Pregnancy and obstetrics in Vienna
For most women, pregnancy is a time of great joy, but also of many questions. Which examinations are useful, and which are necessary? What does an abnormal result mean? And who is there if things do not go to plan? In my private practice in the 9th district, I look after you from the beginning of pregnancy until the time after the birth. My obstetric training at the University Department of Obstetrics and Gynaecology at Vienna General Hospital (AKH Wien) covered the delivery suite, the high-risk pregnancy outpatient clinic and ultrasound diagnostics. I bring this experience to every examination, combined with what a private practice makes possible: time for you and your questions.
When should you come to see me during pregnancy?
A first appointment makes sense after a positive pregnancy test. An early ultrasound can check whether the pregnancy is located in the uterus (womb) and whether its development matches the gestational age. From around the sixth week of pregnancy, the embryo's heartbeat can often be seen as well. We also work out your estimated due date.
At the very first consultation we clarify which examinations are scheduled for the coming months and which additional examinations may be useful for you. If a pregnancy is unplanned and you are thinking about your options, I will also give you factual advice without pressure.
A consultation is also useful before a planned pregnancy, for example if you have existing medical conditions, take regular medication or had complications in a previous pregnancy. If you have bleeding, more severe pain, pronounced vomiting or other worrying symptoms, you should see a doctor at an early stage.
Which examinations does the Eltern-Kind-Pass include?
The former Mutter-Kind-Pass is now called the Eltern-Kind-Pass (Austria's mother-and-child health record). It forms the framework for antenatal care in Austria.
Five medical examinations are scheduled:
These include laboratory tests, among them tests to determine your blood group and rhesus factor and tests for certain infections. Between the 25th and 28th week of pregnancy, an oral glucose tolerance test is scheduled to detect gestational diabetes.
The Eltern-Kind-Pass also provides for three ultrasound examinations: between the eighth and twelfth, the 18th and 22nd, and the 30th and 34th week of pregnancy. I can carry out these examinations in my practice and, depending on your personal situation, add further follow-ups where they are medically useful.
To receive the full amount of childcare allowance (Kinderbetreuungsgeld), you must provide proof that the five mandatory pregnancy examinations were carried out within the set time frames. The three ultrasound examinations themselves, however, are not a requirement for this.
Between the 18th and 22nd week of pregnancy, you can also take up a consultation with a midwife. It offers information on pregnancy, birth, the postnatal period and breastfeeding, and is a useful complement to medical care.
What role do ultrasound and Doppler play?
Ultrasound diagnostics has been one of my specialisms since the beginning of my career. After a training semester in the ultrasound unit of the university department at AKH Wien, I spent several years doing research in this field, in both gynaecological and obstetric diagnostics.
Depending on the week of pregnancy, ultrasound can be used to assess, among other things, the baby's development and growth, the heartbeat, the position of the placenta, the amount of amniotic fluid and certain anatomical structures. During the examination I explain what can be seen on the screen and what the individual findings mean.
Doppler ultrasound is a special ultrasound technique for assessing blood flow, for example in the uterine vessels, the umbilical cord and the baby's blood vessels. It is used mainly in certain risk situations, such as abnormal growth or a suspicion that the baby's supply is restricted. It can also be useful in certain maternal conditions.
Doppler diagnostics in obstetrics is one of the examination methods I worked on intensively during my time at the university department at AKH Wien.
What does prenatal diagnosis offer?
Prenatal diagnosis comprises additional examinations that can estimate the risk of certain malformations and chromosomal disorders, or diagnose individual conditions. These examinations are voluntary. I explain what each method can do and where its limits lie.
First-trimester screening, also known as the combined test, is carried out between the eleventh and 14th week of pregnancy. It combines ultrasound findings such as nuchal translucency with certain blood values and other factors. The result is an individual risk calculation, not a diagnosis.
The non-invasive prenatal test, NIPT for short, is possible from the tenth week of pregnancy. It analyses cell-free DNA from the mother's blood. The test allows a very accurate risk assessment, particularly for trisomies 21, 18 and 13. However, it too is a screening test, and it replaces neither a qualified ultrasound examination nor, if the result is abnormal, diagnostic testing.
The detailed anomaly scan (Organscreening) usually takes place at around 20 to 22 weeks of pregnancy. In it, the baby's organs and physical development are assessed in particular detail by ultrasound.
If one of these examinations produces an abnormal or unclear finding, an invasive test may be necessary. Depending on the week of pregnancy and the question to be answered, this means chorionic villus sampling or amniocentesis. In amniocentesis, a thin needle is used under ultrasound guidance to take a sample of amniotic fluid so that the baby's cells can be genetically tested.
During my time at the university department at AKH Wien, I carried out numerous amniocenteses and did research on prenatal diagnosis. Among other things, I was involved in establishing the triple test that was used at the time. Today this experience helps me to explain modern screening methods, what they can tell us and where their limits lie in a way that is easy to understand.
How do I care for a high-risk pregnancy?
A pregnancy is described as high-risk when certain factors make closer monitoring advisable. These can include existing conditions such as high blood pressure, diabetes or thyroid disorders, a multiple pregnancy, previous miscarriages or premature births, fibroids or abnormal findings in the baby. A higher maternal age can also increase the risk of certain pregnancy complications. This does not mean, however, that a pregnancy will inevitably be problematic.
A previous caesarean section is also taken into account when planning the birth. Another caesarean is not automatically necessary, however. Under suitable conditions, a vaginal birth may also be possible.
During my time at the university department at AKH Wien, I helped to run the high-risk pregnancy outpatient clinic and looked after the antenatal and postnatal wards. In my practice, depending on the situation, a high-risk pregnancy means shorter intervals between follow-ups, additional ultrasound or Doppler examinations and coordination with the hospital where the birth is planned. Where needed, I involve other specialties.
Where does the birth take place?
The birth itself generally takes place in a hospital. Which hospital is suitable depends on your personal wishes, your insurance and any medical risks.
My many years at the University Department of Obstetrics and Gynaecology at Vienna General Hospital (AKH Wien) came to an end at the end of 2023. A birth at AKH Wien is therefore now looked after by the obstetric team there. In a high-risk pregnancy, we discuss together which hospital has the medical facilities your situation requires.
For patients with private insurance or those paying for themselves, the options include Privatklinik Confraternität & Goldenes Kreuz and Privatklinik Döbling. I currently have admitting rights in obstetrics at both hospitals. Whether and in what form I can personally attend your birth is something we clarify in good time and on an individual basis.
You register for the birth directly with the hospital you have chosen. The timing and procedure differ from one hospital to another. I will inform you in good time and put together the necessary reports.
Preparing for the birth
In the final weeks we discuss the baby's position, the possible mode of birth and your personal wishes. Your partner is of course welcome at these conversations.
A particular topic is breech presentation, in which the baby lies with its bottom or feet downwards. I have done research on the mode of delivery in breech presentation and attended many such births during my obstetric training.
If the baby remains in the breech position towards the end of pregnancy, the options, depending on the situation, are external cephalic version (turning the baby from the outside), a vaginal birth at a centre with the relevant experience, or a planned caesarean section. External cephalic version is generally considered towards the end of pregnancy, usually after 37 completed weeks.
What happens after the birth?
A gynaecological follow-up is advisable about six to eight weeks after the birth. Among other things, I assess how the uterus has returned to its normal size, any birth injuries or a caesarean scar, and the pelvic floor.
We also talk about breastfeeding, sleep, physical recovery, your mood and contraception after the birth. If additional support would be useful, for example from a midwife, a breastfeeding consultant, pelvic floor physiotherapy or psychological care, I will help you plan the next steps.
You can find information on the pelvic floor under Chronic pelvic pain and the pelvic floor in Vienna, and on contraception after the birth under Contraception in Vienna.
Why should you have your pregnancy cared for by Prof. Obwegeser?
I have been a specialist in gynaecology and obstetrics since 1993 and worked at the university department at AKH Wien from 1989 to the end of 2023. My obstetric training covered the delivery suite, admissions, the routine antenatal and high-risk pregnancy outpatient clinics and the care of the antenatal and postnatal wards.
In 1994, I received the Thalhammer Prize for Perinatology for my research on how well the Apgar score and umbilical artery pH reflect the condition of the newborn.
Added to this is my many years of experience in gynaecology, for example with fibroids, ovarian cysts and endometriosis, which can also play a part during pregnancy. In my practice there is enough time to explain findings clearly and to discuss your questions and ideas about pregnancy and birth.
What does the care cost and what does health insurance cover?
I run a private practice without a health insurance contract. Eltern-Kind-Pass examinations can be carried out by me as a private doctor (“Wahlarzt”). You first pay the invoice yourself and can then submit it to your health insurer for reimbursement. The amount reimbursed depends on the relevant health insurance tariff.
For additional examinations such as NIPT or the anomaly scan, separate rules apply depending on the medical indication and your insurance. My team will be happy to tell you the specific amount for your care in advance.
When should the first appointment after a positive test take place?
A first appointment between the sixth and eighth week of pregnancy is often sensible. During this period it is usually possible to assess whether the pregnancy is located in the uterus and is developing as expected for its stage. A heartbeat can often already be seen, though not always at a very early appointment. If you have heavier bleeding, pronounced pain, circulatory problems such as dizziness or fainting, or other acute symptoms, you should see a doctor promptly.
Do I have to have prenatal diagnosis?
No. Additional prenatal diagnostic examinations are voluntary. I explain what information the individual tests provide, what their limits are and what further steps may follow from an abnormal result. You then decide for yourself which examinations you would like to have.
Can I give birth with you?
The birth takes place in a hospital. I currently have admitting rights both at Privatklinik Confraternität & Goldenes Kreuz and in the obstetrics department of Privatklinik Döbling. Whether I attend your birth personally is planned on an individual basis. If you give birth at AKH Wien or at another hospital, the hospital's own team will look after you during the birth. I can prepare you for the birth during your pregnancy and put together the necessary reports.
What if my baby is in the breech position?
Many babies still turn by themselves in the course of the pregnancy. If the baby remains in the breech position towards the end of pregnancy, we discuss the possible options. Depending on the findings, these include external cephalic version (turning the baby from the outside), a vaginal birth at a centre with experience in breech births, or a planned caesarean section.
How long does an appointment during pregnancy take?
For the first appointment I allow enough time for a conversation, the examination, previous reports and an ultrasound. At the later follow-ups there is also time to discuss your questions.
From 1989 to 2023 at the University Department of Obstetrics and Gynaecology at Vienna General Hospital (AKH Wien), senior consultant from 1994; founder and long-standing head of the ZEM outpatient clinic for cysts, endometriosis and fibroids.
If you are pregnant or planning a pregnancy, make an appointment on +43 1 317 660 0 or by e-mail at ordination@prof-obwegeser.at. My private practice is at Hörlgasse 14, Top 11, 1090 Wien. Please note: the entrance is at Liechtensteinstraße 8.