Labor & Delivery

Many people think OB/GYN and gynecology are the same. This is not true! An OB/GYN encompasses obstetrics and gynecology, while GYNECOLOGISTS specialize in gynecology only. A physician can have both medical specializations. There are differences between the two. A woman’s needs change throughout life, and it’s essential to know who you need to see for specific conditions and issues.

OBSTETRICS

An OBSTETRICIAN specializes in obstetrics, which deals with all aspects of pregnancy, from prenatal to postnatal care. An obstetrician delivers babies, whereas a GYNECOLOGIST does not. An obstetrician can also provide therapies to help you get pregnant, such as fertility treatments. A neonatologist can also offer guidance in our Neonatal Intensive Care Unit (NICU) if you deliver a premature baby. An obstetrician will care for you with the goal of a healthy pregnancy and baby.

Obstetricians are also trained to handle pregnancy complications, such as:

• Ectopic pregnancy, in which the fetus grows outside of the uterus
• Signs of fetal distress, in which the fetus is not doing well for various reasons
• Placenta issues
• Preeclampsia
• Delivery through Cesarean section

GYNECOLOGY

A GYNECOLOGIST specializes in caring for a woman’s reproductive health from the time she gets her first period to post-menopause. Any conditions that affect the reproductive system, such as those with the cervix, uterus, ovaries, fallopian tubes, or vagina, are diagnosed and treated by a GYNECOLOGIST. GYNECOLOGISTS also perform recommended screenings such as breast exams, pap smears, and pelvic exams. They also perform hysterectomies and tubal ligations. Gynecologists can also advise on sexual matters, such as responsible sexual practices, contraceptives, and protection against sexually transmitted diseases. All in all, if it’s a non-pregnancy issue that is related to female reproductive health, a gynecologist can take care of it.

A gynecologist may diagnose and treat issues, such as:

• Irregular menstruation
• Vaginal infections
• Conditions that cause pain during sex
• Cancers of the reproductive system
• Prolapse of pelvic organs
• Endometriosis
• Cervical and vaginal polyps
• Ovarian cysts
• Uterine fibroids

Many physicians specialize in obstetrics and gynecology to provide comprehensive care to patients. This way, they can address the full spectrum of their patient’s healthcare needs. These physicians are called OB/GYNs.

In addition to being highly qualified, your ideal OB/GYN should be someone you feel entirely comfortable with. This is your doctor and someone you’re inviting to share in your journey. You should also be able to communicate openly with them about sensitive topics and any concerns or fears you may have.

You can start by asking trusted friends and family members about their experiences. However, keep in mind that your needs and preferences may be different. If you’ve begun to narrow down your possible delivery sites, you can also find a pool of candidates on the hospital’s website.

To qualify and narrow down your potential doctors, make sure they’ve gone to an accredited medical school and residency training program. Websites may also provide doctor reviews, but reviewers tend to represent extreme ends of the spectrum, so these may not always be representative.

Finally, make an appointment and give someone a try. If you’re due for your annual exam or Pap smear, this is a perfect chance to meet an OB/GYN and get a feel for their personality, communication style, expertise, and fit.

You should make an appointment to see an obstetrician if you’re pregnant or thinking of becoming pregnant. They can provide you with prenatal care and help you plan for your pregnancy.

You may wish to meet with various doctors before choosing one to take over your care. During your search, you may wish to ask each obstetrician the following:

• What tests do you require during pregnancy?
• Do you attend the birth or the physician on call?
• How do you monitor the baby during labor?
• What are your thoughts on natural childbirth?
• When do you perform cesarean deliveries?
• What is your cesarean delivery rate?
• Do you routinely perform episiotomies? If so, in what situations?
• At what point in pregnancy do you start to consider induction?
• What is your specific policy around labor induction?
• What procedures do you perform on the newborn? When do you perform them?
• What type of postpartum follow-up care do you provide?

Once you find a doctor you like, schedule your prenatal appointments early and often for the best outcome.

You should also see your obstetrician for postnatal care. This enables you to:

• chat about birth control options, such as the pill or intrauterine device
• get clarification on anything that happened during pregnancy or childbirth.
• discuss any issues you may be experiencing while adjusting to motherhood or any concerns about postpartum depression
• follow up on any medical issues you encountered during pregnancy, such as gestational diabetes or high blood pressure
• ensure your vaccinations are up to date

Talk with your doctor before starting any medications, and make sure your doctor knows that you’re pregnant. As long as your doctor stays informed, the following medications can be safely used during pregnancy:

Pain relief/fever reducer

• Acetaminophen, no more than 3,000 mg per 24 hours

Cold medications

• Pseudoephedrine or phenylephrine with caution if you have high blood pressure
• Guaifenesin
• Dextromethorphan

Antihistamines

• Diphenhydramine
• Chlorpheniramine
• Cetirizine
• Loratadine
• Fexofenadine

Antidiarrheals

• Loperamide
• Kaolin and pectin

Throat discomfort

• Menthol and phenol
• Sprays or lozenges with benzocaine

Preeclampsia is a potentially dangerous condition in pregnancy that needs to be managed closely and carefully. Warning signs of preeclampsia include:

• High blood pressure
• Severe headaches that don’t go away with medication
• Vision changes such as seeing spots or double vision
• Rapid weight gain
• Sudden swelling in your face, hands, ankles, or feet
• Upper abdominal pain

You should add around another 300 calories to your diet for each additional baby you’re carrying. These should come from nutrient-packed foods like nuts, fish (no more than 12 oz. weekly), whole and high-fiber grains, seeds, dairy, raw fruits and vegetables, and beans. Avoid empty calories. Try to eat every few hours while awake, including three healthy meals and three healthy snacks each day.

It’s normal to gain more weight for a multiple pregnancy than a single pregnancy. If you start at your recommended weight, you should generally gain 37 to 54 pounds with twins. If you’re expecting triplets or more, ask your OB/GYN how much weight you should gain.

First, if you’re feeling pain, take a break and rest.

Second, pay attention to your posture. When sitting, make sure your back is straight, and watch out for your shoulders curling inward.

Simple exercises can help as well. For example, try getting on your knees, placing your elbows on the ground, and slowly tilting your pelvis to take pressure off your sciatic nerve. Yoga, Pilates, and even swimming are recommended.

You may also find relief with acetaminophen at a recommended dosage, warm baths, dry heat, or massage. See what works for your body. And if you’ve tried these but are still experiencing pain, talk with your doctor.

Morning sickness or even all-day sickness is very common, but you should still talk with your doctor about how to ease these symptoms. With your doctor’s supervision, several things may be able to help:

• Eating something small every one to two hours
• Ginger products
• Acupuncture
• Oral medications or vitamins your doctor recommends

In extreme cases, IV hydration, subcutaneous infusion pumps, steroids, or hospitalization may help if nothing else does.

It’s generally safe to drink caffeine while pregnant, but you should limit how much you have. One cup of coffee per day is reasonable. Because caffeine is a diuretic (it dehydrates you), drink at least one cup of water with your coffee or tea.

Caffeine is also a stimulant (an upper), so drinking too much can cause heart palpitations and other symptoms you should avoid while pregnant.

Yes. The amount of radiation in a dental or chest X-ray is very small. You would need thousands of X-rays in the first trimester to have any risks.

Computerized tomography (CT) scans or other radiological studies have more radiation, but the benefits may outweigh the risks. Make sure your doctor knows you’re pregnant and talk with them to ensure it’s okay to have radiological studies done.

Yes and no. While pregnant, you are eating for two bodies, but one of them only needs a few hundred calories daily. Your baby doesn’t need any additional calories during the first trimester as long as you’re consuming the recommended amount for yourself. During the second and third trimesters, you need only 300 to 450 more calories per day than normal.

Ideally, start taking a prenatal vitamin (and stop taking a multivitamin) at least two months before becoming pregnant.

There are two main differences between a prenatal vitamin and a regular multivitamin. First, prenatal vitamins contain folic acid, which is especially important in the very early stages of pregnancy. Second, unlike other supplements, prenatal vitamins won’t contain more than 100% of the daily recommended dose of any ingredients.

Each woman will experience weight gain differently. Most women can expect to gain two to four pounds during the first three months. If you start at your normal weight, it’s generally recommended you gain around 20 to 30 pounds during your entire pregnancy.

Weight gain during pregnancy is about balance. Too little weight gain can lead to low birth weight. Too much more can put you at risk for high-risk conditions like gestational diabetes or preeclampsia.

It’s unnecessary to count every calorie, but you should monitor your weight, eat well and stay active.

Several prenatal screenings may be able to help prepare expectant mothers for possible genetic conditions. A quad or triple screening is a blood test done between 15 and 20 weeks of pregnancy to check for increased risk of Down syndrome, trisomy 18, or spina bifida. Additionally, a first-trimester screening combines an ultrasound with a blood test to calculate the risk of Down syndrome, trisomy 18, and trisomy 13.

If either of these screenings is abnormal, or in the case of a high-risk pregnancy, a noninvasive prenatal screening looks at small amounts of your baby’s DNA that appear in your blood samples. This can check for numerous chromosomal abnormalities.

Your doctor and a genetic counselor can help you consider your options for genetic testing. Of course, not all women choose to be screened, but many find it gives them peace of mind.

First, it may help to know that most women see an improvement in the number of migraines or headaches they experience as their pregnancy goes on. In the meantime, try keeping a headache diary to help notice potential triggers, which may include simple foods you can avoid.

Generally, to help prevent headaches, stay hydrated with eight to 10 glasses of water daily and well-rested with eight hours of uninterrupted sleep each night. Poor posture can also lead to headaches.

Unfortunately, most over-the-counter (OTC) and prescription medications for headaches aren’t safe to take while pregnant. However, acetaminophen may be an option at a recommended dosage, and magnesium and riboflavin supplements may help. Talk with your doctor before taking any natural remedies. To manage a headache or migraine naturally, try lying in a dark, quiet room or putting a cold rag over your head.

Always talk with your doctor about the symptoms you’re experiencing, especially if your headaches are severe, to see if there are any safe solutions to offer relief.

Yes. You can get a flu shot at any point during your pregnancy and should get one during flu season. Pregnant women are at high risk for complications from the flu, and the flu vaccine has shown no complications in pregnant women.

To date, COVID-19 hasn’t been found in amniotic fluid, but a small number of newborns have tested positive for the virus shortly after delivery. Whether the virus was passed through the placenta or person-to-person spread it’s unknown.

There’s no indication that COVID-19 increases the risks of miscarriage, birth defects, or complications. However, high fevers and other infections during the third trimester are associated with a higher risk of complications.

Pregnant women diagnosed with COVID-19 are more likely to require hospitalization than women who are not pregnant. Follow all safety measures recommended by the CDC and your doctor to minimize any risks. If you start experiencing symptoms, especially if you develop a fever, seek care immediately.

If you start experiencing symptoms of COVID-19, call your doctor right away. Although symptoms vary, they commonly include fever, cough, shortness of breath, sore throat, weakness, muscle pain, diarrhea, vomiting, chills, and/or loss of smell or taste. Call 911 immediately if you experience any of the following symptoms:

• Trouble breathing
• Constant chest pain or pressure
• Confusion or inability to rouse
• Any other severe or concerning symptoms

If you have mild symptoms, take recommended measures to care for yourself and protect others in your household. Stay home, rest and manage symptoms with over-the-counter (OTC) medications as recommended by your doctor.

If you think you have COVID-19 and go into labor, call the hospital in advance so the staff can prepare.

To get a rough estimate of your due date, start from the day your last menstrual period began. From there, count back three months. Next, add one year. Finally, add another week. That will give you an idea based on the average 280-day (40-week) length of a pregnancy.