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October 19, 2016

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 10, 2016

An annual gynecological visit is critical to preventative care. Depending on age and medical history, part of the annual well-woman visit may include a procedure known as a Pap smear. A Pap smear tests for abnormal cervical cells which may be due to inflammation or a precancerous condition of the cervix.

DySIS graphic

Who Needs a Colposcopy?
If a woman receives an abnormal pap smear, the next step may be a colposcopy. A colposcopy is a procedure that allows the doctor to biopsy suspicious tissue.

Receiving an abnormal test result can be a scary experience. Cherokee Women’s Health can ease any woman’s mind with the new, state-of-the-art colposcopy exam. The DySISmap Advanced Cervical Imaging System is a revolutionary technology that measures abnormal areas of the cervix.

With Emory and Grady Memorial Hospital, Fourth in the State of Georgia
Cherokee Women’s Health is the first practice in north Georgia, and only the fourth in the state, to offer this highly sensitive colposcopy technology to women in the community.  We’re proud to bring our patients access to this ground-breaking technology, currently available only in powerhouse healthcare systems including Emory Hospital and Grady Memorial Hospital in Atlanta.

What is the DySISmap?
Unlike a standard colposcopy, the DySISmap offers a color-coded digital map of the acetowhitening process which details abnormal areas of the cervix. The color-coding highlights any cervical abnormality from weak to strong areas of concern, and tells the doctor exactly where to biopsy to test for cancer or precancerous cells.

This precision in detecting any inflammation or precancerous conditions early allows doctors to treat the cervix before the cancer spreads to other areas of the body.

Woman worried about pap smear results

With the DySIS system, patients may choose to watch the scan as the doctor performs it, and the DySIS allows the doctor to store images captured from the scan. By storing these images, later scans can compare cervical changes over time.

Contact Cherokee Women’s Health with any questions related to cervical health or to learn more about the DySIS Advanced Cervical Imaging System, a new technology which can put your mind at ease.

October 4, 2016

Vegans can have healthy pregnancy without adding animal products to their diets.A healthy pregnancy requires that mothers-to-be eat foods rich in vitamins and minerals to help support their growing baby. One of the first prenatal appointments with an obstetrician will include a discussion about what foods to eat or avoid in order to provide optimal nutrition for fetal growth. The American Congress of Obstetricians and Gynecologists suggests that pregnant women eat a well-rounded diet which should consist of fruits and vegetables, whole grains, dairy, and meat. However, for those whose diets stray from the five food groups, such as vegans, or vegetarians, they simply need to find other foods or supplements that will provide adequate nutrition for themselves and their babies.

Veganism is a dietary lifestyle which completely abstains from the consumption of animal products. A vegan’s diet eliminates: eggs, meat, dairy, honey, etc. It is not imperative for a vegan mother-to-be to include these food items in her diet because a 100% plant-based diet can include all the required nutrition a mom and baby need. A fundamental step is making sure to find alternative sources for the all-important vitamins and minerals needed to foster healthy development and less pregnancy complications.

Iodine:

No matter her dietary lifestyle, iodine is one of the essential minerals that a pregnant woman must consume. Iodine is important for proper thyroid function, and critical during pregnancy for fetal neurological development. The recommendation for pregnant women is 220 micrograms of iodine a day. Even a small deficiency can have a major impact on fetal development, which is why sources of iodine need to be included in consumption. Due to its use in the milking process, dairy can often be a main source of iodine intake for women. Instead of dairy, a vegan mother can add iodine to her diet by taking iodine supplements, eating fortified foods, or using iodized table salt.

Iron:

Iron is a mineral often found in red meat. Iron deficiency anemia is a concern for pregnant vegans, unless they can find alternative sources for the mineral. The body requires at least 30 milligrams of iron daily during pregnancy to increase blood supply and foster a healthy fetus. In addition to possibly adding in iron supplements, pregnant vegans should be eating green leafy vegetables, whole grains, and dried beans daily to ensure necessary iron levels.

Calcium:

For vegans, sufficient calcium intake will be more tedious to acquire than simply drinking milk. 1,000 mg. are needed during pregnancy to help build healthy fetal bones and teeth. Vegans can turn to kale as a large source of calcium to add to their diet. Other top vegan calcium sources include: almonds, bok choy, turnip greens, or fortified foods such as soy milk, cereal or orange juice.

Vitamin B12:

When it comes to vitamins, one vitamin vital to pregnancy is Vitamin B12. Vegans do not naturally consume as much B12, because they abstain from eating animal products which are rich sources of the vitamin. Plant products do not contain a considerable amount of B12, but foods such as cereal are often fortified with the vitamin. Pregnant women are recommended to take 2.6 mcg. of B12 a day, and even slightly more when breastfeeding. B12 deficiency is life-threatening, so pregnant and breastfeeding vegans need to ensure that their levels are appropriate for pregnancy.

Vegan mothers should bring up any questions or concerns to their doctor when it comes to meeting the crucial vitamin and mineral intake during both pregnancy and breastfeeding. It is always recommended to not begin taking any additional vitamins or supplements without consulting a physician first. If a mom-to-be is struggling to reach these nutritional values, she may be put in touch with a nutritionist, who can assist in planning a suitable diet for the duration of pregnancy and breastfeeding. Having a baby changes everything; but moms don’t have to completely adjust their dietary lifestyles to keep themselves and their baby healthy.

 

A pap smear is a simple procedure which tests for abnormal cervical cells. The test is performed on an exam table and is generally a painless and quick procedure. The doctor uses a speculum to open the vagina so that a sampling brush can be guided in to gather cells from the cervix. This sampling brush is then sent to the lab for study and results will be communicated to the patient after the lab examination is complete.

Ask your doctor if it is time for you to get a pap smear.If abnormal cervical cells are present, follow-up testing using the DYSIS colposcopy technology can reveal whether the abnormality is related to Human Papillomavirus (HPV) or cervical cancer. Pap smears are a critical component of a well-woman’s health exam. In recent years, the American Congress of Obstetricians and Gynecologists created new guidelines for the time frame between each pap test. The new guidelines were instituted following research that revealed that yearly pap smears were no more likely to catch cervical cancer than tests performed every 3 years. Previously, the pap test was generally conducted at every annual well-woman examination, but currently ACOG suggests the following:

  • Women under 21 do not require a screening
  • Women aged 21-29 should have a pap smear every 3 years
  • Women ages 30-65 years should have a pap test and an HPV test completed every 5 years, or a pap smear every 3 years
  • Women aged 65 or older do not require testing if they have had three negative pap tests in a row

These are current guidelines, but they have proven controversial, and as new data emerges, it is likely these will be changed yet again. Many doctors are concerned that these guidelines are too liberal, and that cancers will be missed. It is important to note that well-woman visits are still just as important even though the pap test guidelines have changed. Women should still have an annual visit with their gynecologist for reproductive health and for any other concerns related to women’s health.

Prevention is key in cervical cancer screening.

Having a monogamous relationship, limiting the number of sexual partners, and using condoms are paramount to a woman’s health. Doctors advise that women receive the HPV vaccine, as well as pap tests, which will help to screen for any abnormalities and catch any precancerous cells (dysplasia) before they spread.  Women who are found to have cervical dysplasia can receive treatment to prevent the cells from turning into cancer. Usually, this is removal of the abnormal cells. If cervical cancer is found to be invasive, surgery, radiation therapy, and chemotherapy may be required to treat the cancer.

Cherokee Women’s Health uses cutting edge DYSIS technology to assist in diagnosing and treating cervical issues including dysplasia and cancer. With proper screening and prevention, cervical cancer diagnoses can continue to decrease.

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.

ultrasoundCongratulations, you’re pregnant! If you’re already a parent, you know what to expect, but if this is your first child, pregnancy can be a mysterious, sometimes almost frightening process.

Today’s pregnancy tests are so precise, that they can detect the presence of human chorionic gonadotropin (Hcg) levels within days following fertilization. Immediately after a fertilized eggs attaches to the woman’s uterine wall, her body produces this hormone. A pregnancy strip can confirm conception has taken place by identifying Hcg presence in only a few drops of urine.

What Happens Next?
The average pregnancy lasts 280 days or 40 weeks, calculated from the first day of the woman’s last menstrual period. The first trimester covers week 1 to 12.

As soon as the fertilized egg (zygote) latches on to the uterine wall, both the umbilical cord and placenta begin to form. Hormonal changes rapidly begin taking place in your body. Often, early symptoms of pregnancy are mistaken for PMS. These symptoms and others include:

  • Spotting or bleeding
  • Fatigue
  • Dizziness (and possibly even fainting)
  • Aversion to certain foods
  • Queasiness or nausea
  • Headache
  • Cramps
  • Bloating
  • Moodiness
  • Backache
  • Breast tenderness
  • More frequent urination (micturition).

Can Anything be Done to Counteract These Symptoms?
When the egg implants itself into the uterine wall, spotting may occur, but it’s always wise to report any bleeding to your doctor to rule out the possibility of miscarriage, ectopic pregnancy or infection.

Additional progesterone can elevate blood pressure, dilate vessels, overheat the body, and force the heart to beat faster when sending blood to the uterus. All these changes can bring about fatigue, moodiness, dizziness and possible fainting.

Progesterone can also slow some body functions down, including digestion which causes nausea, vomiting, constipation, and indigestion. The body reacts by trying to purge what is upsetting it, resulting in morning sickness. Higher Hcg in the body, especially in a multiple pregnancy, can also trigger nausea.

It’s best to avoid foods that repel you during this stage. For intolerable nausea or vomiting, inquire about supplements or devices that can ease discomfort.

If you experience dizziness, move slowly, especially when you get up from sitting or lying down. Should faintness occur, sit down with your head between your knees. Rest when possible. Moderate headaches may be relieved with acetaminophen, but never without consulting your physician. If symptoms are excessive, speak to your doctor.

Cramps, bloating and backache can also be attributed to hormonal fluctuations. Frequent urination, even in this early stage, is usually the result of uterine growth and pressure against the bladder. Fluid intake should not be limited, as this is a normal occurrence.

Breast tenderness is also hormonal. The breasts are preparing themselves for the baby’s upcoming nutritional needs. Investing in a good support bra may help.

What precautions can I take during this time?

  • Don’t smoke, and avoid exposure to second hand smoke.
  • Don’t drink alcohol or use recreational drugs. Mention any prescription drugs you use to your doctor.
  • Avoid caffeine
  • Disclose any work hazards to your obstetrician, such as exposure to harmful chemicals, radiation, dangerous metals, toxic waste, etc.
  • Do not eat or handle raw meat. Wash all fruits and vegetables thoroughly.
  • Wear gloves while handling soil. If you own a cat, have someone else change the litter, and wash hands diligently after animal contact to avoid risk of toxoplasmosis which can harm your baby.
  • Discuss your diet with your doctor and make necessary recommended changes.
  • Take any vitamins, supplements and minerals your doctor prescribes regularly.

Is it Safe to Engage in Sex During the First Trimester?
Unless you have a specific medical condition of concern, it is safe to have sex.

How Big is My Baby in the First Trimester?
Between week four and twelve, your baby grows from the size of a tiny fig seed to roughly the length of that credit card you’re probably beginning to max out in happy anticipation. He or she is almost 3 inches long, weighing approximately one ounce and is about the size of a golf ball. Yet, by now, those tiny fingers have fingerprints. Organs are formed, functioning, and are visible through almost transparent skin. A heartbeat can be detected. The body is beginning to catch up with the head that still accounts for one third of body size. Reflexes are becoming sharper. The fetus can make sucking motions and respond to stimuli such as prodding. Eyes are close together on the face instead on either side of the head. Ears are forming and almost in position. The skeleton is made of cartilage that will gradually become bone. Gender is discernable.

What Tests Are Performed During the First Trimester?

  • Your blood will be will screened for type, count, RH factor, anemia, German measles (rubella), hepatitis B, HIV and other sexually transmitted diseases, along with exposure to diseases such as toxoplasmosis and varicella.
  • Other test will look for genetic problems such as sickle cell anemia, Tay- Sachs disease, cystic fibrosis, etc. A combination blood/ultrasound nuchal translucency for Down syndrome and other chromosomal abnormalities may be offered during the latter part of this trimester.
  • Glucose levels will be analyzed for signs of diabetes and urine checked for albumin which may indicate preeclampsia
    An ultrasound, usually near the end of the first trimester, will determine a due date, gender, and normal fetal progress.

Although your baby develops throughout your entire pregnancy, extra precaution during the first trimester when fetus growth is so accelerated is vital. Our doctors can guide you in all the ways possible to ensure both your health and that of your child. For more information, visit Northside Hospital Cherokee. For an appointment, call our clinic at 770.720.7733.

September 1, 2016

Vulvodynia is persistent, inexplicable pain anywhere in the vulva. The discomfort associated with this condition can be so severe that any sexual activity may be impossible. Even sitting can become intolerable.

Vestibulodynia (Vulvar vestibulitis syndrome or vestibulitis) is another condition which is very similar to Vulvodynia except that pain is situated at the entryway just outside the vagina inside the labia (vestibule).

Though it is not known exactly what causes Vulvodynia, doctors speculate that there may be several triggers:

  • Allergies or sensitive skin that can be easily irritated
  • Hormonal changes or hormonal contraception
  • Injures to the vulvar area’s surrounding nerves
  • Sexual abuse
  • A predisposition to yeast infections
  • Pelvic floor dysfunction
  • Past history of anxiety and/or depression
  • Muscle spasms
  • Frequent antibiotic use.

Vulvodynia has also been associated with several other chronic pain-related conditions, meaning that there is a higher likelihood of Vulvodynia if a woman has any of the following:

  • Interstitial cystitis: (An inflammatory condition that causes moderate to severe pain or pressure of the bladder and surrounding pelvic area).
  • Fibromyalgia: (A chronic disorder causing widespread muscular, joint and tendon pain).
  • Irritable bowel syndrome: (Recurrent abdominal pain, diarrhea and constipation).
  • Endometriosis: (A painful disorder where tissue that is similar to the kind growing in the lining of the uterus (endometrium) grows outside of the uterus instead).
  • Chronic fatigue syndrome: (An unexplained ailment with symptoms of fatigue, fever, tenderness and depression, usually following a virus).

In most cases, however, there is no absolute known cause, and the reasons for Vulvodynia remain a mystery. Investigation of this disorder is still in its medicinal infancy because it was previously thought to be a purely psychological issue.

What are the Symptoms?

  • Itching
  • Throbbing
  • Burning
  • Stinging
  • Painful intercourse (dyspareunia)
  • Soreness
  • Rawness
  • Redness
  • Irritation.

These symptoms can be sporadic or constant. They can last for weeks, months or even years. They may also appear suddenly, and disappear just as abruptly. This discomfort can be centralized in one area such as the vaginal opening, or spread throughout the entire vulvar zone. This area may appear swollen or irritated, but often looks completely normal.

Vulvodynia can seriously impact a woman both physically and mentally. Inability to engage in sexual activity may jeopardize relationships. Chronic pain can also lead to irritability, anxiety, sleeping difficulties, social withdrawal, and low self-esteem. Vulvodynia, and the negative emotions that ripple from the condition, can disrupt quality of life and eventually activate full-blown depression.

How Is Vulvodynia Diagnosed?
There is no actual test for vulvodynia. Diagnosis is made by ruling out any other possible ailments that might mimic the symptoms of this disorder, such as:

  • Skin conditions
  • Diabetes
  • Yeast or bacterial infections
  • Cervicitis or inflammation of the cervix
  • Endometriosis.

A medical history will need to be provided, especially past infections in the pelvic region. Any current drugs you are using, specifically hormonal replacement or contraception should be mentioned.

Female pain photoYou will be asked pertinent questions in order to determine the problem. A pelvic exam will be done, both internally and externally to see if there is a possibility of a present infection. Even if the genitals show no visual signs of any infection, a cell sample may be taken to rule out bacterial vaginosis or yeast infection. Finally, to check for vulvodynia, a swab that has been moistened will be used to gently dab at and probe the vulva and surrounding area to determine the exact locations of your pain.

What Happens if I Have Vulvodynia? Can I Be Helped?
Yes. There are several treatments that can minimize pain or discomfort:

  • Antihistamines can calm itching, steroids, anticonvulsants, and antidepressants can subdue chronic pain.
  • Numbing creams or ointments containing a local anesthetic applied before initiating sex may provide temporary help, but may also cause your partner to experience numbing upon physical contact with these creams.
  • Biofeedback therapy can train you to relax, in turn decreasing suffering. You can be taught how to control your body’s responses to vulvodynia symptoms. If the human body anticipates pain, it involuntary contracts to avoid it, causing the very pain it tries to ward off. In time, this pain becomes chronic. Biofeedback can help with this vicious circle, allowing the pelvic muscles to relax and minimize this innate tightening and the subsequent discomfort.
  • Nerve blocks that are injected can help with chronic pain.
  • Pelvic floor therapy reduces muscle tension in the pelvic floor muscles. These muscles are a support for the bladder, uterus and bowel, and relaxing them can provide vulvodynia relief.
  • Surgery that removes tissue and skin affected by vulvodynia or vestibulodynia (vestibulectomy) can effectively relieve pain in many women.

Is There Anything I Can Do At Home in the Way of Self-Help?
There are some simple measures you can take to decrease some of the uncomfortable symptoms:

  • Sitz bath soaking, which is sitting in cool or lukewarm water for 5 to 10 minutes two or three times a day can soothe symptoms.
  • Avoid those hot tubs and long soaks in scalding water. They contribute to discomfort and itching. Chlorine pools exacerbate the problem as well.
  • Save the control top pantyhose and sexy synthetic panties for special occasions. They restrict airflow to the genitals, causing the temperature down there to rise and trap moisture that can cause irritation. Try to find cotton substitutes that promote dryness through absorption, and that encourage healthy, necessary ventilation to the delicate genital area. If you’re comfortable with it, go ‘commando’ at night and skip underwear altogether.
  • Cold compresses placed directly on the affected area can help itching and pain—especially after sex.
  • Whenever possible, try to avoid any activity that may put pressure on your vulva, such as horseback riding or biking.
  • Treat your lady parts gently. Avoid douches. Wash the area with plain water using your hand, then lightly pat it dry. Avoid soap when possible. Even residue scented laundry detergent and fabric softener in clean towels or facecloths can irritate sensitive tissue. You might even wish to put on a natural emollient without additives or preservatives after washing. Petroleum jelly creates a soothing barrier.
  • If you’re able to tolerate intercourse, a lubricant can greatly help, preferably a water soluble one.
  • Antihistamines before bed can stop itching and provide a restful sleep.
  • Unscented white toilet paper can make a difference. So can tampons and sanitary napkins that don’t smell like they’ve been dragged through a perfume factory. Contraceptive creams and spermicides can also irritate vulvodynia.
  • Harsh, irritating urine caused by certain foods and drinks like citrus beverages, beans, nuts, chocolate, berries, etc. may cause burning upon voiding. Rinsing the vulvar area after urination with cool water helps.

It is important to note that vulvodynia is NOT a sexually transmitted disease. It is not contagious, and is in no way an indication of any kind of cancer.

There is no cure for vulvodynia, but different remedies can ease the symptoms for different women. It may take time to find the combination that works best for you, but our doctors will work with you to help provide a comfortable, better quality of life. To schedule an appointment, call 770.720.7733.

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