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.

There is no such thing as the perfect time of year to have a baby. Each season comes with its own pros and cons to consider, however being pregnant in the winter can have its benefits.

1. Temperature: Perhaps the most obvious benefit, when you’re pregnant in the winter you don’t have to worry about carrying around an extra 25 to 35 pounds in the sweltering heat and humidity. And thanks to the extra insulation and blood pumping through your body, you’re likely to stay warm throughout the season without having to bundle up in excessive layers.
2. Clothes: Take a survey of pregnant women and we can be very few will say they look forward to sporting a bathing suit while pregnant, especially during that “is she or isn’t she?” phase of pregnancy. During the winter, you can cozy up in soft sweaters and cute scarves.
3. Celebrate the season: Being pregnant in the winter adds an extra reason to celebrate and be thankful during the holiday season. Not to mention the endless ideas for holiday-themed pregnancy announcements, gender reveals and bump photos.
4. Free pass: It can be hard to find room to breathe on your calendar from Halloween through New Year’s. But, when you’re pregnant you have the perfect reason to hit the pause button and relax without having to worry about the guilt trip. Plus, it gives you a free pass to wear comfortable, stretchy pants without judgment.
5. Sleep: Thanks to daylight savings time, there’s barely time to eat dinner before the sun goes down. On the bright side, this means you can go to bed earlier. You need all the rest you can get during pregnancy, and what better time to hibernate than winter?

Don’t let this list fool you. While all of these perks are great, there are also some notable downsides to being pregnant in the winter. Some of your otherwise favorite holiday foods may now make you nauseous, you have to be extra careful walking around when there’s snow or ice, and don’t get us started on the heightened anxiety of being pregnant or giving birth during peak cold and flu season.

The bottom line is that growing a human being inside your body will impact your daily life. There is no right time to get pregnant, only the right time for you.

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.

A full-term pregnancy is made up of three trimesters, but did you know there’s actually a fourth trimester? Postpartum refers to the time period after the birth of a child when a mother’s body transitions back to its non-pregnant state. Every woman and every birth is different, but postpartum recovery may include the following:

• Abdominal pain, as your uterus shrinks back to normal size
• Baby blues
• Constipation
• Hemorrhoids
• Hormonal shifts
• Perineum soreness
• Sore nipples and breasts
• Stitches
• Vaginal bleeding and discharge
• Water retention
• Weight loss

If that sounds like a lot, that’s because it is. Mothers should be patient with their bodies both physically and mentally during this time. We know, easier said than done, right? If you are having a difficult time adjusting in the weeks and months following labor and delivery, you are not alone. An estimated 1 in 9 women experience symptoms of postpartum depression. Even more experience a postpartum mood disorder which includes the following subcategories:

• Baby blues
• Postpartum depression
• Postpartum psychosis
• Postpartum anxiety
• Postpartum obsessive-  disorder
• Postpartum post-traumatic stress disorder

Approximately 70-80% of all new mothers experience some negative feelings or mood swings following the birth of their child. Depending on how the birth of the baby went, the symptoms of “baby blues” will often hit within four to five days after the birth. Sometimes they may be noticeable early.

Common symptoms of the “baby blues” include crying for no apparent reason, irritability, anxiety, fatigue, insomnia, sadness, mood changes, and restlessness. These feelings typically last for a few minutes or up to a few hours each day, and often resolve within two weeks post-delivery.

In some cases, these symptoms last longer which may be an indication of a more serious postpartum mood disorder. While they are similar to the “baby blues,”  postpartum depression symptoms are much more severe.

Red flags that may be a sign of postpartum depression are:

1. You might find yourself withdrawing from your partner or other loved ones, and are experiencing an inability to bond well with your baby.
2. You might find that your anxiety is out of control to the point of preventing you from sleeping, even when your baby asleep, or eating appropriately.
3. You might find overwhelming feelings of guilt or worthlessness or begin to develop thoughts preoccupied with death or even wish you were not alive.

If you are unsure whether your feelings fall within the normal range of “baby blues,” you can use the Edinburgh Postnatal Depression Scale–a screening tool designed to detect postpartum depression. Follow the instructions carefully and answer the questions honestly. If you score greater than 13, it is important that you consult a healthcare professional as soon as possible for a more thorough assessment.

The team of physicians at Raleigh OB/GYN are experienced in caring for women in all stages of life including postpartum. Call 919-876-8225 to schedule an appointment today.

Fall is finally in the air. But, cooler temperatures also mean that flu season is on the horizon. Cases of the influenza virus are diagnosed year-round, but peak flu season typically occurs during the fall and winter from November to March. The time to get vaccinated is now, but is the flu shot safe during pregnancy?

Is it recommended?

The Centers for Disease Control and Prevention and the American College of Obstetricians and Gynecologists both recommend that all pregnant women who are pregnant during flu season get the flu shot regardless of trimester.

While the FluMist nasal spray form of the vaccine has been approved for use for the 2018-2019 flu season, it is NOT recommended for expectant mothers. The flu shot is made from the inactivated (dead) flu virus, whereas the nasal mist is made from a live, but weakened version of the virus.

How it helps

Getting the flu shot during pregnancy is important for several reasons. Of course, it can help prevent the flu and any maternal complications that may arise from it, but it can also help prevent potential fetal health problems. Having a high fever during pregnancy can increase the risk of fetal birth defects.

The flu shot during pregnancy also provides protection for your baby after birth. Your baby cannot receive the flu vaccine itself until he or she is 6 months old. By getting the flu shot during pregnancy, the antibodies you develop are then passed onto your baby through the placenta and later breastmilk if you choose to breastfeed.

Encourage others

Not only is important for you to receive the flu vaccine during pregnancy, but you should also encourage anyone in your household or even those you come into contact with regularly (co-workers) to get their flu shot. This will help further reduce your risk of contracting the flu, and they’ll already be vaccinated when the baby arrives.

What if I still get the flu?

The flu shot is not 100% effective at preventing the flu, but getting the shot can help reduce the severity of the symptoms if you do contract it. Many over-the-counter medications that one would normally take to relieve flu symptoms are not safe to take during pregnancy. If you think you have the flu, contact your obstetrician immediately. The prescription antiviral medication is most effective within 48 hours from the onset of symptoms.

Where do I get the flu shot?

You can simply ask for the flu at your next prenatal appointment. Keep in mind, that the CDC recommends getting the flu shot as soon as possible and ideally before the end of October. If you need to schedule an appointment, call Raleigh OB/GYN Centre at (919) 876-8225.

Birth control is not a one-size-fits-all solution, nor is it even one-size-fits-most. From pills to implants and everything in between, there are a wide variety of birth control options available.

The type of birth control that is best for you will be determined by your health, lifestyle, access to certain methods, and even your insurance coverage. Your physician can help you make the most informed decision, but be prepared that you may have to try several different methods before finding the best one for you.

Here is a general overview of the different birth control methods that may be available to you:

• Oral Contraception (the pill): Some birth control pills contain only the progestin hormone, while others contain a combination of estrogen and progestin. In addition to preventing pregnancy, they can also help lessen painful menstrual cramps, achieve lighter periods, or help reduce symptoms of premenstrual syndrome (PMS). The downside is that it can be difficult to remember to take daily, and it’s most effective when taken at the same time each day.
• Barrier Methods: Barrier methods of birth control such as diaphragms block sperm from entering into the uterus. The greatest benefit is that it is a hormone-free method. However, to be most effective they should be used in combination with spermicide and left in place for a minimum of six hours after intercourse.
• Condoms: Condoms are the only birth control option that also prevents the spread of sexually transmitted diseases and infections. There are options available for both women and men.
• Patch or Ring: The patch or ring are hormonal birth control methods similar to the pill, but don’t require the daily activity of having to remember to use it. The patch is a small piece of plastic that can be placed externally on your arm, stomach or buttock. It does need to be replaced weekly. The ring is a small, flexible device that is inserted in the vagina. It can be used for three weeks at a time but requires removal for one week each month in order for you to have a period.
• Shots: For longer-term results, a hormone (progestin) shot in the arm every three months can block ovulation to prevent pregnancy. This method may also reduce the risk of uterine cancer and protect you from pelvic inflammatory disease. On the downside, you will have to go to the doctor’s office each time you need a shot. It can also cause more irregular bleeding, especially in the first few months of use, compared to the pill, patch or ring.
• Intrauterine Device (IUD): An intrauterine device is considered one of the most effective forms of birth control. A T-shaped device is inserted into the uterus by your doctor. There are both hormonal and non-hormonal IUDs. Hormonal IUDs will likely make periods lighter if not completely absent, but whereas non-hormonal IUDs may make periods heavier with more cramping.
• Hormone Implant: Hormone implants are another invisible method. Your physician will insert a small, matchstick-sized piece of plastic containing progestin just under the skin on the upper arm. Some women will not have a period at all, but many women will have irregular bleeding, which can be a downside. It can prevent pregnancy for three years before needing to be replaced.
• Permanent Birth Control: The above birth control methods are all temporary–meaning you can start or discontinue use at any time. For women who know they do not want to have children or are confident they are finished having children, permanent birth control is another option.

  The two methods of permanent birth control available are tubal ligation (often referred to as having your tubes tied) and vasectomy (for men).

Contact Raleigh OB/GYN Centre

Based on your individual circumstances and medical history, your physician can help you decide which birth control method is most suitable for your needs and lifestyle.

Raleigh OB/GYN Centre has three convenient locations in Raleigh, Wake Forest, and Clayton. The practice has been serving the community for more than 40 years, and currently has seven obstetricians and gynecologists committed to providing quality care for every stage of a woman’s life. To schedule an appointment, call (919) 876-8225 or complete our online appointment request form.

Though it’s probably not your favorite thing to do, your annual women’s wellness exam is one of the most important things you can do for your long-term health. Even though in most cases an annual pap smear is no longer required, that doesn’t mean you should skip out on your annual wellness exam altogether. Here’s why:

Build a relationship with your physician

In order for your gynecologist to be an effective partner in your care, you need to build a relationship. Over time, you and your physician will get to know each other. In doing so, they’ll have a better understanding of your medical history and can help you navigate through various life experiences.

Establish health trends

Part of your annual women’s wellness exam will include ensuring systems in your body are functioning correctly. Checking your baseline vitals like heart rate and blood pressure will establish trends that can help your physician spot and address irregularities in a timely manner.

Early detection

Even if you aren’t due for a pap smear, other screenings including a pelvic exam, breast exam, or sexually transmitted disease screening are equally important. These exams can help your physician identify problems before they start. Early detection can mean the difference between catching a serious problem while it can still be managed or having to undergo treatment when it’s already advanced.

Preventative treatment

New studies, equipment, medication and healthcare guidelines come out often. Making sure you get your annual women’s wellness exam will ensure you stay up-to-date on all preventative treatments available to you like the best birth control method for your individual needs or the HPV vaccine.

Supplemental care

You may think that because you already had your annual physical with your primary care physician that you don’t need to see your gynecologist every year. However, the two actually work together to give you a more comprehensive picture of your overall health. While there may be some overlap like a blood pressure check, your gynecologist will screen for things your primary care physician won’t and vice versa.

Contact Raleigh OB/GYN Centre

If it has been more than 12 months since your last annual exam, or if you are a new patient seeking a gynecology practice to partner with for your care, contact Raleigh OB/GYN Centre today to schedule an appointment.

The school year is back in full swing. Unfortunately, just as you’re settling into your new routine, the back-to-school crud is likely to rear its ugly head especially as temperatures slowly begin to cool and flu season approaches.

On average, elementary school children get eight to 12 colds or cases of the flu each school year. Taking care of a sick child is daunting enough, but what if you also have a newborn or infant at home?

Newborn babies are especially susceptible to infection since their immune systems aren’t as developed as older kids. Here are some tips to help prevent school-age siblings from spreading germs during your infant’s first year of life:

• Immunizations: Following the American Academy of Pediatrics vaccination schedule is the first line of defense for protecting against childhood illness. This won’t prevent the common cold, but it will help against more serious disease like pertussis (whooping cough) or measles. The AAP also recommends an annual flu shot for all children from age 6 months to 18 years.
• Handwashing: Frequent handwashing is the single most important thing you can do to prevent the spread of germs. Teach children to sing ‘happy birthday’ to him or herself twice to make sure they wash for at least 20 seconds. Stress the importance of using soap, not just plain water, and to clean between their fingers and around their fingernails. Hands should be dried with a clean paper towel or hot air dryer.
• Change clothes: Schools are a hotbed for germs, and dirt and bacteria can adhere to clothing. Have school-age children change clothes as soon as they get home.
• Establish contact rules: There are few things sweeter than a doting sibling who wants to help take care of or love on their baby brother or sister. To hinder the spread of germs, limit kissing to the top of the head or baby’s feet.
• No sharing: You’ve spent all this time teaching your child the importance of sharing, but now you have to explain the importance of not sharing. Keep frequently-played-with toys out of baby’s reach and clean them at the end of the day with a sanitizing wipe or in the dishwasher. Also make sure the older sibling doesn’t handle things like the baby’s bottle, pacifier or teether.
• How to cough and sneeze: Teach your child to cough or sneeze into his or her elbow. Keep tissues within reach to prevent them using their hand or clothes to wipe or blow their nose. Make sure they throw used tissues away immediately.
• Breastfeeding: If you are breastfeeding, continue to do so even when you or someone else in the household is sick. You should continue to nurse through illnesses such as a cold, sore throat, flu, stomach bug, or fever. Chances are your baby was already exposed before you showed systems and mother’s milk will provide antibodies specifically tailored to help your baby fight off the illness. There are only a few serious illnesses that might require a mom to stop breastfeeding for a period of time or permanently. If you’re unsure, consult your physician.

Unfortunately, you can’t always prevent the spread of germs. Children with viral infections can be infectious before they show symptoms, as well as after their symptoms clear up. But, here are some things you can do to help prepare an older sibling’s ability to fight off infection and reduce the length of time they are sick:

• Sleep: According to the CDC, school-age children should get 10-11 hours of sleep each night. Sleep deprivation hinders the immune system’s ability to fight off infection.
• Diet: A balanced, nutritious diet will help your child have the energy to get through the school day and increase their immunity defense against bacteria and viruses.
• Exercise: Regular activity is a critical part of staying healthy, even in winter months. At a minimum, children should have a daily dose of 40 minutes of activity.
• Proper clothing: Teach your children to keep their jackets zipped and hats on their heads when it’s cold.
• Daily vitamins: Taking the appropriate dose of children’s vitamins gives your child the added boost he or she needs to fight off airborne or direct-contact viruses. There are a lot of options on the shelf. Consult your child’s pediatrician for a recommendation.

Contact Raleigh OB/GYN Centre

If you’re currently pregnant or recently gave birth, contact us today for more tips on keeping you and your family healthy throughout the school year.