Let me first begin with a caveat that this post is solely based on the observations of my gynaecologist colleagues, and my own pregnancy/birthing experiences as a mummy of 3. The timespan of this was over 17 years, during the time I was first practising as a junior doctor, then as a gynaecologist consultant in Singapore.
At least 30 colleagues of mine have had babies over this time period, and for some, certainly more than once or twice.
1. Who did we choose to deliver our babies?
The truth is, many of us were “unbooked” and undecided as to who would actually perform the delivery.
We'd arrange the early dating scans and first trimester screening tests on our own, and then hold off seeing any regular gynae until much later during the pregnancy (if uncomplicated) - this was often in the last month!
The caveat is that all of us were naturally very aware if there were any concerns in the pregnancy.
2. What do our birth plans look like?
Once again, sorry to disappoint, but hardly anyone of us had a birth plan. In fact, I think no one did.
This was probably because we were familiar with how things worked, and we also knew what to say yes or no to.
Like we often joke between ourselves, everyone knows about the birth plan, but no one tells the baby about it! Gynaes best appreciate that the outcome of labour is not always completely within our control.
3. Early dating scans are popular at 6 - 8 weeks
ALL gynaes have an early dating scan in the first trimester around 6 to 8 weeks of pregnancy. This is important to “date” the pregnancy. Also, it helps:
- Determine the period of gestation
- Confirm the viability of the pregnancy (whether the baby has a heartbeat or not)
- Confirm the expected due date (EDD)
4. Ditto the 1st trimester screening test at 12 weeks
Virtually ALL gynaes have the 1st trimester screening test done. This is a screening test done at around 12 weeks of pregnancy to assess for the risks of Down syndrome (trisomy 21), trisomy 13 and 18.
This test also incorporates an early fetal anatomy scan to check the nuchal translucency (fluid at the back of baby's neck), and any gross fetal abnormalities which can sometimes be picked up at this gestation.
5. How often do gynaes have follow-up appointments?
Apart from all the major scans, gynaes have very irregular follow-ups!
In practice, this basically meant that we'd get various available colleagues to scan us at irregular intervals eg. when the consult rooms are free, or after dinner while on-call in the delivery suite.
6. Because a lot of us have babies in our 30s, this DNA blood test is also on the to-do list
The Non-Invasive Prenatal Test (NIPT) picks up the presence of cell free fetal DNA in the mum’s bloodstream, which can pinpoints baby’s risk for a number of genetic disorders, including Down syndrome.
As most gynae mummies are usually in their mid-to-late thirties, a very high percentage would do this test as an adjunct to the first trimester test.
The NIPT can be performed any time after 9 weeks into your pregnancy — earlier than any other prenatal screening or diagnostic test. It is also highly sensitive (97 - 99% accuracy according to a recent study).
7. And detailed fetal anatomy scans are a must at 19 - 20 weeks
ALL gynaes would have the detailed fetal anatomy scan done around 19 - 20 weeks of gestation to check for obvious fetal abnormalities.
About one in every 50 babies (2%) is born with a major structural abnormality. The ultrasound scan can detect about 80% of structural abnormalities. These include:
- Anencephaly (absence of the skull bone)
- Hydrocephalus (excessive fluid in the brain)
- Achondroplasia (dwarf)
- Spina bifida (defect in the spine formation)
- Cleft palate (defect in the lips)
- Heart defects (such as “hole in the heart”)
8. The 28-week mark is a time for celebration
All of us were very happy when we hit the 28 week mark - it's a hospital requirement to do calls until 28 weeks of pregnancy, if uncomplicated.
Calls meant we had to work through the day and night, and go home at 5 pm the next day. Overnight calls were a requirement for completion of specialty training.
Consequently, most gynae mums remained fairly physically fit throughout pregnancy. Hardly anyone put on excessive weight, and none were obese.
Like you'd expect, this resulted in quite a bit of fatigue and grumbling, but it was something that we all had to bear. The upside of being on our feet so much was that it resulted in smoother deliveries for most.
9. Which hospital do we deliver at?
Some chose to deliver in their place of practice, and a good number chose to deliver elsewhere for privacy reasons!
You'd probably appreciate why we wouldn't want to have colleagues do a vaginal exam on us while on call … :)
10. C-section or vaginal birth?
The vast majority of us chose to have vaginal deliveries.
11. Yes, we could do without the labour pain too
Nearly everyone opted for their epidurals, except for the few who didn't manage to get it in time.
12. We like our babies to arrive fairly on time
Few gynaes would go significantly postdates (deliver baby way past the due date) mainly for concern of stillbirth. This is something which we saw fairly commonly in our practice at work. The incidence of stillbirth or infant death is increased in pregnancies that continue beyond 42 weeks.
Quite a few of us were also not keen to have the pregnancy carry on longer than necessary - we'd get a collegue to do a membrane sweep for us!
13. Breast is best!
Many of us breastfed, and a good number continued to express milk after returning to work.
Exclusive pumping and minimal latching was popular - gynaes liked to be able to quantify milk consumption by the infants. Pumping was also much more manageable for full-time working mums who had to do night calls. They'd hole themselves up in the call rooms to pump!
I hope you found this post enlightening! Note that this is just an "observational study" - I don't claim to make any conclusions as to the ideal manner of antenatal care or delivery that my fellow gynaes have chosen!
This also does not include how the wives of MALE gynaes had their babies. That’s a whole different story! :)
Dr Jasmine Mohd practices as a obstetrician and gynaecologist at WC Cheng & Associates. She holds a joint appointment as Adjunct Assistant Professor at NUS. Dr Jasmine remains dedicated to surgical teaching of residents in her role as Visiting Consultant to the Department of Minimally Invasive Surgery in KKH.