Dr Grant Saffer
|Grant Saffer is an Obstetrician and Gynaecologist practicing at the Epworth-Freemasons Consulting Suites in East Melbourne. He is also the Associate Dean of Women’s Health for the Epworth Clinical School of Medicine, University of Melbourne. Grant’s medical focus is geared towards the care and management of natural pregnancy and delivery, ranging from low risk to a focus on high-risk pregnancies that may involve associated complications such as delayed conception, preeclampsia, hypertension, multiple births, gestational diabetes and assisted reproduction (IVF) pregnancies.|
Grant Saffer is an Obstetrician and Gynaecologist at the Epworth-Freemasons Consulting Suites on Victoria Parade in East Melbourne. He has a broad and in-depth interest in all areas of Women’s Health, with over 25 years of medical expertise; initially training in South Africa, then gaining another 15 years of specialist experience in the United Kingdom and Australia. He is also a longstanding Senior Consultant at the Royal Women’s Hospital in Parkville – a world-renowned hospital and leader in Maternity Services.
Dr Saffer is dedicated to developing excellent rapport and communication with his patients something he feels is as integral to promoting good health as rigorous medical science and research. Grant’s philosophy towards his field of medicine can best be described as a gentle, holistic approach to patient care where natural processes and the views of women and their partners are genuinely respected and encouraged.
Firstly, as an Obstetrician, Grant provides an exceptional level of care for women throughout their pregnancy and birth. Progressive and responsive to women-focused care, he will always aim for your pregnancy to be as natural as you want it, and will try to be guided largely by your own needs and expectations.
Grant ensures that all his patients have relevant, up-to-date information about their condition, enabling them to make informed decisions about their pregnancy and delivery, taking into consideration their beliefs and therapeutic preferences. He will always give you plenty of time at your visits for discussion of problems or concerns, which includes working together to arrive at a detailed and mutually agreeable care plan. He will, of course, advise on the safest avenues where medical factors and other circumstances do not allow for a full range of treatment options.
Over the years, Grant has developed a network of specialist support services which are proven to enhance pregnancy outcomes. These include specialist obstetric and gynaecology sonographers, paediatricians, IVF specialists, specialist physicians, physiotherapists, naturopaths, dieticians, psychologists and relaxation therapists both before and after delivery.
As an experienced Gynaecologist, Grant also practices in all areas of Gynaecology, managing a wide range of gynaecological issues affecting women of all ages. These may include regular Pap smears and breast checks, contraception advice, the management of infertility, abnormal bleeding, pelvic pain, peri-menopausal, menopausal and post-menopausal concerns as well as hormonal therapy. He also has a keen interest in laparoscopic or keyhole surgery as well as colposcopy, which is the treatment and follow-up of abnormal Pap smears. He operates at the Epworth-Freemasons Day Procedure Centre on a weekly basis.
Grant is supported in his rooms and practice by an exceptional team of four Senior Midwives who are knowledgeable, relaxed and super-reliable and, above all, always approachable. Jan, Melanie and Jannine provide great medical advice and counselling both during visits and over the telephone.
Dr. Grant Saffer’s practice is supported by a group of highly experienced Midwives: Jan Watt, Melanie Dunlop and Jannine Mashiter. Their extensive midwifery and admin skills offer invaluable support throughout your pregnancy. They also provide helpful advice on general women’s health issues, across all age groups.
Our staff members are committed to the highest standards of professionalism, care and best practice values. Whether you are calling with a query or coming in for an appointment, you will always be greeted with warmth, compassion and understanding. They share a genuine enthusiasm in listening to your concerns, answering your questions and responding promptly to your healthcare requirements. They are available to talk to you for as long as you need and no question is considered unimportant.
Outside office hours, all patients have access to an immediate-response paging service that is operational 24/7.
If you wish for more detailed information or you have any questions about any of the services outlined above, please do not hesitate to call 9419 9989. We look forward to hearing from you.
Jan has been working in our practice for over seven years now and has seen a veritable parade of babies make their Melbourne debut! Jan comes from a medical/admin background and has advanced knowledge of midwifery and women’s health issues. Jan completed her Midwifery degree at the ACU in 2004. Combining these skills and the wisdom that comes with raising three stunning daughters, Jan is definitely the lady to turn to if you have an initial medical concern you’re not sure about.
Jannine brings over 40 years of nursing experience to this role. She began her nursing career at the Royal Children’s Hospital then trained as a midwife, working at the Mercy Hospital for Women in East Melbourne. After overseas travel, Jannine took up the position of Nurse Unit Manager within the Postnatal Department at St Vincent’s Private Hospital. She also worked in Private Rooms for some years before joining our practice in April of 2012. Jannine is a passionate Melbourne AFL supporter and adores horseracing.
Melanie is a popular and well-known Midwife both in Dr Saffer’s private practice and at the Epworth-Freemasons Labour Ward. Chances are, she has delivered some of your babies! She has been practising Midwifery since 1995 and has worked for Dr Saffer since 2009. Melanie balances Midwifery with raising her three sweet children: Lucy aged 16, Will aged 14 and Alice aged 10.
Where and When Dr. Grant Saffer consults
Epworth Freemasons Hospital – Monday, Tuesday, Wednesday, Thursday
Airlie Women’s Clinic, Malvern – Friday
Hospitals that Dr. Grant Saffer attends for deliveries
Epworth Freemasons Hospital & St. Vincent’s Private Hospital
Hospitals that Dr. Grant Saffer operates at as a gynaecologist
Epworth Freemasons Hospital
During office hours please ring the rooms on 9419 9989. The rooms are open from 8:30am to 5pm Monday – Friday.
After hours, Dr. Grant Saffer can be contacted on the call service on 9387 1000.
Dr. Grant Saffer is available every weekday and night and works every 4th weekend. He works a weekend relieving roster with Doctors Len Kliman, Joe Sgroi, Steve Cole, Kent Kuswanto, Pregs Pillay and Sam Soo.
Firstly, what is Gestational Diabetes?
Gestational diabetes is diabetes that develops or is first diagnosed during pregnancy. You can think of it as “insulin resistance” or “carbohydrate intolerance” during pregnancy as a way to understand it better. Basically, it means that a woman cannot tolerate large amounts of carbohydrates without causing her blood sugar levels to rise.
Can Gestational Diabetes be Prevented?
You don’t have to have a history of glucose intolerance or insulin resistance to be at risk of developing gestational diabetes. Research has shown that adopting healthy practises such as not smoking, regular exercise (150 minutes or more per week) and a healthy diet can reduce the risk of gestational diabetes by 41%. Physical activity helps to reduce insulin resistance.
Weight and gestational diabetes:
Weight can significantly influence your likelihood of developing gestational diabetes. It is vital to maintain a healthy weight at conception and during your pregnancy as to prevent causing an increase in insulin resistance.
What impact does high blood sugar have during pregnancy?
High blood sugar can cause various complications in the baby such as macrosomia (large baby) which increases the chance of a caesarean due to an increased chance of an obstructed labour. It also causes an increase in shoulder dystocia which is where the shoulders get stuck during vaginal delivery, with possible nerve damage to the baby. It can also result in hypoglycaemia (low sugar levels) after delivery and permanent changes to a child’s metabolism.
Changes to the baby’s metabolism can cause issues later in life. Exposure to high blood sugar causes the foetal pancreas to produce excessive amounts of insulin to maintain normal blood sugar levels. As a consequence, fat accumulates around the midsection and the foetal pancreas is subjected to hyperplasia (enlargement of the organ). Babies exposed to gestational diabetes in the womb have a greater risk of becoming overweight and developing type 2 diabetes later in life.
Gestational Diabetes Management:
The primary treatment for gestational diabetes is diet and exercise. For those who are unable to control their blood sugar levels by nutritional therapy, insulin or medication may be required.
Another important management measure is to test your blood sugar levels throughout the day. This is to ensure your levels are being maintained. Before eating in the morning, and then two hours after breakfast, lunch and dinner are the recommended times to check your levels to get effective readings.
Gestational Diabetes Diet:
Suggested carbohydrate intake will differ for each individual based on her blood sugar control. Generally speaking, less than 175g of carbohydrates per day is beneficial. “Studies have shown that a low glycaemic index diet reduces the likelihood a woman will need insulin by 50%”.
Fats and proteins tend to stabilize your blood sugar levels. Meat, poultry, eggs, full-fat cheese, nuts, seeds and avocados.
Be mindful of your sugar intake and avoid juice, soft drinks, desserts, honey and dried fruit.
Avoid refined carbohydrates such as cereal and pasta.
Spread your carbohydrate intake throughout the day to avoid spiking your blood sugar levels. This helps to maintain your levels. Calories can be divided over three meals and two to four snacks, comprising of about 40 percent carbohydrate, 20 percent protein, and 40 percent fat.
Got heartburn and reflux? You can thank your hormones again for that…
Acid reflux is a result of stomach acid entering the oesophagus (food pipe). This occurs during pregnancy due to changes in the hormone progesterone which relaxes smooth muscles of the body. As a result, the valve between the stomach and the oesophagus is relaxed and consequently allows some gastric acid to enter the oesophagus and cause a burning sensation. Progesterone also slows down the muscles within the stomach and this causes a reduction in the rate of digestion. Digestion therefore becomes sluggish and contributes to heartburn symptoms. In addition, as the baby grows it pushes your intestines and stomach upwards. This can also force acid up from the stomach and into the oesophagus.
Here are some suggestions to minimise this problem. Remember that different things may work at different times in your pregnancy, and different things work for different people. It is often a matter of trial and error.
– Avoid trigger foods. Some foods are like gasoline and will fire up your heartburn. Avoid spicy and greasy food and coffee.
– Eat at least 2 hours before bed. This aims to settle your stomach before lying down.
– Eat slowly. Chew chew chew! The more you chew, the less your stomach has to do!
– Shrink your food and drink – eat smaller and more frequent meals rather than larger ones.
– Use pillows to prop yourself up at night. Lying down worsens reflux due to gravity.
– Drink tea such as peppermint or camomile
If these standard measures don’t work:
– Try taking antacids such as Gaviscon or Mylanta – Do not take Alka Seltzer or Bicarb soda. Gaviscon and Mylanta come in both tablet and liquid form. Tablets are of course easier to carry with you, but the liquid form is more effective as it coats the stomach better.
– Try taking Zantac. Zantac neutralises stomach acid that has already been produced and works to reduce acid production in the stomach. It is a tablet you can purchase over the counter and it best taken at night.
Research is limited in this area, but so far there has been no indication that dying your hair causes adverse effects to your baby. Although hair dye is a chemical, very little of it is actually absorbed into the body and therefore it isn’t considered to be harmful to the foetus.
If you’re wanting to be extra cautious, perhaps opt for highlights instead as the dye is only applied to the hair strands and not the scalp. Another consideration would be to wait until you’re in your second trimester as this avoids any chemical exposure whatsoever during the initial part of foetal organ development.
If you are getting your hair dyed make sure you are in a well ventilated area. If you’re dying your hair at home, make sure you wear gloves, don’t leave the dye on for any longer than indicated and thoroughly rinse after treatment. Perhaps try and limit your dying sessions to no more than 4 times during your pregnancy.
Dying your hair during breastfeeding is also not considered to be harmful to your baby. As the chemical abortion is so minimal, the chance of them entering the milk and posing a risk to your baby is unlikely.
The chemicals associated with nail treatments have not shown to cause harm to the foetus, although research in this area is also limited.
The biggest issue that could arise from visiting the nail salon is that the fumes may make you feel nauseated, but they aren’t toxic to the baby. Choose a nail salon with good ventilation and sterilised equipment. Pregnancy compromises your immune system and consequently you are more prone to infection.
Ensuring you are being treated with clean, sterile instruments is important.
If you’re wanting to paint your nails at home and want to be extra cautious, try and use nail polish free from chemicals such as dibutyl phthalate, formaldehyde, toluene and acetone. Thankfully brands such as OPI, Sally Hansen and Essie generally don’t contain these chemicals.
The ingredient used in fake tan is called dihydroxyacetone (DHA). It interacts with your skin cells and produces a brown pigment. It only penetrates the outermost layer of your skin and it isn’t absorbed into the blood steam. Fake tan in cream or lotion form is safe as DHA cannot enter the body. Fake tan applied via spray poses a risk as you are more likely to inhale the chemical.
Waxing is safe. You might find your skin becomes more sensitive during pregnancy so perhaps try and use a gentle formula. Laser hair removal is not advised due to lack of evidence and research surrounding its effect upon the foetus.
Botox is not recommended because again there is limited research about its effects upon the baby.
Don’t let bub stop you from tripping off to that much needed holiday you’ve been so looking forward to! Airline travel is generally safe for women with uncomplicated pregnancies, but there are just a few things to be aware of before you head off. So add these to your packing list!
Firstly, have you discussed your travel plans with your obstetrician? This is important particular in the later stages of pregnancy. This allows your doctor to brief you on the dos and dont’s when travelling, as well as just being aware of your whereabouts should anything go pear shaped!
Have you checked the pregnancy travel policies with your airline of choice? Most airlines will allow women to fly up to 36 weeks gestation, however some airline guidelines vary. After 28 weeks of pregnancy you will require to carry a letter from your doctor outlining the estimated due date, single or multiple pregnancies, the absence of complications, and your fitness to fly for the duration of the flights booked.
Have you chosen your plane seat carefully? It is so easy to become uncomfortable on a plane flight without being pregnant, let alone when you’re carrying a child! Try and book an aisle seat, as this provides more space and comfort.
Remember to exercise your calf and foot muscles regularly throughout the flight to reduce the risk of venous thrombosis. Be sure to bend and straighten your legs, feet and toes as much as you can. In addition to this, walk the aisles every hour or so, to increase blood flow and circulation in your legs.
Consider using compression stockings and avoid restricting clothing.
Make sure you maintain hydration throughout the flight. This is so important to maintain your body’s normal functioning and blood flow. Drinking plenty of fluids will prevent headaches, nausea, cramps and dizziness throughout the duration of your flight.
Have you thought about the chance of early delivery? After 25 weeks of gestation the baby is considered ‘viable’ for delivery. Therefore traveling after this time is a bit risky as the membranes can rupture at any time. If they do, you would then essentially be stuck wherever you are until the baby is term (ready to be delivered). This could be in a foreign country, without support networks with you like your friends, family and doctor. You could find yourself feeling quite isolated, stressed uncomfortable and scared. Along with this, insurance policies generally won’t cover you for such a situation. You would have to look into your insurance cover to see what you would be covered for.
So that’s that! Just a few things to consider before booking/leaving for a holiday to make sure you are well prepared for your journey ahead. Bon voyage!
Common pain and fever medication guidelines during pregnancy: The long and the short of it.
Any medication taken during pregnancy should be at the LOWEST effective dose and for the SHORTEST duration.
1. Paracetamol (Panadol)
Paracetamol is the first choice for pain relief medication during pregnancy and breastfeeding.
It is safe to take throughout ALL stages of pregnancy.
2. NSAIDS (Ibuprofen, low-dose Aspirin, Voltaren)
Not recommended during the first trimester.
Second trimester is safe for occasional use, no more than 48 hours.
Avoid during third trimester.
3. Opioid (Codeine)
Minimal use is safe. Given that Opioid’s are addictive, emphasis is on MINIMAL use. Persistent use can cause maternal dependence which leads to withdrawal in the neonate.
Safe nasal sprays to treat hay fever during all trimesters of pregnancy is Dristan nasal decongestant and Fess saline nasal spray. Safe anti-histamine medication through all trimesters is Polaramine, although this is a sedating anti-histamine so best to take this at night. Claratyne is safe to use during the second and third trimester, to be avoided in the first.
Exercise your pelvic floor! It’s quick, easy, free, AND is so important for your body! Let me explain…
Pelvic floor muscles are the layers of muscles that support the bladder and bowel. These can sometimes be left weak after having a baby as labour and delivery stretches the nerves and muscles. If left weakened, this can lead to urinary and faecal incontinence, pelvic organ prolapse and sexual dysfunction.
So it is important to give your pelvic floor muscles a good workout!
Pelvic floor muscle exercises (PFME) are important during pregnancy and especially after delivery. PFME are easy, quick and can fit into your daily life routine – so there’s no excuses!
The first step is finding and identifying these muscles. Sit or lie down with your thigh, buttock and stomach relaxed. Now try and squeeze the ring of muscle around your back passage, as if you are trying to stop passing wind. Now relax this muscle. Squeeze and let go a few more times until you’re sure you have found the right muscles. You should feel a sense of ‘lifting up’ each time you squeeze your pelvic floor muscles. Do not tighten your buttocks or thighs, only squeeze and lift. Each squeeze should be done as strongly and tightly as you can. Try and hold the squeeze for 5 seconds, then relax.
Aim to do 3 sets of 5 second squeezes, 3 times a day. To help you remember, get yourself some red sticker dots from your local newsagent and stick them around the house to remind you to do your PFME. For example stick a dot on the phone, in the kitchen, on the fridge, in the bathroom, on the computer.
Now’s the perfect opportunity – get those muscles moving!
Pelvic girdle pain (PGP) is pain related to the sacroiliac joint. The pain is commonly a stabbing sensation that can be felt in the vicinity of the sacroiliac joint (the discomfort can be felt over the public bone, below the tummy, across one side or both sides of the lower back). The pain can also radiate down the thigh. The pain worsens with weight-bearing, prolonged sitting, walking, turning over in bed or moving your legs apart.
Hormonal changes during pregnancy relaxes the joints and can cause pelvic instability. In addition to this there is of course the increasing weight of the foetus and placenta upon the pelvic region.
• Previous lower back pain
• Multiple pregnancies
• A physically demanding job
Treat it early – Visit a physiotherapist to establish a management plan. A physiotherapist will be able to provide specific exercises to stabilise the pelvic region. They can also fit you a brace or girdle which can be very beneficial for pain management. Braces/girdles compress the joints and stabilise the area. They also disperse weight-bearing forces more evenly through the pelvis, back, hips and legs. Tubigrip can also be used as a tummy support.
Acupuncture has been shown to relieve PGP. Acupuncture methods activate sensory neurons which release chemicals in your body that have a similar effect to that of analgesia.
Hydrotherapy (exercising in water).
Within 6 months postpartum 80% of women recover from PGP. In some cases though, symptoms can continue for over 2 years.
What is Placenta Previa?
Placenta Previa essentially means ‘placenta first’
In a normal pregnancy, the Placenta implants on the uterine wall. Placenta Previa is when the placenta implants partially or entirely over the cervix. This can block the baby’s passage into the vagina for birth. This means the baby cannot be born vaginally.
Placenta Previa can cause severe bleeding from the vagina.
What causes Placenta Previa?
Those who have had more than one c-section are more likely to develop Placenta Previa
Those who have previously had Placenta Previa
Giving multiple births (large placental area), or have had more than 1 baby
Scars on the uterine lining
What are the symptoms?
Sudden, painless, leaking blood from the vagina. This is because as the pregnancy progresses, particularly in the later stages, the bottom part of the uterus thins and spreads to accommodate for the growing baby. This thinning and spreading separates the placenta and this is what causes the bleeding.
Tightening of the uterus
No symptoms at all
How is it tested?
Ultrasound can identify the position of the placenta
What is the treatment?
No sex, as this can cause the Placenta Previa bleed
Sometimes the Placenta moves back to the normal position
Treatment is different for each individual, but can range from bed rest, hospitalisation, close monitoring, and blood transfusion.
Freemasons Medical Centre
320 Victoria Parade
East Melbourne 3002
Telephone 9419 9989
Fax 9419 9987
Pager 9387 1000
Airlie Women’s Clinic
1364 Malvern Road
Provider No. 60081EA