Category Archives: Preventive Care

Delivering Positive Experiences – Birth Plan Options for Expecting Moms

Settling on the right OB and birth plan are very personal choices for expecting mamas. However, it is important to know the facts and learn about each option before creating the right birth plan for you. One key decision of your plan is how you will labor. The board certified obstetricians at Medical Associates have summarized several of the main options and facts below to help you make this decision.

Laboring in an upright position has many benefits. Whether it be standing, leaning forward with your hands on your knees, sitting, or squatting, many women find gravity to be a natural helper during labor. When you’re lying down, the brunt of the weight and force is going against gravity. Being upright or leaning forward allows your contractions to work in a more efficient manner, working with your body, not against it. Your blood flow (the baby’s oxygen supply) is less likely to be compressed while upright, and it helps to open up your pelvis as well. Movement such as swaying, walking, and even dancing can help reduce discomfort, as well as help move your baby into the optimal position to navigate the birth canal.

Another popular method is laboring in warm water. Our obstetricians encourage any expecting mom to labor in the tub if they wish. There is evidence that laboring in a tub can be a successful method of pain management for women, and it may even shorten labor for some. This is because immersion in warm water promotes increased blood flow back to the heart and fluid movement within the body which reduces swelling. Advocates say it also helps to relax laboring moms by reducing their stress.

However, once it’s time to deliver that baby, we believe it’s also time to get out of the tub. On the topic of water births, Medical Associates follows the recommendations of the American College of Obstetricians and Gynecologists (ACOG). They advise that “given the facts and case reports of rare but serious effects in the newborn, the practice of immersion in the second stage of labor (underwater delivery)”2 is not recommended. The American Academy of Pediatrics (AAP) have also agreed with this recommendation.

There will come a time when you need to lie down for a break or for other health reasons. While lying down, there is another birthing tool that can help with your labor’s progression. It’s called a peanut ball and it’s a new option to moms delivering at Mercy Medical Center – Dubuque. Mercy offers the first and only certified ambassador for the peanut ball in Iowa. The peanut ball is an exercise or therapy ball that is shaped like a peanut and can be used in a variety of labor positions:

  • With mom in a semi-reclined position, one leg is placed to the side of the ball, and the other leg over it. A nurse then pushes the ball as close to the mother’s hips as is tolerable to her. This position promotes dilation and descent with a well-positioned baby.
  • If mom is in a side-lying or semi-prone position, the peanut ball can be used to lift the upper leg and open the pelvic outlet. This position helps rotate a baby in a less-favorable posterior position to a more favorable position for delivery.

The use of the peanut ball helps with the descent of your baby in your pelvis. Utilizing this birthing tool has even proven to help reduce the need for an emergency C-section.

At Medical Associates, we take the care of mom and baby very seriously while also being supportive of your wishes. What you will find most helpful during labor will depend on many things. And even the most perfectly prepared birth plan can also change in an instant. Knowing your options and preparing different techniques before birth can help your labor to progress more smoothly.

To help you formulate your birth plan and communicate your needs and wishes to your obstetrician, please utilize this Birth Plan Worksheet offered by Mercy Medical Center in Dubuque.

 

The Department of Obstetrics/Gynecology & Infertility provides complete obstetrical and gynecological care. Specialized services offered by our board certified physicians include: diagnosis and treatment of diseases, problems, or pathology affecting the female reproductive system. Professional infertility services include routine evaluation of infertile couples, diagnosis of infertility problems and treatment such as induction of ovulation and artificial insemination. Call 563-584-4435 to schedule an appointment.

 

Sources:
1. http://pediatrics.aappublications.org/content/133/4/758
2. https://www.acog.org/About-ACOG/News-Room/News-Releases/2016/ObGyns-Weigh-In-Laboring-in-Water-is-OK-but-Deliver-Baby-on-Land

Healthy Choices Count

As a parent, there is nothing more important than the health of your child. The best thing you can do for your child’s health is to help them form healthy habits. The 5-2-1-0 program sets clear goals to help parents achieve this. 5-2-1-0 stands for 5 or more fruits and vegetables, 2 hours or less of screen time, 1 hour or more of physical activity, and 0 sugary drinks (more water). Those four numbers may be catchy and easy to remember, but any parent knows that achieving those tasks with their children is easier said than done. We’ve compiled some facts and tips for each task to try and help your family strive for a 5-2-1-0 lifestyle.

Eat at least 5 servings of fruits and vegetables per day.

First of all, a serving or fruits or vegetables is about the size of a tennis ball. And while fresh fruits and veggies are a great perk of warmer weather, there’s no reason not to have fruits and vegetables year-round. Frozen and canned produce are good choices, too. Did you know that frozen or canned produce is just as good for you? It’s true. Their nutrients are preserved in the canning and freezing process. However, not all are alike. Choose fruit packed in their natural juice, not in syrup. Choose canned vegetables that are salt-free. You can season them later if you like. Or if unsalted isn’t available, just be sure to rinse them before preparing.

Frozen or canned fruits and vegetables are also great because they cost less than fresh produce, are always in season, and provide lots of options for the picky eaters in your home. Plus, they come pre-washed and often pre-cut, so throw them on the table as a side dish for any meal. Vegetables can also easily be added into chili, soups or stews, pasta, or casseroles. Fruits can be added to smoothies, yogurt, fruit salad, or cereal.

Spend 2 hours or less of recreational time on screens each day.

Screen time includes time spent on TVs, computers, gaming consoles, tablets, and smartphones. It’s important to limit the use of ALL screens. How do you do this when screens seem to rule the day? First, set some basic limits. Some examples of rules are: no TV or computer until your homework (or a certain household chore) is done or no screens during meals. By setting these types of rules as a family, and adhering to them yourself, you’ll be setting a great example for your kids. Some more direct tactics might be trying a timer, and eliminating the TV or computer from the room where your child sleeps.

When you are trying to avoid screens with your kids, it’s important to provide other engaging activities for them to do. Puzzles, books, magazines, or board and card games are great alternatives to TVs, video games, or smart phones. They are also easy activities to do together with your child. Other ideas are to draw pictures, turn on some music and dance, go for walks, play ball, or go your town library or museum. All are engaging activities that will help them reduce their daily screen time.

Get at least 1 hour of physical activity every day.

Physical activity is not only healthy for your kids, it is also free and can be quite fun. What counts as physical activity? Well, there are different types: moderate physical activity can be described as doing any activity that makes you breathe hard, like fast walking, hiking, or dancing; vigorous physical exercise involves activities that make you sweat, like running, aerobics, or playing basketball. Physical activity makes you and your kiddos feel good. It is healthy for your heart and lungs, plus it makes you stronger and more flexible.

The best tip to ensuring your kids get the physical activity they need is to simply schedule an activity for the family each day. Some easy things you can do with your family are: taking a walk or bike ride together, playing with your pet in the yard, playing a game of tag, dancing, or jumping rope. There are also a few things you can just incorporate into your daily life, like taking the stairs instead of the elevator and parking at the far end of the parking lot. You can also choose toys and games that promote physical activity. If you are nervous to start, know that making gradual changes to increase your activity level are okay.

Aim for zero sugary drinks each day. Substitute water instead.

The best drinks for young children – and for kids of all ages – are water and milk. Water is essential for good health and milk is loaded with important nutrients, especially calcium. The alternatives like juice, pop, and sports drinks simply have too much sugar! Even 100% juice has a significant amount of sugar. (100% orange juice as 22 grams of sugar per 8 ounce glass.) You can help curb your child’s sugar intake by limiting their drink choices at home. Promote water and milk as the drinks of choice by also trying to drink them while around your children. You can also liven water up with fresh lemon, lime, or orange wedges for some natural flavor.

Another important thing you can do is to simply educate yourself on what exactly is in the drinks we see on grocery and convenience store shelves today. Sports drinks are flavored with sugar and market their minerals and electrolytes. But most people don’t need them! They are only recommended when you are doing intense physical activity for at least an hour or longer. They are not for everyday drinking or even to quench your thirst after routine physical activity. Energy drinks such as Monster, Red Bull, Rockstar, etc., contain caffeine, sugar, and other vitamins and minerals. But again, most people get these nutrients from our food and do not need them. These drinks are not the same as sports drinks and are never recommended for children.

 

Raising healthy and happy children is a long-term goal. It’s a love and commitment for which every parent strives. We hope this article gives you a few ideas and tips to help you kick-start your ambition. Remember to set goals that are attainable. Start small and work to extend your goals over time. All efforts will be beneficial for your family. If you need help or more ideas, ask your pediatrician at your next visit. You can also visit the Iowa Healthiest State Initiative website for more information and tips.

 

Scott_Karen_2016_Ultipro
Karen Hospodar Scott, MD, PhD
Pediatrics Department
(563) 584-3440

 

 

The Department of Pediatrics provides care for patients 18 years of age and younger, including newborns, infants, young children, and adolescents. This department offers services including diagnosis and treatment of infectious disease, chronic illness, and physical problems associated with children, including well child services such as growth and development counseling, periodic check-ups and dietary assistance to maintain good health. Special problems including weight control, anorexia nervosa, bulimia, and others, are also treated. Call 563-584-3440 (East Campus) or 563-584-4440 (West Campus) to schedule an appointment.

Your Health is Important When Trying to Conceive

Every aspect of your health – from the drinks you consume to the exercise you do (or don’t do) – can have an impact on your fertility and on the health of your pregnancy. By looking at your healthy (and unhealthy) habits now (before the bun is in the oven) you can start off on the right foot. Our expert OB/GYN team has shared some important steps to take to ensure your health is at its best for conception, which will hopefully make conception easier and your pregnancy safer.

Habits to Break

Smoking is never good for you, so just don’t do it. But if you need a little motivation not to light up, repeat this fact to yourself: smoking (cigarettes, e-cigarettes, hookahs, vape pens, and so on) causes my 30-year-old eggs to act more like 40-year-old eggs. This results in a more difficult path to conception and a greater risk of miscarriage. Heavy smoking damages the ovaries as well as the uterus, and secondhand smoke can harm your health and fertility, too, so just choose to stay away!

Along with smoking cigarettes, smoking marijuana isn’t good for conception either. Whether you smoke, vape, or consume edibles, you can inadvertently affect the ability of your partner’s sperm to fertilize an egg – even if he doesn’t smoke marijuana! The active ingredient in marijuana, THC, gets in your vaginal fluids and reproductive organs. So to be most fertile (not to mention safe), say goodbye to marijuana. (And you should obviously also not use any illicit drugs, including cocaine, crack, or heroin, etc.).

Some studies have linked too much caffeine consumption with lowered fertility and an increased risk of miscarriage. If a baby is in your immediate plans, it’s time to put a little less coffee in your cup. You don’t have to give it up completely but moderation is the key here. Limit your caffeine intake to no more than 200 mg per day. That’s equivalent to 12 ounces of brewed coffee per day.

Another beverage to limit (or eliminate completely) is alcohol. Drinking alcoholic beverages in excess can mess with your menstrual cycle, possibly interfering with ovulation. And because you won’t necessarily know the moment you conceive, there’s a chance you might be drinking in the first few weeks of your baby’s growth. Drinking alcohol while pregnant could harm your little one in the future. Choose to reduce your drinking to less than 7 drinks a week and never more than one on any occasion when trying to get pregnant. Only you and your bartender need to know you’re drinking a mocktail.

As far as medications go, most over-the-counter and many prescription meds are considered safe while you’re trying to conceive. But because some medications may compromise fertility, you should run any medications you take by your provider before you consume them. This includes the medications you take for your chronic condition and any vitamins or herbals you may take on a regular basis. The good news is there are almost always safer alternatives. Just ask your healthcare provider before making any changes to your medication routine.

Habits to Keep

There is a strong connection between weight and fertility. Reaching a healthy weight for your body type is an important step for conception. It’s not just the scale that determines this, though. The relationship between your weight and height are factored to determine your body mass index, or BMI. Being overweight can cause diminished egg quality, decreased ovarian function, or polycystic ovarian syndrome (PCOS), a fairly common cause of fertility issues. Alternatively, women with a low BMI can also experience conception woes. Being underweight can lower estrogen levels, which can lead to irregular ovulation or periods (or even no ovulation or periods). Women who are obese or underweight when they become pregnant also have a higher risk of miscarriage.

Though it may be different for everyone, a moderate exercise program is the key. Moderate exercise can boost fertility, and you only need 30 minutes of aerobic exercise to do this. It can be walking, stretching, strength training, or anything that increases your heart rate. Remember to keep an eye on your body fat though. Prolonged, strenuous exercise can disrupt the delicate balance of hormones needed for ovulation and conception, especially if your BMI is very low. An ideal BMI for conceiving is between 18.5 and 24.9.

Before you put yourself on a diet or start packing on the carbs, it’s important to talk to your healthcare provider. Come up with a simple plan that features a well-balanced diet. Fill your meals with lean protein, veggies and fruits, and low-fat dairy. Cut down on junk foods and sugary drinks. Try water instead. Add in that moderate workout routine discussed above and you’ll be ready to kick-off your healthy path to pregnancy!

A good night’s rest is also very important. Six to nine hours of sleep per night is best. Beating the stress of the day and letting your body recuperate will only encourage fertility.

Finally, take 400 to 800 micrograms (400 to 800 mcg or 0.4 to 0.8 mg) of folic acid every day if you are planning a pregnancy or are currently pregnant. You can take a vitamin or eat a breakfast cereal containing your daily quota of folic acid. This will lower your risk of some birth defects of the brain and spine, including Spina bifida. Talk with your doctor about your folic acid needs. Some doctors prescribe prenatal vitamins that contain higher amounts of folic acid.

 

Whether it’s your first, second, or fifth baby, your body needs to be nurtured and cared for so that it can do the same for your future child. Both the female AND the male partner’s fertility can benefit from the advice listed above. And remember that no two bodies are exactly the same, so talk to your doctor before getting pregnant. They will discuss your medical history, any medical conditions you have, any medications you are currently taking, and any vaccinations you might need. This will help make a preconception health plan that is best for you.

For more information on preconception health, check out this conception plan template from the CDC.

 

The Obstetrics/Gynecology & Infertility Team at Medical Associates Clinic:
Joseph Berger, MD  |  Tara L. Holste, DO  |  Lisa A. Kramer, MD
Trupti S. Mehta, MD  |  Laura Neal, MD  |  Erika O’Donnell, MD

Call 563-584-4435 to schedule an appointment.

 

Living with Diabetes: What Can I Eat?

Grains and Starchy Vegetables

If you are going to eat grains, choose whole grains. Whole grains are high in fiber. Foods high in fiber take longer to digest and therefore affect your blood glucose more slowly (i.e. whole wheat bread, prunes and other vegetables). Reading food labels can help you with making the best choice.

What is a Whole Grain?

A whole grain is the entire grain—which includes the bran, germ and endosperm (starchy part). “Refined” flours like white and enriched wheat flour include only part of the grain. They are missing many of the nutrients found in whole wheat flour. Examples of whole grain wheat products include 100% whole wheat bread, pasta, tortillas, and crackers. For cereals, pick those with at least 3 grams of fiber per serving and less than 6 grams of sugar.

Best Choices of Starchy Vegetables

Starchy vegetables are great sources of vitamins, minerals and fiber. The best choices do not have added fats, sugar or sodium. Try a variety such as parsnip, plantain, potato, pumpkin, acorn squash, butternut squash, green peas, and corn.

Best Choices of Dried Beans, Legumes, Peas and Lentils

Try to include dried beans into several meals per week. They are a great source of protein and are loaded with fiber, vitamins and minerals. Examples include dried beans (such as black, lima, and pinto), lentils, dried peas (such as black-eyed and split), fat-free refried beans, and vegetarian baked beans.

What you need to know about Cholesterol

LDL (Bad) Cholesterol

LDL cholesterol is called “bad” cholesterol. Think of it as less desirable or even lousy cholesterol, because it contributes to fatty buildups in arteries (atherosclerosis). Plaque buildup narrows arteries and raise the risk for heart attack, stroke and peripheral artery disease.

HDL (Good) Cholesterol

HDL cholesterol is “good” cholesterol. Think of it as the “healthy” cholesterol, so higher levels are better. HDL acts as a scavenger, carrying LDL cholesterol away from the arteries and back to the liver, where it can be broken down and passed from the body.

A healthy HDL cholesterol level may protect against heart attack and stroke. Low levels of HDL cholesterol increases the risk of heart disease. HDL cholesterol does not completely eliminate LDL cholesterol. Only 1/4 to 1/3 of blood cholesterol is carried by HDL.

Triglycerides

Triglycerides are the most common type of fat in the body; they store excess energy from your diet. A high triglyceride level combined with low HDL cholesterol or high LDL cholesterol is linked with fatty buildups in artery walls. This increases the risk of heart attack and stroke.

 

 

The Medical Associates Department of Internal Medicine provides a Fellowship-trained Endocrinologist, who specializes in diabetes, thyroid disease, and osteoporosis. The staff also includes two certified diabetes educators with board certifications in advanced diabetes management. They see patients for diabetes education appointments and medication. Call 563-584-3310 to schedule an appointment.

Source: www.diabetes.org