May is National Mental Health Month, so we thought it would be fitting to shed some light on postpartum depression (PPD)–a mood disorder an estimated 1 in 9 women experience after childbirth. In some areas of the country, the estimate may be as high as 20% of new moms.

In recent years, discussions and research about postpartum depression have helped to reduce the stigma surrounding it. However, there is still far more that needs to be done in terms of awareness and education. From signs and symptoms to risk factors and how to seek help, here is what you need to know about postpartum depression.

What is Postpartum Depression?

Often initially mistaken as the “baby blues,” postpartum depression is a medical condition that involves lasting feelings of extreme sadness, anxiety and exhaustion following childbirth.

In the days following childbirth, a normal amount of worry, overwhelm and fatigue is to be expected considering the hormone fluctuations that occur during pregnancy and after delivery. However, when these feelings don’t subside within a week or two and worsen to the extent that they interfere with day-to-day life, postpartum depression may be the culprit.

Postpartum depression may develop at the time of birth or in the days that follow, but it most commonly starts between a week and a month following delivery. Symptoms may occur up to one year postpartum.

Though postpartum depression is often used interchangeably or as an umbrella term, there are several other postpartum disorders that women may experience including postpartum anxiety, post-traumatic stress, panic disorder, obsessive-compulsive disorder and postpartum psychosis.

What Causes Postpartum Depression?

According to the National Institute of Mental Health, postpartum depression cannot be attributed to a single cause. Instead, it is likely caused by a combination of physical and emotional factors.

Physical factors include the rapid decline of hormones (estrogen and progesterone) that occurs after a woman gives birth which causes chemical changes in the brain that may trigger mood swings.

These factors are often exacerbated by a mother’s inability to get the adequate rest need to recover from childbirth. Continued sleep deprivation can contribute to the symptoms of PPD, particularly feelings of physical pain, discomfort and exhaustion.

One thing that is for certain is that PPD is not caused by something that a mother does or does not do.

What are the Symptoms?

Postpartum depression shares many of the same symptoms as clinical depression, as well as some that are unique to women following childbirth. Some of the common symptoms may include:

• Feeling sad, hopeless, empty or overwhelmed
• Feeling shame, guilt or like a failure
• Feeling panicked or scared a lot of the time
• Feeling worried or overly anxious
• Feeling restless, moody or irritable
• Feelings of anger or rage
• Crying more often than usual or for no apparent reason
• Oversleeping
• Inability to sleep even when the baby is asleep
• Difficulty concentrating, remembering details or making decisions
• Loss of interest in activities once previously enjoyed
• Physical symptoms such as aches, pains, frequent headaches, or stomach problems
• Changes in appetite; Eating too much or too little
• Withdrawal from family and friends
• Difficulting bonding or forming an emotional attachment with the baby
• Doubting one’s ability to care for the baby
• Thoughts of harming oneself or the baby

Women may experience one or many of the symptoms above which can range from mild to severe. Untreated, PPD may last for months or longer.

When to Seek Help

If you or someone you love recently had a baby and is experiencing any of the above symptoms of postpartum depression, contact your healthcare provider right away to evaluate your treatment options. If you are worried about harming yourself or your baby, please call 911.

Because the symptoms of postpartum depression are broad, may vary among women, and often overlap with symptoms of other conditions, it is important to seek help from a licensed healthcare professional who is experienced in the diagnosis of perinatal mood and anxiety disorders such as your OB/GYN.

The board-certified physicians at Raleigh OB/GYN can help determine if the symptoms you are feeling are due to postpartum depression or something else. And if needed, recommended a mental health professional in your area as part of your treatment. To schedule an appointment, call (919) 876-8225.

An estimated 70-80% of pregnant women experience some type of morning sickness during their pregnancy, however, around 2% will experience severe morning sickness–a condition called hyperemesis gravidarum. The tricky thing is that what is considered “normal” morning sickness can be difficult to discern, particularly if it is your first pregnancy. Here are some indicators that can help you decide what’s normal and what’s not:

Morning Sickness vs. Hyperemesis Gravidarum (HG)

Source: American Pregnancy Association

What is hyperemesis gravidarum?

Hyperemesis gravidarum (HG) is a severe form of nausea and vomiting in pregnancy that is generally described as unrelenting, excessive pregnancy-related nausea and/or vomiting that prevents adequate intake of food and fluids.

Unlike morning sickness, HG usually extends beyond the first trimester. It may resolve by 21 weeks, but for some women, it may last for the duration of the pregnancy.

The cause of hyperemesis gravidarum is currently unknown but most theories indicate that it may be hormone-related. It is more common in multiple pregnancies (twins or more) and in women with migraines. Women with a family history of hyperemesis gravidarum or who had the condition in a previous pregnancy are much more likely to have it with future pregnancies.

Diagnosis and Treatment

There is no test to diagnose hyperemesis gravidarum. A diagnosis is usually made by measuring weight loss, conducting a urinalysis to check for ketones, and assessing the overall condition of the mother, including whether she is having difficulty performing her normal, daily activities.

Fortunately, there are medications and other treatment options available with the goal of reducing nausea and vomiting, replacing fluids and electrolytes, and improving nutrition and weight gain. In some cases, hospitalization for treatment may be necessary.

In severe cases or left untreated, HG is commonly associated with:

• Loss of greater than 5% of pre-pregnancy body weight (usually over 10%)
• Dehydration and production of ketones
• Nutritional deficiencies
• Metabolic imbalances
• Difficulty with daily activities

Other concerns include liver damage, jaundice, thiamine deficiency, preterm delivery, low birth weight, and the effects of excessive maternal weight loss and poor nutrition on fetal growth.

When to Seek Help

With no identifiable cause, researchers believe that although the condition is considered rare, hyperemesis gravidarum is likely underreported and undiagnosed. If you are unsure whether your symptoms of morning sickness are considered normal or severe, talk to your physician as soon as possible. Early intervention can help prevent the condition from becoming more severe.

The team of board-certified physicians at Raleigh OB/GYN have been caring for expectant mothers for more than four decades and are experienced in treating a variety of pregnancy-related conditions. To schedule an appointment, call (919) 876-8225.

Pregnancy can bring on a wide range of symptoms from cravings and “the glow” to morning sickness and of course, weight gain. While most are merely uncomfortable, others may indicate a potential complication. It’s important to be aware of what pregnancy symptoms you should call your doctor about right away:

1.  Extreme fatigue or dizziness

While is natural to feel a little more tired than normal during pregnancy, extreme fatigue and dizziness may be a sign of anemia. Anemia is the result of a low count of red blood cells, meaning that not enough oxygen is being transported throughout the body.

In addition to extreme fatigue and shortness of breath, shortness of breath and breathing complications can be seen. This is another indication that oxygen transport is inefficient. Normally, this can be treated conservatively by consuming more iron-rich foods or iron supplements.

2. Severe nausea

Nausea and vomiting are common symptoms, especially in the early stages of pregnancy (thanks, hormones). Commonly referred to as morning sickness, these symptoms can actually strike at any time of day. However, there is a fine line between normal and extreme. If vomiting becomes constant, it may be a sign that you have hyperemesis gravidarum–a condition that has the potential to cause severe dehydration if left untreated. If you are unable to keep fluids down for more than 8 hours, you should call your doctor.

3. Vaginal spotting/bleeding

Research shows that an estimated 20-30% of women experience some degree of bleeding in early pregnancy. In some cases, particularly within the first two weeks following conception, this may be implantation bleeding which occurs as the fertilized egg implants itself in the lining of the uterus. Other potential causes in early pregnancy could be an infection, such as UTI, or irritation caused by intercourse.

However, vaginal bleeding may also be a sign of a more pregnancy complication. If you are bleeding, the American Pregnancy Association recommends wearing a pad or panty liner so that you can monitor how much you are bleeding and what type of bleeding you are experiencing. If you experience heavy, bright red vaginal bleeding or passing clots, you should call your doctor.

4. Severe cramping

While pain with kicking is normal, especially in the later stages of pregnancy, severe cramping or stomach pain should be noted. If the cramping does not subside, this may indicate a potential problem with the placenta or a disruption in the natural progression of the pregnancy, including but not limited to miscarriage.

5. A spike in the mother’s blood pressure

A slight increase in blood pressure during pregnancy can be normal due to the extra stress on the body. However, if blood pressure starts to spike, in association with other symptoms such as swelling and blurred vision, a condition known as preeclampsia may be present.

If this does occur, early delivery may be necessary and the baby may need additional time under medical supervision to continue natural development before being released.

6. Decreased fetal movement

Sometime between 13 and 25 weeks, you will feel your baby begin to move. In many cases, first-time moms may not feel these movements as early as women who have been pregnant before, but it’s important to remember that each woman and each pregnancy is different. If you are more than 20 weeks pregnant and have not felt movement, talk to your doctor.

Once you feel your baby move, you should contact your doctor if you notice a decrease in fetal movement (less than 10 movements in a one hour period).

7. Fever over 101°F

You may think a mild fever is no big deal, but if you are pregnant and have a fever over 101°F that does not respond to Tylenol it’s important that you don’t ignore it.

8. Urinary burning, frequency or pain

Burning or pain when urinating, or changes in the frequency of urination, may be a sign of a urinary tract infection. Around 5% of women can expect to develop at least one UTI during pregnancy and of those, 1 in 3 are likely to experience a recurrence. Generally, UTIs are treated with an antibiotic, but in cases where infection has reached the kidneys, IV antibiotics may be recommended.

Left untreated, UTIs can lead to kidney infection, as well as an increased risk of fetal growth restriction, preeclampsia and preterm birth.

9. Vaginal fluid with color or odor

Discharge is not uncommon during pregnancy, however, it should be clear or white with no smell.

10. Labor Symptoms

If you experience labor symptoms, you should call your doctor immediately. These include five contractions in 1 hour, if less than 36 weeks; contractions every five minutes or less for 1 hour; and/or rupture of membranes, commonly known as your “water breaking.”

Contact Raleigh OB/GYN

While no one ever wants to incur a complication during pregnancy, preparing for the “what-ifs” and knowing what to look out for is the best way to prevent harm to the baby or the mother. Careful observation and open communication with your physician is necessary in order to promote the best interests for both throughout the duration of a pregnancy.

If you experience any of the above symptoms, call Raleigh OB/GYN at (919) 876-8225. One of our physicians is on call 24 hours a day to handle emergencies and deliveries.

One of the common misconceptions about labor and delivery involves the various pain relief options that are available. In particular, many first-time moms might assume that the options include epidural or no epidural. But, there are various other medication and non-medication forms for pain management.

Each woman has a different threshold for pain and reacts to pain medications differently. In many cases, you won’t know what kind of pain relief you want until you’re in labor. But, in order to make an educated decision, it’s important to understand the pros and cons of each. Here are six options to relieve labor pain that you may consider:

1. Epidural Anesthesia

As an expectant mother, you have more than likely heard of epidural anesthesia. One of the most common medical pain relief options available, an epidural is a regional anesthesia that blocks pain in a particular part of the body, a pain management option chosen by more than 50% of women giving birth at hospitals.

Before epidural anesthesia is administered, the pregnant patient is given intravenous (IV) fluids. While sitting up and leaning forward to arch your back, an anesthesiologist will apply an antiseptic solution then inject a local anesthetic to numb the area.

A needle is then inserted into the spinal cord in the lower back followed by a catheter which is threaded through the needle into the epidural space. Once the needle is removed, the catheter remains in place and allows the medication to be injected either periodically or continuously. Pain relief typically occurs in around 20 minutes.

While an epidural does not slow dilation, it may slow your ability to push effectively. As with any medication, epidurals do have potential side effects such as nausea, itching, shivering, drop in blood pressure or severe headache.

If you have had spine surgery, are allergic to anesthetic or have blood-clotting problems, you may not be able to get an epidural and will need to consider other options to relieve labor pain.

2. IV Analgesics

For women who choose not to get an epidural, or are early in labor and would like to wait to get an epidural, pain medication through an IV is an option. This type of medication relieves pain without the loss of feeling or muscle movement that occurs with an epidural. While IV analgesics can help to dull the pain, they typically do not take the pain away like an epidural may. They are commonly administered with a single shot or intravenously (IV). It’s important to know that analgesics are another term for opioids. They have the potential to make your baby drowsy, so may not be an option if you are within an hour of delivery.

3. Nitrous Oxide

Rex Hospital also now offers nitrous oxide, which is an inhaled gas, to help with labor pain. According to the Journal of Midwifery & Women’s Health, “Nitrous oxide labor analgesia is safe for the mother, fetus, and neonate and can be made safe for caregivers. It is simple to administer, does not interfere with the release and function of endogenous oxytocin, and has no adverse effects on the normal physiology and progress of labor.”

Those who choose to use nitrous oxide during labor may still have an awareness of labor pain, but many women find it helps them relax and decreases their perception of labor pain.

4. Heat or Cold Therapy

Your body temperature may change drastically throughout the labor and delivery process. A hot or cold pack can help relieve the pain and discomforts that arise with contractions.

Cold therapy can useful for reducing swelling and inflammation. Similarly, heat therapy may help relieve severe pain and tension in your muscles. By relieving major muscle tension and loosening your body, you may be better able to rest between your contractions making for a more enjoyable labor and delivery.  

5. Rhythmic Breathing

Another common non-medical labor pain relief tactic is to ‘just breathe’. Breathing along with your contractions can significantly help you control your ‘labor waves’ and offer relief. During your pregnancy, consider taking a Lamaze class or learn guided meditation techniques.

Depending on what feels most natural for you, you will want to either take deep inhales that expand your diaphragm or short patterned breaths that keep you focused more on your breaths than on the pain.

Not only does rhythmic breathing help pregnant women feel more relaxed and in control during labor but increased oxygen also helps the individual in pain feel stronger and have more energy during the pregnancy and labor.

Additionally, patterned rhythmic breathing can quickly become an automatic response to pain which can help mothers even after their pregnancy to manage stress in their everyday lives.

6. Averting Focus: Music, Imagery, Conversation

Similar to breathing exercises and rhythmic breathing, you can use music, imagery, and conversation to avert your focus and still feel in control during labor.

According to the College of Nursing and Health Sciences, music therapy is one of the most powerful non-medical treatments for labor pain because music targets the parts of the brain that also respond to pain and replaces them with feelings of happiness and calm.

Similarly, by choosing imagery such as your phone, your significant other’s face, or an object in the room, you can focus your attention on something other than the pain which can help you cope.

Lastly, just like medical professionals recommend talking to people who have experienced a trauma such as a car accident, having a conversation as you labor can help shift your focus away from the pain.

Which Option is Best?

When it comes to options to relieve labor pain, there is no one size fits all solution. What works for you or what you feel most comfortable with may be different than another expectant mother.

Of course, any woman can choose not to have any medications for pain control in labor, and if this is your desire, it may be helpful to take a childbirth class with this focus or to work with a labor support person, like a doula.

Your doctor can help answer any questions and address any concerns you have about the various options and offer suggestions about what may be best for you.

At Raleigh OB/GYN, our goal is to help expectant parents have a positive labor and delivery experience. For more information or to request an appointment, call (919) 876-8225.

When you’d like to prevent pregnancy, birth control pills are one of the most popular methods with over 99% effectiveness. But, did you know that there are numerous other reasons to consider taking birth control beyond preventing pregnancy? Here are some of the additional benefits:

• Regulate menstrual cycle: That time of the month isn’t exactly always pleasant, but it can be even worse if you never know when it is going to occur. One month it may last 3-4 days only to start again two weeks later and last for 7 days. If you have irregular periods or heavy bleeding, hormonal birth control methods may help to regulate your menstrual making periods lighter and more consistent.

• Less painful periods: An estimated 31% of women who use birth control pills say that menstrual cramps are one of their main reasons for taking them. Hormonal birth control, such as the pill, prevents pregnancy by preventing ovulation. Without ovulation, your uterus has no need to contract thus resulting in less painful periods.

• Improve the appearance of your skin: Acne that occurs during adolescence is often triggered by fluctuating hormones. That’s why hormonal acne in women commonly occurs during or following pregnancy. Birth control pills containing the hormones estrogen and progesterone are proven to help reduce or eliminate acne.

• Relieve symptoms of PMS: Painful cramps aren’t the only symptom commonly associated with your period. The hormonal fluctuations that occur leading up to your period may also cause premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD)–a form of PMS whose symptoms include mood swings, depression, anger, anxiety and irritability. Some birth control methods may help relieve these symptoms.

• Manage Polycystic Ovary Syndrome (PCOS): Polycystic ovary syndrome is a condition in which women have a hormone imbalance. Trademark symptoms include acne, excess body hair, weight gain, irregular periods and heavy bleeding. Birth control pills can help balance testosterone levels and regulate bleeding associated with PCOS.

• Manage endometriosis: Another condition affecting the female reproductive system, endometriosis occurs when the tissue lining the uterus grows in places other than inside your uterus. It causes both pain and inflammation. Hormonal birth control methods, continuous birth control pills and intrauterine devices (IUDs) can help manage endometriosis because they allow you to skip periods.

• Reduce the risk of uterine and ovarian cancer: In 2019, an estimated 61,800 new cases of uterine cancer will be diagnosed in the United States. However, women who take combination birth control pills are 50% less likely to develop uterine cancer. It is also proven to reduce the risk of ovarian cancer–the fifth leading cause in cancer deaths among women.

• Reduce the risk of ovarian cysts: During ovulation, small cysts may form in your ovaries. While these cysts aren’t considered harmful, they are often painful, particularly for women with PCOS who have a large number of these small cysts. Because they prevent ovulation from occurring, hormonal birth control can also help prevent these cysts from forming and help prevent the regrowth of former cysts.

As with any medication, women who take birth control may experience side effects. However, in many cases, the benefits far outweigh them. Keep in mind, it can take trying several different types of birth control before you find one that works best for your individual needs.

If you are interested in taking birth control to prevent pregnancy or for any of the reasons listed above, call (919) 876-8225 to schedule an appointment with Raleigh OB/GYN. Our providers can help recommend which method will work best for you based on your current health status, medical history, lifestyle and preferences.

Most parents are well-versed in preventative healthcare for their children. They follow the recommended schedule for well visits and immunization and schedule the sports physical so their child can play soccer. They know when it’s time for dental cleanings, and inevitably when it’s time to consult an orthodontist. But, when it comes to raising girls, parents may not realize a first gynecologist visit should be scheduled between ages 13 and 15.

What to Expect

Most girls will not need a pelvic exam during the first visit. Many gynecologists will just do a regular health exam and talk to your daughter about her development. A regular health exam typically includes:

• Basic checks for vitals such as weight, heart rate and blood pressure
• Breast exam to detect lumps, cysts or breast problems
• External exam
• Pelvic (internal) exam, if needed
• STD testing, if sexually active

The provider will ask questions that can help determine which tests to run and what issues to discuss, such as:

• When was your last period?
• Are you having any problems with your period, such as pain or heavy bleeding?
• Have you noticed any unusual vaginal discharge or sores, itchiness or discomfort in the vaginal area?
• Are you, or have you ever been, sexually active?
• If so, are you using birth control or protection for sexually transmitted diseases?
• Do you think you could be pregnant?

These question may your daughter feel uncomfortable, but before the appointment discuss the importance of answering truthfully.

How to Prepare

Before your daughter’s first well-woman exam with a gynecologist, there are a few things you can do to help prepare and make her feel more comfortable.

For starters, before her first appointment, you may consider bringing her with you to one of your exams. This will help alleviate any nerves by letting her see firsthand what a well-woman visit entails.

If either of you doesn’t feel comfortable attending one of your appointments together, have a conversation about what to expect and why the doctor is doing it.

Here you can introduce to her gynecologist and prepare her for the first examination.  Also mostly the first examination is just a simple regular health check and talk about the developments.  Apart from that, if any case your daughter is sexually active, she should take her exams with the gynecologist. Even she is not; still, she needs to know about how to keep her healthy and protected.

Contact Raleigh OB/GYN Centre

The team at Raleigh OB/GYN includes six board-certified physicians–both male and female should you or your daughter have a preference for which she sees. Our practice believes that routine gynecological care is key to living a happy, healthy life. For this reason, we begin seeing patients in their adolescence and continue this relationship throughout their lifetime. To schedule an appointment for your daughter’s first gynecological exam, call (919) 876-8225.

Preparing for the arrival of your baby is exciting, but it can also be overwhelming–especially if you are a first-time mom. Once you’re around 34 weeks pregnant, you should start preparing for your delivery date. Even if you have a scheduled C-section or induction date, there is still the possibility you could go into labor naturally before then. So, it’s a good idea to be as prepared as possible well in advanced.

Once you’ve set up the crib or bassinet and installed the car seat, go ahead and start packing your hospital bag for labor and delivery. We suggest designating an area, like the nursery or a spare bedroom, to gather all your items before you pack them.

Here is a helpful labor and delivery hospital bag packing list that you can check off as you go:

• Personal documents & ID: At a minimum, you will need your health insurance card and a government-issued photo ID. Of course, these are items traditionally kept in your wallet and purse so they won’t actually get “packed.” It’s also a good idea to carry a printed copy of any hospital paperwork you have already filled out such as a pre-registration form. If you anticipate being away from the local area where you plan to deliver, request a copy of your medical records from your physician’s office to keep with you.
• Birth Plan: If you’ve chosen to write a birth plan, bring a few copies with you to the hospital. You care team will include several doctors and nurses, so this can be a helpful reference to ensure everyone is on the same page about your labor and delivery preferences.
• Phone Charger: Aside from using it to update your loved ones, your phone can help you pass the time while you labor. You may want to play music, scroll through social media or use helpful apps like a contraction timer or for guided meditation. You may opt to bring a traditional camera, but you’re bound to take some snaps with your phone as well. All of this can drain your battery quickly, so don’t forget to pack a charger. You might consider purchasing a charging cord with extended length since there’s no way to predict where power outlets will be in the labor or recovery rooms.
• Toiletries: Deodorant, body wash, shampoo, facial cleansing wipes, toothpaste, and a toothbrush are necessities. Don’t forget the lip balm and moisturizer – hospitals are dry, and pregnancy has likely already taken a toll on your skin! If you aren’t keen on the idea of using the hospital’s, you may also want to pack your own towel from home. Those who wear glasses or contacts should back those in their hospital bag as well.
• Hair Care and Cosmetic Products: Stick to the bare minimum on this category. A ponytail holder can help keep your hair out of your face during labor, and brush and dry shampoo will come in handy for those first photos with your new baby. If a swipe of mascara or pat of blush make you feel better, by all means, pack them. Though you’re not likely to need or use your entire makeup bag.
• Flip-Flops for the shower. No explanation, necessary.
• Slippers or Dark-Colored Socks: Whether you’re in bed or need to walk on the cold tile floor, socks can keep your feet warm and clean. These can get dirty, so pack a dark-colored pair or ones you don’t mind throwing away. Slippers or a pair of shoes you can easily slide on can be helpful when getting in and out of bed or walking the halls of the labor and delivery wing.
• Sleepwear, Robe, and Underwear: A lightweight nightgown will be much more comfortable than a hospital gown, and a robe will come in handy for walking the hallways or when visitors stop by. if you don’t want to wear the mesh underwear the hospital gives you after delivery, pack a few pairs of underwear like briefs, maternity, or disposables (ex. Depends). As with the socks, these should be items you would not be upset if they got ruined.
• Nursing Bra: Don’t forget to pack a nursing tank top or bra. If you buy them at the end of your pregnancy, most women are about the same size postpartum. They are obviously designed to help make it easier to nurse, but are also more comfortable to sleep in. If you need to use a pump, the hospital will provide one to use during your stay along with any parts or bottles that you need to go along with it.
• Homecoming Outfit for Baby: The hospital will provide everything that your baby needs during your stay. Unless you have your heart set on a specific style, don’t worry about packing any swaddles or blankets. You won’t need multiple outfits for each day, but be sure to pack an outfit for going home. Newborn gowns make for easy diaper changes, but if you opt for a kimono-style shirt and footed pants you don’t have to worry about packing socks. This style top wraps around the baby and fastens with snaps so you don’t have to put it over their head. Most also have built-in cuffs to keep tiny fingernails from scratching, so you can skip the mittens too.
• Homecoming Outfit for You: You’ll most likely still look around 5 months pregnant when you leave the hospital, so don’t throw out your maternity clothes just yet. Depending on the weather, pack your favorite maternity dress or leggings and tunic.
• Extra Bag: All of your items should fit nicely in a weekender-style bag or small roller-style luggage. With all the supplies from the hospital—diapers, blankets, and creams—and gifts from any visitors, you’re likely to have more stuff coming out than you did going in. We suggest tucking one or two extra bags into your hospital bag. Reusable shopping bags that can easily be folded up are great for this.

Extras

Other items that you may want to consider putting on your hospital bag packing list aren’t exactly necessities, though some women may consider them as such. Rather, most are comfort items that can help provide relief during your labor or post-delivery.

• Pillow for you and/or your partner
• Relaxation tools such as back massager, stress-relief ball or massage oil/lotion
• Cash for the vending machine just in case
• Snacks for you and/or your partner to munch on
• Thank you gift for the doctors and nurses that care for you and your baby. Something as simple as fun-size candy are great or, if you prefer, you can schedule for a fruit basket or something similar to be delivered. There are great ideas on Pinterest if that’s your sort of things.
• Eye mask & earplugs to help you sleep. There are generally quiet hours in the labor and delivery department, but hospitals can be noisy.
• Camera and charger if you’d like to capture baby’s first days with something besides your smartphone

You might feel inclined to overpack because after all, you’ll never know what you’re going to need. But, keep in mind the average hospital stay for labor and delivery is typically only 2-3 days. The hospital will provide most items you and your baby will need during your stay, and for comfort items, your partner or another loved one can always run out to pick up something you’ve forgotten or decided you would like.

Talk to your doctor if you have additional questions about how to prepare for your upcoming labor and delivery. The team of providers at Raleigh OB/GYN has been delivering babies for decades, so their knowledge is based on experience. For more information or to request an appointment, call (919) 876-8225.

From pills to implants and everything in between, there are a wide variety of birth control options available. However, most methods are temporary – meaning you can start or discontinue use at any time.

Permanent birth control may be the better solution for women who know they do not want to have children or are confident they are finished having children. It eliminates the need to remember to take a pill each day or the periodic maintenance of an implant or IUD.

Types of Permanent Birth Control

To help determine if permanent birth control is right for you, it is important to know what your options are. There are currently two methods of permanent birth control available.

1. Tubal Ligation
Commonly referred to as “having your tubes tied,” tubal ligation is a procedure for women that is performed at a hospital or outpatient surgical clinic. Using a small telescope (called a laparoscope) through one or two small incisions, the fallopian tubes are cut, sealed, banded, clamped or tied shut. The tubes can also be removed in their entirety. This prevents eggs from traveling from the ovaries to the uterus so you can’t get pregnant. The procedure is performed under anesthesia, but you are able to go home a few hours later.

2. Vasectomy
A vasectomy is the term for the male sterilization procedure. Your male partner can have this procedure done at a physician’s office with the use of a local anesthetic. The procedure prevents the sperm from being able to leave the testes and ever enter a woman’s body.

Is permanent birth control 100% effective?

Each of these methods is nearly 100 percent effective when it comes to preventing pregnancy. However, there is a waiting period that follows where you will want to use a secondary method of birth control. The amount of time depends on the type of procedure.

It is important to understand that while all types of permanent birth control work to prevent pregnancy, they do not protect against the spread of sexually transmitted infections.

You shouldn’t pursue permanent birth control unless you are sure you and your partner do not want to get pregnant in the future. While in some instances the procedures may be successfully reversed, they should largely be considered irreversible.

How to choose which type is right for you

In the U.S., tubal ligations outnumber vasectomies three to one – with roughly 600,000 tubal ligations and 200,000 vasectomies performed each year. Determining if permanent birth control is right for you should be discussed with your partner, as well as a healthcare professional. Based on your circumstances, your physician can help you decide which method is most suitable.

Raleigh OB/GYN Centre has three convenient locations in Raleigh, Wake Forest and Clayton, North Carolina. With nearly 45 years of experience serving women in their community, the healthcare team at Raleigh OB/GYN is committed to providing quality care for every stage of a woman’s life. To discuss your birth control options with one of our six dedicated and experienced providers, call (919) 876-8225 to schedule an appointment today.

Each time we turn on the news or scroll through social media, it seems like another female celebrity is sharing her experience with endometriosis–a disease in which the lining of the uterus grows in other places in the body.

From Dancing with the Stars’ Julianne Hough and Top Chef host Padma Lakshmi to Susan Sarandon and Whoopi Goldberg, it’s apparent that endometriosis doesn’t appear to discriminate based on race, ethnicity or socioeconomic background. While these women and countless others have helped raise awareness about this disease, it’s important to focus on the facts.

Here are six signs of endometriosis that all women should know:

• Painful periods: An estimated 75% of women with endometriosis have been found to have a history of painful, crampy periods that can be traced back to their adolescence. We’re not talking about the occasional slight cramps on your heavier day, but pain to the extent that it interferes with daily life like your work day, relationships, ability to have intercourse or ability to exercise. You may start to feel pain before your period starts and possibly for several days after.
• Abnormal bleeding: Heavy periods lasting longer than 7 days that may or may not include large clots, or breakthrough spotting or bleeding between periods, may be signs of endometriosis.
• Pain with intercourse: Pain during or after sex is a common symptom of endometriosis, particularly with deep penetration or orgasm. This can be due to positioning, but it often means that the endometriosis is deep in the rectovaginal septum and pelvic walls. Women who experience this symptom may lose their desire to have sex and develop intimacy issues.
• Pain with bowel movements: Depending on the areas of the body affected by endometriosis, it may hurt to go to the bathroom. In severe cases, it might also cause bleeding and/or constipation.
• Changes with urination: In some cases, endometriosis may affect the bladder which can cause pain with urination, a greater sense of urgency or increased frequency.
• Infertility: An estimated 40% of women with infertility have endometriosis. In fact, seeking treatment for infertility is often how many women are first diagnosed with endometriosis. Inflammation caused by endometriosis may damage the sperm or egg or interfere with their movement through the fallopian tubes and uterus. The fallopian tubes may be blocked entirely by adhesions or scar tissue in severe cases.

Additional symptoms, especially during menstrual periods, may include diarrhea, constipation, nausea or bloating. Because endometriosis shares many of the same symptoms as other conditions it is sometimes mistaken for pelvic inflammatory disease (PID), ovarian cysts or irritable bowel syndrome (IBS).  

It’s important to note that not all women with endometriosis experience pain. If you have any of the signs that may indicate endometriosis, you should consult a physician. The condition can be difficult to manage, but not impossible and early detection may result in more effective management of your symptoms. Call Raleigh OB/GYN Centre at (919) 875-8225 to schedule an appointment today.

Contact Raleigh OB/GYN Centre

At Raleigh OB/GYN Centre, we offer a full range of obstetrical care from preconception to delivery. We have offered state-of-the-art care for mothers, daughters and now granddaughters since 1974 and have since grown to three locations to best serve our patients including Raleigh, Wake Forest and Clayton, North Carolina. For more information or to schedule an appointment with our team of dedicated providers, call 919-875-8225.

Raleigh OB/GYN Centre recently began offering midwifery services. This service is not commonplace among most OB/GYN practices, so we wanted to highlight the key differences between a midwife and an obstetrician.

Education

Perhaps the most notable difference, midwives and OB/GYNs complete different levels of medical training. An OB/GYN completes four years of medical school followed by an additional four years of residency plus three years of specialized training. To become a certified nurse midwife (CNM), you must first become a registered nurse then complete a graduate program in midwifery and pass a national certification exam. This certification allows a CNM they are able to practice in any of the 50 states.

While both types of practitioners are trained and experienced in labor and delivery, nurse midwives cannot provide all of the services that a doctor can. In the event surgery is needed to deliver a baby, such as a cesarean section, only an obstetrician has the training to deliver the baby under those circumstances.

Services

Both a midwife and OB/GYN offer family planning, pre-conceptual care, delivery and postpartum care. Additionally, they both offer gynecological care including preventative screenings. Midwives are able to care for women during pregnancy who are considered low risk, while physicians can provide care for both low and high-risk pregnancies. Your first visit to our office will include a thorough medical history and exam to determine whether your pregnancy is considered high-risk.

While many midwives are advocates for natural childbirth, they are able to prescribe medications and provide an epidural for pain relief if that is your preference during labor. However, it is important that you understand your midwife’s position on pain medication before you select midwifery care.

While research shows that OB/GYNs are more likely to use interventions during birth such as instrument deliveries, that is simply because midwives are legally prohibited from doing so. In a study published by the American Journal of Public Health comparing two groups of women with low-risk pregnancies, research indicated that fetal and maternal outcomes are equally good when comparing midwife and OB/GYN births.

Birthing location

An OB/GYN offers delivery in a hospital setting, whereas midwives have the option to work in a variety of settings. These may include private practice, private homes, birth centers and hospitals.

Which should you choose?

Whether you choose a midwife or OB/GYN for your pregnancy care is a personal choice. You must consider the type of birthing experience that you would like. Start by answering these basic questions:

• Is a vaginal birth your priority? Ask your doctor about his or her C-section rate and philosophy. If a vaginal birth is important to you, make sure your care provider supports it.
• What kind of support do you during labor? Midwives are able to spend more time with patients to offer labor support because they generally are not pulled in as many different directions as a physician. If having a caregiver through your entire labor is important to you, you may want to consider hiring a doula who is trained to support and advocate for you throughout the labor and delivery process.
• What are your plans for pain management? While they are able to administer pain medication, midwives are likely to encourage medication-free methods of pain management. This might include showers, massage, acupressure, trying different positions or using a birthing ball.
• What are your expectations while at the hospital? Make sure that your expectations align with your caregiver’s policies for childbirth in the hospital. Will you be restricted to a bed and hooked up to a continuous fetal monitor or are you able to move around freely while taking pause for intermittent monitoring?
• Are you considered high-risk? If you have a condition that will make your pregnancy high-risk you should seek care from an OB/GYN and deliver in a hospital setting. A high-risk pregnancy is defined as one that threatens the life of the mother or her fetus. These may include women with pre-existing health conditions such as diabetes or high blood pressure, advanced maternal age, and pregnancies with multiples (twins or more). A collaborative practice may allow for a midwife to co-manage higher-risk patients alongside OB/GYNS during a pregnancy. Which one delivers your baby will ultimately depend on your medical circumstances.
• Is this your first birth? If you had a C-section in a previous birth, that doesn’t necessarily mean you cannot choose midwifery care for a future pregnancy. However, you should discuss with your current OB/GYN and prospective midwife whether you are a candidate for vaginal birth after Cesarean section (VBAC). In some cases, the answer may be dictated by hospital policy.

About Raleigh OB/GYN Centre

At Raleigh OB/GYN Centre, we believe in empowering women to make the best birthing choices for her and her family. This includes offering midwifery services. By offering this collaborative approach with a certified nurse midwife and a team of obstetricians under the same roof, we can better achieve our goal of helping parents have a positive birthing experience. To learn more about our midwifery services or to schedule an appointment, call 919-876-8225 today.