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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.


December 18, 2013

Holiday travel – two words that can incite overwhelming fear into the hearts of new mothers everywhere. How will your baby react on an airplane? Can you spend 6 hours in a car with an infant? What if junior doesn’t nap well over at grandma’s house? All these thoughts are enough to make a new mother stay home, but with a little planning and a lot of patience, you can enjoy visiting during the holidays without losing your mind. Here are are few of Cherokee Women’s Health‘s favorite tips and tricks to surviving holiday travel with a new baby.

Traveling with a Baby Avoid holiday travel flubs with a new baby

  • Expect delays. Even during regular holiday travel, not everything runs as smoothly as it should. This is especially true when it comes to traveling with a baby. Pack extra finger foods or bottles in the event of a delay. If you’re formula feeding, pack more formula than you think you’ll need (but be mindful of the restrictions of liquids allowed – bring the powder to mix up as-needed).
  • Pack extra diapers, wipes, and a change of clothes for baby and for you. You never know when a blowout might occur, leaving you stranded without an extra set of clothes.
  • For older babies who might be newly mobile, plan for plenty of rest stops if you’re traveling by car or allow for some time in the airport before you board to exert some of that curious crawling.
  • To ease ear pain often caused by airplane takeoff and landing, offer your baby a pacifier, bottle or sippy cup.
  • Here’s a helpful link offering even more tips on airplane travel with a baby.

Maintaining a Sleep Schedule

One of the toughest things about traveling with a baby or toddler is maintaining their normal sleep schedule. No nap or a night filled with more wake-ups than usual can make even the sweetest babies cranky.

  • If at all possible, don’t plan activities during your baby’s normal nap time. If you have a baby that naps once in the morning and once in the afternoon, try to plan a holiday lunch gathering to accommodate the sleep schedule.
  • If you’re traveling, pack all of baby’s favorite sleep essentials. Maybe a blanket or a soft toy that will help soothe them, even in a new space. Books, favorite music or a sound machine can also work wonders to help get baby to sleep in a new place.
  • A few days before you leave, set your baby to sleep in the pack n’ play where she’ll be sleeping during the visit. This will help her adjust to a new sleeping space, and it won’t be such a shock when you arrive at your destination.
  • If you’re crossing time zones, get your baby used to the different sleep times by slowly inching up naps and bedtime a few days before leaving.

If you’ve already “been there, done that” as far as holiday travel with kids, what other suggestions would you recommend? Share by leaving a comment below, and safe travels to all from Cherokee Women’s Health!

Photo via FreeDigitalPhotos.net

December 12, 2013

We listen to our patients! And we can say with certainty that women feel the stress of the holidays more than men. Many of the activities that make the holidays special are carried out by the woman – gifts for loved ones, holiday cooking and celebrations, hosting guests and family in your home.

Those responsibilities can lead to a sense of being overwhelmed, and even take a toll on your health. Here are three important but easy tips to keep in mind during your holiday celebrations: 

1. Don’t abandon healthy habits. Don’t let the holidays become a free-for-all. Overindulgence adds to your stress and guilt. Have a healthy snack before parties so you don’t go overboard on sweets, cheese or drinks. Continue to get plenty of sleep and physical activity.

2. Take a breather. Make some time for yourself. Spending just 15 minutes alone, without distractions, may refresh you enough to handle everything you need to do. A short walk outside can do wonders. Look around at what you see to get “out of your head”. You will be amazed at what this simple action can do!

 3. Be realistic. The holidays don’t have to be perfect or just like last year. As families change and grow, traditions and rituals often change as well. Choose to hold on to a few, and be open to creating new ones. For example, holiday dinners can be potlucks, with shared responsibilities; they don’t have to be an exercise in perfect decorations and menus.

Dr. Litrel talks about a family holiday celebration that didn’t start off in quite the right way in this excerpt from his new book “Family – A MisMatch Made In Heaven: Surviving True Love, Children, and Other Blessings In Disguise“. 


Holiday Crackers

My doctor partners and I take turns being on call for the holidays: one of us has to be ready to run to the hospital if needed. Last year, my turn fell on Thanksgiving, but with no patient emergencies, I found myself, to my surprise, sitting down to the big dinner with my friends and family.

As I looked across the table at my loved ones and listened to their loud and animated conversation, I noticed they all seemed to be in various states of inebriation. I was not joining in the festivities of the fermented grape. No, I was on call and had responsibilities. After a while, I began to wish that the hospital would actually call me. Nothing is more annoying than being the only sober one at the dinner table.

Particularly when you paid for all the wine.

I sat at the table and thought about my unhappiness. The way I saw it, I had three choices

One, I could make sure I wasn’t on call the following year so I could join in the frivolity worry-free.

Two, I could cultivate new friends and family relations, ones less inclined to intoxicate themselves at holiday meals.

Or three, I could view this moment of unhappiness as a spiritual lesson and walk more strongly the path of Love, steadfastly refusing to experience unworthy, lesser emotions.

It was a no-brainer; I decided just not to be on call again.

Holidays are stressful, but particularly so for women. Women are more aware of the subtleties of celebration. They put effort into esthetic touches that would never dawn on a man. The intention, I believe, is to manifest beauty.

But occasionally the result is marital conflict instead.

Every Thanksgiving, Ann makes six dozen homemade crackers called Cheddar Crisps. They come in three flavors: cracked blacked pepper, caraway seed, and something called nigella seed.

I never heard of nigella seed either; she orders it special online.

After watchfully monitoring the baking time and removing these handmade creations from the oven to cool, Ann carefully sequesters them in a tin box to be doled out at the proper moment. She serves them with a small bowl of homemade butternut squash soup – right after we say grace, and before we sit down for the main meal.

Every guest is given three crackers, one of each flavor. You feel yourself handling each one as though it’s Great Grandma’s favorite antique tea cup.

As far as crackers go, the Cheddar Crisps are delicious. Unfortunately, I am more a Ritz cracker kind of guy, accustomed to shoveling large quantities of whatever I am eating into my mouth until I am full. So for me, this cracker moment represents holiday stress. How do I express genuine appreciation for the work my wife has put into this pre-Thanksgiving snack, without conveying my true thoughts? Stop wasting so much time already – they’re just crackers!

So I channel Effete Cracker Connoisseur and solemnly critique the subtleties of each flavor – how the steam from the soup opens up the palate so one can fully appreciate the differences.

The next year I finally got my wish. I was not on call, and there were no homemade crackers to be found!

I noticed a few things that surprised me.

Free to imbibe a glass of wine now that I wasn’t working, I found I did not want any, but chose instead sparkling water. I also noticed that my holiday guests were not the sodden idiots inclined to boorish conversation that I remembered from the year before.  They were actually beautiful people I am blessed to have in my life.

Perhaps the previous Thanksgiving I had been just a tad bit grumpy.

But the thing that surprised me most was that I actually missed Ann’s homemade crackers.

It’s not always easy for a man to appreciate the attention to detail an effortful woman brings into her family’s life. Sometimes what she does seems frivolous. And God knows, sometimes it’s expensive. But there is a reason for a woman’s efforts, and this I understand – as a father, as a husband of twenty-five years, and also as a physician who has listened to so many of his extra effortful patients over the years…

A woman gives Life to her children, brings beauty to her home, and creates ties in her community. And wherever she goes, a woman will make Life more beautiful for us men –

Whether we want her to or not.

December 11, 2013

For pregnant women, the symptoms of severe aches and pains, high fever, and inability to keep food down due to the flu virus is not an ideal combination with the already exhaustive symptoms of pregnancy. This is why it’s so important for pregnant women to get vaccinated for influenza. The flu vaccine is safe during pregnancy and protects both mother and the baby from the flu and its possible consequences.

Pregnant women are at a higher risk of complications from the flu because pregnancy affects their respiratory and immune systems. Pregnant women have a higher chance of being hospitalized with the flu and infections relating to influenza, which can increase their risk of preterm labor and delivery. Health complications from influenza, such as pneumonia, are very serious and can even be deadly.

The Good News Ask your OB/GYN about the flu vaccine for pregnant women

According to pregnancy experts March of Dimes, it’s not too late to get a flu shot. The flu season typically runs from late October through early March, and many insurance plans cover the vaccinations. Conducting a quick online search for locations in your neighborhood that offer the vaccine should allow you some options, as many pharmacies and grocery stores offer the vaccine  as well.

The CDC and FDA are monitoring the safety of seasonal influenza and other vaccines licensed for use in the United States in cooperation with state and local health departments, health care providers, and other partners. Monitoring the safety of the seasonal flu vaccine in pregnant women is part of this effort.

Extra Protection From the Flu

Of course, it never hurts to be more cautious during pregnancy when it comes to guarding yourself from the flu and other viruses. Limit contact with others who are sick and wash your hands with soap and water before and after touching others. Make sure not to share dishes, glasses or utensils with anyone to limit exposure to germs. If you do get sick, cough or sneeze into a tissue or an arm, and avoid touching your eyes, nose and mouth. Practicing healthy habits like getting plenty of sleep, exercise and a healthy diet can also aid in keeping you healthy throughout the flu season.

If you have questions or concerns about the flu vaccine during pregnancy, don’t hesitate to ask your provider questions during your next appointment.



December 4, 2013

When it comes to holiday gift-giving, are you a pro, or could you use a little help? If you have a pregnant woman on your holiday gift list, you might find yourself wondering, “What can I surprise her with that she will truly enjoy? Look no further – Cherokee Women’s Health has compiled a list of of a few gift ideas that will warm any mom-to-be’s heart.

A comfy scarf – During the colder months, a warm scarf can help shield mama and baby when the growing tummy doesn’t allow for much coverage in a coat. Opt for a longer version that she can layer and wrap around as needed.

Spa services – Most pregnant women will melt at the idea of getting a massage. During pregnancy, muscles and bones are stretching and moving, and a massage is a great way to ease some of that all-too-common pain and pressure that carrying a little one puts on the body. Another indulgent option? A facial. Skin problems during pregnancy are also common, and while there are many skincare lines available for pregnant women, nothing beats getting professionally pampered. (And if you’re on a budget, a coupon for an at-home massage can’t be beat. Truly.) Pregnant belly - gift from Santa

A handmade gift basket – Nothing says personalized like a gift basket with her favorite chocolate or other sweet treats, some cozy socks, a picture frame to put a photo of her new bundle in, or some at-home indulgences like lotions or creams.

A locket – A locket with her latest ultrasound photo is sure to make her sentimental. Once the new baby arrives, she can switch the photo out, and even switch the photos as your baby grows.

The gift of sleep – Tossing and turning due to to insomnia and the inability to get comfortable as your body grows is a pain most pregnant women know. Give her the gift of sleep with a full-size body pillow that will conform to the shape of her body. There are many types available that help prevent sciatica and lower back pain, create a cradle for the growing tummy, and solve other pregnancy sleep problems. She’ll say “Thanks and goodnight,” guaranteed.

A Clean House – For most women, the idea of a clean house that they didn’t have to clean themselves is heavenly. No woman in her third trimester (or one with a newborn) is going to excited about cleaning the toilet. Give her the gift a clean house with a gift certificate to a local cleaning service.

A Gift for Him (but really for her) – A (humorous) book on how to properly treat your pregnant wife. One of our favorite tips from inside: Don t say, Man, I wish I could just get comfortable.


For the team at Cherokee Women’s Health, our goal is to provide happy, healthy pregnancies for all our pregnant patients this year. While this list of gift ideas isn’t exhaustive, it might help you brainstorm other ideas for the mom-to-be in your life. What other gifts would you include on this list?

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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