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.

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.

Throughout a woman’s life, there are many health concerns she should keep in mind. Often, these concerns change with age. One of the best practices in maintaining good health is getting recommended screenings to detect any illness early so it can be treated more easily. American Congress of Obstetricians and Gynecologists has a guide to well-woman care based on age. We will look at an overview of some of the important screenings every woman should get throughout her life when she should get them, and how often. And because September is Sexual Health Awareness Month, we will end by touching on some of the screenings you should get to improve and maintain sexual health.

Cholesterol

Women should get their cholesterol tested regularly starting at age 20 if they are at increased risk of heart disease due to family history or other illnesses that might be linked to heart disease or high cholesterol. Because it varies on individual health, your doctor can talk to you about how often you should be tested.

Blood Pressure

Your blood pressure is probably taken at the beginning of most doctor’s appointments. But if not, it should be tested regularly. If you have normal blood pressure lower than 120/80, then you can get tested every 2 years. If you have blood pressure between 120/80 and 139/89, then a test once a year is necessary. If your blood pressure is any higher than that, you should discuss a treatment plan with your doctor. 

Breast Cancer

Doctors recommend women of all ages to do monthly self-exams to detect any lumps or changes in breast tissue. Beginning at age 40, the American College of Obstetrics and Gynecology recommends annual mammograms.

Cervical Cancer

If you have a cervix (for various reasons not all women do), you should get regular screenings for cervical cancer. Pap smears, or Pap tests, are performed by collecting cells from the cervix with a swab and then screening them for abnormalities. HPV tests can also be a part of a cervical cancer screening, as HPV is a leading cause of cervical cancer.

 Many gynecologists include a Pap smear in an annual well-woman exam, but not all of them do. So, if it’s not part of your annual checkup, how often should you get tested?

• Women 21 and over should get a Pap test at least every 3 years.
• Women 30 – 64 can get an HPV test and a Pap smear together every 5 years.
• Women 65 and older should talk to their doctor about when and if you need to get a Pap test.

Colorectal Cancer

From ages 50-75, a woman should get screened for colorectal cancer once every 5-10 years. This range changes if you are at greater risk for colorectal cancer due to family history, a hereditary condition, inflammatory bowel disease, or if polyps have been found in prior screenings. Then the frequency could be every 1-5 years.

There are several types of colorectal screenings, and your doctor will discuss with you the best option for you. These screening methods can include:

• Colonoscopy
• CT colonography
• Flexible sigmoidoscopy
• Barium enemas
• Stool tests

Diabetes

Type 2 diabetes affects almost 10% of the U.S. population, with even more Americans considered prediabetic. How often and when you should get tested for diabetes varies on your overall health, family history, and whether you have other conditions that are linked to the disease. 

It is recommended for most people to get tested for diabetes once every 3 years after age 45. If you have high blood pressure, especially if you take hypertension medication, you should get screened for diabetes earlier and more often than people without hypertension. Other factors that may cause your doctor to recommend more frequent screenings include family history, personal history of gestational diabetes, and obesity.

Sexually Transmitted Infections

Depending on the kind of sex education you had and how well you’ve educated yourself outside of school, you may or may not know the risks of common sexually transmitted infections (STIs). Even if you are generally knowledgeable, then you might not know when or how often to get tested for STIs. The CDC has excellent information on many sexually transmitted diseases, including the symptoms, risks, and guidelines for testing and treatment.

If you are sexually active, it is important to know the symptoms of STIs and when you should get tested, even if you use protection. STIs can not only affect your sexual health but other body systems. Left untreated they can be serious. However, with appropriate screening, many STIs are treatable if not curable. To get details on each STI, click the link at the beginning of the screening recommendations.

• HPV (Human Papillomavirus): For most women who are not immunocompromised, HIV positive, or have a history of cervical cancer, screenings for HPV are based on age.
  • Age 21-29: Pap test with cytology (looking at cells under a microscope) screening every three years. No separate HPV testing is done.
  • Age 30 – 65: Pap test with cytology and an HPV test should be given together every five years.
  • Age 65+: Recommendations vary based on previous results
• HSV (Herpes Simplex Virus): If you are sexually active, you should be tested for HSV if you are exhibiting symptoms or are concerned you may have been exposed to HSV by a sexual partner. If you think you or your partner may have herpes and are pregnant, talk to your doctor about testing and ways to prevent passing it on to your baby.
• Chlamydia: If you are sexually active and under 25, you should get tested for Chlamydia every year. Continue or resume yearly testing if you are over 25 and have new or multiple partners or a partner that has been diagnosed with an STI. Pregnant women should also get tested.
• HIV (Human Immunodeficiency Virus): Every woman should be tested for HIV at least once if they’ve been sexually active. The CDC recommends that all pregnant women be tested for HIV. Talk to your doctor about your sexual activity to determine if you are at higher risk and need to be tested more frequently.
• Gonorrhea: If you are sexually active, an honest conversation with your doctor can determine whether and when you should be tested for gonorrhea. If you have new or multiple sex partners or a partner who has an STI, get tested once a year. Testing is also recommended for pregnant women.
• Syphilis: You should get tested for syphilis if you are sexually active and have had a partner who has tested positive for the infection. Pregnant women should also get tested at least once to avoid passing the infection to the baby.
• Trichomoniasis: Testing for this common STI should be done if you are sexually active, at increased risk, or are experiencing symptoms.

 At Raleigh OB/GYN, we are committed to providing care for all stages of a woman’s life. This includes making sure she gets the necessary screenings to monitor her health and prevent illnesses. If you have questions about what kind of screenings you should get and when, contact us at 919-876-8225 or request an appointment online. 

If you have made the decision to breastfeed your baby, you might have some questions about what it’s like and how you can nurse successfully. To prepare for National Breastfeeding Month in August, we have come up with some breastfeeding tips for new moms.

1. Enlist Help

One of the first breastfeeding tips that can help new moms is to see a lactation consultant. You can research local consultants and meet them before you give birth so they can help you from the very start of your baby’s life. Some insurance plans will cover or pay for part of a lactation consultant’s services. Get your partner involved as well, because they’ll need to provide support even if they aren’t going to be nursing the baby. UNC Rex Hospital has excellent lactation consultants on staff to help you get started and address any difficulties while you are in the hospital, and many pediatricians also have lactation consultants to help after discharge.

2. Join a Lactation Support Group

Some women find it useful to find a local lactation group to join. That way you can get breastfeeding tips in person from other women going through the same process you are.

3. Start Right Away

Experts recommend starting nursing within the first hour after delivery when possible. Skin to skin contact is also recommended as soon as possible. In uncomplicated deliveries, immediate skin to skn is standard at UNC Rex Hospital. It may seem like you’re just producing a few drops, but starting early is important and the first you produce (colostrum) is great for your baby.

4. Get Comfortable & Relaxed

Find breastfeeding positions that are comfortable for you and your baby. If either one of you is tense or uncomfortable, it probably won’t be a very productive nursing session.

5. Help Your Baby Find a Good Position

One breastfeeding tip some moms have found useful is to make sure the baby’s feet touching a surface like your leg, a pillow, or the arm of a chair. This can help make them feel more secure when they’re tucked up against you.

6. Try a Nursing Stool

Many moms swear by nursing stools to help them find a comfortable position while nursing. You put the stool at your feet while you sit on a chair or the couch. The stool will allow you to stay in a comfortable position that is good for your back, neck, and shoulders. 

7. Hold Off On Bottles if You Can

If possible, hold off on feeding with a bottle until you and your baby are completely comfortable with breastfeeding. Once you’ve gotten good at nursing, you can start expressing milk with a pump and feeding with a bottle. Many people find that they can introduce the bottle at 4-6 weeks.

8. Make Sure You’re Eating Right (And Enough!)

Unlike during pregnancy, what you eat and drink doesn’t pass directly to your baby when you breastfeed. However, the things you consume can still affect the baby. Plus, you need to maintain good nutrition for yourself so you can continue to produce nutritious breast milk and have enough good stuff left to fuel your own body. And make sure you’re always well hydrated.

9. Research a Good Pump

If you plan to pump, do some research before you commit to one. Most insurance plans will cover the cost of a breast pump, and we’ll take care of starting the ordering process during your pregnancy. If you plan to buy one yourself, check reviews and ask your friends for recommendations. You don’t want to invest in something that doesn’t work for you.

10. Find Ways to Soothe Soreness

As you continue to nurse, you and your baby will both get more comfortable with it. However, along the way, you might still have some soreness or chapped skin on your nipples. There are many products available to soreness and keep nipples moisturized. Some moms like ointments and creams with lanolin but there are vegan options as well. Cooling pads or compresses can also help with discomfort.

11. Be Kind to Yourself

You might have heard that breastfeeding is the most natural thing in the world. But the truth is that everyone needs a bit of time to adjust to it. And it’s difficult for some people even after they spend time working at it. Just do the best you can for you and your baby and don’t beat yourself up if you feel like you’re struggling. And know you can always reach out for help.

The physicians, nurses, and medical staff at Raleigh OB/GYN offer a comprehensive list of gynecological and obstetric services to the women of the Raleigh, NC area. If you have questions about pregnancy and breastfeeding, call our office at (919) 876-8225 to make an appointment.

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.

Cord blood banking involves the preservation of a baby’s cord blood–the blood that remains inside the umbilical cord and placenta after birth. Usually, the umbilical cord and placenta are discarded with the blood still inside. But cord blood banking is a way to keep and store this valuable resource.

Why Should I Preserve and Store My Baby’s Cord Blood?

Cord blood is medically valuable because it contains hematopoietic stem cells. This type of stem cell can be used to treat certain diseases. Hematopoietic stem cells are different than most cells because while most cells can only make copies of themselves, these stem cells can mature into different types of blood cells. 

This type of stem cell is also present in blood and bone marrow. The stem cells in cord blood will match more people than those from bone marrow and stem cells from cord blood are less likely to be rejected by the transplant recipient. It is also easier to collect cord blood than bone marrow.

Hematopoietic stem cells can effectively treat more than 70 types of diseases. These diseases include genetic disorders, neurologic disorders, and immune system diseases. There are also some forms of cancer that have successfully been treated with hematopoietic stem cells, including lymphoma and leukemia.

Stem cells collected from cord blood are used to treat diseases via two different types of transplants: 

• Autologous transplants are transplants in which the cord blood collected after birth is used by that same child. This is an uncommon transplant type due to the fact that it cannot treat the kind of diseases cord blood is often used for. This is due to the fact the stem cells have the same genetic makeup of the child.
• Allogenic transplants are transplants in which donated tissues, organs, or cells (in this case, the stem cells in cord blood) come from another person. Sometimes the cells are donated by a family member and sometimes they come from a stranger from a blood bank.

The American College of Obstetricians and Gynecologists can provide you with more detailed information on what makes cord blood valuable and how it is used on this fact sheet.

How is the Cord Blood Collected?

Cord blood collection poses no risk to the baby or mother. It happens after the umbilical cord has been cut so it is safe and pain-free for all involved.

There are two methods used to collect cord blood.

• In the syringe method, blood is drawn from the cord using a syringe, similar to a regular blood draw. The collection should take place shortly after the umbilical cord is cut.
• Using the bag method, the umbilical cord is elevated and the cord blood is drained into a bag.

Bags and syringes are pre-labeled with an ID number to link it to your baby. No matter which method is used, the cord blood collection should take place within the first 15 minutes after birth. The lab needs to process the cord blood within 48 hours of collection.

What Happens to Cord Blood after Collection?

Once cord blood is collected it must be processed. During processing, the cord blood screened and typed. Both the cord blood and the mother’s blood are tested for blood or immune system disorders, genetic disorders and infections before the cord blood is banked. 

The blood is then sent to the blood bank where it is “typed” (tested to see which blood type it is). When it is stored, it is entered into a computerized tracking system. That way it can be found and retrieved quickly when it is needed.

Choosing a Cord Blood Bank

When choosing a cord there are several things to consider. You want to choose a reliable and accredited blood bank equipped to store the cord blood properly. 

First, you need to decide the type of bank to use. The type of bank you use will depend on if you are donating the cord blood or keeping it yourself. There are two types of cord blood banks

• Public cord banks store cord blood for allogeneic transplants. There is no charge to store cord blood at public banks because you are donating the blood for someone else to use. Sometimes public banks offer something called “directed donation.” In a directed donation you donate the blood to be used for a family member that may benefit from stem cell treatment. Not all public banks offer this and often private blood banks are used for this purpose.
• Private banks store blood that will be used in autologous transplants or for a directed donation to a family member. Private banks charge fees to collect, preserve, and store the cord blood. Sometimes exceptions are made for directed donations, but not always.

Whichever type of blood bank you decide on, make sure you choose an American Association of Blood Banks (AABB) accredited blood bank.

Is Cord Blood Banking Expensive?

If you are using a private bank, cord blood banking does require an investment for the initial fee to have the blood collected, preserved, and initially stored. There is also the ongoing expense of storing the blood in the facility. 

The cost of private cord blood banking varies depending on the bank you choose. Often the initial fee is between $900 and $2,100 depending on how long the initial storage period is. Many private cord blood banks offer pre-paid and discount plans to help make cord blood banking more accessible for families that are interested. After the initial fee, annual storage fees are often around $100.

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At Raleigh OB/GYN we can provide you with education and support throughout your pregnancy. And if there is something more specialized you are interested in, like cord blood banking, we can help direct you to the best resources. We partner with Carolinas Cord Blood Bank (CCBB) which is part of the Duke University School of Medicine and one of the largest public cord blood banks in the world. 

To talk to someone on our team about pregnancy or gynecological care, request an appointment online or by calling (919) 876-8225.

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

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.

Postpartum depression affects more women than you might think. And not all women who struggle with it are aware that what they’re experiencing goes beyond the “baby blues.”  That’s why we’re outlining a few of the warning signs of postpartum depression for Maternal Mental Health Month in May.

The Postpartum Period

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.