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Pre-pregnancy

Planning for a pregnancy is an exciting time but few people realise how important your overall health is during this time. There is good evidence in relation to the environment that the baby is exposed to whilst growing as a fetus and the life long consequences this environment can have. This means that optimising your health – both physically and mentally, is important to try to achieve before you get pregnant.
This includes :

Diet – healthy, fresh and well rounded. If you are vegetarian try to enhance your iron intake before conceiving

Exercise – try to have some daily exercise as part of your routine. It makes it easier to then maintain it in pregnancy and is good for weight optimisation. Exercise is also good for mental wellbeing

Weight – this is a sensitive and difficult area for all women. However purely from a health aspect if your BMI (body mass index) is in the normal range you are giving the pregnancy the best chance of success and your baby the best start possible.

Smoking– it really is best not to smoke at all – but especially in pregnancy and with a newborn baby. Please see your GP for helpful advice before you conceive if you do smoke

Vitamins – folic acid (0.5 mg) for one month before you get pregnant and then for the first 3 months has been shown to decrease the risk of Spina bififda. If you are at a high risk for this condition (eg. previous affected baby, if you take epilepsy medication, have diabetes or absorption disorders) then you should take 5mg of folic acid instead. Iodine (150 micrograms) should also be taken before and then continued throughout the whole pregnancy.

Prepregnancy review
It is often helpful to book a checkup before you get pregnant. This will allow the above areas to be discussed but also any blood tests that may need to be done eg. Check rubella immunity, Iron if you are at risk of it being low. If you have more specific medical problems then a pre-pregnancy review with Dr Chandler is important. This also allows her to liaise with your other specialists early or coordinate care with other doctors if you don’t have that in place yet. For more information please read information under our ‘gynaecology’ tab or call us on (08) 8364 3642.

Meet and Greet
We recognise that choosing an obstetrician can be daunting- whilst most people rely on word of mouth you might be the first in your circle of friends/family to have a baby and not have that resource. Although you will need a referral (Medicare policy) we are more than happy to make you an appointment for you to come in and see us. You are welcome to come by yourself or with your partner – whichever you prefer.

Staff

Here at Attunga Obstetrics and Gynaecology we want you to feel comfortable from the moment you first make contact with us. Please find below some information on our staff to help you get to know us a little better.

Reception staff 

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When you first make contact with us you will be greeted by one of our friendly reception staff. This includes Eleanor, our practice manager, Anna our accounts manager and Amanda and Natasha our receptionists. If you have any queries about appointments, fees, or need to talk to a midwife the girls on the front desk will be able to help you.

Midwives

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Our midwives, Liz and Catherine work in close collaboration with all of our doctors. In particular our obstetric patients will see the midwife in conjunction with Dr Chandler at every antenatal visit. Our midwives are happy to answer any questions you have, whether they be obstetric or gynaecological in nature.

Philosophy

A note from Dr Chandler..

I feel it is important to share with my obstetric patients my personal philosophy on childbirth and care of pregnant women. 
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I believe obstetrics is called an ‘Art’ for a reason. It is a complicated blend of medicine, midwifery and social health on a background of expectation, hope and a deep seated desire for a certain outcome. Whilst it is true that every woman only wants a positive outcome – healthy mum and healthy baby (and at the end of the day this is the only thing that truly matters) it’s naive to think that Obstetrics is that simple. 
Whilst childbirth is an amazing and exciting journey it can be something that many look upon with fear and dread. There is anxiousness about pain, body trauma, outcomes and recovery just to name a few concerns that women may have. There is also social pressure, expectations of birth plans and everybody’s very helpful advice!! And don’t forget the partner – it’s their baby too! I remember having my own children – it was a ‘we’ process, not just ‘me’.
So why am I saying all of this? Because I believe my role as an obstetrician is to guide the process of nature- observe and watch, fine tune if necessary and step in only if necessary. Intervention for interventions sake is wrong. My role is to  learn about my patient –  what makes her worry and or scared, what she is hoping to achieve, what are her goals? You then build a relationship that lets those fears disappear because,  it’s at this point that you have an excellent birthing experience that not only delivers a good outcome but a true happiness with the process itself. And this process will be different for everybody. Some people may want a very natural vaginal delivery without pain relief whilst others for the own very personal reasons will want an elective caesarean. I believe that my role is to understand the individual woman and to do my very best to help her achieve her desired outcome.
Sometimes you need to be a pure obstetrician; use your skills and truly save a life, while other time you just need to sit back and be in awe and marvel at the wonders of Mother Nature. They are each relatively easy – the trick is to know who needs what.
I have been in private practice now for over 12 years. I love delivering babies just as much now as I did when I started – perhaps even more. The miracle of childbirth never dulls and the sound of hearing a baby cry for the first time is still so magical. It is a privileged position to be in and one that I never take for granted.

Sincerely,

 Karen 

Quick Links

Please find below some quick links that we hope you will find useful. If you can’t find below the information you are searching for, please don’t hesitate to call the office on (08) 8364 3642 for assistance from one of the receptionist or midwifes.

Burnside War Memorial Hospital 

http://burnsidehospital.asn.au/

 

Physiotherapists

Mary Teague 

https://www.facebook.com/maryteaguephysiotherapy/

Alice Adamson 

http://www.adamsonphysio.com.au/

Postnatal visiting service 

Mandy White 

http://maternityservices.com.au/

Food Standards Australia New Zealand

http://foodstandards.gov.au

Cell care

http://cellcare.com.au

Immunisations During Pregnancy

http://sahealth.sa.gov.au/immunisation

 

 

Antenatal tests

Ultrasounds – A dating ultrasound will be performed in the rooms at your first visit to confirm the dates of the pregnancy so please come to your first appointment with a reasonably full bladder. After this, there are generally two further ultrasound scans performed during the pregnancy. The first is often as part of the Downs Syndrome screening test at 11 to 14 weeks. The second is the morphology scan (detailed head to toe examination of the baby) that is performed at 19-20 weeks. Ultrasound scans in later pregnancy are sometimes required in certain situations such as to monitor the growth of the baby (too big or too small), if you have a medical condition (such as diabetes or high blood pressure) or a follow up scan to check placental position.

Blood tests – Routine blood tests are performed at some point in the first trimester. This is to give an idea of your blood count, blood group etc, plus to look at whether you have any infections that can be managed eg. Hepatitis, syphilis.  More blood tests are then routine at 28 weeks – this is a diagnostic diabetes test, repeat blood count and antibody screen. Sometimes iron and vitamin D will be added in. This is generally he only routine blood tests that are done although follow up tests may need to be performed. All blood tests are however tailored to the individual.

Swabs – A low vaginal swab will be performed at 36 weeks if you are planning on a vaginal delivery. This is to check for GBS (Group B Streptococcus), a common bacteria that is present in the female genital tract in up to 15 to 20 per cent of women. Although generally not having an affect on you, the bacteria may have an affect on the baby during a vaginal delivery. To minimise the chances of this happening, antibiotics will be given to you during labour if you swab is positive. An information sheet will be given to you by the midwife at the time the swab is performed.

Down Syndrome Testing – The most important thing to note about these tests is that they are purely optional,  for most people a decision is based around their thoughts/ believes around termination of a pregnancy. It is also important that no matter where you start in the screening process a termination for Trisomy 21 (Down Syndrome) cannot be carried out without having the result of a diagnostic test, either a CVS or amniocentesis.
There are 2 options. The first is the First Trimester Maternal Serum Screening test – this is a blood test (that measures placental hormones) in conjunction with the 12 week ultrasound. Given that the 12 week scan in now considered routine in SA there is no additional cost for this test. This provides you with a ‘risk factor’ assessment  that helps you decide if you need further testing and if so, what sort.
The other option is known as NIPT (non- invasive perinatal testing) – of which the most common one in use is called ‘Harmony’. This is an assessment  of the amount of free dNA from the baby that is present in the mums blood. It has a high level of accuracy, is performed as well as the 12 week ultrasound and costs around $450. This is not reclaimable from either Medicare or your private health fund. The Clinpath website is excellent and worth a look at if you’re considering this option, you can visit it at http://www.sonicgenetics.com.au/nipt/
Please be aware that these tests will be discussed in much more detail at your first visit, this is written to provide you with a brief overview.

Postnatal Visiting Service

Once you have had your baby, your next visit in the rooms is usually scheduled between 6 to 8 weeks post delivery. Although your follow up visit is scheduled around this time, we encourage you to call the rooms on 8364 3642 if you have any queries or concerns. A follow up appointment can be scheduled or sooner than 6 weeks if you or Dr Chandler feel you require a review.

Attunga Obstetrics and Gynaecology is partnered with Blissful Beginnings to offer obstetric patients the opportunity to have a postnatal visit in the comfort of their own home. Mandy, accredited lactation consultant and owner of Blissful Beginnings, has previously worked as a midwife here in the rooms, and is able to work closely with us to ensure you feel supported once you take your baby home. Mandy’s home visit includes:

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  • Baby weighing and advice about feeding
  • Breastfeeding reassurance and help
  • Bottle-feeding information and assistance if needed
  • Settling your baby
  • Wound care
  • Prescriptions for medications if required
  • Liaising with your obstetrician and paediatrician if necessary
  • Referrals to other health providers
  • General help and support for new

For more information please visit http://maternityservices.com.au/ or contact Attunga Obstetrics and Gynaecology on 8364 3642.

Dr Karen Chandler

Born in Adelaide, Dr Karen Chandler graduated from Adelaide Ukcniversity in 1996.  She trained in Adelaide, Darwin and the United Kingdom and became a Fellow of the Royal Australian and New Zealand College of Obstetrics and Gynaecology in 2004.

Dr Chandler is a very keen and enthusiastic obstetrician. She maintains a busy obstetric practice with all aspects of obstetrics included (low and high risk care, pre pregnancy counselling and multiple births are just a few examples). Deliveries are currently booked at Burnside or Ashford Hospital with the exception of preterm babies (before 34 weeks) which are delivered at the Women’s and Children’s Hospital.

On the home front Dr Chandler has three children; Markus, Chloe and Harrison, and is able to run her practice thanks to the full time support of her husband Ben, who is a stay at home dad, thereby giving her the flexibility required to manage her obstetric commitments.

Alongside her commitments to her private obstetric patients Dr Chandler is also the chair person of the perinatal committee, a role she has held since 2010. She is also a member of the Burnside Medical Executive committee and the Clinical Privileges Review Committee.