Obstetrics Questions

Due to an outbreak of the Zika virus, the Centers for Disease Control and Prevention (CDC) has issued a travel alert for South America, Central America, and the Caribbean.  The virus is linked to birth defects and poor pregnancy outcomes.  At OGA, the health of all pregnant women is of vital importance.  If you are pregnant, you should avoid travel to these areas.  If you have recently traveled, or cannot avoid traveling, to one of these locations, please contact your healthcare provider to discuss your risks.

Here are CDC’s answers to some of the common questions regarding the Zika virus.

Is there a vaccine to prevent infection or medicine to treat Zika? 

No.  There is no vaccine to prevent infection or medicine to treat Zika.

I am pregnant.  Should I travel to a country where cases of Zika have been reported?

Until more is known, and out of an abundance of caution, CDC recommends special precautions for pregnant women and women trying to become pregnant:

  • Pregnant women in any trimester should consider postponing travel to the areas where Zika virus transmission is ongoing. Pregnant women who do travel to one of these areas should talk to their doctor or other healthcare provider first and strictly follow steps to avoid mosquito bites during the trip.
  • Women trying to become pregnant or who are thinking about becoming pregnant should consult with their healthcare provider before traveling to these areas and strictly follow steps to prevent mosquito bites during the trip.

CDC will update the travel notice as information becomes available.  Check the CDC travel website frequently for the most up-to-date recommendations.

I am pregnant.  How will Zika virus affect me or my unborn baby?

CDC has issued a travel notice (Level 2-Practice Enhanced Precautions) for people traveling to regions and certain countries where Zika virus transmission is ongoing.  The most recent alert follows reports in Brazil of microcephaly and other poor pregnancy outcomes in babies of mothers who were infected with Zika virus while pregnant.  However, additional studies are needed to further characterize this relationship.  Further studies are planned to learn more about the risks of Zika virus infection during pregnancy.

Until more is known, and out of an abundance of caution, CDC recommends special precautions for pregnant women and women trying to become pregnant.

Is it safe to use an insect repellent if I am pregnant or nursing?

     Yes!  Using an insect repellent is safe and effective.  Pregnant women and women who are breastfeeding can and should use an EPA-registered insect repellent and use it according to the product label.

Should a pregnant woman who traveled to an area with Zika virus be tested for the virus?

Contact your doctor or other healthcare provider if you are pregnant and develop a rash, fever, joint pain, or red eyes within 2 weeks after traveling to a country where Zika virus cases have been reported.  Be sure to tell your healthcare provider where you traveled.

Can a pregnant woman be tested for Zika weeks or months after being in a country with Zika?

At this time, CDC does not recommend routine Zika virus testing in pregnant women who have traveled to a country with known transmission.  First, there can be false-positive results due to antibodies that are made against other related viruses.  Second, CDC does not know the risk to the fetus if the mother tests positive for Zika virus antibodies.  Nor does the CDC know if the risks are different in mothers who do or do not have symptoms due to Zika virus infection.

For more information on the Zika virus and what it means for pregnant women, visit these sites or call us at (208) 888-0909.

CDC link

PAHO link

Most forms of exercise are safe to do throughout pregnancy so long as your take caution and do not overdo it. The safest forms of exercise are low impact and include the following:

  • Brisk walking
  • Swimming
  • Cycling
  • Low-impact aerobics

Other activities like jogging may be done in moderation. Activities like tennis and racquetball are generally safe, but changes in your balance during pregnancy may affect rapid movements.

You may want to choose exercises or activities that do not require great balance or coordination, especially later in pregnancy.

Exercise may be harmful to women with the following obstetrical conditions:

  • Bleeding or spotting
  • Low-placenta
  • Threatened or recurrent miscarriage
  • Previous premature births or history of early labor
  • Weak cervix

For women with chronic medical conditions such as asthma, heart disease, or diabetes, exercise may not be advisable. In all cases, we advise you to talk with an OGA practitioner before beginning any exercise program. He or she will help identify the type of exercise that is right for you based upon your medical history.

There are certain exercises and activities that can be harmful if done while pregnant. Please avoid the following:/p>

  • Holding your breath during any activity
  • Activities with a high risk of falling (downhill skiing, horseback riding, etc.)
  • Contact sports (softball, football, volleyball, etc.)
  • Activities that require extensive jumping, hopping, skipping, bouncing or running.
  • Bouncing while stretching
  • Deep knee bends, full sit-ups, double-leg raises, and straight-leg toe touches
  • Any exercise that may cause even mild abdominal trauma
  • Activities that include jarring motions or rapid changes in direction
  • Exercise that requires lying on your back for more than 3 minutes (especially after your 3rd month of pregnancy)
  • Waist twisting movements while standing
  • Heavy spurts of exercise followed by long periods of no activity
  • Exercising in hot or humid weather

There are no firm restrictions against lifting heavy objects while pregnant. However, pregnant women’s bodies are more susceptible to musculoskeletal injury. Lifting heavy objects may result in damage to the muscles or joints so we recommend care be taken to use good body ergonomics and encourage you to enlist the help of others if there is any question about your ability to lift an object without putting unnecessary strain on your body.

Healthy eating during pregnancy is important for you and your baby. We encourage you to eat plenty of fruits and vegetables, to choose whole-grains (wheat bread, whole wheat pasta, brown rice, oatmeal, etc.) and to get 4 or more servings of dairy each day. If you eat meat, we encourage you to select lean cuts such as chicken or turkey without the skin.

You can eat fish in moderation. Up to 12 ounces of fish or shellfish low in mercury (shrimp, wild salmon, pollack and catfish are good options) is considered safe. Avoid improperly prepared or under-cooked food items.

Food items to avoid are unpasteurized soft cheeses (they could contain bacteria that are unsafe for your baby) and fish with high levels of mercury such as shark, swordfish, king mackerel, or tilefish. Do not eat more than one small can of albacore tuna each week.

Avoid caffeine or limit your intake to about 1-2 cups of coffee or tea each day. Caffeine is also found in many cola products so limit your intake of soda as well.

No amount of alcohol, tobacco or nicotine has been found to be safe during pregnancy.

Breastfeeding is good for both mom and baby. More and more women are choosing to breastfeed their babies because breast milk offers health benefits such as:

Babies
• The right amount of fat, sugar, water, protein and minerals
• Easier on digestions – breastfed babies have less gas, fewer feeding problems, and less constipation
• Antibodies that protect infants from certain illnesses such as ear infections, diarrhea, and allergies
• Lowered risk of sudden infant death syndrome (SIDS)
Moms
• Breastfeeding triggers the release of a hormone called oxytocin. It helps the uterus contract and return to its normal size more quickly
• Breastfeeding may make it easier to lose the weight gained through pregnancy
• Breastfeeding may reduce the risk of breast cancer and ovarian cancer

Exclusive breastfeeding is recommended for the first 6 months of a baby’s life. This means feeding only breastmilk and no other foods or liquids unless advised by the baby’s doctor.

Yes, it is safe to color your hair and whiten your teeth while pregnant.

At OGA, we have a better approach to better obstetrical care.  This means OGA practitioners will collaborate on your pregnancy in the office and behind the scenes right up to (and beyond) your big day.  You have the strength of our entire team to support you!  We have a dedicated doctor on the labor and delivery floor whose primary responsibility is to ensure your delivery is done in the safest manner possible.  This physician isn’t distracted by a busy clinic, isn’t being pulled away from a family function, and isn’t tired from inadequate rest.  Their focus is entirely on you and the impending birth of your child.

Because our physicians share this responsibility, we offer the opportunity to meet each member of our team during prenatal visits.  Some women choose to do so while others prefer to see the same practitioner throughout the entire pregnancy.  Either option is fine.  This is your pregnancy and you choose how you want to best learn the information about your care.

At OGA, we put women and their health first.  We’ve designed your obstetrical care around evidenced-based medicine.  That means throughout your pregnancy, you can be confident that we will provide professional recommendations and will apply sound principles and practices to achieve positive outcomes for you and your family.

Yes! OGA is dedicated to supporting all parties involved in infant adoption or surrogacy with compassion and sensitivity. We respect the unique needs of intended and prospective parents, birth parents, surrogates, and the newborns who connect them.
Birth parents will receive expert care during childbirth and our commitment to do all we can to meet your individual needs.
Intended parents will receive the same information and education we share with all women who have a new baby and the support and understanding they need to navigate these complex arrangements.
Yes.  OGA is proud to deliver exclusively at St. Luke’s Meridian Medical Center because:

  • the nursing care is excellent
  • labor rooms and post partum rooms are located on the same floor
  • 24-hour access to anesthesia services
  • 24-hour access to obstetrical services
  • Level II NICU services for infants born 32 weeks and older

Contact our office for information on how to arrange a tour of this beautiful facility or visit https://www.stlukesonline.org/health-services/service-groups/newborn-intensive-care.

Gynecology Questions

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Osteoporosis is a disease of the bones. Over time, bones can become weak and break more easily. Bone is alive, constantly changing throughout life. Bone cells dissolve, while new bone cells develop and grow. As we age, this process usually favors losing bone cells, making the bones thinner and more brittle. In women, bone loss accelerates with the loss of estrogen after menopause. Other causes of osteoporosis include disease of the parathyroid gland, prolonged use of steroid medication, and insufficient calcium in the diet.
Osteoporosis is common. One in two women over the age of 50 will break a bone due to osteoporosis.
To help prevent osteoporosis, you should do the following:
1) Eat a healthy diet that is rich in calcium, fruits and green vegetables.
2) Maintain an active lifestyle with daily weight-bearing exercise.
3) Avoid smoking and over-consuming alcoholic beverages.
4) Take a calcium supplement (women under age 50 should get 1,000 mg of calcium per day and women age 50 and older should get 1,200 mg of calcium per day)
You can read more about osteoporosis at www.NOF.org

Gardasil is a vaccine that protects against the human papillomavirus, or HPV. There are about 40 types of HPV that can affect the genital area. Gardasil is recommended for girls and young women aged 9 to 26 to protect against cervical cancer. In fact, Gardasil helps protect against 2 types of HPV that cause 70% of cervical cancer cases, 70% of vaginal cancer cases, and up to 50% of vulvar cancer cases.

Most insurance companies do not cover Gardasil for patients under the age of 18; however it is available at no cost to girls and young women aged 17 and younger through the Idaho Department of Health and Welfare. For this reason, OGA only offers Gardasil vaccination to women aged 18 years and older.

It is important that you take care of your body after surgery. In addition to eating well and getting sufficient rest, keeping your skin clean and healthy is important, too. You may shower at any time after 24 hours of your operation. In general, we ask you to wait longer to resume tub bathing. For abdominal surgeries, you can resume tub baths after 2 weeks as long as there are no complications with the incision site. For vaginal surgeries, you should discuss the type of skin care that is appropriate for you during your pre-operative visit with your surgeon.

Hormone replacement therapy – or the use of medications containing female hormones to replace the ones the body no longer produces or produces insufficiently – is a standard treatment for the symptoms of menopause. For example, hormone therapy can alleviate hot flashes, night sweats, vaginal dryness, reduced risk of colon cancer, and protection against bone loss. The benefits and risks associated with hormone therapy vary depending on your age and other health risks such as heart and vessel disease, cancer risks and family medical history. Talk to your healthcare provider to determine if hormone replacement therapy is right for you.

Female Genital Cosmetic Surgery

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Absolutely. You can still have a normal vaginal delivery after labiaplasty surgery.
Most local patients are seen for an initial consultation to discuss the decision for surgery, result expectations, different surgical options, and surgical risks. A second visit is typically done as a pre-operative visit and includes a formal review of the surgical plan. Post-operative visits are typically within the first week, and again at the 4-week and 3-month point. Patients traveling from a distance may elect for virtual visits prior to the procedure and a post-operative visit with her local physician.
Yes! The two most popular techniques are:

– Curved Linear Resection
– Modified V-Wedge

Your physician should be familiar with both types. Each type will provide three different cosmetic results to the labial edge. It will be important to review your preferences on how you want your labia to look, including the overall size. This will help guide which procedure best fits your anatomy.

Labial reduction surgery is an in-office procedure that can be done under local anesthesia with a mild sedative. It can also be done with intravenous sedation under the care of our anesthesia team. Your physician will advise you on which option is best for you.
Yes. Dissolvable sutures are used exclusively for these procedures.
You should resume only light activity for the first 7-10 days after the procedure. Most women can resume moderate activity after about 2 weeks. For most procedures, sexual intercourse, horseback riding, running or biking should not resume for at least 1 month. Women who have vaginoplasty or perineoplasty should avoid sexual activity for 6-8 weeks.
This depends on your individual anatomy. In many cases, the redundant tissue in this area should be addressed to achieve an optimal cosmetic result.

These FAQs are provided for your information. They should not take the place of regular healthcare appointments or personalized consultations from our staff. If you have questions or concerns about your health please contact our on-call nurse at (208) 888-0909.

In the event of a medical emergency, always dial 911 first.