Gina Fox (FGHG Naturopath) talks with Dr Sushen Naidoo (Obstetrician)
Want some help with deciding which Obstetrician to choose and how to go about getting an appointment?
What qualities do you want in your Obstetrician? What does a good relationship with your Obstetrician look like?
Have a listen to this podcast for a short discussion and get some questions answered before you decide.
Listen to the podcast here: Choosing Your Obstetrician
We are all abuzz at FGHG with news of an exciting new collaboration with Obstetrician & Gynaecologist Dr.Sushen Naidoo, who will be consulting from Fertile Ground Health Group from November 2017.
Whilst we have long collaborated with our patients’ primary medical carers and pride ourselves on being in communication with them whenever needed, working alongside an empathetic obstetrician who we know and trust is going to be an absolute bonus for everyone coming to FGHG.
The opportunity for education and information sharing amongst practitioners at FGHG has always been a contributing factor to our inspired practice and most importantly, better health outcomes for our patients. Now with Sushen practicing from our rooms we bring another dimension to the collaboration.
There is also just the simple convenience of having all your needs met in one location so there is less running around between appointments – phew!
By way of introduction we thought we’d let the charming Dr Sush do his own talking. Here he is talking to us about his practice, his work ethic and his hopes and dreams for patients and the future.
I understand the name Naidoo has some history in the gynaecological/obstetric world?
Yes my dad, Jan Naidoo was an O&G who worked for almost 30 years in Melbourne’s West, so I’ve grown up with maternity and women’s health. He retired recently and I’m actually going to be consulting from his old rooms in Keilor as well, which will be nice.
I decided to call my webpage and practice, “Next Generation Obstetrics Gynaecology and Fertility”, which is a nice allusion to Dad, and also to a more open minded philosophy to health care.
Do you think growing up with a dad who is an obstetrician kind of normalised birth for you in some way?
Yeah I think it did. I remember being dragged to the hospital as a kid, when my dad had to go in for a delivery. So I think I understood even at an early age that my dad did something special.
Other doctors often say you must be mad to do obstetrics after seeing your dad be on call your whole life!
But I think it was only when I starting my training that I realised how amazing the relationship between the Obstetrician and the mother is, and how this is the most rewarding interaction you can have in medicine.
Now that I have become a specialist, my dad and I have a great bond, and he is the first one I call to discuss an interesting case or to discuss my plans for private practice. His reputation in Melbourne was exemplary, so it is very special to follow in his footsteps.
Where have you been working prior to setting up in private practice here in East Melbourne?
I trained at Monash Medical Centre and completed my advanced training in Sydney, with a special interest in Laparoscopic surgery.
I also worked and travelled last year in regional Australia, working as a Consultant in Darwin, Rockhampton and Launceston.
This was an invaluable experience clinically, and gave me an opportunity to explore and have a few adventures before starting in Private. I needed a break after the long period of training, and I really feel that now I have the energy and passion to build a great practice in Melbourne.
This year, I have been covering for some great specialists in the city, and working at the Royal Women’s Hospital and the Northern Hospital, and have begun consulting in North Melbourne and Keilor, in addition to FGHG.
How do you think private practice will be different from working within the public system?
I don’t think my approach will differ greatly, I feel like I’ve been waiting to have “my own” patients all these years in training.
Often in a public clinic you only encounter patients sporadically or by chance. The nature of public work is that you may not see patients again, or have the opportunity to be involved in their birth.
I feel now that I really can’t wait for the continuity of care that comes with private practice. I covered for a colleague for 2 weeks earlier this year, and even within this very short period I was amazed at how rewarding and wonderful the continuity actually was.
In the last few years many of my friends have started their families and I have readily made myself available for advice or opinion on their pregnancy. Often my friends will ask whether it’s a drag discussing pregnancy outside of work. It is never ever a burden, it’s an absolute pleasure to be able to really help people I know and care for.
These are the type of relationships I hope to foster with my own patients. I want to be excited to see my patients at each visit, and for them to look forward to seeing me.
And my hope to be then involved in the care of families long after I meet their babies.
Everyone at Fertile Ground Health Group is pretty excited to have you working with us. It sounds like you are open to collaborating with natural approaches to support women in pregnancy and birth? What do you think the benefits are?
I think I’ve always been open minded and have had the philosophy that as long as there is no risk for the patient, I’m willing to support their choices.
I was introduced to FGHG by my sister Yudhika, who had worked there for many years as a musculoskeletal and massage therapist. She always said that FGHG was an amazing multi disciplinary team, that does amazing things with their patients.
When I met Charmaine and the team, I felt we definitely had the right philosophy, connection and energy to work together. Working in collaboration with FGHG I aim to learn about aspects of complementary medicine that I am ignorant of and hopefully we can develop approaches that provide the best information for me, for FGHG practitioners and most importantly for our shared patients.
To me, the idea of collaboration and learning through an integrative approach to patient care, between complementary fertility practitioners and an Obstetrician is an achievable goal in Women’s health. There are historical barriers to this – there is still that notion of an “ us and them” mentality that perpetuates between complementary and conventional medicine. I think there is a distinct ignorance of what CM practitioners actually do, and I think better communication can help resolve this.
I’m hopeful that our new partnership can highlight these many benefits, so that our patients can get the best of both worlds, and we can show that collaboration is actually what women want.
When you consider the remarkably high rate of women under the care of a complementary medicine practitioner for fertility,( around 45%) it is clear that collaboration and better communication between providers is essential for safer and better health outcomes.
I also have an interest in supporting both women and their partners with perinatal anxiety and depression. Having spent time with the team at FGHG , its clearly evident that pratitioners from each CM speciality have a wealth of experience and insight into helping their patients with anxiety and depression. This is certainly true of our infertile clients, many of whom go on to healthy pregnancies and l still rely on their CM practitioner for psychological support.
In pregnancy, patients are commonly reluctant to take medications, and the management of anxiety and depression can be a challenge. Each CM speciality at can offer a unique potential benefit for a patient’s psychological wellbeing. Hence this is the perfect situation to encourage a holistic and collaborative approach and certainly at FGHG we can embrace this together.
What do you think is the most important element in your relationship with your patients? What do you hope for them? How do you get there?
Trust is the most important element, as most of what I do during the pregnancy is reassure mothers. I feel my strength as a communicator and my temperament ensure meaningful, informative and reassuring consultations. It has always been a pleasure to see anxious and stressed couples leave a consultation feeling more informed and confident.
Every step of the pregnancy journey can be stressful, and this can exacerbated when combined with a lack of understanding or poor communication with your doctor.
My hope for my couples is for them to truly enjoy their pregnancy and to look forward to our consultations together, knowing they can ask me anything, and be reassured when needed and then feel secure and supported, confident under my care. This culminates in us sharing a safe and rewarding birthing experience, where my patient’s choices are well informed and supported.
Every patient you meet is unique. So you have to take an individualised and respectful approach to get them through their birthing experience.
Birth plans don’t always go to script, and this can sometimes be devastating to a woman and her partner.
My job is to use the trust built over the whole journey, to guide and support them through these challenges. And again communication is vital to achieve this.
What are your top recommendations for women during their pregnancy to optimise their health/birth outcomes?
General good health principles are a must. A healthy balanced diet and some exercise is important, as well as good pregnancy vitamins in the first trimester.
I would not be too worried about weight gain. The focus in the antenatal period is on your baby’s growth, not your weight, everyone is different with weight. For some patients with a high BMI it may actually be beneficial to have static weight or even some loss in pregnancy.
I think if your diet is an issue, then certainly input from a Naturopath can certainly be useful.
My biggest tip to new mothers is to be open minded and flexible.
Its great to read, prepare, plan, and have a clear idea of what you want your birth to be like, but the classic cliché for pregnancy and birth is that “ we don’t have a crystal ball”.
Its ok to get an epidural if you need one, even if you were certain you weren’t going to, and its equally ok to not get one, if you’re coping well, even if you were certain you’d need it.
Everyone’s labour is different, and not always predictable, that’s what makes my job so interesting.
I do believe in the power of positive thinking, preparation and having the right mind set for labour and birthing. Thinking about your breathing and being in the right mind set before labour starts can be very helpful for coping with your labour.
There are great resources such as Hypno birthing and Calm birth, and of course the wonderful Rhea Dempsey does classes at FGHG.
I am also a fan of Juju Sundin’s book Birth Skills. As well as Rhea’s birthing book “Birth With Confidence”.
Also I can only see benefits from massage in pregnancy, which I’m going to encourage for all my patients.
What do you wish men knew about birth before they came into the birthing room with their partners?
Another common phone call from friends is from fathers coping with stressed partners. Pregnancy is a time where emotions are commonly labile, due to hormonal changes, past stressors and the nervous energy of experiencing everything for the first time.
Some men just want to reassure and convince their partner that everything is fine and may not be used to seeing their loved one as emotional. Even the most caring and logical reassurance can be unsuccessful.
I tell them that they just need to let their partner go through it: “It’s part of their process”. I advise them to just be there for them without trying to fix anything.
Knowing how to support women through labour and birth can also be a challenge for men, that is certainly part of my job to make sure they know everything is going well, even when things appear very uncontrolled.
There is a good resource for fathers that I’m involved with called “Beer and Bubs”. This is birth education for men, where the class is held at the Pub, over a beer and meal.
I’ve attended a few, and they are great, fun and informative and a great experience for expectant fathers
You Recently premiered your Webpage: www.drsush.com.au It looks great and is a bit different. Tell us about it?
Yeah I was really happy with it, I had been working on it for a while. I wanted it to be modern and stylish, and different, and I think I’ve achieved that.
It has a bright colour scheme to go with the Dr Sush Next Generation branding. It has some awesome images of babies I’ve delivered, (one which some find a little confronting, but others have really liked)
And some original content as well. Dr Sush Healthy Minds is a video channel for patient information and support. I hope to maybe create some videos with FGHG moving forward, that highlight the team’s expertise.
There is also Birth Beats by Dr Sush, with is a collection of specially selected songs for Mothers to possibly include in their birth experience.
The tracks selected had to firstly sound very good, reference baby, birth, parenting in some way. And also convey an emotion, complimenting the Joy of birth, and become a reminder for parents, who could then tell their child “that was the song you were born to…..”
The response to this has been really positive, and it was really fun putting it together for the website page. In fact, just recently a fabulous story from one of my patients about her birth experience with Birth beats was featured on channel 10 news! (See the story).
What can someone come to see you for?
I look after pregnant women and manage their antenatal care and birth. I support natural physiological birth, as its many benefits are well documented. Hence I’m also interested in Vaginal birth after caesarean section and Vaginal twin delivery.
I can see women for a full range of Gynaecology services including pap smears, colposcopy, painful and heavy periods, PCOS and endoscopic surgery, including ovarian cysts , laparoscopic hysterectomy and treatment of endometriosis. I can also assess and work with couples for infertility.
How do they make an appointment with you?
Appointment’s can be made via my team directly on 03 8579 0958 or email hello@drsush.com.au . I am consulting at Fertile Ground Health Group and also at Chelsea House, 55 Flemington Rd North Melbourne and at Complete Children’s Health 769 Old Calder highway Keilor.
And I provide private care at Frances Perry House, Epworth Freemasons, and St Vincent’s Private.
Dr.Sushen Naidoo, Obstetrician & Gynaecologist consulting from Fertile Ground Health Group
Sushen genuinely believes it is a privilege to be involved in a family’s pregnancy and birth. He values his time with his patients and his strength in communication and temperament ensure meaningful, informative and reassuring consultations. It is his aim and pleasure to see anxious and stressed couples leave a consultation feeling more confident. Sushen aims to foster long lasting relationships and hopes to be involved in care of families long after meeting their babies.
We are very excited to share this article written by our Head Naturopath Gina Fox, recently published with Concieve Baby…
Staying Calm During the first 12 Weeks
If you’ve just conceived it’s usually a happy time but may be tinged with feeling anxious about the development of your baby, especially if you’ve taken a while to get here or if you’ve suffered a previous pregnancy loss. Typically the stress and worry builds up before each scan and then a feeling of relief floods through you at the scan; but often this relief is short lived. What you can do to take back control, is to to take steps to change the storyline in your head. You may have noticed that the negative story we tell ourselves seem to stick whether it’s based on anything real or not.
In reality you don’t know the outcome and it’s useless to second guess but the truth is that at this very moment you are pregnant. Developing a trust in your body (which can sometimes be difficult) that it knows what to do and that the hormones are effortlessly doing just what they should to support the growth of your baby. I can hear you saying “that’s all very well but how exactly do I do that”?
How does keeping calm help your baby?
There are plenty of good reasons to support your emotional health during pregnancy and most importantly it’s been shown to be beneficial for the bub. Short term stress is fine and normal and will be helpful for the the baby to be resilient. The problem is ongoing stress during pregnancy – if you’re rushing around, feeling overwhelmed and constantly worrying, or experiencing low or anxious moods then this needs attention.
The stress hormones that course through your blood also cross the placenta and this heightened state of stress can cause change in the baby’s own response to stressors. Worry, anxiety and depression in pregnancy are all risk factors for adverse outcomes including pre-term delivery, lower birth weight, poorer infant development and behavioural and emotional problems in childhood (1). It can have direct effects on early brain development leading to a delay in cognitive function and dysfunctional response to stress (2).
What can I do to help me stay calm?
This is not said to alarm you but to assure you that you can take more control. The benefits of meditation are now so well recognised for our health and wellbeing showing a positive impact on reducing stress and depression, improving our immune system, better sleep, heart health; in fact it supports a better functioning all round. Pregnancy is a natural time of higher stress on the body and it makes sense to support yourself with a regular practice. Not only good in the first trimester but meditation is also a great preparation for labour and improved mood during the pregnancy and less risk of postpartum depression. Allowing some quiet time also gives space for you to connect with your baby as well as feeling more energised and able to cope with everyday challenges.
You may not be able to change the stressful events in your life but you can change your emotional response to them and the effect they have on your own and your baby’s health. Put aside some time for yourself each day to release tension and relax your body and you’ll both be glad you did.
To help women connect with and trust the process of the pregnancy happening within their body Be Fertile have created guided relaxations especially for this often tricky and worrisome first trimester. These mindfulness meditations guide you with words which is often easier than meditating in silence when you have a busy mind. The very act of a daily relaxation activity gives a cumulative benefit – it helps your peace of mind and it helps your baby too.
You can also watch Gina’s Webinar on Stress and Fertility and register for the Webinar Series.
by Rachel Steward, Acupuncturist
After working with women undergoing fertility treatment for over fifteen years I thought I was well aware of how stressful it can be. Every day I talk about, and treat, stress with my patients. However, I recently came across some research which shocked me:
A group of women undergoing IVF who took part in a behavioural study reported similar psychological stress to people with cancer (1).
Let that sink in for a moment.
What would the similarities be?
Research shows that the stress of IVF falls into three broad categories – social, financial and emotional.
Social stresses include stigmatisation, decreased self-esteem and unmet reproductive potential. Women also report low levels of support because of a lack of understanding about what IVF entails (2).
The financial stress of fertility treatment is always there and often limits how much treatment people are able to seek – or – curtails other goals. Unfortunately it has also been shown to reduce positive outcomes (3).
Perhaps the emotional stress is the worst though – one patient of mine described the two week wait, from her embryo transfer until her blood test, as “terrifying”. Others talk about the lack of control and the sense of failure. One research study found the emotional impact of IVF “more strenuous” than the physical impact (4) and in many cases, stress is enough to discontinue treatment. In a survey of the reasons people stop IVF 35% cited emotional reasons (5).
What can be done to address this?
Acupuncture is a therapy that can give immediate relief. Every day patients emerge from their sessions feeling noticeably better than when they came in. Many people say that their weekly treatment is a time when they can relax and recharge – a circuit breaker to the stress cycle. The beauty of acupuncture is that each treatment is individually tailored and a single treatment can include points to optimise the response to IVF (and other fertility) treatment, address any symptoms that may be present such as insomnia or digestive issues and, importantly, relax the nervous system.
A 2011 study conducted in Australia found that:
“Women described the experience and impact of acupuncture as positive relating to a sense of relaxation and time out, the engagement with the practitioner and an intervention that had very few negative side-effects. Changes were also perceived after treatment with women describing a physical and psychological sense of relaxation and calmness and a changed perspective in relation to coping” (6).
But what if physical therapy isn’t enough?
What then? What if your partner is sick of talking about it or struggling to cope themselves? Where do you turn? Many patients talk about not wanting to “burden” friends and family – or they do talk about their struggles but feel time-limited doing so.
One of our directors, naturopath, Charmaine Dennis, is pioneering a support group for a small number of women to come together and share in a supported setting. The group will meet once a week for four weeks for a two-hour period. The total cost is $120.
The focus of the group is to provide a space for women to connect with themselves and each other – and the hope is that, in sharing stories and similar experiences, women will realise they are not alone and hopefully find some meaning in their journeys. Being heard by other people who genuinely understand what you are going through can be very therapeutic.
Charmaine will also teach some really practical self-care strategies and relaxation practices. Her aim is to break through the isolation and loneliness that can come with infertility and the IVF experience.
If you have been trying to conceive for over a year, either naturally or with IVF (or other fertility treatment), and need some more support you can email Charmaine to find out more or register for the group at charmaine@fertileground.com.au
You can also download and listen to the beautiful guided relaxation tracks Charmaine has produced along with our naturopath Gina Fox for people trying to conceive naturally or with IVF. We use these tracks with headphones during acupuncture treatments and hear so much positive feedback about them. Ideally you can listen to them every day for extra support and to continue the benefits of your acupuncture treatment at home. You’ll find more information about these meditations here.
Support matters – and many people are missing out on this vital element of their treatment. If a small group is not for you talk to your practitioner about what extra support could assist you.
by Rachel Steward, Acupuncturist
Rachel Steward brings 15 years of clinical experience to FGHG and practices Japanese Acupuncture – a very gentle, yet effective form of treatment. Rachel has studied in Japan under senior teachers of Toyohari to further her studies in this area. Also qualified in Western Herbal Medicine she is passionate about integrating Western and Eastern approaches to treatment.
Rachel has a wealth of experience in working with couples experiencing fertility problems and/or undergoing IVF, pregnancy, birth, breastfeeding and beyond. She also enjoys treating a wide range of more general health issues which can impact on fertility such as adrenal exhaustion, anxiety and depression, sleep disorders, structural problems, digestive weakness and immune issues – and draws from a wide treatment repertoire to do so. Rachel loves treating babies and children and finds Japanese acupuncture particularly suited to them. She has worked successfully with “older” women/couples, same- sex couples and couples utilising donor tissues.
References:
1.Skiadas CC, Terry K, Pari MD, Geoghegan A, Lubetsky L, Levy S, et al. Does emotional support during the luteal phase decrease the stress of in vitro fertilisation? Fertility and Sterility, 2011; 96 (6):1467-72.
2. Chang R, Chung PH, Rozenwaks Z. Role of acupuncture in the treatment of female infertility. Fertility and Sterility, 2002: 78(6):1149-53;
AND Lyttleton, J. Treatment of Fertility with Chinese Medicine. China: Churchill Livingstone; 2004.
3. Klonoff-Cohen H, Natarajan, L. The conerns during assisted reproductive technologies (CART) scale and pregnancy outcomes. Fertility and Sterility, 2004:81(4):982-8.
4. Bouwmans CAM, Linsten BAME, Al M, Verhaak CM, Eijkemans RJC, Habbema JDF, et al. Absence from work and emotional stress in women undergoing IVF or ICSI: An analysis of IVF-related absence from work in women and the contribution of general and emotional factors. Acta Obstet Gynecol. Scand. 2008;87(11):1169-75.
5. Verhaak CM, Smeenk JMJ, Evers AWM, Kremer JAM, Kraaimaar FW, Braat DDM. Women’s emotional adjustment to IVF: a systematic review of 25 years of research. Hum Reprod. Update January/February 2007;13(1):27-36.
6. Caroline A. Smith, PhD et al. The Effect of Acupuncture on Psychosocial Outcomes for Women Experiencing Infertility: A Pilot Randomized Controlled Trial, The journal of alternative and complementary medicine, Volume 17, Number 10, 2011, pp. 923–930.
