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Dr John delivers babies at Mitcham Private Hospital, Waverley Private Hospital & Knox Private Hospital

Striving To Cover All Your Pregnancy Care and Gynaecology Medical Needs

Is a surgical procedure to deliver a baby or multiple babies. There are a few reasons why a caesarean section would be performed:

  • A mother and baby are at risk during a natural delivery
  • The baby is in a breech position {the baby is positioned with its bottom first instead of its head)
  • If the baby is in a transverse position {lying sideways)
  • The placenta is partially or completely covering the cervix
  • There might problems with the umbilical cord
  • If the mother has gestational diabetes in some cases

A caesarean can take up to 1 hour for the procedure to be carried out. There are different types of anaesthetics used for this procedure; epidural, spinal block or a general anaesthetic.

The recovery period from a caesarean is around 6 weeks.

 

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During a natural birth a perineal tear can occur. This is when the baby’s head passes through the vaginal opening and the perineum is strained. There are different degrees of severity but the majority of tears are superficial and will heal in time. This tear is a laceration of the skin and other soft tissue structures which in women, separate the vagina from the anus.

An episiotomy is usually performed during the second stage of labour if the vaginal opening is not wide enough for the baby’s head to pass through. It is a surgical incision of the perineum and the posterior vaginal wall. The incision is repaired with sutures after the delivery.

 

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Dr John is a skilled, experienced, and professional medical doctor with almost 33 years of medical practice in Australia, New Zealand, and abroad, taking care of women’s health before, during and after pregnancy.

As an obstetrician-gynecologist, Dr John has dedicated his professional life to making sure his patients receive the best possible attention pertaining to her reproductive system’s health as well as pre and postnatal care, including pregnancy and delivery.

Dr John received his medical degree in 1986 in Singapore and his master’s degree in 1992. He is a proud member of the Royal College of Obstetricians and Gynecologists since 1993 and has a fellowship from the Royal Australian and New Zealand College of Obstetricians and Gynecologists since 2003.

Dr John works in several hospitals and institutions, among them Knox Private Hospital, Mitcham Private Hospital, Angliss Hospital, Box Hill Hospital, and Yarra Ranges Health.

He also has a very successful practice at Waverley Private Hospital, an independent institute delivering health care and services to eastern and southeastern communities in Melbourne for the last 47 years.

Waverley Private Hospital has 98 beds all in private rooms, including the maternity section, with its own ensuites, attended by a professional staff focused on providing a high-quality stay when you need it most; as well as 7 operating theatres equipped with the latest technological and medical advances.

Waverley Private Hospital is an Australian Council on Healthcare Standards’ fully accredited hospital which ensures the highest standards of health services, safety and comfort, supervised continuously by competent and committed medical personnel. Waverley Hospital is even aware of the critical environmental issue that concerns us all and works diligently to look for ways to operate according to sustainable ecological development.

Dr John is one of the specialized staffs working at Waverley Private Hospital. At this prestigious and modern Hospital, Dr John offers his vast experience in medical procedures oriented to women, their reproductive system, pregnancy and delivery. Dr John is fully proficient performing deliveries, cesarean sections, hysterectomies, endometriosis, the latest laparoscopic gynecologic techniques, among several other procedures and surgeries.

Dr John and Waverley Private Hospital are a powerful combination of knowledge, professional skill, technical resources, state of the art equipment and a high standard health environment that guarantees the best possible care in everything relevant to gynecology and obstetrics.

If you experience bleeding during the first trimester is quite common and is not necessarily a threatened miscarriage.  Bleeding can appear in various forms e.g. spotting or blood clots. You should inform your GP or Obstetrician.  However, if you are over 20 weeks pregnant you should seek medical advice immediately and do not use tampons only wear pads.

There are a few reasons for bleeding:

Anaemia is when your blood doesn’t produce enough red blood cells to carry oxygen to your tissues and to your baby.

During pregnancy, your body produces more blood to support the growth of your baby. If you are not getting enough iron and other nutrients your body will not be able to produce the amount of red blood cells needed to generate the additional blood required.

Anaemia can make you feel very tired and weak. You will need to be treated for this condition.

 

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This is a blood test done for pregnant women who would like to know about their risk of having a baby with Down Syndrome.

 

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Gestational diabetes usually occurs in pregnant women around 24 to 28 weeks of gestation. This is diagnosed when the blood glucose levels appear higher than normal. A pregnant woman may not have any symptoms of gestational diabetes. Some pregnant women may need to be put onto a strict diet or exercise or in some cases insulin may be required.

 

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Depending on your medical circumstances, if you have previously delivered a baby by caesarean section you may have a choice to have a vaginal birth with your next pregnancy.

VBAC is pretty much the same as any other vaginal birth, with one big exception. When you go into labour, midwives and doctors will monitor you very closely – more closely than if you hadn’t had a previous caesarean.

Some benefits of vaginal births – including VBACs – are:

  • a lower risk of some complications such as infections
  • a shorter recovery time and hospital stay
  • a higher likelihood that you can feed and cuddle your baby straight after birth
  • a lower risk of complications during future pregnancies

About 80% of women who start a VBAC will have a vaginal birth.

 

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Nausea and vomiting is common during pregnancy and usually occurs between 5 to 18 weeks of pregnancy. However, it can be worse around 9 weeks of pregnancy. It is often known as “morning sickness” which is a mild form of these symptoms.

The symptoms will generally improve in the second trimester of pregnancy. Although some symptoms may continue into the third trimester and there may be different levels of severity.

 

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Many women expecting twins have a vaginal delivery, however, twins are usually born

twin-pregnancy

earlier. It is recommended that you have an epidural.

If the first twin is presented in the “head down position”, it is likely you will be able to have a vaginal birth.

Once you have given birth to your first baby. The doctor will check the position of the second baby and if the baby is presented in a good position, the doctor will start the process to delivery your second baby.

Abnormal period symptoms are usually signs that your reproductive system is not doing business as usual. Heavy and Painful periods should not be ignored.

A very heavy or painful period can be a sign of uterine fibroids, thyroid or hormonal disorders, pelvic inflammatory disease, or sometimes, even cancer so getting checked out by a doctor is important.

 

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There are many different types of contraception and it can be very confusing trying to work out which is the best type for you. Your doctor is the best person to discuss this with.

There are 9 types of contraception available

The pill – the combined pill and progestogen only pill (mini pill) both taken orally daily.

IUD – Mirena  This is a very effective long term small contraceptive device that is placed in the uterus. It works by effecting the sperm movement and survival in the uterus so it cannot reach the egg to fertilise it. The IUD also changes the lining of the womb so it is not suitable for pregnancy.

Sterilisation – both men and women can have an operation to make them sterile. The procedure for women involves blocking the fallopian tubes. The male procedure is called a vasectomy. Both procedures are more than 99 percent effective and are permanent.

Condoms

Diaphragm – a soft silicon cap worn inside the vagina

Contraceptive skin implant

Contraceptive injection

Emergency pill (morning after pill)

Vaginal ring

 

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There are several definitions of infertility. The general understanding of the word is that despite regular sexual intercourse, without any form of contraception, a couple are unable to conceive a baby. The time period quoted will vary depending upon where you are getting your information.

If you are under 35 years and both healthy, the majority of couples will successfully become pregnant in less than 2 years. The National Institute for Health and Clinical Excellence (NICE) in the UK defines infertility as – 

‘failure to conceive a pregnancy after regular unprotected sexual intercourse for two years in the absence of known reproductive pathology’. 

Other sources, however, do define infertility as the inability to become pregnant after 1 year. 

If a couple believe they are having problems conceiving a baby they should seek support and advice at any time.

Causes of Infertility

There are many different causes of infertility – and in fact there are so many possible factors that can go wrong from the moment of sexual intercourse to the next menstrual period being due, that it can seem a miracle that anyone does get pregnant!

In 35% of cases of infertility a cause will be found with the woman; in 35% of cases a cause will be found with the man; in approximately 20% of couples there may be a problem found in the man and the woman and in the remaining 10% of cases no problem will be found and yet infertility persists.

What are the causes of female infertility?

Endometriosis

This is a common cause of infertility among women. The endometrium is the medical term for the lining that grows inside the womb and is shed every month during menstrual periods.
This endometrial tissue can grow outside the womb and this is known as endometriosis, which sometimes causes:

  • possible infertility by damaging the ovaries or fallopian tubes
  • heavy painful periods
  • irregular bleeding
  • repeated miscarriages.

Ovulation problems

Various conditions can affect the production and release of an egg form the woman’s ovaries during the menstrual cycle. Symptoms that could alert the possibility of this include:

  • Absent or irregular periods
  • Light bleeding
  • Excessively heavy bleeding (needing to change pads or tampons more frequently than every 2-3 hours).

The egg itself

The egg the woman produces may be poor quality and there are no symptoms that would alert the couple to this possibility.

If the egg is damaged or has a chromosomal abnormality it may not result in a pregnancy. This is more common as the woman gets older (over 35).

Polycystic ovary syndrome

As a result of small cysts on the ovaries, there is an imbalance of the female hormones and the woman does not ovulate regularly. Symptoms of this condition include:

  • Irregular periods
  • Acne
  • Being overweight
  • Unusual hair growth on the face, for example.

Blocked tubes in the female reproductive system

A successful pregnancy depends upon the sperm being able to reach the egg and the fertilised egg reaching the womb, to implant safely in the wall of the womb. If there are blockages in the fallopian tubes, the chances of a successful pregnancy will be greatly impeded. Common causes are: 

  • pelvic inflammatory disease
  • sexually transmitted infections, such as chlamydia
  • infection from a previous birth
  • blockages from previous surgery (following ectopic pregnancy or sterilisation procedures).

Usually the woman would not be aware of blocked fallopian tubes.

What are the causes of male infertility?

Blocked tubes in the male reproductive system

Sperm is made in the testicles and moves along the vas deferens to the urethra during ejaculation. If there is a blockage in the epididymis in the testicles or the vas deferens then sperm will not be able to leave the penis during sexual intercourse. Obstruction may occur due to sexually transmitted infections, or varicose veins in the testicles, known as varicoceles. Blocked tubes do not have any symptoms, so you won’t be aware that this is the case until tests are done.

Problems with spermatozoa – or sperm:

  • Sperm may be absent
  • Sperm may be reduced – there is an amazingly large number of sperm in each ejaculate, with the World Health Organisation (WHO) recommending that a normal ejaculate contains at least 40 million spermatozoa!
  • Sperm may not move well – known as poor motility (50% of sperm should be moving forwards)
  • Sperm may be abnormally shaped

There are no symptoms with sperm problems, so you won’t be aware that this is the case until tests are done. 

Allergy to sperm

Men may have an immune reaction to sperm cells – producing antibodies which kill the sperm. This is more common after a vasectomy.

There is controversy surrounding these diagnoses.

Combination Infertility

In approximately 10-20% of couples both partners have a problem which is contributing to infertility. This term is also used if the man or woman has more than one problem.

Unexplained infertility (UI)
Many couples (approximately 10%) endure endless fertility tests, but no problem is ever found with either partner.  It is possible that factors such as:

  • being under weight
  • being overweight
  • environmental factors, such as exposure to leads or pesticides

– may contribute to this.

There are other causes of infertility in men and women, only the common causes are outlined in this article. If you would like to speak with a doctor regarding your own individual circumstances, Dr John is available for an infertility consultation at either Mitcham or Waverly Private Hospital.

pap smear test is a simple procedure that looks for abnormal cell changes in the cervix. It can detect abnormal cells and pre-cancerous cells. This means the cells can be removed before they have a chance to develop into cervical cancer.

If the results of your pap smear come back positive it means your doctor has found abnormal or unusual cells on your cervix. It does not necessarily mean you have cervical cancer. More than often, a positive result means there have been cell changes caused by the human papilloma virus (HPV).

HPV is a sexually transmitted infection. Sometimes the changed cells are due to other types of infection, such as those caused by bacteria or yeast.

 

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Ovarian cysts are fluid-filled sacs on one or both ovaries that usually form during ovulation. Most ovarian cysts don’t cause symptoms. In some cases, menstrual irregularities, pain during intercourse or irregular bowel movements can occur. Ovarian cysts usually disappear in a few months but if they do not go away they can be treated with contraceptive pills or surgery.

Symptoms of fibroids, polyps and cysts vary, but these structural abnormalities can all contribute to pelvic pain, abnormal uterine bleeding and other complications including infertility

Uterine fibroids are benign tumours that originate in the uterus (womb). In most cases, fibroids do not cause pain or other symptoms. Gynaecological surgery to remove the entire uterus (Hysterectomy) is the most common and complete fibroid treatment as it prevents any risk of recurrence.

 

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Family planning may involve consideration of the number of children a woman wishes to have, including the choice to have no children, as well as the age at which she wishes to have them.

These matters are influenced by external factors such as marital situation, career considerations, financial position, any disabilities that may affect their ability to have children and raise them, and many other considerations.family-planning-melbourne

If sexually active, it may involve the use of contraception and other techniques to control the timing of reproduction. Other techniques commonly used include sex education, prevention and management of sexually transmitted diseases, pre-conception counselling and management, and infertility management.

 

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A Colposcopy is a simple procedure using a large magnifying instrument called a colposcope. It allows your doctor to get a good look at your cervix and usually takes up to 10 to 15 minutes to perform. It is like getting pap smear. You usually get a colposcopy if you had some sort of abnormal results on your Pap smear test so your doctor can further diagnose any problems.

If your doctor believes there might be something not quite right with your cervix, they might recommend a colposcopy. Some of these reasons may be abnormal pap smear results, abnormal looking cervix during pelvic exam, tests that show you have HPV or unexplained bleeding or other issues.

Your doctor can use a colposcope to diagnose cervical cancergenital warts, vaginal cancer, and vulvar cancer, as well. Once your doctor gets the results from your colposcopy, he’ll know whether or not you need further tests.

A cervical biopsy is a procedure to remove tissue from the cervix to test abnormal or precancerous conditions, or cervical cancer. The cervix is the lower, narrow part of the uterus. It forms a canal that opens into the vagina. Cervical biopsies can be done in several ways.

  • Punch biopsy: In this method, small pieces of tissue are taken from the cervix with an instrument called “biopsy forceps.” Your cervix might be stained with a dye to make it easier for your doctor to see any abnormalities.
  • Cone biopsy: This surgery uses a scalpel or laser to remove large, cone-shaped pieces of tissue from the cervix.
  • Endocervical curettage (ECC): During this procedure, cells are removed from the endocervical canal (the area between the uterus and vagina). This is done with a hand-held instrument called a “curette.”

 

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Novasure Endometrial Ablation is a fast procedure designed to remove just the uterine lining, which is called the endometrium (the part of the body that causes heavy bleeding)

Some of the benefits include less heavy menstrual bleeding, improved energy levels, better moods and a reduction in painful periods and premenstrual symptoms, such as irritability.

It’s mainly for premenopausal women with heavy periods due to benign causes who are done with having children. Some of the risks include thermal injury, perforation and infection.

Temporary side effects may include cramping, nausea, vomiting, discharge and spotting.

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It is possible for the scan to show up a small blood clot around the pregnancy sac (called a Subchorionic haematoma), which identifies the source of the bleeding.

What are the ongoing effects?

A subchorionic haematoma can continue to bleed intermittently during the first trimester and usually does not cause a miscarriage.   They often disappear by the second trimester. In most cases, the bleeding will settle after a few days.  However if the scan showed a subchorionic haematoma, there may continue to be bleeding on and off until around the second trimester.  It is also possible for bleeding to increase after going to the toilet.  This is simply due to the blood in the vagina from lying down that comes out as a result of gravity.   The bleeding may also increase as a result of coughing/vomiting, exercise and heavy lifting, so do not be alarmed should this occur.

Still unsure?

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MANAGEMENT OF ENDOMETRIOSIS

Endometriosis is a condition resulting from the appearance of endometrial tissue outside the uterus and causing pelvic pain, especially associated with menstruation. The most common symptoms are pain and menstrual irregularities. Endometriosis can be treated medically (with drugs or medicine) or with surgery. Sometimes both medicine and surgery are used. Medications range from pain relief drugs (such as paracetamol and non-steroidal anti-inflammatories) to hormonal treatments that suppress ovulation and menstruation). Surgery can be used to remove or burn the endometriosis. The most common surgery used is laparoscopy (key-hole surgery). This procedure has been shown to improve fertility. In a small group of women who have severe symptoms that are not relieved by medical or other surgical treatment a more extensive procedure may be considered (Hysterectomy) Mild endometriosis doesn’t always need treatment. You are usually offered treatment to help relieve the symptoms rather than to cure the disease itself. If left untreated, some endometriosis will improve, but most will stay the same. Some will become more severe without treatment. For most women with endometriosis, the symptoms will settle once they go through the menopause. If you should wish to further discuss or clarify any of the  information contained in this submission, please do not hesitate to contact me

Breastfeeding Tips

Breastfeeding is unique for mothers and babies.  Breastmilk is perfectly designed for your baby and changes to meet your baby’s growing needs. Lactation is the process of producing breastmilk for your baby and it can take up to six weeks to be well established. Breastmilk is produced using a ‘demand and supply’ principle.The more your baby feeds, the more breastmilk is produced. It is normal for a newborn to feed at intervals of two to five hours and feeds may take 45 minutes to an hour. In the early months your baby needs a minimum of 6-8 feeds in 24 hours.

POSTURE

Good positioning and attachment is the important.Position yourself comfortably with your back well supported. Allow your breast to fall naturally.Unwrap your baby to allow easy handling, skin contact and avoid overheating Your baby’s chin is touching or tucked into the breast.Support your breast using your free hand with fingers well back from the nipple/areola, aim your nipple towards your baby’s nose. As your baby’s mouth opens wide, bring your baby to your breast, aiming the nipple towards the roof of the mouth with the chin coming to the breast.After an initial short burst of sucking, the rhythm should be slow and even with intermittent pauses and deep jaw movements. A change in breast fullness indicates transfer of milk (breast emptied) in the early weeks.You may hear your baby’s gulps at the start of breastfeeding as the let flow of high volume milk is swallowed. Increased nipple and areola sensitivity (discomfort) is normal whilst feeding is being established. Nipple sensitivity when you start a feed should ease after a minute or two if your baby is attached properly.Constant discomfort can indicate that your baby is damaging the nipple. In this situation it is important to gently detach your baby from the breast and reattach. To detach baby, place your finger in the corner of your baby’s mouth, and push down onto the breast to break the suction.

How do I know if my baby is hungry?

Early hunger signs include your baby licking lips, opening and closing his/her mouth or sucking on lips, tongue, hands, fingers or fists.Active hunger signs, fidgeting or squirming a lot or clenching fingers or making a tight fist over the chest or tummy or trying to suck on the person who is carrying them.Late hunger signs include your baby crying and/or moving their head frantically from side to side.

How do I know if my baby is full?

Some babies may detach from the breast abruptly and will quit feeding suddenly when full. For other babies, it can be a gradual process as their sucking becomes slower and slower until they are full.A healthy baby knows how much milk they need so let your baby dictate the frequency and length of time for each feed.

Is my baby getting enough breastmilk?

If your young baby has 6-8 wet nappies per day and 1 or 2 soft bowel movements, (a bit less in an older baby), is gaining weight, has good skin colour and is alert and not wanting to feed constantly, it is likely you have enough milk.

How can I increase my breastmilk supply?

The key to increasing your breastmilk supply is to increase the number of times you feed your baby and therefore effectively drain your breasts of milk. (maybe also express between feeds).Look after yourself with enough rest and good nutrition

Top tips for breastfeeding

Babies go through growth spurts during which they need to breastfeed more frequently. It doesn’t mean you don’t have enough milk or your milk isn’t good enough. The more frequently you breastfeed your baby, the more milk you will make. If you have concerns about breastfeeding it’s always best to take the advice of a lactation consultant, your local child and family health nurse or an early parenting organisation . If you should wish to further discuss or clarify any of the  information contained in this submission, please do not hesitate to contact me
Testimonials

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Good prenatal care is essential for you and your baby during Pregnancy Care. Call your health care provider to schedule your first prenatal visit. During that visit, you will be screened for certain conditions that could lead to complications.
Anna Orsulic

I’ve been a patient of Dr John’s for a few years now and during that time he has provided me with the very best of medical advice in a caring and humorous manner....

Lashini Andradi

Dr Suresh John is an amazing doctor!! I cant describe his excellent work in words ♥️ First I wanna thank Dr Suresh for the miracle he bought.....

Jess Cribbin

I could not recommend Dr John highly enough. He went above and beyond all expectations while caring for me during my pregnancy. Dr John is a kind hearted man....

Nan Jiang

I was very confident and relax during my whole pregnancy as I knew I was in good hands with Dr John. Dr John is very professional and experienced. I had my first baby with....

Pooja Daniel

Suresh John is the most compassionate and empathetic doctor I have ever seen. He spends lot of time with his clients and listens patiently to all your queries. Suresh shows genuine concerns...

Jenni Osborne

Dr John is wonderful. He is genuinely caring and kind, and goes above and beyond for his patients. I have recommended Dr John to several women who have all had a positive experience....

Lisa Austin

“Dr John and his staff gave us exceptional care throughout my pregnancy, birth and even post birth. He genuinely cares, is knowledgeable and is very thorough. We are so grateful we chose him”

Sheree Spiteri

“I was very impressed with the standard of professional service and facilities when I went for my appointment with Dr John. I had been in a car accident “

Paige Hilder

“Dr John has looked after my 2 pregnancies and I have found him to be great! He is very thorough, kind and professional. I had to have a c-section and it went better than I could have expected”

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