postnatal care and support.

​

Falling pregnant for some couples is extraordinarily straight forward, whilst for others it represents the end of a long, often challenging journey involving a whole array of medical interventions and investigations.  In all cases, the hope is to deliver a healthy baby (or babies) and to do so in the best of possible health.  For most women that is exactly what happens,  For others, however, numerous potential challenges can arise during the course of their pregnancy that require the involvement of an obstetrician to ensure they and their baby are delivered safely.  

​

Even in "normal risk" pregnancies the unexpected can occur.  By way of example, the latest Australian national birth data (Australian Institute of Health and Welfare) from 2019 reveals the following statistics:

• 16% of first time mothers, presenting in spontaneous labour after 37 weeks (ie term) were delivered by caesarean section (common reasons will include acute foetal distress and obstructed labours);

• 2.5% of women having their second or subsequent baby, also presenting in spontaneous labour at term, were delivered by caesarean section;

• 26% of first time mothers had an instrumental, or assisted, vaginal delivery (data on mothers having their second or subsequent baby was not published but can reasonably be estimated to be between 1-5%).

​

The above is an indication of some of the challenges that can arise during delivery and does not capture additional medical challenges that can arise during a pregnancy such as:​

• blood pressure disorders (around 4%);

• diabetes (11%);

• foetal growth concerns (5-10% of babies in the third trimester develop concerns of growth restriction).

​​

These concerns are by no means an exhaustive list of potential complications in pregnancy but do serve to illustrate the important role that an obstetrician plays in monitoring and safely delivering a pregnancy.  Further, a number of risk factors and early interventions to improve risk are now identifiable with appropriate screening in the first trimester.  Unfortunately, a number of women miss out on early screening and risk modification opportunities simply due to delay in involving a maternity care provider early in the pregnancy (a common example is missed counselling around the role of low dose aspirin for women determined to be at increased risk of foetal growth restriction or hypertensive disorders in pregnancy).

​

Of course, pregnancy management is not all about risk.  The experience and journey of pregnancy is a unique and wonderful experience for many women.  Optimising that experience through support, education, advice and empathy are critical components of good maternity care.

​

Dr Holland believes in adopting a holistic approach to pregnancy management and prides himself on taking the time, over the course of a pregnancy, to ensure that women and their partners feel listened to and informed at all steps along the way.  A variety of additional services are often suggested to complement the care that is provided through our rooms including:

• Women's health physiotherapy - in particular, sub-specialty physiotherapists who have engaged in the additional training to properly understand and assist with the physical challenges of pregnancy including valuable strategies to assist with the labour process;

• The Know My Midwife program at Pindara Private Hospital - this is a valuable, cost free initiative of Pindara Private Hospital providing the insights and benefits of midwifery continuity of care in tandem with the expert care and support that Dr Holland provides.

​​

Finally, it is important to remember that this is your pregnancy and your journey.

​