Chattanooga's Best Obstetricians & Gynecologists 

What is a Colposcopy?

A Colposcopy is a procedure to closely examine the cervix using. Special magnifying device called a colposcope. 

When is this procedure used?

This procedure may be recommended if your pap smear is abnormal. This procedure can be used to diagnose: genital warts, inflammation of the cervix (cervicitis,) or1 benign growths such as polyps.

daVinci surgery is a surgical system for minimally-invasive surgery that puts an advanced set of instruments in the surgeon’s control. “Robotic” does not mean the robot performs surgery - rather, the surgeon performs surgery through a console using the daVinci system.

Fibroids are noncancerous uterine growths that develop from the muscle tissue of the uterus. They can range in size and may be inside the uterus, on its outer surface or within its wall, or attached by a stem-like structure. Symptoms of a uterine fibroid could include: heavy menstrual bleeding, menstrual periods lasting longer than one week, pelvic pressure or pain, frequent urination, difficulty urinating, constipation, and/or back pain. 

WHAT IS A HYSTEROSCOPY?

This is a procedure where a doctor uses a thin tube with a camera to look inside the uterus.  Saline solution is used to expand the uterus in order to look inside of the uterus. There are no incisions.

WHEN IS THIS SURGERY USED?

This procedure allows us to see any abnormalities in your uterus.

TO EVALUATE AND OR TREAT DISEASES OF THE UTERUS

Recurrent miscarriages

Lost or retained IUD, will be removed if seen.

Heavy or irregular vaginal bleeding, a scraping will be obtained.

Inability to obtain an office endometrial sampling will be obtained.

Scar tissue inside the uterus, will be cut out or use electrical energy to remove

Endometrial polyps will be removed using electrical energy or cut out.

Sub mucosal fibroids, will be removed using electrical energy or cut out.

Permanent sterilization (Essure), these devices will be placed into the openings of the Fallopian tubes.

HOW DO I PREPARE FOR SURGERY?

Depending on your health, we may ask you to see your primary doctor, a specialist, and/or an anesthesiologist to make sure you are healthy for surgery.

Some medications may need to be stopped before the surgery. A list of medications will be provided at your pre-operative appointment.

Smoking can affect your surgery and recovery. Smokers may have difficulty breathing during the surgery and tend to heal more slowly after surgery. If you are a smoker, it is best to quit 6-8 weeks before surgery. If you are unable to stop smoking before surgery, your doctor may order a nicotine patch while you are in the hospital.

You will be told at your pre-op visit whether you will need a bowel prep for your surgery and if you do, what type you will use. The prep to clean your bowel will have to be completed the night before your surgery.

You will need to shower at home before surgery. Instructions will be provided at your pre-operative appointment.

Do not wear makeup, nail polish, lotion, deodorant, or antiperspirant on the day of surgery.

Remove all body piercings and acrylic nails.

If you have a “Living Will” or an “Advance Directive”, bring a copy with you to the hospital the day of surgery.

Plan for your care and recovery for after your surgery is complete . Most women recover and are back to most activities in 1-2 days.

WHAT CAN I EXPECT DURING THE SURGERY?

In the operating room, you will be given either a general ,  spinal , or a local anesthesia. The choice of anesthesia is a decision that will be made by the anesthesiologist based upon your history and wishes.

If a general anesthesia is given, after you are asleep and before the surgery starts:

1.A tube to help you breathe will be placed in your throat.

2.Another tube will be placed in your stomach to remove any gas or other contents to reduce the likelihood of injury during the surgery. The tube is usually removed before you wake up.

3.A catheter will be inserted into your bladder to drain urine and to monitor the amount of urine coming out during surgery. The catheter will stay in until the next day.

Compression stockings will be placed on your legs to prevent blood clots in your legs and lungs during surgery.

Your cervix will be dilated and then the hysteroscopy is placed through the cervix into the uterus. Fluid is instilled into the uterus for better visualization.

A dilation and curettage is often performed at the same time to remove tissue for any further testing.

Photographs may be taken during the surgery and placed in your medical records for future reference.

WHAT ARE POSSIBLE RISKS FROM THIS SURGERY?

Although there can be problems that result from any surgery, we work very hard to make sure it is as safe as possible. However, problems can occur, even when things go as planned. You should be aware of these possible problems, and what will be done to correct them..

POSSIBLE RISKS DURING SURGERY INCLUDE:

Bleeding: If there is excessive bleeding, you will be given a blood transfusion unless you have personal or religious reasons for not wanting blood. This should be discussed with your doctor prior to the surgery.

Damage to the bladder, ureters the tubes that drain the kidneys into the bladder), uterus, and to the bowel: Damage can occur in less than 1% of surgeries. If there is damage to the bladder, ureters, uterus, or to the bowel they will be repaired while you are still in surgery.

Death: All surgeries have a risk of death. Some surgeries have a higher risk than others.

POSSIBLE RISKS THAT CAN OCCUR DAYS TO WEEKS AFTER SURGERY:

A blood clot in the legs or lung: Swelling or pain, shortness of breath, or chest pain are signs of blood clots. Call you doctor immediately if any of these occur.

Bowel obstruction: A block in the bowels that results in not being able to pass stool or gas. May cause stomach pain, bloating or vomiting.

Scar tissue: Tissue thicker than normal skin forms at the cervix or uterus.

Infection: Fever, redness, swelling or pain at the site of surgery.

WHAT HAPPENS AFTER THE SURGERY?

You will be taken to a recovery room and monitored for a short time before going home.

You will be given medications for pain and nausea as needed.

You will have the compression stockings on your legs to improve circulation and to help prevent the formation of blood clots.

You may have some vaginal spotting of bright red, brown, or black discharge. This is normal.

You may have a scratchy throat if a general anesthetic was used.

You will start walking as soon as possible after the surgery to help the healing and recovery process.

AT HOME AFTER SURGERY

CALL YOUR DOCTOR RIGHT AWAY IF YOU EXPERIENCE :

develop a fever over 100.4°F (38°C)

have pain with urination

start bleeding like a menstrual period or (and) are changing a pad every hour

have heavy vaginal discharge with a bad odor

have severe pain in your abdomen or pelvis that pain medication is not helping

have nausea and vomiting

develop swelling, redness, or pain in your legs

develop a rash

have chest pain or difficulty breathing

OTHER SYMPTOMS:

Vaginal Bleeding: You may have some vaginal spotting of a watery bright red, brown, or black discharge for up to 3-4 weeks. You may have abdominal cramping for 48 hours.

Diet: You will continue with your regular diet.

Medications:

Pain: Medication for pain will be prescribed for you after surgery. Do not take it more frequently than instructed.

Nausea: Anti-nausea medication is not typically prescribed.  Tell your doctor if you have a history of nausea with general anesthesia.

 Activities: 

1.Energy level: It is normal to have a decreased energy level after any surgery. After you are home, you should minimize any strenuous activity for the first day or two. It is very important not to overdo, but once you settle into a normal routine at home, you will find that you slowly begin to feel better. Walking around the house and taking short walks outside can help you get back to your normal energy level quicker.

2.Showers are allowed within 24 hours after your surgery.  Do not take baths for at least 1 week after surgery.

3.Climbing: Climbing stairs is permitted, but you may require assistance initially.

4.Lifting: For 1-2 days after your surgery you should not lift anything heavier than a gallon of milk. This includes pushing objects like a vacuum cleaner and vigorous exercise.

5.Driving: The reason you are asked not to drive after surgery is because you may be prescribed medications that may impair your ability to drive. You should not drive or operate heavy machinery for 24 hours after surgery.

6.Exercise: Exercise is important for a healthy lifestyle. You may resume normal physical activity within hours of surgery. Start with short walks and gradually increase the length of time and distance that you walk. To allow your body enough time to heal, you should not return to a more difficult exercise routine until 2 days after your surgery.  Please talk to your doctor about when you can begin exercising again.

7.Intercourse: No sexual activity for 2 weeks after surgery.

8.Work: Most patients can return to work between 1-2 days after surgery. You may continue to feel tired for a couple of weeks.

Contact your doctor office if you have any concerns.

What is Laparoscopy?

Laparoscopy is a minimally invasive procedure used to examine the organs inside the abdomen. It involves inserting an instrument called a laparoscope through an incision in the abdominal wall, and allows the doctor to see inside the abdomen in real-time using a high resolution camera on the laparoscope.

Why is a laparoscopy performed?

A laparoscopy is used to identify and diagnose the source of pelvic or abdominal pain, after non-invasive methods like ultrasound have been exhausted. A laparoscopy may also be used to take a biopsy, or tissue sample, from a particular abdominal organ. A laparoscopy may be used to look for the cause of chronic pelvic pain, infertility, or a pelvic mass. If a problem is found, it can often be treated during the same surgery. Laparoscopy is also used to diagnose and treat the following medical conditions: endometriosis, fibroids, ovarian cysts, ectopic pregnancy, pelvic floor disorders, and some types of cancer.

What is LEEP Treatment?

A LEEP, Loop Electrosurgical Excision Procedure, allows us to remove any abnormal tissue around your cervix.

Why is this procedure needed?

We recommend a LEEP Treatment if your pap smear revealed any abnormal growths.

What happens during a LEEP Treatment?

During the procedure, a speculum will be inserted to widen your vagina and get a clear view of the cervix. A solution will be placed on your cervix to make the abnormal cells visible, and afterwards, lidocaine will be placed on your cervix to numb it. Once numb, we will take a thin wire loop that acts as a scalpel to remove the abnormal cells. Once the procedure is completed, a paste will be used to stop the bleeding. The procedure generally takes 20 minutes and is not very painful. 

What should I expect after my LEEP Treatment?

After your procedure, recovery is about 4 weeks. Throughout your recovery, you should expect the following:

Cramping

Vaginal Drainage

Restrictions on physical exercise 

Why LEEP Treatment?

LEEP is used as part of the diagnosis and treatment for abnormal or cancerous conditions.

What is a Pap smear?

A Pap smear involves collecting cells from the cervix to test for cervical cancer.

Why get a Pap smear?

A Pap smear gives a greater chance for a cure by detecting cervical cancer early. A Pap smear can also detect changes in the cervical cells that suggest cancer may develop in the future.

What is a sonohysterography?

A sonohysterography is a special kind of ultrasound; fluid is put into the uterus through the cervix and sound waves are used to create images of the uterine lining. 

and outlines the inside lining of the uterus, which provides more detail than a conventional ultrasound.

What is a sonohysterography used for?

A sonohysterography can detect uterine abnormalities such as endometrial polyps, fibroids, or uterine scars.

What is STD screening?

There is not a single test for all STDs, so your doctor can help you figure out which tests you need. The screening methods may include: a urine test, a cheek swab, a blood test, a physical exam, testing sores, or using a swab to take discharge or cell samples from the throat, anus, or cervix.

What if I have an STD?

Many STDs can be cured with medication, and even though some STDs can’t be cured, there are many ways to treat symptoms and prevent giving your STD to other sexual partners. In the case that your STD test is positive, your doctor will discuss all available options for treatment with you.

WHAT IS A TRANSOBTURATOR TAPE PLACEMENT?

Transobturator tape placement (TOT) is when mesh (prolene) tape is placed underneath the urethra. It acts as a layer of support so the urethra is closed off when there is laughing, coughing, sneezing and exercising.

WHEN IS THIS SURGERY USED?

To treat stress urinary leakage, such as a loss of urine with coughing, sneezing, laughing or exercise.

HOW DO I PREPARE FOR SURGERY?

Depending on your health, we may ask you to see your primary doctor, a specialist, and/or an anesthesiologist to make sure you are healthy for surgery.

Some medications need to be stopped before the surgery.

Smoking can affect your surgery and recovery. Smokers may have difficulty breathing during the surgery and tend to heal more slowly after surgery. If you are a smoker, it is best to quit 6-8 weeks before surgery. If you are unable to stop smoking before surgery, your doctor can order a nicotine patch while you are in the hospital.

You will be told at your pre-op visit whether you will need a bowel prep for your surgery and if you do, what type you will use. The prep to clean your bowels will have to be completed the night before your surgery.

You will need to shower at home before surgery. Instructions will be provided at your pre-operative appointment.

Do not wear makeup, nail polish, lotion, deodorant, or antiperspirant on the day of surgery.

Remove all body piercings and acrylic nails.

If you have a “Living Will” or an “Advance Directive,” bring a copy with you to the hospital on the day of surgery.

Most women recover and are back to most normal activities in four to six weeks. You may need a family member or  friend to help with your day-to-day activities for a few days after surgery.

WHAT CAN I EXPECT DURING THE SURGERY?

Once in the operating room, you will be given either a spinal or general anesthesia before the surgery to keep you from feeling pain. The choice of anesthesia is a decision that will be made  based upon your history and your wishes.

If a general anesthesia is given, after you are asleep and before the surgery starts:

1. A tube to help you breathe will be placed in your throat.

2. Another tube will be placed in your stomach to remove any gas or other contents to reduce the likelihood of injury during the surgery. The tube is usually removed before you wake up.

3. A catheter will be inserted into your bladder to drain urine and to monitor the amount of urine coming out during surgery. The catheter will stay in until the next day.

4. Compression stockings will be placed on your legs to help prevent blood clots in your legs and lungs during surgery.

The inside of the bladder will be examined with a camera after the surgery, to be certain there were no bladder injuries.

WHAT ARE POSSIBLE RISKS FROM THIS SURGERY?

Problems can occur, even when things go as planned. You should be aware of these possible problems, how often they happen, and what can be done to correct them.

POSSIBLE RISKS DURING SURGERY INCLUDE:

Bleeding: If there is excessive bleeding, you will be given a blood transfusion unless you have personal or religious reasons for not wanting blood.

Conversion to an open surgery requiring an up and down or Bikini incision. If a bigger open incision is needed during your surgery, you may need to stay in the hospital for one or two nights.

Damage to the bladder, ureters (the tubes that drain the kidneys into the bladder), and to the bowel: Damage occurs in less than 1% of surgeries. If there is damage to the bladder, ureters, or to the bowels they will be repaired while you are still in surgery.

Death: All surgeries have a risk of death.  Some surgeries have a higher risk than others.

WHAT HAPPENS AFTER THE SURGERY?

You will be taken to the recovery room and monitored for one hour before going to your hospital room. Depending on the length of your surgery, you may not be able to eat or drink anything until the next morning or you will be started on a liquid diet.

You may have cramping, or feel bloated.

YOU WILL:

Be given medications for pain and nausea as needed.

Still have the tube in your bladder.  The tube will be left in until the next morning.

If you are at a high risk for blood clots, a blood thinning medication may be given to you during your hospital stay.

Have the compression stockings on your legs to improve circulation. The stockings will stay on until you are actively walking. 

 Start walking as soon as possible after the surgery to help healing and recovery.

Be restarted on your routine medications. Be instructed to use a small plastic device at your bedside to help expand your lungs after surgery. 

Stay in the hospital for one to two days.

POSSIBLE RISKS THAT CAN OCCUR DAYS TO WEEKS AFTER SURGERY:

Blood clot in the legs or lungs: Swelling or pain, shortness of breath, or chest pain are signs of blood clots.

Infection:  Bladder or surgical site infection.  This may cause fever, redness, swelling or pain. 

Urinary symptoms:  Failure to cure the bulge, develop urine leakage, and inability to urinate without a catheter.

Bowel obstruction:  A blockage in the bowel that causes abdominal pain, bloating, nausea and/or vomiting

Scar tissue: Tissue thicker than normal skin forms at the site of surgery

Pain: Pain with intercourse.

CALL YOUR DOCTOR RIGHT AWAY IF YOU EXPERIENCE ANY OF THE FOLLOWING :

Develop a fever over 100.4°F (38°C)

Have nausea and vomiting

Develop a rash

Have pain with urination

Start bleeding like a menstrual period or (and) are Changing a pad every hour

Have severe pain in your abdomen or pelvis that the pain medication is not helping

Have heavy vaginal discharge with a bad odor

Have chest pain or difficulty breathing

Leak fluid or blood from the incision or if the incision opens

Develop swelling, redness, or pain in your legs

You may need menstrual pads at home, due to some bleeding and spotting that will occur after the surgery.

Bleeding:

Spotting is normal. Discharge will change to a brownish color followed by yellow cream color that can continue for up to four to eight weeks.

It is common for the brownish discharge to have a slight odor because it is old blood.

Urination:

Your urine stream may be slower. Some women are temporarily unable to empty the bladder completely. If you are unable to empty your bladder after surgery we will teach you how to do so before you go home, or you may go home with a catheter tube in place. If the catheter is left in place, you will need to discuss with your doctor when the catheter can be removed.

Medications:

Pain: Medication for pain will be prescribed for you after surgery. Do not take it more frequently than instructed.

Stool softener: Narcotic pain medications may cause constipation. A stool softener may be needed while taking these medications.

Activities:

Energy level:  It is normal to have a decreased energy level after surgery. Once you settle into a normal routine at home, you will slowly begin to feel better.  Walking around the house and taking short walks outside can help you get back to your normal energy levels more quickly. 

Climbing: Climbing stairs is permitted, but you may require assistance when you first return home. 

Lifting: For six weeks after your surgery you should not lift anything heavier than a gallon of milk. This includes pushing objects such as a vacuum cleaner and vigorous exercise.

Showers: Showers are allowed within 24 hours after your surgery.  Tub baths are encouraged 24 hours after surgery.

Intercourse:  No sexual activity for eight weeks after surgery. 

Driving: The reason you are asked not to drive after surgery is because you have be given pain medications.  Even after you stop taking pain medications; driving is restricted because you may not be able to make sudden movements due to discomfort from surgery.

Exercise: Exercise is important for a healthy lifestyle.  You may begin normal physical activity within hours of surgery.  Start with short walks and gradually increase the distance and length of time.

Work: Most patients can return to work in 6 weeks after surgery. 

Please contact your doctor if you have any questions or concerns before or after your surgery.

What is an ultrasound?

A diagnostic ultrasound, also called a sonography, is an imaging method that uses high-frequency sound waves to produce images of structures within the body. 

Why get an ultrasound?

Ultrasound is used for many reasons, including to view the uterus and ovaries during pregnancy and monitor the baby’s health, a

Pregnancy is a time of many changes, both physical and emotional, for almost all women. Some women find that they are more anxious or depressed during pregnancy. This can be especially true for women who have had anxiety or depression in the past, have had a prior pregnancy loss, who are going through a high-risk pregnancy or in a stressful time with relationships, finances or work. If you feel you are seriously depressed or anxious, please tell your health care provider.

The following are suggestions that have helped other women with depression and anxiety during  pregnancy:

Read You, Your Baby, and Us. Pay particular attention to the sections on normal changes during pregnancy and common discomforts (and what to do about them).

Attend childbirth classes and infant care classes.

Start planning for the postpartum period now. Identify your positive support people and ask them to plan to help once the baby is here. Give them specific and practical jobs to do.

Plan to join a new mother’s support group. If you plan to breastfeed, this can be a breastfeeding mom’s support group.

Remember to take good care of yourself, physically and emotionally. The single most important thing you can do for your baby is to be healthy.

Identify the positive and helpful people around you. This can be your partner, a family member, a friend or your health care providers. Talking things over with a person  you trust can be a very helpful way to deal with stress. They can also help you decide if you should get professional help.

Contact your doctor office if you have any concerns.

WHAT IS FETAL MOVEMENT COUNTING?

It is normal for your healthy, growing fetus to move frequently in your womb. You can help look out for the health of your baby by recording a count of the number of times your baby kicks, twists, or turns. Doing this is called fetal movement counting, or “Kick Counts.” You will usually feel your baby move by the 20th week of pregnancy.

WHEN DO I DO KICK COUNTS?

Your obstetrician or nurse-midwife may ask you to keep a record of how long it takes your baby to move five times.

Count fetal movements twice each day at the baby’s “busy times.” This is usually in the evening, around bedtime, after meals and after exercise.

HOW DO I DO KICK COUNTS?

Get relaxed and comfortable. Loosen tight clothing. Lay down on your side or sit with your feet propped up. You may find it easier to concentrate with the TV off.

Note the time you start. Count movements until you reach at least five. Each roll, kick, or punch or twist counts as 1 fetal movement.

On the “My Baby Movement’s” counting sheet, put a check mark on the line for each movement you feel. Note the time you finish.

If the baby is quiet, drink a glass of cold juice and start over.

WHAT DO I DO IF I DON’T FEEL 5 MOVEMENTS IN AN HOUR?

If the baby does not move five times in one hour, please call your heath care provider and follow their recommendations.

Contact your doctor office if you have any concerns.

What is fetal non-stress testing?

A fetal non-stress test is a common prenatal test used to check on a baby’s health. During a test, the baby’s heart rate is monitored to see how it responds to the baby’s movements. “Non-stress” refers to the fact that nothing is done during the test to place stress on you or the baby.

Why get a fetal non-stress test?

A non-stress test is used to monitor the fetus’ heartbeat and determine if the heart rate is healthy, or too slow, which could indicate issues.

What is considered a high-risk pregnancy?

First of all, being considered high-risk does not necessarily mean anything bad will happen to you or your baby. It simply means that because of a medical condition or other situation, you have a higher chance of pregnancy complications. Some of these common causes include: pregnant women over 35 years of age; being pregnant with multiple babies; having a history of complications such as preterm labor, c-section, miscarriage, or having a child with a birth defect; a family history of genetic conditions; having a heart condition; conditions such as epilepsy, kidney disease, or polycystic ovary syndrome; problems with the structure of the uterus, cervix, or placenta; Rh sensitization.

What do I do if I am considered a high-risk pregnancy?

Your doctor will make recommendations based on your specific situation, but things you can do at home to help a high-risk pregnancy include: eating a nutritious, well-balanced diet; exercising per your doctor’s instructions; getting a healthy amount of rest; limiting caffeine intake; avoiding smoking, alcohol, and illegal drugs.

What is infertility evaluation?

An infertility evaluation involves exams and tests to try to find the reason why you and/or you and your partner have been unable to get pregnant. An infertility evaluation is recommended if you have been unable to get pregnant after one year of trying without using birth control. If you are older than 35 an evaluation is recommended after six months of trying.

What should I expect during an infertility evaluation?

The first visit usually involves a detailed medical history and a physical exam. You will be asked questions about your menstrual period, abnormal vaginal bleeding or discharge, pelvic pain, and disorders that can affect reproduction, such as thyroid disease. You, and your partner if applicable, will be asked about health concerns including: medications, both prescription and over the counter;  illnesses, including STIs and past surgeries; birth defects in your family; past pregnancies and their outcomes; use of tobacco, alcohol, and illegal drugs. You, and your partner if applicable, will also be asked about your sexual history, including: methods of birth control; how long you have been trying to get pregnant; how often you have sex and if you have difficulties; if you use lubricants during sex; past sexual relationships.

The majority of pregnancies are considered low-risk - this means that there are no active complications and no maternal or fetal factors to place the pregnancy at increased risk for complications.

What is a miscarriage?

Miscarriage is the loss of pregnancy before 20 weeks. It can often happen before an individual knows they are pregnant, and they may notice one of these signs to indicate a miscarriage has occurred: vaginal spotting or bleeding, pain or cramping in the lower back or abdomen, and/or fluid or tissue passing from the vagina. 

(Note: spotting and bleeding early in pregnancy is common, and does not necessarily indicate miscarriage.)

Why does miscarriage occur?

There are many reasons why miscarriage occurs. The most common is that the fetus does not develop as it should; this is most often a problem with the baby’s genes or chromosomes, and not typically a problem inherited from the parents. There are factors that may increase the risk of miscarriage, such as: pregnancy at age 35+; previous miscarriages; chronic conditions like diabetes, cardiac or thyroid disease; uterine or cervical problems; smoking, drug or alcohol use; excessive caffeine levels.

*It is important to take care of yourself after experiencing a miscarriage. It is normal to have depression or become upset. Talk to your loved ones, a spiritual advisor, and/or your doctor if you have questions or concerns. Most importantly, do not blame yourself for the miscarriage.

A D&C (dilatation and curettage) is a procedure that involves suctioning the uterine cavity to remove tissue. It is often done to treat an incomplete miscarriage. Following a D&C you may have bleeding from the uterus for a few days, cramping, and some back or pelvic pain. This is considered normal.

INSTRUCTIONS.

Do not douche, use tampons, or have sexual intercourse for 2 weeks or until your caregiver tells you that you are cleared by a medical professional.

You may begin eating and drinking as soon as you feel up to it.

You may go back to work or normal activities in 2 to 4 days.

It is normal to have painful feelings of grief after a miscarriage. You may even cry or feel very sad. Talking with friends, family , or a counselor about your feelings is helpful. Don’t blame yourself for the miscarriage.

Please call your doctor or nurse if you notice any of the following:

Severe pain that is not relived by medication.

A temperature more than 100.4 °F (38°C).

Heavy vaginal bleeding (saturating 1 or 2 maxipads in 1 hour) that gets worse instead of better.

A vaginal discharge that smells unpleasant.

Signs of infection such as headache, muscle aches, dizziness, or general ill feeling.

Contact your doctor office if you have any concerns.

Our providers will offer counseling services such as: an in depth health history, ultrasounds, tube check, recommending infertility medication, and making any necessary referrals. 

What is a Cesarean Section?

A cesarean section, or c-section, is the surgical delivery of a baby through incisions made in the mother’s abdomen and uterus. This is done as an alternative to vaginal delivery. 

Why get a Cesarean Section?

There are certain conditions and situations that may make a c-section a safer option than vaginal delivery. The c-section may be planned due to pre-existing conditions, issues, or concerns that develop during pregnancy. Some reasons a c-section may be necessary are as follows: breech presentation; a large baby; pregnancy with multiple babies; maternal medical conditions like hypertension or diabetes; maternal infections such as HIV or herpes; failure of the labor to progress, where the cervix may not open enough for the baby to move into the vagina; concern for the baby due to abnormalities detected in fetal monitoring or umbilical cord compression; concern for the mother, such as hemorrhaging; uterine rupture; placental abruption, which is the placenta peeling away from the uterine wall.

For most women, the early part of labor, before active labor, is best spent at home. During this time it is important to save your energy for later by resting, eating and drinking plenty of fluids. These are some suggestions that have helped other women:

Drink/eat at least 16 ounces of fluids with energy each hour (juice, popsicles, broth, Gatorade, soda without caffeine).

Snack on small amounts of light, easily digested foods.

Alternate walking with the shower and resting

Some women may feel nauseous and even vomit during labor, this is normal. Wait a short while and continue to drink.

If your contractions allow, try to sleep. Sometimes a warm bath or using a heating pad will help relax you enough to fall asleep for a short while.

Remember that your coach should also rest, eat and drink, too!

Labor contractions feel like very painful (you can’t walk or talk during them) menstrual cramps in the low abdomen, pelvis, hips, low back and upper thighs. They build to a peak and then they ease and go away. To time how often your contractions are coming, start at the beginning of one contraction and time until the beginning of the next contraction. Duration of your contraction is the time each contraction lasts (the start to the end of one contraction).

YOUR CONTRACTIONS ARE PAINFUL AND REGULAR:

coming every 3 to 5 minutes, lasting 60 seconds for an hour for a first labor

coming every 5 to 7 minutes, lasting 60 seconds for an hour for all other labors

OTHER REASONS TO CALL YOUR DOCTOR:

Big gush or steady trickle of watery like discharge from your vagina. ( your bag of waters may have broken )

Heavy, bright red bleeding like a period.

A small amount of red, pink or brown blood or “bloody show” is normal, especially after a vaginal exam.

Continuous, severe, sharp abdominal pain that doesn’t stop after 3 – 5 minutes.

Absent or decreased fetal movement.

If you can’t eat or drink, are exhausted, can’t cope with the pain or have questions or concerns call you medical professional right away.

Contact your doctor office if you have any concerns

What is Group B Streptococcus?

Group B streptococcus, or GBS, is one of the many bacteria that live in the body. It usually does not cause serious illness, and is different than group A streptococcus, the bacteria that causes “strep throat.”

Why is GBS a concern for pregnant women?

In women, GBS is most often found in the vagina and rectum. This means there is a possibility for GBS to pass from a pregnant woman to her fetus during labor. This is rare, and only happens to 1-2 babies out of 100 when the mother does not receive antibiotic treatment during labor. The chance of a newborn getting sick is much lower when the mother receives treatment.

How can GBS affect a newborn?

Even though it is rare to occur, babies who get GBS can be seriously affected by early-onset or late-onset disease. Early-onset disease typically occurs within 12-48 hours after birth, or up to the first 7 days. Early-onset disease can cause problems such as: inflammation of the covering of the brain or spinal cord, meningitis; infection of the lungs, pneumonia; or infection of the blood, sepsis. Late-onset disease occurs between a week and a few months after birth. The disease is usually caused by contact with the mother after delivery if she is infected, but it can come from contact with other people who have GBS too. Late-onset disease can cause meningitis. Symptoms of this disease in babies include: lack of energy, irritability, poor feeding, and high fever.

Can I be tested for GBS?

Yes, pregnant women are screened for GBS as part of routine prenatal care. The test for GBS is typically done between 36 and 38 weeks of pregnancy. This test, called a culture, involves using a swab to take a sample from the vagina and rectum.

What is breastfeeding?

Breastfeeding is when the mother feeds her baby milk from her breasts. This can be done by feeding the baby directly at the breast, or pumping the milk to be put into a bottle for the baby.

How long should I breastfeed?

Your doctor will advise an ideal timeframe to breastfeed, usually for 6 months and until the baby’s first birthday it should continue. However, your baby benefits from any amount of breastfeeding you are able to do. Breast milk is the only food most babies need until approximately 6 months of age. You will gradually breastfeed less often as your baby starts to eat other foods; ask your doctor when you can start feeding your baby solid foods. Ultimately, how long you breastfeed is entirely up to you.

CARE IN THE HOSPITAL

Immediately after the circumcision, a double diaper (one cloth diaper inside the disposable diaper) with petroleum jelly (Vaseline) applied to the front will be placed on you baby and remain on for about two hours. This double diaper will aid in preventing any bleeding. The petroleum jelly will protect the tip of the penis from burning when the baby urinates. It will also keep it from drying and sticking to the diaper.

Your nurse will be checking on your baby for bleeding and pain. If you need help changing your baby or have any questions, please ask your nurse and/or midwife.

At first, the tip of the penis is swollen and bright red. Within one or two days, you will notice a decrease in the swelling and may see a yellow covering of the tip of the penis. This is normal new tissue growth.

Your baby may be given acetaminophen (Tylenol) after the circumcision for pain control with your permission.

CARE AT HOME

After the initial two-hour period, you may diaper your baby normally, using about one tablespoon of petroleum jelly every diaper change until the penis is healed. The healing will occur in three to four days. The healing is complete when the tip of the penis is no longer yellow and is pink like the rest of the skin.

For cleaning the penis for the first two or three days, pouring warm (not hot) water over it should be sufficient. If it is necessary, you may also use a mild soap.

CALL YOUR BABY’S DOCTOR

If the penis becomes swollen and reddened and has a greenish-yellow, foul smelling discharge, this could be a possible infection.If this should occur, contact your baby’s doctor immediately.

It is normal to have some blood spots on the diaper for the first couple days. If you notice any active blood dripping from the penis, call your baby’s doctor immediately.

If you baby does not urinate once within 24 hours after the circumcision, call your baby’s doctor immediately.

Contact your doctor office if you have any concerns.

Our providers will offer a mental and physical survey, follow-up sessions regarding labs, and a three-month follow-up appointment. 

What is postpartum tubal ligation?

Postpartum tubal ligation is a surgical procedure to cause permanent sterilization. It is sometimes referred to as “getting your tubes tied.” This procedure can be done at the same time as a c-section, or about 48 hours following vaginal delivery.

Are there risks involved with postpartum tubal ligation?

There are generally no risks wit this procedure, and it is a safe form of birth control. The most common complications are related to anesthesia.

What is endometrial ablation?

Endometrial ablation is a procedure that surgically destroys (ablates) the lining of your uterus (endometrium.) The goal of this procedure is to reduce menstrual flow, and in some patients it may stop menstrual flow completely. 

Why get endometrial ablation?

This procedure is a treatment for excessive menstrual blood loss. Your doctor may recommend it if heavy bleeding cannot be controlled by medication.

Are there risks involved with endometrial ablation?

Pregnancy can occur after endometrial ablation, however, these pregnancies may be higher risk to mother and baby. The pregnancy could end in miscarriage as the lining of the uterus has been damaged, or the pregnancy may occur in the fallopian tubes or cervix instead of the uterus (ectopic pregnancy.) If someone wants to become pregnant, they should not have this procedure done.