If you’ve ever been pregnant or had a routine annual well-woman exam, you are probably familiar with many of the services an OB/GYN can provide. Things that immediately spring to mind include pregnancy care and all that can be involved in annual or other routine exams (Pap smears, pelvic exams, breast exams, etc.). However, these are not the only things your OB/GYN can help you with. After all, an OB/GYN is a fully-trained medical doctor with a large knowledge base.

Naturally, OB/GYNs are associated with reproductive health, but they are also committed to helping you achieve optimal overall wellness. Many obstetrician-gynecologists also offer an array of well-woman care in addition to the typical reproductive care you are familiar with. Let’s look at nine things you might not have known your OB/GYN can help you with.

1. Vaccinations 

Many doctors will tell you that providing immunizations is one of the most basic forms of healthcare they can provide. Your OB/GYN can assist you in keeping up to date with your vaccinations. This is especially true for women that use an OB/GYN as their primary health care provider. If your gynecologist is indeed your primary source for health care, then you both should discuss other routine procedures like colonoscopies or other screenings that are necessary throughout a woman’s life.

2. Family Planning and Birth Control Counseling

Your doctor can counsel you on the best birth control methods for you depending on when you want to have kids, if at all, and how many you want to have. While a primary care or clinic physician can certainly talk to you about birth control and give you a prescription, your OB/GYN may have more information for you based on your individual circumstances and knowledge of your reproductive health and history. This is especially true if you are considering long-term or even permanent birth control. 

3. Bone and Joint Health

Many women may think joint and bone health should only be a concern during menopause, but this is not true. The average woman begins to lose minerals in her bones starting at around 35. That’s well before the average age of women experiencing the onset of menopause. So, it’s important to be proactive and talk about prevention with your doctor before it becomes a problem.

4. Weight Monitoring and Management 

Ideally, you should make an appointment with your gynecologist at least once a year. Because of this frequency, your chart will have a comprehensive record of your weight history. Using this information, you and your doctor can discuss concerns about your weight and healthy ways to manage it. Whether your goal is to get to a healthy weight for overall wellness reasons or to be in a healthy weight range for pregnancy, your OB/GYN is a great resource. 

As a part of monitoring and helping you manage your weight, he or she can check and test for diabetes, which is often linked to being overweight or obese.

5. Skin Issues 

Skin issues can sometimes be indicators of conditions that affect reproductive hormones. The most common example of this is the onset of acne during puberty. But your OB/GYN can also be helpful with skin issues that are not linked to hormonal issues. If you see a new mole or growth during a routine self-examination, you can ask your OB/GYN to take a look. They can then refer you to a dermatologist if necessary.

6. Thyroid Problems

Thyroid problems affect one in eight women at some point in their lives. As previously mentioned, this can be linked to weight management problems because unusual weight gain and loss are symptoms of thyroid disorders. Your OB/GYN can evaluate for these types of conditions.

7. Depression, Anxiety, and Mood Issues

If you are having issues with your mood or suffering from depression or anxiety, talking to your OB/GYN can a good first step. Many women find that they are more comfortable with talking to their OB/GYN about mood-related concerns than their primary care doctor.

Whether your mental health is being affected by a condition that can alter your hormones (like pregnancy or menopause) or another reason, they can help you. If it is not something they can handle by themselves, then they often have good relationships with counselors or other mental health specialists that they can refer you to. 

8. Educating Children on Reproduction and Sexual Health 

If you have a daughter that is either asking questions and/or approaching puberty, you may be uncomfortable about discussing the mechanics of reproduction or the changes her body will go through during puberty. Your OB/GYN is a great resource and ally to have on your side for this. Have a conversation with your doctor to see what they recommend before having “the talk.”

Your doctor can help you by providing you with suggestions that can make an awkward conversation a bit smoother. Because of their extensive medical experience, they may be able to guide you with the right words to use as well as highlighting which topics to make sure you discuss. Having the medical and technical knowledge to back up a potentially emotional topic and provide reassurance and clarity to a young woman facing big changes.

9. Transitioning Through Life Stages

While treating you for the physical changes you go through during your life, your OB/GYN can help you cope with these sometimes difficult transitions emotionally. They can provide you with strategies to keep your sanity through the transition from puberty all the way through menopause and after. Your doctor is also a great resource when you’re looking for recommendations for other professionals, like other specialists or counselors.

At Raleigh OB/GYN we are committed to providing our patients with state-of-the-art care throughout all stages of a woman’s life. Whether you are pregnant, going through menopause, or at any point in between, our team of physicians, nurses and medical staff will create a supportive environment to address any medical concerns. Call 919.876.8225 or request an appointment online.

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

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

What is Postpartum Depression?

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

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

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

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

What Causes Postpartum Depression?

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

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

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

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

What are the Symptoms?

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

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

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

When to Seek Help

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

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

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

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

Morning Sickness vs. Hyperemesis Gravidarum (HG)

Source: American Pregnancy Association

What is hyperemesis gravidarum?

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

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

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

Diagnosis and Treatment

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

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

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

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

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

When to Seek Help

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

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

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

1.  Extreme fatigue or dizziness

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

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

2. Severe nausea

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

3. Vaginal spotting/bleeding

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

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

4. Severe cramping

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

5. A spike in the mother’s blood pressure

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

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

6. Decreased fetal movement

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

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

7. Fever over 101°F

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

8. Urinary burning, frequency or pain

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

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

9. Vaginal fluid with color or odor

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

10. Labor Symptoms

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

Contact Raleigh OB/GYN

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

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

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

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

1. Epidural Anesthesia

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

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

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

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

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

2. IV Analgesics

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

3. Nitrous Oxide

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

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

4. Heat or Cold Therapy

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

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

5. Rhythmic Breathing

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

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

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

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

6. Averting Focus: Music, Imagery, Conversation

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

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

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

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

Which Option is Best?

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

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

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

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

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.