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A Message from Dr. Campbell

To My Dear Patients,

It is with a great deal of sadness and a sense of regret that I inform you I am retiring and am no longer seeing patients at Raleigh OB/GYN.

This decision was the result of a very serious family accident and several personal medical issues. Part of my regret rests in the unplanned nature of these circumstances and my inability to prepare myself or inform you of a retirement planned for years hence.

It has been my privilege to practice medicine at Raleigh OB-GYN and to serve you over the past decades. I have no reservation in telling you that the current staff is the finest iteration of this practice since I joined in 1992. I trust you will continue to find excellent care with my five associates and wish you all the best that life has to offer.

Sincerely,

Joseph D. Campbell, M.D.

Teen suffering belly pms symptoms

5 Tips to Help Ease PMS Symptoms

We’ve all heard the stereotypes about premenstrual syndrome (PMS) that make it seem like women who suffer from it are just irrational and unpredictably moody. But PMS can be more than pesky mood swings that are inconvenient to the person dealing with PMS and those around them. Severe PMS can be a condition that disrupts daily life for several days every month.

What is PMS?

As the name suggests, premenstrual syndrome is a condition that affects women before their menstrual period. According to the Office on Women’s Health, the symptoms can occur up to two weeks before the start of menstruation. 

While there no one definitive cause of PMS, according to the Mayo Clinic, it is thought to be related to cyclical hormone changes, fluctuation in chemicals in the brain, and perhaps even undiagnosed depression. However, it is impossible to positively diagnose with a lab test or physical examination.

Symptoms of PMS

The most common symptoms can be emotional or related to behavior. These symptoms include depressed mood, mood swings, irritability, anger, crying spells, change in libido, and insomnia.

Physical symptoms of PMS can include abdominal bloating, breast tenderness, weight gain, fatigue, headache, joint or muscle pain, digestive issues, and acne flare-ups.

How to Ease PMS Symptoms

In some cases, PMS can be managed with lifestyle changes. In other cases, consultation with women’s health care professional is necessary. Severe PMS may be a sign of premenstrual dysphoric disorder (PMDD), which is a more serious condition.

If you are suffering from the symptoms of PMS and they are becoming difficult to manage on your own with lifestyle changes or over the counter medication such as ibuprofen or acetaminophen to ease discomfort, you should talk to your doctor to get a definitive diagnosis and professional treatment. 

For many women, here are some other tips that may help ease PMS symptoms:

 

1. Exercise 

Exercise is something that can help with a multitude of health issues. Along with diet, exercise will help keep your body in top working condition. It is one of the most basic steps you can take to improve your overall health. 

Exercise helps with the depressed mood and fatigue associated with PMS. It is recommended that you get at least 30 minutes of exercise most days of the week. Aerobic exercises like swimming, biking, and walking briskly are good options

 

2. Change in Diet

Like exercise, changing dietary habits is one of the most frequently recommended things to improve your health and wellness. To ease PMS symptoms, take the following steps to manage your diet:

  • Avoid caffeine and alcohol
  • Limit salt to help with bloating
  • Eat frequent smaller meals rather than a few big meals
  • Look for foods high in calcium (a supplement may also help)
  • Avoid processed simple carbohydrates and eat complex carbs instead. Complex carbohydrates include fruits, vegetables, and whole grains

If you need more help with your diet, you can consult with your OB/GYN for suggestions or seek counseling from a qualified nutritionist or dietician.

 

3. Stress Reduction

Stress can make almost any health issue worse, and PMS is no exception. To combat stress you can try:

  • Getting adequate sleep
  • Yoga
  • Massage
  • Deep breathing exercises
  • Progressive muscle relaxation

 

4. Medication

If lifestyle changes do not help enough, your doctor may prescribe medication or suggest over the counter meds.

  • Antidepressants are often prescribed to help with PMS and PMDD mood symptoms. The types of antidepressant used in the treatment of these conditions are selective serotonin reuptake inhibitors (SSRIs). Your doctor may prescribe one of these types of antidepressant such as Prozac, Sarafem, Zoloft, Paxil, Pexeva and their generic versions.
  • Hormonal birth control may be prescribed to treat PMS symptoms. Hormonal birth control stops ovulation, which can make your menstrual cycle more regular and decrease the intensity of symptoms. There are also hormonal birth control options available that prevent you from having a period. For these reasons, hormonal birth control is also prescribed for women who experience heavy and painful periods.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) are some of the most common over the counter pain relievers. They can be helpful in treating cramps and breast tenderness. You are probably familiar with many of these drugs, which include ibuprofen (Advil and Motrin IB) or naproxen sodium (Aleve).
  • Diuretics can help reduce water retention and ease bloating when exercise and limiting your salt intake are not effective enough. Known as “water pills,” diuretics like Spironolactone push excess fluid through the kidneys. Although versions may be available over-the-counter, diuretics should never be taken without first consulting a licensed healthcare provider.

 

5. Alternative Remedies

While these treatments are not regulated by the FDA, and are not scientifically proven, many women report they have benefitted from alternative medicine. Anecdotal evidence is not a viable replacement for professional medical advice. Examples of alternative remedies that may help are:

  • Vitamin supplements
  • Herbal supplements
  • Acupuncture

The main thing to remember with vitamin and herbal supplements is that they are not regulated by the FDA, so there is a small chance you won’t be getting exactly what is on the label. You should always speak to your provider before trying products, even those marketed as “safe” and/or “natural.”

If you make positive lifestyle changes for a while and do not experience enough of an improvement in your symptoms, it might be time to consult a professional. At Raleigh OB/GYN we offer comprehensive gynecological care and can help with issues related to your menstrual cycle, including PMS. To make an appointment, call 919-876-8225 or request one online.

VBAC; Emergency In the Hospital: Woman Giving Birth, Husband Holds Her Hand in Support, Obstetricians Assisting. Modern Delivery Ward with Professional Midwives.

Am I a Good Candidate for a VBAC?

Many women in the US have given birth via Cesarean, or C-section. There are many reasons that this may be necessary or planned for, but there are some preconceived notions about C-sections that may not be true. One of those notions is that once you’ve had a C-section, all of your subsequent deliveries must be via C-section as well. This is not necessarily true. Given the circumstances of your previous Cesarean, you may be a candidate for VBAC.

What is VBAC?

VBAC stands for vaginal birth after Cesarean. This type of delivery is pretty much what the name says: it is vaginal childbirth in a woman who has had a previous Cesarean. If you’ve given birth by Cesarean before, you will probably have a choice of how to give birth again: a scheduled C-section or a VBAC. The latter may not be an option for you depending on the circumstances of your previous Cesarean, but there’s a good chance that it is. Below are some things to know about VBAC when speaking to your doctor about the plan for your next delivery.

What are the Benefits of VBAC?

There are many reasons women are interested in Vaginal Birth after Cesarean. One is that a lot of women desire the experience of vaginal birth. Also, if the woman is planning on giving birth to more children in the future, VBAC can help them reduce the risk of complications from multiple C-sections.

A big reason VBAC is attractive to a lot of women is that it does not require abdominal surgery. Recovery after childbirth is different for every woman no matter how she delivers, but major surgery can make it a little more difficult.

Cesarean is often necessary for the safety of the mother and child, but if it’s an option, some women might choose vaginal birth so they do not have to cope with the longer recovery period of a major surgery while taking care of a new baby.

Also, because there is no surgery required, the risk of infection and blood loss are lower in a VBAC.

What are the Risks of VBAC?

Of course, along with benefits, VBAC has risks. You and your doctor should pay special attention and go over your medical history, especially involving pregnancy and birth when considering VBAC over a repeat Cesarean. But before you have that conversation with your physician, there are a few risks you might want to know about.

The American Pregnancy Association says the biggest risk for women who have had a previous C-section is that of uterine rupture during vaginal birth. Or rather, rupture of the Cesarean scar on the uterus. This risk is fairly low statistically, as stated below, but if you have had a previous uterine rupture or have a condition that makes you vulnerable to uterine rupture, Vaginal Birth after Cesarean should not be attempted.

Other risks include infection, blood loss, and other complications related to vaginal childbirth.

What are the Statistics on VBAC?

Most studies show results of about 60-80% of women who have previously undergone Cesarean birth can successfully give birth vaginally.  As stated above, the biggest risk is generally uterine rupture, and in the past, the American College of Obstetricians and Gynecologists (ACOG) reported that in women with previous C-sections with low transverse incisions (instead of high vertical, or classical, incisions), the chance of uterine rupture during vaginal delivery was about 1 in 500.

What Makes Someone a Good Candidate for VBAC?

There are a number of criteria that should be met for someone to be a good candidate for Vaginal Birth after Cesarean. In recent years, these criteria have become a bit less restrictive as more has been learned about the risks and benefits of VBAC. And in accordance with the statistics above, many women will fit into these criteria. These include:

  • Your prior Cesarean was performed using a low-transverse incision rather than a high
  • You’ve never had a uterine rupture.
  • Past uterine surgeries haven’t been extensive, such as a myomectomy to remove fibroids.
  • Having access to a doctor on-site who can monitor labor and perform an emergency Cesarean if needed.
  • In addition to the doctor who can do the C-section, other doctors and personnel such as an anesthesiologist as well as equipment are available to you and your baby.

What Factors Might Make a VBAC Less Likely?

There are other factors that make it less likely for a woman to be considered a candidate for VBAC. These factors may create conditions that could pose a threat to the health of the mother or the child. These risk factors include:

  • Being overweight
  • Going beyond 40 weeks of gestation
  • Requiring labor induction
  • Being an older mother
  • Having a short period between pregnancies, usually 18 months or less
  • Having a baby with a high estimated birth weight. This is usually over 8.8 pounds or 4 kg

Schedule an Appointment

Of course, you and your doctor are the only ones who can determine if you can safely deliver vaginally after having a previous cesarean. The board-certified physicians at Raleigh OB/GYN can work with you figure out what your birth plan might look like. If you want to talk more about Vaginal Birth After Cesarean and whether or not it might be possible for you, schedule an appointment by calling (919) 876-8225

 

Benefits of an IUD

What are the Benefits of an IUD?

Women may choose to use birth control for a variety of reasons from preventing pregnancy to regulating the menstrual cycle or relieving PMS symptoms. There are different types of birth control methods, each with their own pros and cons. In recent years, one method, in particular, has continued to gain popularity among both women and providers–intrauterine devices (IUD). But, what exactly are they and what are the benefits of an IUD?

What is an IUD?

You’ve likely seen one in a photo or at your doctor’s office. An IUD is a small, flexible, T-shaped device that is inserted through the vagina, past the cervix and into the uterus in order to prevent pregnancy from occurring. The simple, in-office procedure is completed by a doctor or nurse practitioner in as little as 5-10 minutes.

There are two main types of this device: copper and hormonal. The only copper IUD approved by the FDA in the United States is ParaGard. Skyla, Kyleena, Liletta and Mirena are the brand names of hormonal IUDs on the market.

How They Work

Both hormonal and copper intrauterine devices work by changing the path of sperm so they cannot ultimately reach and fertilize the egg. ParaGard repels sperm with its copper material, as sperm are averse to copper. Hormonal devices thicken cervical mucus, trapping sperm. They also can prevent ovulation, the process in which the egg leaves the ovaries. Therefore, there is no egg to be fertilized.

Benefits of an IUD

There are a variety of benefits of an IUD. They are:

    • Effective: IUDs are one of the most effective methods of birth control because it limits human involvement. Unlike the pill or ring, you can’t forget to use it and unlike condoms, there isn’t a risk of using it incorrectly. They are more than 99% effective, making IUDs as effective as sterilization and the birth control implant at preventing pregnancy.
    • Long-lasting: A copper device can last up to 12 years, while hormones devices remain effective from three to six years depending on the brand used.
    • Convenient: Unlike other forms of birth control, you rarely have to worry about an IUD once it’s in place. It works until it expires or you have it taken out. No more running to the pharmacy to pick up your monthly prescription or worrying about remembering to take a pill every day.
    • Flexible: An IUD is not permanent and can be removed at any time, for any reason. Getting pregnant is possible immediately upon the removal of the device if you should decide pregnancy is something you desire. In addition, the copper IUD can be used as emergency contraception and is quite effective in this capacity as long as it is inserted within five days of unprotected sex.
    • Multi-purpose: A progestin (hormonal) IUD not only works to prevent pregnancy but can also be used to help reduce blood flow for women or girls that have heavy, painful periods.

What are the Side Effects?

As with any type of birth control, there are potential side effects associated with using an IUD.

Once the device is placed, you may experience irregular or breakthrough bleeding for the first few months. With a hormonal device, PMS-like symptoms are also possible including irritability, headaches, acne, nausea and breast tenderness. With the copper IUD, some women may experience heavier periods with more cramps.

Potentially rare side effects include accidental expulsion, perforation of the uterus and pelvic inflammatory disease.

Is an IUD Right For Me?

As you can see, the IUD is a safe, reliable and convenient form of birth control for many women. Your doctor will conduct a medical exam and discuss your history to ensure you are a good candidate if you feel this might be a contraceptive you’d like to consider. Call (919) 876-8225 to schedule an appointment at Raleigh OB/GYN Centre.

postpartum depression

Postpartum Depression: What You Need to Know

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.

morning sickness or hyperemesis gravidarum

Morning Sickness: What’s Normal and What’s Not

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)

morning sickness chart

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 Symptoms

10 Pregnancy Symptoms You Should Call Your Doctor About

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.

Options to Relieve Labor Pain

6 Options to Relieve Labor Pain

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.

Benefits of Birth Control

8 Benefits of Birth Control Other Than Preventing Pregnancy

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.

What Age Should My Daughter See a Gynecologist?

What Age Should My Daughter See a Gynecologist?

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.