“Growing up, I always loved babies,” says Alka Kothari, when asked why she chose a career in O&G. “I considered a pathway in paediatrics all through my medical school years. However, I changed my mind during internship as I enjoyed the surgical aspect of O&G.”

Born in India from a large family of five siblings, Alka was a breech baby born at home when her mother could not be transferred to hospital. Her background left her acutely aware of the healthcare deficiencies in developing countries, including high maternal and infant mortality rates. However, on taking her first job in Alice Springs after completing her training, she saw that Australia faces many similar challenges, particularly among Aboriginal and Torres Strait Islander peoples.

“It was quite heartbreaking to see some of the situations,” she recalls. “Complicated clinical scenarios in obstetrics that I had never seen anywhere else. Terrible complications, such as end-stage renal failure in young women. And high prevalence of diabetes and rheumatic heart disease in pregnancy. O&G healthcare has significantly evolved, but we still have a long way to go.”

Today Alka is a specialist obstetrician and gynaecologist practicing in Brisbane for the last 20 years; she is also a Conjoint Associate Professor at University of Queensland. While she relishes both aspects of her work, she cites juggling professional commitments with home life as just one of the difficulties of an O&G career.

“Obstetrics is a unique specialty, treating two lives at once,” she says. “It comes with its own occupational hazards, including the impact on mental health; it’s also a fairly physical specialty. And as with any other branch of medicine, we’re facing high expectations. I think it’s really important to be careful about burnout.”

Nonetheless, such challenges are outweighed by the upsides the job brings.

“The privilege of being in this position to help bring new life into this world is undoubtedly the most rewarding aspect,” says Alka. “Being able to scan babies, showing parents their baby’s heartbeat for the first time, gets me every single time. And I love seeing the baby’s face for the very first time as they come out of the womb. It’s an amazing feeling.”

At the RANZCOG ASM, Alka’s presentation will be on ‘Forgotten Fathers in Pregnancy and Childbirth’ – also the subject of a PhD she is currently working on. Alka describes how the project came about.

“I had a mum who lost twins at about 20 weeks, and while we were all surrounding her bed and supporting her, I noticed the father in a corner feeling completely lost and shattered. I went up to check how he was, and he said: ‘You’re the first person who’s asked me, let alone acknowledged that I’m the father of these babies. I’ve lost my babies as well.’ And I felt this situation needed to change, because fathers are not just bystanders; they play an important role in the whole pregnancy journey.”

Through her PhD with the University of Queensland, Alka conducted a series of studies on the role, support needs and perceived gaps in care for fathers, through the pre-conception period to childbirth. The research uncovered the extremely detrimental consequences of traumatic births on fathers, including post-traumatic stress and suicidal ideation. It highlighted a need for careful screening of expectant fathers, for physical and mental health problems, occupational hazards and other factors, as key contributors to good maternal and neonatal outcomes.

“It’s important we have a better understanding of fathers’ needs and the gaps in their care, to develop policies and targeted resources to improve outcomes for the whole family unit. I firmly believe that it’s high time we changed women’s and newborn services to father-inclusive maternity services. The whole system has to be geared towards the whole family unit, not just the mother and baby.”

In 2019 Alka presented her PhD work at the World Congress in Obstetrics & Gynaecology in London, winning the award are best oral presentation in perinatal mental health. She is excited about presenting on it again at the RANZCOG ASM.

“As a speaker, I really appreciate the human connection when presenting to an audience because it provides direct feedback. When you’re presenting to your peers, you also get the people in the room to share to provide feedback, ask questions and share their experiences. And obviously all these interactions contribute to improved rigour and methodology and help to develop new collaborations for future research.”

This will be the first RANZCOG ASM to be held in person in three years, and Alka is looking forward to the opportunity to reconnect with colleagues in the O&G sphere.

“Nothing replaces meeting people in person, and this ASM will be an amazing opportunity to develop new relationships and rekindle old ones. O&G is a tough specialty with a fair bit of heartbreak involved. Meeting in person brings about a sense of community. It’s important for collaboration, teambuilding, mental wellbeing, and forming a cohesive group of clinicians who support one another.”

The 2022 RANZCOG Annual Scientific Meeting will be held as a hybrid conference at the Gold Coast Convention Centre from 10-12 October 2022. Associate Professor Alka Kothari will give her presentation ‘Forgotten Fathers in Obstetric Care’ at 2.00pm on 12 October.

www.ranzcogasm.com.au