Obstetrician / Obstetrics

Pregnancy and birthing a baby is a normal life event – albeit an important one. A journey of renewal and should be the most enjoyable period in your and family’s life. However, about 30% of pregnancies and deliveries will have a complication that only occasionally can be life threatening. That is where and when a specialist is needed. I am privileged for your choosing me to care and share with you this important part of your life and journey.

I have outlined below my responsibilities in your care. A folder with handheld records, booklets and pamphlets will be given to you during your first visit. The handouts will explain important aspects of pregnancy and care. Please note down any questions you may have that are not covered in these pamphlets and ask me when you are next in clinic or email me at your convenience.

Remember, I am only a phone call away. I (or a nominated specialist) am available 24 hours a day, 365 days a year to attend to your urgent queries or problems. Prioritisation of care is important so that women with a more urgent problem are attended to first.

My responsibilities to you are:

Pregnancy Care

  • Assess your risk profile early in pregnancy and to discuss with you an individualised care plan.
  • The usual schedule of visits is every 4 weeks until 28 weeks, fortnightly until 36 weeks, then weekly until delivery. This schedule may change depending on risks identified or developed during the pregnancy.
  • Provide relevant information or sources of information you may require or need.
  • Order and check your laboratory test results.
  • Provide specialist availability 24 hours a day to answer any questions you may have and to attend to relevant problems during your pregnancy, labour and for the first four weeks after delivery;
  • Refer you to other services (eg. subspecialty, support services) should you need these.

Labour and Delivery

  • Examine you at least once in labour and provide specialist support to the attending midwife.
  • Deliver your baby.

Postnatal Care

  • See you at least once in the postnatal period before discharge making sure all is well.
  • Provide specialist support to the postnatal midwife and a 4 week postnatal check.

Your responsibilities are:

  • Provide all necessary past medical/obstetrical history and risk factors
  • Regular attendance of antenatal visits
  • Report any concerns or major problems
(for example, vaginal bleeding, leaking water, abdominal pain, fever, etc).
  • Read widely and be well informed. Ask questions
Limit if not stop any lifestyle habits that may harm your baby or cause complications in the pregnancy
(for example, smoking, alcohol, drugs, etc)
  • Heed medical advise

Important things to remember during pregnancy

In the first 12 weeks (3 months) of pregnancy

  • booking tests – blood tests, vaginal swabs, smear (if needed)
  • dating and nuchal translucency scan, biochemical screening, HIV test
  • sign LMC form
  • folic acid and Iodine supplementation
  • pamphlets & reading material
  • advise re: smoking, alcohol, sex, work

From 13 to 28 weeks of pregnancy

  • scan at 18-20 weeks for anatomy
  • booking forms for your hospital of choice
  • information on antenatal classes
  • diabetes exclusion and blood tests at 28 weeks
  • iron supplementation (if needed)

From 29 weeks to labour

  • attend antenatal classes
  • discussion of birth plan
  • blood tests at 36 weeks
  • tour of hospital (if needed)
  • a midwife for labour and postnatal care is arranged

There are two main aims of care in labour and delivery:

  • Safety – to deliver a healthy baby without undue trauma to baby and yourself
  • Satisfaction – to ensure, without compromising safety, an enjoyable childbirth experience

It is important to remember that 30% of low risk women become high risk in labour. Therefore, a birth plan may have to be changed where and when a complication or emergency arises. The Care Plan may also change if a test result returns abnormal.

I deliver at Middlemore Hospital only. I provide postnatal care in hospital and transfer to Birthcare Hospital or any of the Counties Manukau DHB Community Hospitals (eg Papakura, Botany, Pukekohe) can be arranged. Postnatal visits in the community hospitals and home will be the responsibility of the postnatal midwife.

Feedback and Satisfaction

However, despite best efforts and care, I am sure I will not make everyone absolutely happy and everything may not be absolutely perfect. Therefore, I appreciate your feedback about my service and I am happy to listen to any concerns you may have. A patient satisfaction questionnaire is given to you at the 4 week visit to return completed at 6 weeks. Your feedback will not in any way, affect your statutory rights.


To enable me to fulfil my responsibilities to you and your care, we have a partnership in care. This partnership means that you also have certain responsibilities that you will need to fulfil so that your pregnancy remains well.


Evidence

Most of the evidence in pregnancy care comes from widely accepted professional guidelines and statements. These are also contained in the patient information pamphlets in the information section.

Obstetrician Costs/Fees

  • The fee is $3500.00 for antenatal care and delivery at Middlemore Hospital.
  • A fee of $2200 is charged for Dr Ekeroma to perform a caesarean section delivery if the woman remains under the care of a midwife LMC.
  • The full fee should be paid by 36 weeks gestation. $1750 is payable by 28 weeks gestation for the antenatal care and $1750 by 36 weeks for the delivery. All fees are inclusive of GST. Non-payment may result in the withdrawal of services. Discounts are considered for my previous patients, health staff and on request.
  • My return patients get a discount of $700.
  • Consultation fee for one-off visits in pregnancy is $250 including GST.

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