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February 25, 2014

Sometime between the 24th and 28th week of pregnancy, most women will come in for their glucose screening and glucose tolerance tests. These tests determine if you have gestational diabetes, a high blood sugar condition that some women get during pregnancy. If you have been diagnosed with gestational diabetes, Cherokee Women’s Health sheds some light on what it means for you and your baby.

What Causes Gestational Diabetes?

Gestational diabetes occurs as a result of hormonal changes during pregnancy. Increased levels of certain hormones interfere with the body’s ability to manage blood sugar. This condition is known as insulin resistance, and as the placenta grows larger during pregnancy, it produces more hormones, increasing the resistance to insulin. If a pregnant woman’s pancreas is unable to produce more insulin to overcome the effects of additional hormones in the body, blood sugar levels will rise, resulting in gestational diabetes.

Treatment for Gestational Diabetes

For women who test positive for gestational diabetes, there is extra treatment and doctor’s visits required, with the goal of making sure that blood glucose levels remain at a normal level. Treatment will most likely involve special care when it comes to diet and exercise, and checking your blood sugar levels daily. Monitoring gestational diabetes with healthy food choices

  • Diet – A registered dietician will be able to help you limit the amount of carbohydrates you eat to control blood sugar, as well as outline a healthy eating regimen. On average, a healthy weight gain during pregnancy is between 25 and 35 pounds, and your obstetrician or midwife will work with your dietician to recommend ways to monitor your overall weight gain.
  • Exercise – Aim for 2 hours a week or 30 minutes 5 times a week of moderate exercise to help your body use insulin better and help control your blood sugar level. Low-impact exercise such as walking and swimming are great options for pregnant women.
  • Checking blood sugar – Checking your blood sugar at home daily will help to make sure your level is within target range. Some women may require testing more than once a day, so it’s important to talk to your doctor about frequency during your routine prenatal visits.
  • Fetal monitoringYour doctor may want you to monitor fetal movements to let him or her know if your baby is moving regularly. You may also have more fetal ultrasounds to monitor baby’s growth, or a test known as the nonstress test to check how your baby’s heart responds to movement.
  • Insulin shots – If your blood sugar levels are still too high after making changes in diet and exercise routine, you may need insulin shots, which can lower your blood sugar without harming your baby. Or you can ask your doctor about pills such as glyburide or metformin that help regulate blood sugar.

If you’re diagnosed with gestational diabetes, it’s important to maintain regularly scheduled prenatal checkups. Your provider will check your blood pressure and test a sample of your urine, as well as discuss your blood sugar levels, your diet and exercise routine and how much weight you’ve gained. If you’re due for your next prenatal visit or are concerned about gestational diabetes, don’t hesitate to contact our office to schedule your next appointment.

February 21, 2014

Whether you’ve been trying to get pregnant for a long time or you discovered a happy accident, the moment a woman realizes she’s pregnant, she often begins to think of all the things she once did or likes to do, wondering if they’re still OK to continue during a pregnancy. The good news is, your list of pregnancy “don’ts” is much smaller than you might think, and there’s still a lot you can do during the next nine to ten months. Cherokee Women’s Health Specialists has compiled a few of our most asked “Is it safe?” questions here on our blog this week. Read up and know that you’ve got an exciting nine months ahead!

Is it safe to color your hair while pregnant? Woman thinking about questions to ask her doctor

Many women begin coloring their hair long before pregnancy, and often wonder if it’s still safe to do so once they see those two little lines. For these women, the good news is that very little chemicals in the hair dye are actually absorbed into your system, and as long as you’re coloring your hair in a well-ventilated area and using protective gloves (if you’re doing it yourself), you should be perfectly fine. If the idea of coloring your hair during pregnancy still concerns you, you can wait until your second trimester when baby is less vulnerable.

Is it safe to be around paint while pregnant?

One of the most exciting things for a pregnant mother can be decorating a new nursery. Naturally, selecting a wall color for baby’s room is one of the first steps in creating the mother’s ideal space, but what about painting it? The type of paint used is the key here. Latex, or acrylic paint, is the most common and is generally considered safe to be around while you’re pregnant as long as you’re in a well-ventilated area. If you start to feel sick or nauseous at all, get some fresh air and have someone else finish the job. It’s best if you avoid using oil-based paints on your own, but you can let someone else do this for you as long as you’re not around while they’re doing the work. Lead-based paints are a strict no-no, and if you have to have some removed, make sure you’re not home during the process. Afterward, you should be fine to return to the home.

How much caffeine consumption is OK?

If you’re used to waking up with a cup of coffee or have to have a soda in the afternoon to help with that afternoon crash, there’s no reason for you to give caffeine up entirely during pregnancy unless you’d like to. Experts have stated that moderate levels of caffeine have not been found to have a negative effect on pregnancy, with the definition of moderate varying between 150mg-300mg a day. For reference, there’s about 259mg of caffeine in a 16oz Starbucks House Blend Coffee. If you’re concerned about caffeine intake during pregnancy, you can always talk to your provider at your next prenatal checkup.

What medications are off limits during pregnancy?

Another concern of newly pregnant mothers is making sure that if needed, they’re taking only the medications that have been cleared by their doctor during pregnancy. At your first pregnancy checkup, your provider will send you home with a complete list of medications that are generally thought as safe to use, including treatments for pain like Tylenol, treatment for nausea, cough and cold, and other symptoms. If at any point in your pregnancy you’re unsure about a medication, it’s always best to ask your doctor before taking it.

While these questions are just a sampling of the many questions we hear from patients during prenatal visits, we urge our patients never to be shy about asking questions. Having an open communication with your doctor or midwife during your pregnancy is the key to having a safe and healthy pregnancy. To schedule a prenatal visit at either our Woodstock or Canton office, contact our office by calling 770-720-7733.





February 13, 2014

Bringing a new baby home is one of the most exciting exciting experiences new parents can have. Understandably, new parents may feel overwhelmed with all of the advice and information available, and trying to get a feel for what works best for you and your new family member can be daunting. In the spirit of Valentine’s week, the Cherokee Women’s Health team wishes to share some of the most helpful advice for new parents that we know to be true:

Quite simply, love each other, as this models a healthy relationship for your new child as they learn and grow.

Need a Relationship Pick-Me-Up? Couple with new baby's hands in a circle

If the upcoming romantic holiday has you thinking that your relationship (whether it involves a new baby or your children have flown the nest) could use a little pick-me-up, why not try one of these ideas that don’t have to end with Valentine’s Day:

  • Try something new together. Test out a new restaurant, sign up for a cooking or dancing class, or see if you can steal away a night from the kids in the Georgia mountains.
  • Laugh. Laughter is of the essentials to building a strong, healthy relationship. It brings people closer together, creates intimacy, and helps resolve conflict.
  • Eat healthy. A colorful diet full of fruits, veggies and plenty of protein will not only help you feel better, it might help put you in “the mood.” Common aphrodisiacs include oysters, figs, almonds, and avocados.
  • Take a walk. Exercising together, even if taking a quick 30-minute stroll, can help increase blood flow, which helps boost mood, reduces stress, and can lead to a bigger desire in the bedroom.
  • Remember that you’re a team. If anyone can attest to the trials and tribulations of family and marriage, it’s Dr. Litrel and his wife, Ann. Try to remember that you’re not alone in your struggles, and that if you can work as a team, your entire family will benefit.

If your family is growing this month, we hope that you have the love and support needed to help inspire your children to grow up and experience healthy relationships. If you’re done adding to your family, what other advice would you give to new parents about starting a family? Share with us by leaving a comment below.

Photo via FreeDigitalPhotos.net


February 6, 2014

For many women, their bodies post-childbirth are something they feel they have to “deal with.” Skin is sagging, they may have stretch marks, and if they had a successful vaginal delivery, they may feel that their vaginal opening is less-than what it was beforehand. Some women experience complications  related to other pelvic floor issues like incontinence and pelvic prolapse, and these issues can be embarrassing and hard to discuss. Knowing the specifics of what vaginal rejuvenation surgery can offer will allow you to make more informed decisions about whether or not the surgery is the right option for you.

Understanding the Types of Vaginal Rejuvenation

Vaginal rejuvenation surgery in the simplest terms is the tightening of the vaginal canal. Vaginoplasty is a procedure for women who want to firm up and reshape the tissue to gain a more youthful appearance and feel. With straight vaginoplasty, typically no other procedures are needed to reconstruct the tissues surrounding the vaginal opening.  Labiaplasty, another common procedure, is the reduction of the labia, usually done because they are too large.

Some women, depending on the severity of damage done during childbirth or another trauma, require reconstructive surgery to repair those same areas, often involving slings or mesh to reconstruct the gentle tissues that make up a woman’s anatomy. These types of procedures will repair the pelvic floor, addressing problems caused by a displaced organ, also known as pelvic prolapse. Pelvic prolapse afflicts over 3 million women in the United States.

What Does Insurance Cover?

Vaginaplasty and Labiaplasty

Both vaginaplasty and labiaplasty are considered cosmetic procedures. However, if a medical condition is diagnosed, a portion of your expenses may be covered by your insurance.

Medical Conditions

In the cases of women who have more severe damage to their pelvic organs and tissues, insurance does cover medical procedures for anterior and posterior repair, since they’re considered medical problems. Anesthesia and hospital care for the procedure are covered by insurance in this case as well. If you’re already considering talking to your doctor about reconstructive vaginal surgery and are interested in vaginoplasty or labiaplasty, you can add the cosmetic enhancements on top of your current procedure and pay for those separately.

The OB/GYNs at Cherokee Women’s Health Specialists understand that reconstructive surgery of the vagina is both a delicate topic and procedure. Our surgeons possess a combined experience of over 35 years performing vaginal rejuvenation procedures. Don’t hesitate to contact our female representative on her private and confidential line at 770-720-7733 ext. 2232 or you can contact us via our confidential contact form.







January 29, 2014

Moderate weight gain during pregnancy is absolutely normal – after all, you are growing a tiny person in your uterus! However, making sure that you’re gaining the right amount of weight for your body type is important. Gaining too much weight during pregnancy poses health problems including an increased risk of gestational diabetes, hypertension, and other serious complications.

How Much is Too Much?

At your first prenatal visit, ask your OB/GYN how much weight gain is appropriate for your current weight. For example, a woman who was average weight before getting pregnant should gain 25 to 35 pounds after becoming pregnant. Underweight women should gain 28 to 40 pounds. And overweight women may need to gain only 15 to 25 pounds during pregnancy.

Tips on Keeping a Healthy Weight During Pregnancy Pregnant woman with an apple resting on her belly

To make sure you’re staying on track with a weight gain that’s right for your body type, here some ideas on maintaining a healthy weight during pregnancy.

  • Contrary to popular belief, there’s no need to “eat for two.” In your first trimester, you only need about 30 extra calories per day, and in the third trimester, only 300 extra calories a day. Adding a healthy, filling snack into your normal routine should cover the need for these extra calories.
  • If you were exercising before your pregnancy, it’s normally OK to maintain your current workout routine (Although make sure you’re cleared by your doctor first).
  • Reduce consumption of sugar, fat and salt. Sugar and fatty foods pack on unwanted extra pounds quickly, and too much salt can increase swelling in your hands and feet.
  • Make sure you’re getting enough sleep. Plenty of sleep allows for healthier weight gain, improved mood, and may help for easier weight loss after pregnancy.

If you have any concerns about how much weight gain is recommended during your pregnancy, be sure to discuss them with your provider at your next visit. To set up your next prenatal visit at either our Woodstock or Canton location, you can contact our office.

Photo credit.

January 21, 2014

When pregnant women hear that c-word – cesarean – a lot of times they can build up fears based on not knowing what to expect. This week, our goal on the Cherokee Women’s Health blog is to take the scary out of the c-section, and share why you might need one and what to expect during the procedure.

Why You Might Need a C-Section

Your OB/GYN might need to perform a scheduled or unscheduled c-section, depending on the health of you and your baby. Some reasons to need a scheduled C-section include:

  • An illness or congenital condition in your baby that might make delivering vaginally more difficult.
  • If your baby is too large to move safely through the birth canal
  • If your baby is in the breech position and can’t be moved
  • You’re having triplets or more
  • Placentia previa, or when the placenta is blocking the cervical opening or abruptio placenta, when it has separated from the uterine wall.
  • If you develop pre-eclampsia, which is pregnancy-induced high blood pressure, and treatment isn’t working.

In addition to these situations, your doctor might decide that the safest route for you and your baby is an unscheduled c-section. This might happen if you were laboring normally in the early stages of labor and then quit progressing, or if you or your baby start showing signs of distress or have other complications.

What to Expect During the C-Section Procedure

One of the first things to happen before a c-section is anesthesia. This is usually either an epidural or spinal block so the lower half of your body is numb but you will remain awake. Next, you will be prepped by shaving your abdomen and pubic hair in the area of the incision, and and the operating room staff will insert a catheter into your bladder. They’ll also place sterile drapes on your stomach to cover the actual incision. Once you’re completely numb, the doctor will make a horizontal incision about the length of your middle finger just above your pubic hair line. Then, the doctor makes another incision in the lower part of your uterus, and you will probably feel a fair amount of tugging as the operating room staff move your baby into position so that the doctor can safely and gently pull your baby’s head out.

Next, the umbilical cord is cut and the surgeon removes your placenta, followed by the process of stitching you back up, starting with your uterus then the outer layers and skin are realigned and stitched back up either with dissolving stitches or staples. Most new Moms rarely notice this part however, as they’re bonding with their newest addition to the family.

Here’s a short video from the Mayo Clinic that shows what to expect during the c-section procedure (Please note: Certain parts of this video are graphic) :

After a C-Section

Women can expect many of the same symptoms during the recovery from a c-section as they would have from a vaginal delivery, including afterpains as your uterus contracts, postpartum bleeding, discomfort in the perinal area, and exhaustion. On the second day, they will remove the catheter, and you’ll be able to try and walk around and go to the bathroom. The typical hospital stay for a c-section is 3-4 days so the hospital staff can effectively monitor you post-surgery. After two weeks, you will have a follow-up appointment with your doctor to check the incision, and at six weeks you’ll have a postpartum visit.

Communicating With Your Doctor

If you’re concerned about having a c-section delivery, talk to your doctor or midwife about your labor preferences and have a clear plan in place. Discuss any concerns about your pregnancy that might affect your ability to deliver vaginally and talk to your doctor about your thoughts on c-section. By having an open dialogue during your last few prenatal visits, you can be sure you’re on the same page to providing the best care for you and your little one.

January 16, 2014

Contractions are a part of the rising action in pregnancy that lead up to the climax of birth. In the anticipation prior to delivery, many women wonder if they are experiencing true or false contractions. False contractions, or Braxton-Hicks contractions, are a common part of pregnancy. While no Mom wants to arrive at the hospital too early, you also don’t want to risk giving birth in a car. Here’s a quick rundown on what they are and how to tell if you’re experiencing Braxton-Hicks contractions or if you’re truly going into labor.

What are Braxton-Hicks contractions?

Braxton-Hicks contractions are experienced when the uterus irregularly contracts, typically during the third trimester. Also known as “practice contractions,” they are considered the body’s warm-up or rehearsal for actual labor. They can be triggered if mother or baby are very active, if someone touches the mother’s belly, when the bladder is full, after sex or because of dehydration.

How do I know if I am experiencing Braxton-Hicks contractions? Pregnant woman feeling discomfort

Generally, Braxton-Hicks contractions are weak and irregular, while true contractions will get stronger and closer together. In an effort to help determine if your contractions are Braxton-Hicks or the real deal, there are a few things to look for:

  • Time between contractions: You can time your contractions from the beginning of one contraction to the beginning of the next contraction. If the time between contractions is inconsistent, or if it does not get shorter, then you are most likely experiencing Braxton-Hicks contractions. If you are experiencing more than four contractions in a one hour period, it is a good idea to contact your OB/GYN or midwife.
  • Varying strength of contractions: If the contractions that you are experiencing are not consistently getting stronger, that is another sign to point you away from actual labor contractions. True contractions will get stronger as your body prepares for delivery.

What if I’m still unsure?

If you are still unsure as to whether or not the contractions you are experiencing are true contractions or Braxton-Hicks contractions, it’s a good idea to call your doctor just to make sure.

Here are a few additional resources regarding Braxton-Hicks contractions:

The Bump-Braxton-Hicks Contractions

What to Expect- Braxton-Hicks Contractions

The American College of Obstetricians and Gynecologists – How to Tell When Labor Begins


Photo courtesy of FreeDigitalPhotos.net

January 7, 2014

One of the things that new moms-to-be can do to help with any pre-delivery jitters is getting their hospital bag packed and ready to go at a moment’s notice. Most experts agree that pre-packing around week 34 or 35 will ensure that you still have plenty of time before you need to grab it and go. Packing some of the “comforts of home” items will help keep you calm and minimize unwanted stress when it comes time to the actual delivery. We researched some of the best Mom blogs on the Internet and Pinterest and here’s a list of some of of the absolute must-haves when packing your hospital bag.

Documents & Paperwork Hospital bag checklist for pregnancy

While not terribly exciting, be sure that you have all the necessary documents and paperwork you might need, such as:

  • Identification
  • Insurance information
  • Birth plan


That first shower post-delivery will feel oh-so-good. Bringing a travel size bottle of your favorite body wash can really bring a small comfort of home into your hospital room. Here some other toiletry items to pack:

  • Travel bottles of shampoo & condition
  • Travel size bottles of skincare items like face wash and moisturizer
  • Deodorant
  • Hair ties or headband to keep hair out of your face
  • Make-up, if you want it


After delivery, your wardrobe should be all about comfort. Don’t forget the following:

  • Comfy robe
  • Pajamas with open-front top
  • Nursing bra(s)
  • 2-3 pairs of comfy, non-skid socks
  • Loose, comfortable outfit to wear home
  • 2-3 pairs of loose maternity underwear, preferably those that you don’t mind if they get ruined.
  • Slippers / comfortable shoes
  • Change of clothes for your partner and/or siblings

Electronics & Miscellaneous

  • Cell phone and charger
  • Camera
  • Snacks (in case the hospital’s kitchen is closed)
  • Tablet (For dad and for you, in case your labor is long)

Baby Items

  • Approved car seat
  • A coming-home outfit
  • 2-3 warm blankets
  • Season-appropriate clothing like hats, mittens and coat

And a few other helpful resources:

Daily Mom – Hospital Bag Necessities

The Bump: Packing a Hospital Bag

Parents.com – The Ultimate Hospital Packing List

What other items do you plan on packing in your hospital bag? If you’re done having babies, is there an item that you’d recommend to new moms? Share with us by leaving a comment below!


December 31, 2013

Once the dust from the Christmas holiday begins to settle, lots of people use the days in between to begin thinking about their resolutions for the upcoming year. A common theme for New Year’s Resolutions are health-related, whether it’s losing a few pounds, starting an exercise routine, or adding more healthy foods to your diet. With everything they have to juggle each day, many women make health-related new year’s resolutions with good intentions, only to stall due to family obligations, a lack of time and energy, career demands or other culprits.

Allowing a little wiggle room in your resolutions can help you stick to them easier while managing everything else in your schedule. Here are a few suggestions:

1.) Instead of going on a diet, resolve to maintain healthy portion sizes and add more fruits and vegetables. Women are known for vowing to try the “next big thing” in dieting, and crashing and burning because their bodies aren’t conditioned to such rapid changes. Instead of a diet, opt for portion control. Instead of banning all things sweet, indulge in a treat once in a while to reward yourself for good choices throughout the week. Focus on getting adequate amounts of whole grains, fruits, vegetables, calcium and fiber. New Year's Resolutions

2.) Getting more physically fit. If getting to the gym more often is one of your goals for 2014, you can help achieve your goals by making simple changes. According to Saralyn Mark, MD senior medical adviser for the Office on Women’s Health in the U.S. Department of Health and Human Services, “walking a little bit further in the parking lot, using the stairs, or raking leaves (and other yardwork)” will offer some of the exercise your body needs. Setting realistic goals that are well-defined will lead to greater success over making a goal to lose 20 pounds.

 3.) Make time for self-care. Taking a little time for yourself (massage, anyone?) can vastly improve stress levels. Many women find themselves in the role of mom, spouse, sister, daughter and so many others that they forget to take time for themselves to regroup. Stress can affect the body in a number of ways, including anxiety, depression, digestive problems, heart disease, sleep problems, weight gain, and memory problems. Managing stress can help keep you healthy, and has been shown to link to diet and exercise in terms of maintaining overall health.

In addition to these important resolutions, make sure you visit your OB/GYN for your annual well visit. This is a perfect time to talk to your doctor regarding your overall health and to discuss any issues you may have. Contact one of our offices to schedule your next visit. Happy New Year from Cherokee Women’s Health Specialists!


December 20, 2013

As 2013 draws to a close, the staff and providers at Cherokee Women’s Health have much to be grateful for. Each year, we are able to collaborate with an amazing team at Northside-Cherokee to help give each and every one of our patients the best care possible.

Thank you capture - CWHS

It is our wish to extend our gratitude to our patients, family and friends for allowing our staff and providers to do what we love – providing expert care to our patients. We appreciate your continued support and trust in our team when it comes to your obstetric, gynecologic and surgical needs.

Happy Holidays from everyone at Cherokee Women’s and best wishes for a prosperous new year.


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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