How to choose an Obstetrician

A letter to you from Dr Pamela Tan, obstetrics and gynaecology specialist at Thomson Medical Center.

Dearest Mum-to-be,

It is a heady mix of excitement and nervousness that accompanies that first missed period and smiley faced pee stick. Congratulations and welcome to the new mom club.

Take a deep breath. Honestly, it’s not that scary. And importantly, you are not alone. Many women before you have walked the same journey and emerged stronger and wiser with a deeper appreciation of their bodies, their relationships and their lives. Pregnancy may not be a walk in the park but we are blessed with the ability to carry new life within us and I assure you, it will be a humbling, life-affirming and powerfully transformative experience. Decades on, every single mother still remembers their birth story in great, vivid, mind-blowing detail.

Mothers often come to clinic consultations with the same questions and anxieties: Is my baby normal and healthy? Am I doing the right thing for my baby and body? Will we have a smooth delivery? (And sometimes, when will this or that annoying symptom go away?). When a patient asks a question in clinic, more than 90% of the time they’ve probably already consulted Dr Google beforehand. Or one of the myriad of pregnancy books they have had Amazon deliver - pronto - to their doorstep. Such is the current state of clinical practice.

The obstetrician’s role is manifold. One main clinical objective is to screen pregnancies and triage the high risk from the low risk patient population. We are looking for deviations from normality that warrant special attention. The good news is that 80-90% of patients have absolutely normal, low risk pregnancies and deliveries. In the majority of the pregnant population, the antenatal follow ups with ultrasounds and investigations are monitoring very normal pregnancies. But this monthly screen also gives us the opportunity to detect any abnormality early and provide the best outcomes for the minority with special needs. Appropriately managing higher risk pregnancies gives the babies the best possible start to life.

Just as important as the professional duty to guide and advise a patient on clinical matters is something I bundle together and call “the intangibles”. It is that feeling of trust and security that a patient feels when there is good doctor-patient rapport. The patient feels better walking out of the clinic than when walking in. This happens when the doctor takes on the dual role of a genuine caregiver and fulfills the needs and expectations of the patient. Being attentive to concerns, available for the patient and communicating clearly are all features of an obstetrician who places great importance in developing that relationship.

Hence the right fit for a patient is not only an obstetrician with the appropriate professional credentials and experience practising in a conducive environment for regular visits, but also with the right personality fit for the patient to help make the pregnancy journey memorable and comfortable. To provide the most optimal birth experience for patients with specific requests during delivery, there also has to be a match in how the obstetrician practices with the expectations and preferences of the patient.

How does one prepare for the best birth experience? I tend to think of the prep work akin to an athlete training for a race. The first thing that everyone needs is a healthy body and mind. The basics of regular exercise and healthy eating still hold true. Exercise helps your body transition through the different stages of pregnancy better and helps you recover your pre-pregnancy body more quickly after labour. Labour is a little like a gym session and some stamina is needed. Being a couch potato the whole nine months will not be the least bit helpful. Mental and emotional health is just as important. Being calm, centred and confident helps one prepare for the labour ahead and feel empowered to achieve a normal delivery.

The second is doing the theory: antenatal classes, books and reliable sources for information accessible online are good adjuncts for information outside of the clinic to help you through the changes you are feeling as well as prepare for the childbirth, lactation and caring for your baby.

Thirdly, everyone needs a cheer leader. Establish a good support team of the best people cheering you on through this journey. Besides your husband, family and friends, it can be helpful to reach out to a community of similar soon-to-be-Mums who are going through the same daily experiences as you. In labour, besides your obstetrician and midwife, some patients may feel the presence of a birth partner (doula) helpful and reassuring.

I’ll end off with saying that pregnant mothers often think of childbirth as the finishing line - but it really is a speck in the continuum of the journey of parenting and marks really only the beginning of another whole new adventure. Remember to also be kind to yourself and have self-love. It will give you nourishment to love someone else with intensity you’ve never known before and be ready to face whatever challenges that lie ahead.

All the best!

Dr Pamela

Dr Pamela Tan | Thomson Medical Clinic

Dr Tan is an obstetrics and gynaecology specialist practising at Thomson Medical Center in Singapore. Prior to private practice, Dr Tan was a Consultant at KK Women’s & Children’s Hospital. She obtained her undergraduate degree at the National University of Singapore and her post-graduate MRCOG degree with the Royal College of O&G (UK). She is accredited with the Specialist Accreditation Board (Ministry of Health) and is a Fellow of the Academy of Medicine, Singapore (FAMS). She serves on the board of the Society for Colposcopy and Cervical Pathology of Singapore (SCCPS) with a subspecialty interest in colposcopy and vulval disease. In further pursuing this interest, she was a fellow for pre-invasive disease at the colposcopy and vulval unit at the Whittington Hospital in the United Kingdom where she was also attached to the Assisted Conception Unit in Guys Hospital to learn the latest in reproductive techniques for subfertility. She is accredited to perform advanced minimally invasive keyhole surgery. Her philosophy to doctoring is one that is focused on building relationships with her patients. She strives to deliver patient care that is warm, caring, professional and well advised. She is a believer of pro-natural birthing and providing an optimal birthing experience as desired by her patients.

Contact her clinic, TLC Gynaecology Practice, on 6254 2878, www.drpamelatan.com, 339 Thomson Road, #03-02 Thomson Medical Centre, Singapore 307677.

Dr Paul Tseng | Thomson Medical Clinic

Dr Tseng is an experienced fertility specialist, obstetrician and gynaecologist who is well known for his holistic approach to treatment. Dr Tseng’s medical career began at Singapore General Hospital achieving his OBGYN specialty and then becoming an integral part of the pioneering team to first offer fertility care and IVF technology to Singaporeans in 1988. For the next decade, Dr Tseng helped build the Hospital’s Centre for Assisted Reproduction ‘CARE’ fertility service before starting his private practice. As technology has improved over his 30 year career, Dr Tseng has seen the benefits of the less invasive, effective fertility treatment in helping reduce patients’ associated stress and anxiety.

With a busy obstetric practice, Dr Tseng is focussed on helping women from conception to delivery and beyond. Having spent a year at St George’s Hospital London - a centre of excellence for the sub specialty of uro-gynaecology - Dr Tseng also manages clinical problems associated with the dysfunction of the pelvic floor and bladder as these disorders can have broader implications for reproductive organs, and quality of life.

Contact his clinic, TLC Gynaecology Practice, on 6254 2878, 339 Thomson Road, #03-02 Thomson Medical Centre, Singapore 307677.

Dr TC Chang | Thomson Medical Centre & Mt Elizabeth Hospital Novena

Dr. Chang is the Head and Clinical Director of the Fetal Assessment Centre in the Singapore Women’ Medical Group. Dr. Chang has been working in Singapore since 1994 at the KK Women’s Hospital from (1994-1998) and in Thomson Medical Centre since 1998. He was made a Consultant Obstetrician and Gynaecologist, Department of Maternal Fetal Medicine, KK Hospital in 1997 and was a Visiting Consultant to that Department from 1998 to 2006. From 1998 - 2020, he was the Head of the Fetal Assessment Unit (Centre for Prenatal Diagnosis and Obstetric Ultrasound) at Thomson Medical Centre. In 2005, Dr Chang spent time as an Associate Professor in Obstetrics and Gynaecology at the University of Auckland, New Zealand and worked as a Consultant in National Women’s Health, Auckland City Hospital. Between 2007 and 2009, Dr Chang was the President of the College of Obstetricians and Gynaecologists, Singapore.

His interests are in the medical and surgical management of low and high risk pregnancies, ultrasound assessment of the at-risk fetus, invasive prenatal diagnostic procedures and gynaecological laparoscopic surgery. Dr Chang has admitting rights to six private hospitals in Singapore but does most of his obstetric deliveries and surgical operations at Thomson Medical Centre and Mt Elizabeth Novena Hospital.

Contact his clinic, WC Cheng & Associates, on 6253 4122, 339 Thomson Road, #01-01 Thomson Medical Centre, Singapore 307677.

Dr Dharshini | Mount Elizabeth Hospital Novena

Dr Dharsh was born in the United Kingdom, educated in Singapore, and graduated from the Faculty of Medicine, National University of Singapore (NUS), with a Bachelor’s degree in Medicine and Surgery. She subsequently went on to obtain her Masters in Obstetrics and Gynaecology and became a Member of the Royal College of Obstetricians and Gynaecologists (London).

She is currently the Medical Director of Kierauniv International Clinic for Women, located at the top floor of Mount Elizabeth Novena, where she guides her patients on their special journey towards natural childbirth.

Dr Dharsh has also extensively trained in medically indicated caesarean sections, gynaecological surgery (hysterectomies, myomectomies, cystectomies), laparoscopic (key-hole) procedure and has a keen interest in hysteroscopic surgeries (a non-invasive procedure to surgically treat small masses within the womb). Her clinical practice performs Intra Uterine Inseminations in the process of fertility management. She has a special interest in Adolescent Gynaecology and has a close rapport with her teen patients.

Dr Dharsh was a Clinical Teacher and Examiner with the Dept of Obstetrics and Gynaecology, NUS, has conducted Clinical Skills workshops to train medical students and young doctors in Obstetrics management, was made Chief Registrar in 2011 at the National University Hospital, and regularly presents her research papers at local and international conferences.

Dr Dharsh currently delivers her patients at the suites of Mt Elizabeth Hospital Novena and Thomson Medical Centre.

Contact her clinic on 6694 0755, www.mountelizabeth.com.sg, 38 Irrawaddy Road #11-48, Mount Elizabeth Novena Specialist Centre, Singapore 329563.

Dr Sivananthan | Raffles Hospital

Dr Sivananthan received her medical degree from the University of Bristol, UK and did her postgraduate training in obstetrics and gynaecology at the John Radcliffe Hospital, in Oxford, UK., where she undertook higher specialist training in high risk obstetrics and maternal medicine. She has also worked at the National University Hospital, Singapore. Dr Sivananthan is a registered specialist in obstetrics and gynaecology both with the General Medical Council, UK and Singapore Medical Council. She is a Member of the Royal College of Obstetricians and Gynaecologists and holds a Diploma in Family Planning from the Faculty of Sexual and Reproductive Health.

As a consultant in Raffles Women’s Centre, her practice includes all areas of general obstetrics and gynaecology. Her special interests are in women with medical conditions in pregnancy (diabetes, asthma, thyroid disease, cardiac disease), and women with pregnancy complications (raised blood pressure in pregnancy, bleeding in pregnancy, foetal growth restriction). Dr Sivananthan has published in peer-reviewed journals (American Journal of O&G, Ultrasound in Medicine & Biology), is a Cochrane review author and has presented at international and local meetings (FIGO, British International Congress of O&G). Dr Sivananthan sees patients at Raffles Hospital.

Contact her clinic on 6311 1230, www.rafflesmedicalgroup.com, Level 12 Raffles Hospital, 585 North Bridge Road, Singapore 188770.

Dr Jazlan | Raffles Hospital

Dr Jazlan obtained his medical degree from the National University of Singapore and completed his post-graduate training in obstetrics and gynaecology. He obtained his masters from the Royal College of Obstetrics & Gynaecology, UK. Thereafter, he achieved his specialist accreditation with the Ministry of Health, Singapore and was admitted as a Fellow of the Academy of Medicine, and College of Obstetricians & Gynaecologists in Singapore.

Dr Jazlan was an appointed clinical tutor and examiner of the medical faculty in the National University, Singapore. He is a specialist lecturer with the Singapore Armed Forces and Singapore Civil Defence Force. Apart from pursuing his clinical practice, Dr Jazlan is keenly involved in research with various publications in scientific and medical journals. He has authored publications in journals such as The Singapore Medical Journal, Annals Academy of Medicine, Singapore and The Singapore Journal of Obstetrics & Gynaecology.

Dr Jazlan is avidly involved in public health and education. He has organised and participated in many public forums, seminars, scientific meetings, and media interviews as well as television and radio health programs. Dr Jazlan is a weekly health columnist in Singapore’s only local Malay newspaper, Berita Harian, and a writer with Majalah Perkahwinan magazine. He was previously a writer in the health segment of Singapore’s Mediacorp Manja magazine.

Contact his clinic on 6311 1230, www.rafflesmedicalgroup.com, Level 12 Raffles Hospital, 585 North Bridge Road, Singapore 188770.

Dr FM Lai | Gleneagles Hospital & Homebirths

In practice since 1999, Dr. Lai Fon-Min understands the choices women must make regarding their gynaecological and obstetrical care. His more than 20 years of training and experience with high-risk pregnancies, deliveries and key-hole surgery gives women the reassurance needed fortheir pregnancy. He supports women to make informed choices by providing information about options available.

Dr Lai is aware that many practitioners have a pre-set idea of the best way to deliver a baby or treat a gynaecological condition. In contrast, he takes the time to listen to what the patient wants – whatever that may be. Your choices are important to him; he will not push a particular path unless he believes it is in your best interest. Even then, the patient is not subjected to scare tactics. He believes in offering real choices, supported by evidence-based practice and does not believe in using fear in pressuring women into a course of action.

He is an active supporter of natural birthing options and is willing to attend a home birth. He is supportive of women choosing to have a birth plan and utilising methods such as HypnoBirthing and Spinning Babies. Dr. Lai started attending homebirths and waterbirths in 2006 and has since started the waterbirth movement in private hospitals in Singapore. As he is skilled in various delivery options, he is able to achieve high success rates for vaginal delivery without compromising on the safety of the mother or baby for breech, twin pregnancies and previous Caesarean Section births (VBAC). He has admitting rights to most hospitals in Singapore.

Contact his clinic, A Company for Women, on 6333 6181, www.acompanyforwomen.com.sg, Camden Medical Centre, 1 Orchard Boulevard #03-05/06, Singapore 248649.

Dr Ng Kai Lyn [MBBS (Singapore), MMed (Singapore), MRCOG (UK)] is a Consultant Obstetrician and Gynaecologist with sub-specialty expertise in urogynaecology and minimally invasive surgery, as well as a clinical interest in fertility. Prior to moving to private practice, she worked at National University Hospital, Singapore. She is the recipient of Healthcare Manpower Development Plan award from Singapore Ministry of Health and completed a prestigious Urogynaecology Fellowship at an International Urogynaecology Association accredited institution. Besides general obstetrics and advanced laparoscopy, she is well versed in managing pelvic organ prolapse, urinary incontinence, overactive bladder, uterine fibroids, ovarian cysts, endometrial polyps, endometriosis and fertility issues.

Dr Ng currently practices at Gleneagles Hospital with ACRM.

Contact the clinic on +65 6474 3900, info@acrm.com.sg, 6A Napier Road, #05-35, Gleneagles Hospital, Annexe block, Singapore 258500.

Dr EK Tan | Mount Elizabeth Hospital (Novena)

Dr Tan Eng Kien obtained his medical degree from the University of Manchester in 1997, graduating with Honours. He completed his obstetrics and gynaecology training in the United Kingdom and is an accredited specialist in the UK and Singapore. Dr Tan has a special interest in the management of high-risk pregnancies such as multiple births (twins) and pregnancies with complications (like diabetes, high blood pressure, babies with congenital problems). Other interests include water births and obstetric ultrasound imaging.

An active contributor on articles on women’s health in magazines and symposiums, Dr Tan is certified by Advanced Life Support Group UK to be a MOET trainer. The Management of Obstetric Emergencies and Trauma (MOET) is a course to train senior doctors in life-saving techniques for pregnant women with serious complications. He regularly teaches MOET in the UK, Australia and New Zealand.

Prior to starting his private practice in 2016, Dr Tan held multiple portfolios at National University Hospital where he was a Senior Consultant, Assistant Professor and the Residency Program Director. He was the consultant in charge of the Delivery Suite, updating the protocols, ensuring that pregnant mothers were well looked after during labour and their babies were delivered safely.

Contact his clinic, EK Women’s Clinic, on 6926 9818, WhatsApp 9348 9996, www.drtanengkien.com, 101 Irrawaddy Road Royal Square @ Novena, #13-14 Singapore 329565.

Associate Professor Choolani | National University Hospital (NUH)

Prof Choolani completed his PhD doctoral thesis on non-invasive prenatal diagnosis at Imperial College, London, UK. His principal areas of research are non-invasive prenatal diagnosis, fetal mesenchymal stem cells for intrauterine fetal therapy, and early detection of epithelial ovarian cancer. He was awarded the NMRC Clinician Scientist Award to continue his research in the prenatal diagnosis field.

Contact his clinic on 6772 2002, appointment@nuhs.edu.sg, www.nuh.com.sg/nuhgynae, 5 Lower Kent Ridge Road, National University Hospital, Singapore 119074.

Professor Chong Yap-Seng | National University Hospital (NUH)

Professor Chong was awarded his MBBS from the NUS Yong Loo Lin School of Medicine in 1988, and obtained his MMED (O&G) in 1995. Subsequently, he was conferred a Doctor of Medicine (MD) degree by NUS in 2006. Presently, Prof Chong is a Senior Consultant in the Department of Obstetrics & Gynaecology at the National University Hospital (NUH), Dean of the NUS Yong Loo Lin School of Medicine as well as the Executive Director of the Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR) since 2015.

Prof Chong has been a firm advocate of natural birth since 2006. His research interests cover developmental origins of health and disease, breastfeeding and early childhood programming, genetic epidemiology of pregnancy-related disorders and intrapartum and postpartum management. As a respected clinician and researcher with a profound interest in women’s health and early development, Prof Chong is the Lead Principal Investigator of the National Research Foundation Translational and Clinical Research Flagship Program on the Developmental Origins of Health and Disease. To date, he has well over 300 peer-reviewed research publications covering topics such as the genetic epidemiology of pregnancy-related disorders, intrapartum and postpartum management, natural childbirth, strategies to promote breastfeeding, and the developmental origins of health and disease.

Contact the clinic on 6772 2002, appointment@nuhs.edu.sg, www.nuh.com.sg/nuhgynae, 5 Lower Kent Ridge Road, National University Hospital, Singapore 119074.