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Category: Babies

April 24, 2017

Natural Childbirth is a labor and delivery that does not include the use of routine medical interventions, particularly anesthesia, the most common forms being epidurals and spinal blocks. It also attempts to minimize surgical interventions such as episiotomies, forceps, and caesarean sections.

Many women prefer natural childbirth.A natural childbirth may occur in a hospital while under the supervision of a physician or midwife, or at home assisted by a midwife. Statistics show that in 2008 approximately 39 percent of documented vaginal births in the United States were natural.

Natural Child Birth Options

Pregnant women who are approaching their due date may often become anxious about the process of delivering a healthy baby and what it may entail. In order to relieve any unnecessary anxiety or concern, it is helpful to become informed about childbirth, which options are available and have a birth plan ready for when it is time for delivery.

It is important to speak with your health care provider to explore both natural and medical options for you and your baby. This way you can be prepared and empowered to make a decision. Each birth is different, and the health of mother and baby is ultimately paramount.

The following are different options that are available as an alternative to medical interventions.

Massage

Massage stimulates your body to release endorphins that can help ease the pain, reduce anxiety and make contractions feel less intense. Massage can be performed on the shoulders, back, feet/hands and the perineal area.

Breathing and Relaxation Exercises

This can include a variety of methods such as mindfulness and meditation, specific breathing techniques, vocalization, visualization, and progressive muscle relaxation.

Acupressure

A form of Traditional Chinese Medicine, acupressure can be used to apply pressure on specific points to provide pain relief, calm anxiety and encourage an efficient labor. This can be learned and practiced on yourself or by your partner.

Positioning and Movement

Certain birth positions have been favored in natural childbirth including squatting, and being on hands and knees versus the traditional lithotomy – laying on the back with hips and knees flexed – position. Walking, gentle stretching and the use of a birthing ball can also be helpful in the labor process.

Hot and Cold Therapy

Intermittent heat and cold in the form of warm and cold packs may be used on the lower back, lower abdomen and perineum during labor to help with pain and discomfort.

Hypnotherapy

This is an integrative mind-body technique which can aid women to replace fear and expectations of pain with expectations of a safe, gentle and comfortable birth. It can be self-performed or performed by a partner using deep breathing, vocabulary cues or visualization.

Final Thoughts

When it comes to childbirth today, women have a variety of options to explore and choose from. It is important that you feel as comfortable, prepared and relaxed as possible when preparing for your labor and delivery.

Being educated about both natural and traditional medical birth options will allow you and your doctor to make an informed plan that best suits you and your baby’s needs.

Please don’t hesitate to call with any further questions or concerns you may have regarding Natural Childbirth.

December 1, 2016

In vitro fertilization has become a wonderful option for many women who suffer from fertility issues. At Cherokee Women’s Health Specialists, our OB-GYNs and Female Pelvic Medicine Specialists are not only qualified to diagnose and treat these issues, but have the accreditations and combined decades of experience to effectively change lives child-free lives with their accumulated wisdom, experience, and access to the most cutting edge, up-to-date medical technology.

What is In Vitro Fertilization?
In vitro fertilization (IVF) is the most successful of several fertility treatments known as assisted reproductive technology (ART). Both the female egg and sperm are fertilized outside of the body, processed, and then reintroduced into a woman’s uterus to achieve conception.

Is In Vitro Fertilization My Only Recourse If I Suffer From Infertility?
There are several assisted reproductive technologies. In vitro fertilization may be necessary if other methods cannot help you achieve conception. Our OB-GYNs and FPMRS specialists are skilled in all aspects of Women’s Health, including fertility issues. We examine, diagnose and treat each patient with the same intense scrutiny and care we would a member of our own family. You will be assessed on an individual basis. We will recommend the best options based on your unique case, providing you with any available resources and referrals that meet your specific requirements.

Am I a Good Candidate for In Vitro Fertilization?
When other options have failed, or if we consider IVF the best course of action based on our expertise and knowledge, then this procedure will be recommended, if you:

  • Have been trying unsuccessfully to conceive through unprotected sex for more than six to twelve months.
  • Have ineffectively tried other forms of assisted reproductive technology.
  • Are 35 years or older (natural egg production decreases as women enter their late thirties).
  • Have blocked, scarred, missing or damaged fallopian tubes.
  • Suffer from endometriosis as endometrial scarring may prevent conception.
  • Have been diagnosed with polycystic ovarian syndrome (PCOS), a condition where excessive androgen (male) hormones may inhibit or cause irregular ovulation.
  • Produce too much prolactin in the blood (hyperprolactinemia).
  • Have incurred damage from pelvic inflammatory disease or another STD.
  • Have a partner with male fertility issues, such as a low sperm count.

in-vitro-photoHow Does In Vitro Fertilization Work?
In vitro fertilization is done in stages beginning with hormonal treatments to stimulate the growth of multiple eggs needed in the event that one or more may not develop or fertilize during the later process. These eggs are subsequently retrieved through a simple surgical procedure, and inseminated with the prepared, furnished sperm. Eggs are then monitored carefully to insure that fertilization and cell division are occurring. If success is achieved, the egg officially becomes an embryo and is ready for transfer into the uterus, where implantation will hopefully take place. The entire process from retrieval to implantation takes approximately a week. Close monitoring is done at every stage of this process to insure optimal results.

What if My Eggs or My Partner’s Sperm Are Deemed Weak or Unhealthy, or if There Are Dangerous Genetic Factors in My Family Tree?
From the moment of your first appointment, we will study and assess any problems that may be preventing you from conceiving, after which we will outline your best options. In the case of a low sperm count, intracytoplasmic injection can be used to infuse a single strong and healthy sperm directly into the egg. If healthy sperm cannot be provided by your partner, if your own eggs are not viable for this procedure, or if you are a female in a same sex relationship, you may opt to use donor sperm or eggs.

If genetic abnormalities are a concern, we will thoroughly study your family history, along with your own medical information. After careful analysis and testing, if we concur that your child may be at risk for inheriting a genetic or infectious disease, the above mentioned donor option is, again, available to you. Today’s technology also allows us to screen an IVF embryo for certain diseases or conditions before implantation.

What About Multiple Births?
During the in vitro fertilization process, several fertilized eggs are reintroduced into your uterus to insure a better chance of successful pregnancy. However, if you prefer not to have more than one baby and wish to avoid a multiple birth, today’s technology makes it possible to limit the number of fertilized eggs implanted to one in order to insure a single birth.

What Happens to Perfectly Good Eggs, Sperm or Embryos That Are Not Used?
Both fertilized and unfertilized eggs and sperm can be frozen (cryopreservation) for use at a later date. If you no longer wish to have another baby, you are free to donate them for use by someone else.

Freezing for later use is an excellent option if, for some reason, it is inconvenient to become pregnant immediately due to health or other concerns such as cancer treatment, a medical condition that can compromise fertility, etc.

How Successful is In Vitro Fertilization and How Can I Improve My Chances of Getting Pregnant?
As with every assisted reproductive technology, there is never a 100% guarantee, but IVF is one of the most effective methods to insure pregnancy. You can help guarantee even better results with the following lifestyle changes:

  • Eat a nutritious, balance diet.
  • Don’t smoke.
  • Take precautions to avoid contracting sexually transmitted diseases.
  • Maintain a healthy weight.
  • Schedule regular medical and gynecological checkups.
  • Limit alcohol intake.
  • Don’t use recreational drugs.
  • Try to keep a day job (studies shows that night or evening shifts can disrupt natural hormonal balance).
  • Exercise moderately (too much vigorous exercise can inhibit progesterone production).
  • Avoid exposure to toxins.
  • Limit caffeine consumption.
  • Practice pelvic exercises.

Today’s technology gives more women than ever the opportunity to conceive in cases where there was little hope only a few decades ago. For a consult with one of our OB-GYNs, book an appointment by calling 770.720.7733.

November 4, 2016

ultrasound photo with brenda

A registered ultrasound technician, or diagnostic medical sonographer, is a highly educated and skilled expert working in the field of medical practice who operates an ultrasound machine, performing diagnostic examinations. Your doctor will then study the resulting images and, based on calculations and other factors, conclude if any abnormalities exist.

How Ultrasound Changed Pregnancy

When the technology of ultrasound first emerged, pregnant women were ecstatic. They could now see their developing babies. As they lay on the cold table, with bladders ready to explode from the gallons of water they were forced to drink to get a clear picture, an ultrasound technician lubricated their stomachs with ice cold gel and proceeded to rub a transducer probe across their bellies while the anxious future moms and dads looked on.

The pictures were often disappointing – blurred and grainy. Most patients squinted, trying to discern what was placenta and what was baby. Without the sonographer patiently tracing the image with a finger on the monitor, they didn’t know if they were admiring their baby’s face or the uterus it was inside. As for gender, well, that was still a hit and miss thing – basically no different from the baby shower tradition of swinging a ring on a rope, and guessing the baby’s sex based on whether the ring twirled or swung like a pendulum. Even when parents were given a snapshot to take home, they could peer at it for hours attempting to guess if they were looking at a foot or an umbilical cord.

Back then, only the sonographer’s experienced eye could differentiate the important information from the blips and blotches on the monitor to insure that all was well. But since then, ultrasound and its technicians have evolved a hundredfold. Accreditation to be a professional in this career requires years of learning and expertise, along with the competency, diagnostic astuteness, and personality to become highly successful at this specialty.

Briefly, How Does Ultrasound Work?

The ultrasonographer sends harmless high frequency sounds undetected by human ears toward a ‘target’ he or she is aiming at, based on his or her training in anatomy. In this case, the target is a growing baby. Those sound waves are directed via a probe called a transducer. The sound waves basically bounce back. When they encounter the bone or tissue of the baby, an echo is created, much as when you yell into a cavern. That echo pings back to create an image on a monitor—in essence, a picture of the baby complete with all its parts, including internal bones, tissue, organs and even blood flow. You’ll only see larger parts of the baby, like face, limbs, heart, etc., but the technician knows what all the little pieces of the fetus are. He or she is trained to measure, decipher and make calculations of every part to verify due date, gender, and see if anything is out of the ordinary.

Does Your Clinic Offer Ultrasound Services?

Yes, we offer ultrasound services at our practice and are accredited at both our Canton and Woodstock locations. Headed up by our chief ultrasonographer, Brenda Peters, our practice has earned an enviable place on a limited list of practices fully accredited by the American Institute of Ultrasound in medicine for obstetric and gynecologic ultrasound. Brenda’s training includes a Bachelor of Science degree from the diagnostic medical sonography program of the Rochester Institute of Technology, where she graduated with high honors in 2000. She is also a registered OB-GYN Ultrasonographer by the American Registry for Diagnostic Medical Sonography, and is certified in nuchal translucency, a specific screening to determine the presence of Down syndrome.

What Does Ultrasound Accreditation Involve?

A minimum number of required hours of clinical experience must be met, and the ultrasonographers must continue to update their skills and stay current by attending the obligatory programs available to them. If they wish to specialize in a particular field, additional education is necessary. Many not only excel in this choice of career, but also mentor and train others to become proficient in this vocation. Also, physicians must take ongoing ultrasound classes and pass a test every three years in order to read ultrasound studies.

What Skills Does a Registered Ultrasonographer Have?

  • They are required to have basic knowledge of pathophysiology (knowledge of disorders and syndromes), anatomy, and physiology (knowledge of the function of living matter such as cells, tissues and organs)
  • They must be able to differentiate between normal and abnormal sonographic findings, recognizing particular conditions and diseases.
  • They must be able to recognize ultrasound patterns and imaging.
  • Sonographers do not simply diagnose findings, but must also know how to efficiently operate the equipment to acquire all the necessary data for diagnosis.
  • They must possess excellent clinical and communication skills
  • They must be able to assess and care for their patients, be adept at problem solving, and apply unbiased, logical, critical thinking to all findings.
  • They must adhere to all sanitary guidelines to prevent infection, and be mindful of all safety and health issues.
  • They are required to have knowledge of ultrasound physics
  • They keep image copies, accurate records, precise charts and detailed information, sharing their diagnosis with their medical colleagues in order to insure optimum patient care.
  • They often communicate findings to patients in real time, taking however long is necessary to explain all procedures, thus instilling trust, confidence and calmness in the person under their care.
  • They need strong verbal and written skills, in both medical and layman terminology to be able to communicate their findings to their colleagues.
  • In many cases, they may be required to move patients and be able to stand for long hours, requiring them to be in peak physical condition.Ultrasound registry takes years of study, dedication and experience to achieve.
  • Reaccreditation is done every three years for our office.

Our staff of professionals in this field are available to care for you, the patient, with their knowledge and expertise at all times.

For more information, visit Northside Hospital-Cherokee.For an appointment, call our clinic at 770.720.7733.

November 1, 2016

woman-choosing-food

It’s common knowledge that smoking, drinking or misusing drugs can be harmful to a growing fetus. It’s also becoming widely known that a proper prenatal diet is vitally important to a baby’s health and development.

We consider diet such an important factor in pre-pregnancy planning and prenatal care that we offer the options of both regular and holistic plant based prenatal nutrition information to all our patients. Our providers can help advise you on a regimen that works for you, based on your specific needs and preferences, even allowing for any budgetary limitations you may have. This service is available before, during, and after pregnancy.

Two of our physicians, Dr. Britton Crigler (MD, FACOG), and Dr. Kathryn Hale (MD, MPH, FACOG), are practicing vegans and pegans, respectively. Their expertise and input into prenatal holistic nutrition can prove invaluable should you choose to follow a plant based diet while pregnant.

What is Holistic Nutrition?

Holistic nutrition is eating foods that are as close to nature as possible. None of us would dream of walking into a lab, grabbing random test tubes, and drinking the contents. Yet, in essence, we do something similar to this every day by ingesting foods saturated in chemicals, additives and preservatives. Grocery store shelves bulge with genetically altered meat, produce, dry goods and beverages that make them look, sound, or taste more appealing.

The list of ingredients on most packaging has become so long that one almost needs a microscope to read the fine print. Even someone with 20/20 vision needs a PhD to decipher the multisyllabic contents on a box of crackers.

Your baby is completely dependent on you to provide her with the nourishment she needs to grow healthy and strong while she develops inside your body. Her bones, muscles, tissue and organs are sensitive to every bite you eat and every drop you drink, so if you opt for holistic nutrition, your baby also benefits from the purity of unprocessed, unrefined and organic food.

What’s the Difference Between a Vegetarian, Vegan and Pegan Diet?

A strict vegetarian diet consists of grains, seeds, nuts, vegetables and fruits, with no fish, meat, poultry, game or shellfish. In some cases, vegetarians will eat occasional dairy products and eggs, but emphasis in this diet is on the exclusion of all slaughtered animals. Less strict plant-based diets may include fish, dairy products, eggs and poultry. Most vegetarians exclude meat, but some include it infrequently.

A vegan diet is entirely plant based with no animal products. Emphasis is on seeds, nuts, fruits, grains and vegetables.

A pegan (paleo-vegan) low-glycemic diet consists of fruit, vegetables, meat, fish, and eggs. It omits dairy products, processed foods, grains, sugars and legumes.

Although these sound like contradictions of each other, they’re not. All three place importance on a natural plant based diet, and all are beneficial to good health, prenatal and otherwise. Though the pegan diet includes meat, it is in extremely limited quantities.

How Can Any of These Diets Help Me and My Baby?

Dr. Hale’s and Dr. Crigler’s diet regimens vary somewhat, but both stress the benefits of natural plant based nutrition to you and your baby. As a vegan, Dr. Crigler avoids meat completely and encourages eliminating it. He states:

“… A plant based diet has multiple benefits for women’s health…Even for our pregnant patients, a vegan or plant based diet free of dairy and meat can be very healthy for both baby and mother.”

As a pegan, Dr. Hale, who holds a plant based nutrition certificate, is not opposed to a scant quantity of organic meat or low toxin fish, but only considers inclusion of it as a second choice. Meatless pegan is her first. She also affirms:

“…Contrary to what many people think, pregnant women can be completely meat-free and get sufficient protein to support a healthy pregnancy…”

Both also agree that protein can be derived from other holistic sources.

Dr. Hale recommends taking B12 and DHEA if you opt for pegan. Dr. Crigler prescribes B12 and Vitamin D if you prefer vegan. These supplements round out a healthy regimen, supplying the body with everything it needs to maintain optimum prenatal performance.

Both are also in total agreement that vegan and paleo-vegan nutrition help prenatal and postnatal women in the following ways by:

    • Decreasing preeclampsia risk
    • Providing antioxidants
    • Producing more beneficial, purer breast milk
    • Preventing breast, colon and ovarian cancer
    • Minimizing incidents of allergies to your baby
    • Lowering exposure to additional or harmful hormones.

Holistic nutrition can also alleviate the symptoms of chronic conditions and diseases such as:

    • Endometriosis
    • Lupus
    • Acne
    • Irritable bowel syndrome
    • Heart disease
    • Type 2 diabetes
    • Constipation
    • Systemic inflammation
    • Polycystic ovarian syndrome
    • Heavy menstrual periods
    • Menstrual cramps.

Additionally, holistic nutrition has been known to enhance mental clarity, improve energy and help with weight loss.

Isn’t it Dangerous to Suddenly Change My Diet While Pregnant? Am I Not Eating for Two Now?

Pregnancy is one of the best times to address the subject of nutrition. In a sense, you are eating for two, but this doesn’t mean double the amount. It means that you have to fuel two growing bodies with the vitamins, minerals and nutrients they both need to remain healthy.

A developing fetus can not only sap your energy by absorbing all the ‘goodness’ it needs from the food you ingest, it can deprive you of what you need to remain strong and fit enough to handle all the physical, emotional, and hormonal changes that are going to happen during the next few months.

Proper nutrition replaces what the fetus depletes, preparing the two of you for the intensity of labor and delivery. Holistic nutrition counseling can help make the choices that are right for you.

For more information on high risk pregnancy, visit Northside Hospital-Cherokee.

To schedule an appointment to discuss your needs, call 770.720.7733.

October 19, 2016

Routine prenatal care is not a luxury or indulgence. It’s something both you and your baby deserve, and it’s a service that we excel at and are happy to provide.

Just as a gardener waters, nurtures, and cares for the seeds that he planted in rich, fertile soil, your baby, who is even smaller at conception than those seeds, needs the same dedication and attention to insure its prenatal growth and development in the womb. We help make that happen.

Whether this is your first pregnancy, or you’re already familiar with the whole process of giving birth, the importance of prenatal care can’t be emphasized enough. No matter how typical your pregnancy is, or how little risk your baby is exposed to health-wise and genetically, proper vigilance from conception to safe delivery is vital.

routine prenatal care exam photoOur specialists are trained in every facet of women’s health. We excel in the fields of fertility, obstetrics, gynecology and pelvic surgery. Not only do we offer optimum prenatal care, but we treat you, the patient, the same way we would treat our own mothers, sisters, daughters and all other females in our lives. Having successfully delivered over 10,000 babies, our priority is to safeguard not only your continuing well-being, but that of your baby. We offer every advantage currently known to women’s medicine, all with a compassionate and dedicated approach.

What Can You Expect From Us?
From your very first prenatal care visit, we treat you with the utmost care and respect, beginning with the initial pleasant greeting you receive the moment you walk through our doors. We’re professionals, but first and foremost, we’re human, just like you. We want you to feel as comfortable as possible so that you can establish a trusting relationship with your physician, and with his or her assisting staff.

How Can You Prepare For Your First Visit?
Bring your medical history and background. They’re important. That information gives us an idea of how closely we need to scrutinize your progress. It can help us decide what tests we should run during your first few prenatal care appointments. Your information and subsequent test results, if merited, determine whether your pregnancy should be considered high risk, moderate risk or risk free. No matter what the results, we are qualified to treat all levels.

What Happens During Routine Prenatal Care Appointments?
Our standard examinations during each visit include the following:

  • Blood tests
  • Blood pressure monitoring
  • Listening to your baby’s heartbeat
  • Urinalysis
  • Abdominal measurement to verify normal fetal growth
  • Pelvic examinations when necessary
  • Addressing any patient concerns.

When you’re ready for your first ultrasound, our prenatal care physicians are among the few who are fully accredited in the use of the most modern up-to-date 4D ultrasound. This procedure allows you to see your growing baby in full detail. It also lets our trained specialists evaluate your baby’s progress, detecting any potential problems that might occur as it matures from embryo to fetus, and finally to the infant you’ll cradle in your arms.

What Other Routine Prenatal Care Services Are Available?
We check for gestational diabetes, anemia and any genetic abnormalities. By conscientiously monitoring both your baby’s development along with your own, we want to relieve you of any stress or worry. When you leave after an appointment with us, we want you to do so with complete peace of mind.
We also offer the following prenatal care services:

    • Nutrition and diet: Our experts will help you maintain a healthy weight throughout your pregnancy, insuring a less complicated delivery. We provide information on regular, vegetarian, gluten free, vegan, and holistic nutrition. We take every precaution to insure that you and your baby receive the proper nourishment you need to sustain a trouble-free pregnancy.
    • Physical therapy: On-staff professionals will guide you in preparing your body for labor. Their recommended prenatal exercises and fitness regimens will minimize any possible trauma your body might experience during delivery, such as perineum damage, pelvic organ prolapse, or urinary incontinence. Their expertise has been proven invaluable, reducing previously unavoidable pelvic injury while giving birth.
    • Midwifery: You may be more comfortable with a nurse-midwife to assist you during delivery. We will partner you with a highly skilled nurse midwife, who has decades of experience. As long as your pregnancy is uncomplicated and progressing within normal guidelines, this practitioner is available to you.
    • Counsel and advice: No topic or concern you wish to broach regarding your pregnancy is trivial to us. We’re happy to address any subject, including such topics as breastfeeding, natural childbirth, having participants in the delivery room, umbilical cord blood banking, signs of postpartum depression, or circumcision if you are having a boy. You might be strongly opposed to routine afterbirth procedures, like a nurse washing your baby instead of leaving that first bath to you, or allowing it to have a pacifier in your absence. If it’s important to you, it’s important to us. We’ll answer your questions, dispense guidance as you need it and accommodate you to the best of our ability.

Getting you through your pregnancy with as little stress and complication as possible is our primary focus. We accomplish this goal successfully during every routine prenatal exam by treating you as the important and unique individual you are.

To schedule an appointment, please call us at 770.720.7733. For more information on prenatal care, visit Northside Hospital-Cherokee.

Midwife-attended births have doubled in the United States since 1990, and the numbers continue to rise every year. In fact, the demand for them is beginning to far outweigh their availability. We are proud that our staff of these professional caregivers is among the very best, and prouder still that they manage to find the time in their busy schedules to help ensure that their numbers continue to grow by mentoring, educating and indoctrinating future midwives to fill the fast growing gap of need.

What Exactly Do Midwives Do?
Our midwives have accumulated years of learning, experience and training in women’s health in order to receive their certification. They hold the highest degree possible in their field CNM (Certified Nurse Midwife). Their primary focus, however, is on providing care to women and their families during their pregnancy, delivery, and the following postpartum period. They are also qualified to:

  • Provide prenatal care
  • Dispense medication
  • Recognize any potential problems that may arise during pregnancy or delivery
  • Conduct annual women’s examinations
  • Administer birth control
  • Give pre-pregnancy counseling
  • Diagnose infections
  • Provide postnatal care to mothers and newborns
  • Advise on nutrition and diet
  • Arrange for all routine prenatal testing
  • Make limited medical decisions within their scope of training and expertise
  • Deliver routine pregnancy babies
  • Prepare women for delivery with relaxation and breathing techniques
  • Discuss breastfeeding and its options
  • Provide parenting education.

Why Would I Choose a Midwife Instead Of a Doctor?
Many women prefer to opt for natural childbirth in a more subdued, comfortable setting. Midwives approach childbirth as a holistic, rather than medicinal, experience. They concentrate on alternative drug-free methods to bring your child into the world, such as breathing and relaxation techniques, massage, comfortable positioning, and advice to help you cope with contractions as they become more intense.

midwife-photoAlthough our midwives encourage non-anesthesia delivery, you will not be refused medication if you should happen to change your mind during labor. In fact, if your midwife recognizes that you are in too much painful distress, she will urge you to accept relief so that the birthing process does not become a traumatic memory.

Our midwives also develop a more intimate bond with their patients, something physicians and surgeons are not always able to provide due to time constraints. Though all our doctors strive to answer all your questions and concerns, taking whatever time is necessary to put your mind at rest during your prenatal appointments, midwives offer more availability. Since they usually have less patients at one time than an OB-GYN, this allows them to concentrate more fully on each individual pregnancy.

By questioning and getting to know you better, our midwives will learn exactly what your preferences are during your natural birth process and will do their best to accommodate those wishes.

I’ve Already Had a Caesarean but Would Really Like to Give Birth Naturally This Time. Can I Still Ask for a Midwife or Natural Birth?
In many cases, absolutely! You’ll have to be evaluated by one of our OB-GYNs to make sure there is no risk to you or your child, of course. Your health and safety, along with your baby’s, are our primary concern at all times, but once we’re confident that a natural vaginal birth is possible, one of our staff nurse-midwives can take over your prenatal care, and often your labor and delivery.

Should any problems arise at any given time, our midwives are trained to immediately notify a physician for help and support.

Midwives are our respected colleagues, and we rely heavily on their knowledge and sound medical training to alert us to step in at any time we are needed to assist if they encounter a problem outside their scope of expertise.

Childbirth is one of the most memorable experiences in a woman’s life. A midwife is proficient in extracting the inner strength and determination you may not even be aware you have to give birth naturally and still revel in the whole process.

For more information on midwifery, visit Northside Hospital -Cherokee. To make an appointment with us, call us at 770.720.7733.

Our doctors have decades of combined experience and expertise in the field of women’s health and fertility assistance. We understand your frustration, sadness, and heartache over your efforts to conceive, and we want you to know that there is hope for your situation. Thanks to constant medical breakthroughs, that hope grows larger every day.

sad-woman-inferilityOur priorities are twofold. The first is to treat every woman that walks into our clinic with the same counsel, focused care, and individual attention that we would treat a beloved member of our own family.

The second priority, equally important to us, is to make sure that we are constantly abreast of the most up-to-the-minute technology and knowledge in all facets of women’s health. This includes reproductive assistance. Our technology is equally cutting edge, allowing us to correct many previously irreparable infertility issues.

What Causes Infertility?
Sometimes the causes are unknown, but the more common ones are:

  • Ovulation problems
  • Blocked fallopian tubes
  • Endometriosis
  • Inferior egg quality
  • Hormonal problems
  • Past infections
  • Uterine fibroids
  • Ovarian issues such as cysts (polycystic ovary syndrome)
  • Past miscarriages
  • Irregular periods
  • Low or ineffective male sperm.

If My Cause is Unknown, Can Cherokee Women’s Reproductive Assistance Specialists Still Help Me?
Yes. Even though your tests may come back completely normal, we can still help you. Though every reproductive system functions the same way, there are also differences. Just as you have a unique fingerprint, your body may have variations that can affect the process of fertilization. Simple lifestyle factors can affect your ability to conceive, and these can be as simple as:

  • Caffeine consumption
  • Diet
  • Overweight or underweight
  • Smoking
  • Medication, either prescribed or social drug use
  • Lack of exercise or excessive exercise
  • Alcohol intake
  • Stress.

Our staff of reproductive assistance experts is persistent in finding the reason for your infertility, and once we do, we will recommended different modifications to help you through your dilemma.

What Can You Do For Me?
Not only do we offer the most in-depth testing to pinpoint your specific reason for infertility, our diet and nutrition experts can help adjust or change your diet, and recommend vitamins and supplements to help with any deficiencies that might be contributing to your difficulties with conception.

If you are suffering from any weakness in your pelvic area that might be preventing you from carrying a baby full term, our doctors can customize an exercise regimen to strengthen those frailties.
Our OB-GYNs and FPMRS surgeons (Female Pelvic Medicine and Reconstructive Surgery) hold the highest certifications and are qualified to perform the surgeries necessary to correct any physical impairment or disorder that may be interfering with your successful reproduction, including:

  • Laparoscopic surgery to correct ovarian disorders and restore ovulation.
  • Tubal cannulation, salpingectomy, salpingectomy, or fimbrioplasty to eliminate scar tissue or remove or rebuild damaged sections of blocked fallopian tubes
  • Tubal reanastomosis to reverse tubal ligation
  • Myomectomy to remove uterine fibroids
  • Laparotomy to remove larger fibroids.

What if I Still Can’t Get Pregnant?
There are still reproductive assistance options available. Once we’ve looked at and corrected any possible physical, nutritional or lifestyle detriments that may be hampering your ability to conceive, there are still alternatives available. These include:

  • Fertility medications and hormonal therapy to boost ovulation and egg production.
  • Gamete Intrafallopian Transfer (GIFT): Eggs and sperm are extracted, mixed and placed in the fallopian tubes to fertilize.
  • Zygote Intrafallopian Transfer (ZIFT): An option in cases of low sperm count, or where at least one fallopian tube is unscarred. A scientifically fertilized embryo is injected into the healthy tube.
  • Intracytoplasmic Sperm Injection (ICSI): A healthy sperm is injected directly into your egg.
  • Artificial or Intrauterine insemination: ‘Washed’ sperm is introduced into the uterus, bypassing any sluggish sperm issues or hostile environment, such as thick or acidic mucous preventing the sperm from reaching the egg to make conception possible.
  • In vitro fertilization (IVF): A common approach today in cases where age, internal pelvic scarring, or low sperm count contribute to infertility. A lab developed embryo grown from egg and sperm is implanted into the uterus. Donor eggs from volunteers or previous IVF patients who no longer wish to have more children can be used if your partner’s sperm or your eggs are compromised and cannot achieve conception.

There are almost as many solutions as there are reasons for infertility, and our women’s health specialists are here to help you with your situation. To make an appointment for fertility assistance, please call us at 770.720.7733.

October 12, 2016

If your pregnancy has been defined as high risk, there is no need to panic. The truth is, all pregnancies on some level are high risk; to grow another human being inside your body is a significant event! A high risk pregnancy status is a precautionary determination to make sure that any pre-existing risk factors you have, along with any you may develop during your pregnancy, are monitored closely to ensure both your baby’s safety and yours.

Our obstetrics team has successfully delivered over 10,000 babies, many of those deemed high risk. We’re trained to detect and evaluate situations hazardous throughout gestation, and equipped with the technology to do so.

Most of all, our tenet is to treat every pregnant patient the way we would want our loved ones treated.

What Is Considered a High Risk Pregnancy?
There are many factors that can designate a pregnancy as high risk. Some medical, physical or genetic influences may predispose you to being susceptible to certain problems. These are:

    • High blood pressure
    • Being overweight or underweight
    • Diabetes
    • Cancer
    • High blood pressure
    • Heart, lung, or kidney disease
    • Epilepsy
    • Alcohol or illegal drug usage
    • Age (under 17 or over 35)
    • Multiple births
    • History of miscarriage
    • Family member or previous child with Down syndrome
    • Infections such as HIV, chicken pox, rubella, toxoplasmosis, hepatitis C, syphilis
    • Certain medications
    • Chronic health issues such a lupus, asthma, rheumatoid arthritis, heart valve abnormalities or sickle cell disease
    • History of preterm labor or preeclampsia.

What Can You Do For Me If I Have Any of These High Risk Pregnancy Markers?
The first step is to establish a trusting relationship with you, taking the time to answer all your questions and concerns.

In many cases, just a few lifestyle modifications can ensure a safe, healthy pregnancy. Some of these changes can be as simple as speaking to our diet and nutrition experts, who will counsel you on a food and supplement regimen appropriate for your specific needs. We may schedule more frequent prenatal visits so that we can carefully monitor your progress, taking immediate steps to treat whatever problems might occur.

high risk pregnancy photoYour blood pressure will be watched closely. Blood and urine tests will be taken during every prenatal visit, along with any physical examinations or scans that may be indicated.

Our high risk obstetric specialists will evaluate any medications you might be taking, making adjustments as necessary to protect you and your child. If you suffer from pre-existing chronic conditions, we will work with you to minimize any arising difficulties.

We may monitor your pregnancy more frequently with ultrasounds and fetal monitoring.

Finally, we screen for genetic abnormalities, providing information, counsel, and advice if required.

If My Pregnancy is Normal, With No Pre-Existing Conditions, Will it Stay That Way?
Usually, but not always. This is why prenatal care appointments are so important for both you and your baby. You can develop complications at any time, placing you into a high risk pregnancy category. Again, don’t become alarmed. Our specialists have combined decades of experience and training to deal with that if it happens, and the earlier we detect something, the better. Here are some of the things we look for:

  • Gestational diabetes mellitus (GDM or gestational diabetes): High blood sugar sometimes develops during pregnancy, causing headaches, depression, high blood pressure, hydramnios (increased amniotic sac fluid), and birth defects. It can also increase the danger of preeclampsia and premature labor. Babies can grow too large, resulting in a need for a caesarean, and they may suffer from jaundice and low blood sugar after birth. We screen for this between your 24th and 28th week- earlier if your history warrants it.
  • Preeclampsia: Preeclampsia causes persistent high blood pressure which can lead to organ damage and seizures, possibly requiring medication and/or early delivery. Routine urine testing at every prenatal visit can detect this, alerting us to rigidly monitor your progress.
  • Rh factor: Rh is an inherited protein found in some blood. If yours differs from your baby’s, difficulties may arise. We routinely test for this incompatibility to safeguard the well-being of the fetus.
  • Bleeding: Though not all bleeding is dangerous, if you’re deemed a high risk pregnancy, we follow up to make sure there is no jeopardy to you or your baby.
  • hCG: (human chorionic gonadotropin): This substance not only confirms pregnancy, but analyzing levels regularly can indicate if you are at high risk for ectopic pregnancy, possible miscarriage, or a Down syndrome baby.
  • Placenta previa: Sometimes the placenta covers the cervix, causing bleeding during delivery. Transvaginal ultrasound tests warn us beforehand if a caesarian is necessary.
  • Fetal problems: Our 4D ultrasound and other equipment can detect complications or abnormalities before they become a problem.
  • Premature labor: We can’t always predict if your baby will thumb its little nose at our calculated due date, but a previous history of early labor, a shortened cervix, or certain infections alert us to be vigilant of that possibility.
  • Placental abruption: When the placenta separates or peels away from the uterine wall, the situation may become detrimental to both mother and baby. We always look out for this and other potential dangers.

Our hospital partner, Northside Hospital-Cherokee, opens its new facility in early 2017, continuing to handle a full range of services for our patients with high risk pregnancies. Since 1993, Cherokee Women’s Health has delivered more babies at Northside Hospital-Cherokee than all other OB practices combined.

Whether yours is a routine or high risk pregnancy, our highly qualified, expert providers pride themselves on giving you the best individual prenatal care necessary to ensure a safe and healthy pregnancy.

For an appointment, call us at 770.720.7733.

October 4, 2016

pregnant womanThe third trimester begins in the 28th week of pregnancy and ends when your baby officially becomes a newborn. This is a bulkier, less comfortable time, but will soon be over. At the end of this trimester, the fetus will be 17 to 23 inches long, fully formed, and weigh anywhere from 6 to 10 pounds.

What Happens Now?
Some new symptoms may appear, and familiar ones may intensify. They might include:

  • Restless Leg syndrome (RLS) and leg cramps: These can occur at any time. RLS is common in about 15% of pregnant women. Support hose, moderate exercise, less caffeine, and more fluids during the day may alleviate discomfort.
  • Nasal congestion and snoring: Estrogen increases blood flow throughout the body, including nasal membranes. Nasal strips and saline drops often help. So can elevating the head during sleep. If snoring becomes intense, your obstetrician may want to rule out sleep apnea.
  • Abdominal aches: The fetus is becoming more active. Growth is accelerating, widening the uterus so that it presses against your bladder, diaphragm and other organs. Discomfort is usually minimal.
  • Fatigue: Finding a comfortable position in bed sometimes becomes difficult. It’s recommended that you not sleep on your back now, as the growing uterus can press on the main vein (vena cava) which pumps blood from your heart to the lower part of your body. Try sleeping on your left side, using pillows as props.
  • Insomnia and/or bad dreams: Anxiety and overactive hormones may rob you of rest. Moderate exercise, a warm bath, massage, cutting caffeine and lowering the bedroom temperature helps enable sleep.
  • Heartburn: Hormones and pressure from the uterus pushing the stomach upward can trigger indigestion. Consult your obstetrician before trying any remedies.
  • Stretch marks: These may become itchy and more prominent. A good moisturizer can help.
  • Varicose veins and hemorrhoids: Extra blood pumping through your body now can make these appear. Both usually diminish or disappear after birth.
  • Clumsiness: Rapid body shape and size changes can make you misjudge distances and bump into surroundings. Try moving slower. This minimizes injury both to yourself and the fetus.
  • Pregnancy fog and distraction: Forgetfulness and distraction are attributable to brain function changes during pregnancy. Research actually shows that women pregnant with females experience pregnancy fog more than those carrying males. This haziness disappears a month or two after birth. Until then, keep to-do lists on hand to jog your memory.
  • Lack of bladder control/ frequent urination: Extra weight and pressure on the pelvic floor can result in leakage and constant bathroom visits. Do your Kegels and wear panty liners.
  • Backache: A growing stomach pulls your center of gravity forward, triggering backache. Elevating your feet, a warm bath, and gentle massage can ease pain. If it’s intolerable, however, your doctor may want to rule out injuries like sciatica.
  • Breast leakage: Your body is preparing for breastfeeding. Nursing Pads aid in preventing staining.
  • Lightening: At about week 36, you might notice your shape changing. Your stomach will drop lower and you could start waddling. Your baby is changing position to prepare for birth. Your breathing will be easier, heartburn may diminish, but urination may become more frequent.
  • Mucus plug: A clear gelatinous plug may detach from the uterus weeks or immediately before labor. This means the cervix is softening and preparing for delivery.
  • Braxton Hicks: These irregular contractions are often mistaken for the real thing by first time moms. They can occur intermittently weeks before you actually go into labor.
  • Bloody show: Pink or brown tinged mucous indicates that you are effacing and dilating. Labor is close at hand, but it can still be several days to a few hours away. Blood should not be bright red or excessive though. Call your doctor if it is.
  • Water breaking: The amniotic sac has ruptured and labor is approaching. If steady contractions have not begun within 24 hours, labor might be induced to avoid infection.
  • Contractions: These are regular and stronger than Braxton Hicks and will not diminish. Your doctor will advise you as to how long to wait before leaving for the hospital.

What Precautions Can I Take During This Time?
You can continue to do exactly what you’ve been doing all along- take care of yourself and your baby. Eat well but watch your weight. Rest when necessary, but avoid becoming inactive. Moderate exercise will make your labor and delivery easier. Avoid strenuous activity or heavy lifting. If you are uneasy about anything or notice radical symptoms that worry you, consult your doctor.

Fetal Kick Counts
Your baby’s movement may provide information that help us care for you during this pregnancy. During a convenient hour each day, after eating and emptying your bladder, please lie down (on your side is best) and concentrate on your baby’s movement. Note each movement. Smoking may interfere with the movements and should be avoided during pregnancy. Count the number of movements for thirty minutes. Your baby should move at least five times in that thirty minutes. If your baby moves less than five times during that thirty minutes call your physician or go to the hospital.

Call your doctor if you experience: 

  • Decreased fetal movement
  • Rupture of membranes (water breaking)
  • Contractions every 2-5 minutes (more than five per hour)
  • Cramps in the lower abdomen with or without diarrhea
  • Low, dull backache felt below the waistline
  • Temperature over 100 degrees
  • Vaginal spotting or bleeding.

Helpful Hints: 

  • Be sure to drink at least 8-10 glasses of water every day (in addition to anything else you drink).
  • Eat small frequent meals to avoid heartburn.
  • Use Tylenol for minor aches and pains.
  • You may take warm baths or showers, place a heating pad on your back using low heat setting and rest with your feet elevated.

What Tests are Performed During the Third Trimester?
By this time, most precautionary tests have been completed, and only these regular routine tests are done during prenatal visits

  • Urine test
  • Blood pressure check
  • Fetal heartbeat check
  • Measuring of the uterus.

You could possibly require a pelvic exam to check that the cervix is changing the way it should, along with a test for group B streptococcus, a bacterium that approximately 30% of women can transfer to their babies during delivery. If results are positive, an antibiotic will be administered during labor.

Additional tests may be warranted, especially if:

  • You are having a multiple birth
  • Your baby is growing slowly
  • You have chronic problems
  • You are past your due date.

Each trimester has its own unique milestones, and our doctors have the knowledge and expertise to make sure that your pregnancy is progressing safely and well. For more information, visit Northside Hospital-Cherokee. For an appointment, call our clinic at 770.720.7733.

Pregnant woman photoThe second trimester takes place from the 14th to the 27th week of a woman’s pregnancy. This is usually the most comfortable and pleasant time. Mercurial Jekyll/Hyde moods begin to balance out. You no longer sob uncontrollably over a run in your hose, or laugh maniacally when someone passes gas. Morning sickness is becoming a distant memory, and you can now start showing off that baby bump in all those maternity tops you’ve carefully selected. Even that sex drive that may have waned somewhat during the nausea, exhaustion and general malaise of your first trimester may return.

What Happens Next?
The egg (zygote) evolved from being the size of a pinhead into a recognizable little human being, first called an embryo and, after 8 weeks of gestation, a full-fledged fetus. New symptoms may occur, but generally, they are more tolerable than the previous three months. These may include:

  • Nightmares: Stress, hormonal change and anxiety can affect sleep, causing you to dream about outrageous, even horrible scenarios. Waking up in a cold sweat may happen more often.
  • Abdominal discomfort: Aches and pains caused by a stretching uterus and ligaments is normal. Excruciating pain, however, is not. Call your doctor if you experience anything other than moderate discomfort.
  • Quickening: This is the term given to feeling the fetus stir inside you. At about 16 to 20 weeks, you will feel a slight flutter. As the baby grows and takes up more room, movement is felt more distinctly.
  • Blips: An odd bubbling sensation that turns into a stronger methodical twitch as pregnancy continues is simply the fetus experiencing hiccups. Don’t worry. He or she is not having seizures. Your dinner probably just didn’t agree with it.
  • Breathlessness: The uterus can crowd the lungs as the fetus grows, disrupting smooth air flow. Unless you are gasping for air, some breathlessness is normal.
  • Body shape changes: The waist thickens, hips expand, your derriere can widen, and even your face may produce an extra temporary chin if you gain too much weight too quickly. By the end of the second trimester, you will have probably gained 16 to 22 pounds. Only two can be attributed to the baby. The rest is placenta, uterus, amniotic fluid, body fluid and blood. Your body also stores about 7 pounds of fat throughout pregnancy to prepare you for breastfeeding.
  • Stretch marks: Your tummy and thigh skin, elastic as it is, can only stretch so much at a rapid pace before the middle layer of skin (dermis) tears, exposing the deeper layers. Most of these marks diminish or disappear after birth.
  • Bleeding gums: Many women experience sensitive, bleeding gums due to hormonal changes. Use floss gently and get a softer toothbrush, but don’t skimp on your dental hygiene habits.
  • Heartburn, constipation and hemorrhoids: All are common. Smaller meals are recommended, along with more fiber and fluids. Try Sitz baths and speak to your doctor about an ointment or cream to relieve irritation.

What Precautions Can I Take During This Time?

  • Keep in shape with moderate, low impact exercise.
  • Eat healthy and keep junk food to a minimum. The more weight you gain, the harder your labor can be, and losing excess pounds afterwards may be difficult.
  • Avoid unnecessary medical procedures such as Botox injections, chemical peels etc. Even whitening your teeth or coloring your hair can be harmful.
  • Take no medications without speaking to your obstetrician.
  • Keep all your prenatal appointments. You will probably be seen once a month during this time, more often if problems are detected. It’s important to monitor your progress.

What Tests Are Performed During the Second Trimester?

  • Urine tests: These will be requested at every visit to monitor protein levels.
  • Maternal serum alpha-fetoprotein (MSAFP) and multiple marker screening (MMS): One or the other are offered for genetic screening and are optional. They are used to measure specific fetal protein output to determine if there is a possibility of Down syndrome or spina bifida. If positive, an ultrasound or amniocentesis is done for confirmation.
  • Sonogram: This non-invasive procedure can be done at any time during pregnancy, but is typically conducted at the end of the first trimester or during the second to confirm gender and due date. It can also reveal such conditions as placenta previa, cleft palate, and many other developmental or growth problems.
  • Glucose screening: This checks blood sugar levels for gestational diabetes. If readings are elevated, a glucose tolerance test may be ordered.
  • Fetal Doppler ultrasound: Sound waves determine if fetal blood flow is normal.

How Big is My Baby Now?
The fetus is about 14.5 inches long and weighs a little less than 2 pounds. It is about the size of a cantaloupe and is able to blink, sleep and wake up. The brain is very active and developing rapidly. Its maturing taste buds can now taste what you eat. Experts even believe dreaming is possible. Hearing is becoming more acute and sensitive eyes may react to light.

Each trimester has its own unique milestones, and our doctors have the knowledge and expertise to make sure that your pregnancy is progressing safely and well. For more information, visit Northside Hospital-Cherokee. For an appointment, call our clinic at 770.720.7733.

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“Dr. Litrel was a fantastic doctor. I had my first exam with him, although at first I was skeptical about a male doctor for my GYN. But after I met him I’m glad I kept an open mind, and I couldn’t have dreamed up a better doctor. He cares about you as a person and not just a patient. The front desk ladies and nurses were very friendly and it’s a great office, very clean and not intimidating. I highly recommend Cherokee Women’s Health.”
- Vicki