Tag Archives: Dr. Lisa Kramer

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

Tips to Help with Common Menopausal Symptoms

Menopause is the time in a woman’s life when her period stops. It usually occurs naturally, most often between the ages of 40-58. The average age is 51. Menopause happens because the woman’s ovaries stop producing the hormones estrogen and progesterone. A woman has reached menopause when she has not had a period for one year.

Changes and symptoms can start several years earlier. This transition phase is called perimenopause and may last for 4 to 8 years. Each woman’s experience of menopause is different. Many women report no physical changes during perimenopause except irregular menstrual periods that stop when menopause is reached. Other women experience many combinations of the following symptoms:

• A change in periods – shorter or longer, lighter or heavier, with more or less time in between
• Hot flashes and/or night sweats
• Trouble sleeping
• Vaginal dryness
• Mood swings
• Trouble focusing
• Less hair on head, more on face

How severe these body changes are varies from woman to woman, but for the most part these changes are perfectly natural and normal. Below are some simple suggestions you can do to try and relieve common menopausal symptoms.

Hot Flashes and Night Sweats
Hot flashes are the most common menopause-related discomfort. They involve a sudden wave of heat or warmth often accompanied by sweating, reddening of the skin, and rapid heartbeat. They usually last 1 to 5 minutes. Hot flashes frequently are followed by a cold chill. Night sweats are hot flashes at night that interfere with sleep. If hot flashes and/or night sweats are interfering with your daily activities, don’t hesitate to seek relief. There are some easy and practical steps you can try:

• Sleeping in a cool room
• Dressing in layers, which can be removed at the start of a hot flash
• Drinking cold water or juice when you feel a hot flash coming on
• Using sheets and clothing that let your skin “breathe”
• Not smoking

You can also try to keep a written record of what you were doing just before the hot flash started. This might reveal some triggers for your hot flashes which you could then try to avoid. Exercise can improve your quality of life and may help with hot flashes. It will also help reduce your risk of heart disease and osteoporosis. Another technique of deep breathing, known as relaxation breathing, may also help reduce hot flashes.

Relaxation Breathing
Deep breathing, relaxation breathing, and paced respiration all refer to a method used to reduce stress. It involves breathing in (inhaling) deeply and breathing out (exhaling) at an even pace. Do this for several minutes while in a comfortable position. Slowly breathe in through your nose. With a hand on your stomach right below your ribs, you should first feel your stomach push your hand out, and then your chest should fill. Slowly exhale through your mouth, first letting your lungs empty and then feeling your stomach sink back. You can do this almost anywhere and several times during the day, whenever you feel stressed. You can also try this if you feel a hot flash beginning or if you need to relax before falling asleep.

Sleep Problems
Because different things can cause sleep problems, the solutions vary. If night sweats are disrupting your sleep, treating them could help you sleep better. If you find yourself getting up to go to the bathroom, try limiting fluids shortly before bedtime unless you need a cool drink to handle a hot flash. If you aren’t sure what is keeping you from getting to sleep or causing you to wake during the night or early in the morning, there are still some things you can do to get a good night’s sleep:

• Be physically active most days of the week but not within 3 hours of bedtime.
• Go to bed and get up at the same time every day, even on weekends, and avoid naps, if possible, in the late afternoon and evening.
• Have a bedtime routine that you follow each night—read a book or magazine, take a bath, etc.
• Make sure your bedroom and bed are comfortable for sleeping, and only use the bedroom for sleeping and sexual activity.
• Don’t eat a large meal close to bedtime, and stay away from caffeine later in the day.
• After turning off the light, give yourself about 15 minutes to fall asleep. If you don’t go to sleep, get out of bed, and only go back when you feel sleepy.
• Try relaxation breathing.

Vaginal Dryness
The drop in estrogen around menopause leads to vaginal atrophy (the drying and thinning of vaginal tissues) in many women. It can cause a feeling of vaginal tightness during sex along with pain, burning, or soreness. Over-the-counter water-based vaginal lubricants and moisturizers are effective in relieving pain during intercourse. For women with more severe vaginal atrophy and related pain, speak to your primary care provider about treatment options.

What about hormones for symptoms of menopause?
Some symptoms may require medical treatment. Hormone Replacement Therapy (HRT) uses hormones to ease the symptoms of menopause or to prevent osteoporosis. This type of treatment comes in a variety of types and doses such as pills, creams, or skin patches. The FDA recommends that HRT be used at the lowest dose that relieves symptoms for the shortest time needed. If you are not able to take hormones, other management options may be available.

Talk to your primary care provider about how to best manage menopause. Make sure the doctor knows your medical history and your family’s medical history. This includes whether you are at risk for heart disease, osteoporosis, or breast cancer. Then work with them to find the best treatment option for you.

 

The Department of Obstetrics/Gynecology & Infertility is concerned with diagnosis and treatment of diseases, problems, or pathology affecting the female reproductive system. Additionally, the department deals with wellness of the female population. Our board certified physicians provide complete obstetrical and gynecology care. 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:
National Institute on Aging
The North American Menopause Society