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An obstetrician gynaecologist is a doctor who specialises in conditions that affect thereproductive system of women. Obstetrics involves the care of pregnancy; gynaecology
the non-pregnant conditions including infertility, menstrual disorders, pelvic infection,
post-menopause symptoms and gynaecological cancers.

Helping women with diabetes through pregnancy
Regarding pregnancy, the obstetrician is a member of the team who cares for the woman and her developing baby. They are primarily responsible for monitoring the well-being of the mother and the development of the baby.

Along with midwives, obstetricians are involved in the care of the woman when she is in labour and post-natally. If the mother requires assistance at the time of birth, obstetricians perform the instrumental delivery – forceps or vacuum, or a Caesarean.

It is highly preferable that the woman who has diabetes, both type 1 and type 2 and those who had gestational diabetes previously, see the healthcare team about their pregnancy before they actually conceive.

The healthcare team will make sure with the endocrinologist that the intending mother’s diabetes control is as good as possible and that she takes folic acid to minimise the risk of the baby developing neural tube defects such as spina bifida.
Between and after pregnancies, the healthcare professionals can provide contraceptive advice, working with her to select the method most suitable for her needs.

Where a gynaecologist can help
Women with diabetes are a little more prone to gynaecological conditions such as pelvic infections, including candidiasis or thrush, and abnormal menstrual bleeding.

Later in life, women with diabetes are at a greater risk of cancer of the lining of the uterus or endometrial cancer but provided it is diagnosed early and treated appropriately, the outlook is very good for these women.

Women with diabetes can also suffer from any of the gynaecological conditions that can affect all women, such as prolapse, bladder control difficulties and troublesome menopausal symptoms, such as hot flushes and vaginal dryness.

For all these conditions, the gynaecologist has the specialist knowledge and experience to give the appropriate advice and treatments to reduce their impact.

Obstetricians and gynaecologists work in both public hospitals and in private. A woman’s general practitioner is the best person to decide and arrange a referral for specialist advice when it is required.

Prof Jeremy JN Oats is Chair, Victorian Consultative Council on Obstetric and Paediatric Mortality and Morbidity

This article was originally published in Conquest magazine published by Health Publishing Australia