Recently I saw a woman with a BRCA gene mutation who had recently had both breasts removed and was now being urged to have both ovaries removed, she was 39 years of age. Understandably she was considerably anxious about the prospect of losing most physical vestiges of her femininity. She was keen to know how much risk she would incur of ovarian cancer if she deferred her bilateral oophorectomy until she reached 45 years of age. Hereditary Breast and Ovarian Cancer Syndrome (HBOC). The...

Megan Markle, Duchess of Sussex, is reputed to have engaged a doula as a support person for the birth of Archie on 6 May 2019. This was not viewed with favour by a senior UK obstetrician, Professor Tim Draycott, who was concerned about the obstetric risks of a 37year-old mother in labour. In recent times doulas offer their services for the antenatal, intrapartum, and postnatal care of women, mostly from the middle classes, who can afford the out of pocket expense involved. In the US, the ...

Case Report A  34-year-old primigravida presented with a fetal death in utero at 36+ weeks having had no fetal movements for 24 hours previously. Her blood pressure was then 140/100 and the protein/creatinine ratio was 144 mg/mmol. She had given the GP and obstetricians a strong family history of pre-eclampsia in her mother, sister and maternal aunt. Her blood pressure during pregnancy had been 100/65 at booking at 23-6 and had remained within normal limits until 36 weeks. Her urine had ...

In this current pandemic of COVID-19 (SARS-CoV-2) it is easy to think that the health risks to Australia have never been more dire. In pregnant women there is understandable anxiety about the risks to them and their unborn babies. However in the first 3 months of this pandemic from March to June 2020 there have been no COVID 19 Australian maternal deaths and few SARS_COV 2 infections amongst the pregnant Australian population. By 10 May 2020 the COVID-19 pandemic had infected 3.7 million ...

In the last three years the reputation of the pioneering gynaecologist J Marion Sims has been questioned by a scandal over experimental surgery on African American slave women. Sims was attempting to find a surgical cure for vesico-vaginal fistulae - an obstetric injury resulting from bladder damage after obstructed labour. His statue was removed from Central Park, New York in 2018 in deference to the public outcry regarding his racist behaviour. A debate has raged over failures of consen...