Tag Archives: gynecology

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

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.

 

Surviving your summer pregnancy

By Dr. Lisa Kramer –

Swelling ankles, constant sweating, never ending thirst – welcome to your summer pregnancy. If you’re an expectant mom, dealing with the pains of pregnancy during the summer months can be less than fun. Use these five tips to survive your summer pregnancy, even when it’s sweltering hot!

Dealing with swelling

We can’t say this enough. The best way to deal with swelling is to hydrate, hydrate, hydrate! Eight glasses of water daily is a must. Squeezing lemon into your water not only adds flavor, but the lemon juice helps to reduce your swelling as well. Continue reading