First Trimester Screening

First trimester screening involves blood a blood test and an ultrasound. The ultrasound measures the thickness of the baby’s neck called nuchal translucency. First trimester screening looks for an increased […] Continue

CVS (Chorionic villus sampling)

Chorionic villus sampling, CVS, is a procedure that can obtain genetic information about the unborn baby. CVS is typically done between 10-12 weeks. The advantage to CVS over amniocentesis is […] Continue

Menopause Overview

Menopause refers to the condition when a woman’s ovaries stop producing eggs and female hormones due to age. This causes an end to menstrual cycles. For some women the menopause […] Continue

Infertility Overview

Infertility is defined as a person that is not pregnant after one year of trying to conceive. About 40% of infertility is due to a problem with the woman, 40% […] Continue

In Vitro Fertilization

In vitro fertilization (IVF) is a procedure in which the eggs from the women are mixed with the sperm from the man in a laboratory outside of the body. Embryos […] Continue

Infertility Treatment: Clomid

The most common infertility medication is clomiphene citrate brand name Clomid. This is used for women who are not ovulating. Glucophage aka metformin can be added to the Clomid for […] Continue

Advanced Reproductive Technology

Advanced reproductive Technology (ART) is defined on any medical treatment that helps overcome infertility. For the purposes here I am using it to describe some of the more techniquely advanced […] Continue

Breastfeeding Overview

One of the things that often surprises new moms is the fact that breastfeeding can sometimes be a challenge. Many women think that breastfeeding should be the easiest thing in […] Continue

Breastfeeding Practical Aspects

This video talks about help and resources, positions, diet, birth control, and safe medications while breastfeeding. Help and Resources: There are a lot of resources available to help with breastfeeding. […] Continue

Breastfeeding Milk Supply

There are two mechanisms that are in place for the production of breast milk. The rapid drop in hormones that occurs after delivery of the baby is responsible for the […] Continue

Breastfeeding Complications

Most women who breast feed their baby experience no problems. In some cases complications can occur. Cracked nipples can be very painful and is typically caused by the baby not […] Continue

Treatment of Ovarian Cysts

Treatment of ovarian cysts has two general options. One is surgery to remove the cyst. The other is what is referred to as expectant management. This is simply following the […] Continue

Bleeding After Intercourse

Post-coital bleeding is the medical term for bleeding after intercourse and it is not normal. Post-coital bleeding can be caused from an infection, inflammation, or lesion on the cervix. It […] Continue

Classification of Ovarian Cysts

The classification of ovarian cysts is important because it helps guide therapy and treatment options. The first important question is weather the patient has gone through menopause. Cysts in a […] Continue

Normal Ovarian Function

In order to understand abnormal ovarian cysts one must first understand normal ovarian function. The ovary is responsible for making the female hormones as well as producing the eggs for […] Continue

Fibroids Overview

Fibroids are very common, 25% of women have some fibroids. Fibriods usually do not cause problems or symptoms but for some women fibroids can cause significant abnormal bleeding or pain. […] Continue

Decreased Menstrual Cycles

When people think of abnormal vaginal bleeding they usually think of too much bleeding. Infrequent or absent bleeding can be problematic as well. This can be a cause of infertility; […] Continue

Am I Pregnant?

One of the common questions that women have is “am I pregnant?” The obvious answer is to do a pregnancy test. It can, however, take up to 2 weeks for […] Continue

Endometrial Biopsy

Endometrial biopsy (EMB) is an office procedure that samples the inside lining of the uterus looking for cancer or precancerous changes. This test is most frequently done as part of […] Continue

Circumcision Overview

Circumcision is removal of the foreskin from the penis. This is a practice that is hotly debated and people feel passionately on both sides. There are definite medical benefits to […] Continue

Circumcision Procedure

Before the circumcision is performed, numbing medicine is used on the penis. The baby is then held down on a special board and the circumcision is performed using a specialized […] Continue


Hysterectomy is surgical removal of the uterus. A total hysterectomy is removal of the uterus and cervix, and a subtotal or partial hysterectomy is removal of the uterus while leaving […] Continue

Birth Control Overview

There are many different contraceptive choices available. There is no perfect birth control; each has its advantages and disadvantages. This is a “big picture” discussion of birth control discussing the […] Continue

How to Quit Smoking

There are many ways to quit smoking. This method is simple, does not use drugs, nicotine replacement, patches, gum, or pills. It is also free. I have had a great […] Continue

Dating A Pregnancy

The due date is 40 weeks from the first day of the last menstrual period. Because the first day of the last menstrual period is sometimes not accurate, the first […] Continue

Emergency Contraception

Emergency contraception is used in a situation where a woman has had unprotected intercourse. It is 80-90% effective if used within 72 hours after unprotected sex. Emergency contraception is also […] Continue

Medical Treatments of Fibroids

There are several options for treating fibroids medically. Birth control pills, progesterones such as Provera, the Mirena IUD, and Lupron are all in this category. These will not cure the […] Continue

Surgical Treatments of Fibroids

Surgical management of fibroids includes uterine artery embolization, myomectomy, and hysterectomy. Uterine artery embolization is an outpatient procedure that is done by an invasive radiologist to stop the blood flow […] Continue

Bilateral Tubal Ligation

Bilateral Tubal ligation (BTL), also called getting the tubes tied, is a permanent form of birth control for a woman. The BTL has a very low failure rate, less than […] Continue

Pap Smear

The Papanicolaou test, or Pap smear is a test of the cervix looking for precancerous or cancerous cells. It is one of the most successful screening tests available and has […] Continue


LGSIL and HGSIL are designations of abnormal pap smears. They stand for Low (or High) Grade Squmous Intraepithelial Lesion and are often referred to as “low grade pap” or “high […] Continue

LEEP Cone Biopsy

LEEP stands for Loop Electrosurgical Excision Procedure. It is used to treat significant dysplasia and can usually be done in the office. This is done after a colposcopy that confirms […] Continue


HPV stands for human papillomavirus. It is really a family of viruses rather than a single entity. There are over 100 different strains of HPV and new ones are being […] Continue


ASCUS stands for “atypical squamous cells of undetermined significance”. It is a designation given to pap smears when the cells are not frankly abnormal but they are not perfectly normal […] Continue


Colposcopy is simply looking at the cervix with a microscope; it is often combined with biopsies of the cervix. Colposcopy is most commonly done to evaluate the cervix after an […] Continue

Cervical Dysplasia

Cervical Dysplasia is a pre-cancerous change of the cervix. It is not cancer and should never become cancer because there is a simple office procedure to treat dysplasia. Cervical dysplasia […] Continue

Barrier Methods

Condoms, the sponge, the diaphragm, the female condom, and the cervical cap are all examples of barrier methods. These need to be placed and then removed with each sexual encounter. […] Continue

Birth Control Shot

The birth control shot is called Depo Provera in the US. It is a shot given once per month and is very effective in preventing pregnancy. The side effects of […] Continue

Birth Control Ring

The contraceptive ring (Nuva Ring) is a soft plastic ring that is placed in the vagina and left in for 3 weeks. It is then removed and a new ring […] Continue

Birth Control Pills

Oral contraceptive agents (birth control pills) are what most people think of when people talk about birth control. They are most commonly a combination of estrogen and progesterone. They are […] Continue


The contraceptive patch is called Ortho Evra in the US. The patch has the same types of hormone as is found in birth control pills.  It just uses a different […] Continue


The IUD (or IUS) is a device that is placed in the uterus in the doctor’s office and stays in for 5 or 10 years depending on the individual product. […] Continue


The contraceptive implant is a single progesterone rod. It has a very low dose of hormone to minimize side effects. The main side effect is periods become irregular and unpredictable […] Continue

Placenta Previa

Placenta previa is a condition where the placenta is attached over the cervix. This is fairly common early in pregnancy but usually goes away so that it becomes uncommon near […] Continue

Induction of Labor

Labor can be induced for medical reasons or social reasons and is safe for the baby if done after 39 weeks. There are many agents that can be used for […] Continue

Hypertension During Pregnancy

Hypertension, or high blood pressure, does put the pregnancy at higher risk. Some women have preexisting high blood pressure meaning the blood pressure was high before the pregnancy started. This […] Continue

High Risk Pregnancy Overview

There are many things that can make a pregnancy high risk. An underlying medical condition such as hypertension, diabetes, seizure disorder, and a blood clotting disorder are all examples of […] Continue

Advanced Maternal Age

For pregnancy, 35 is considered advanced maternal age (AMA). The vast majority of 35 year old women have normal, uncomplicated pregnancies. 35 is chosen because of a statistical comparison of […] Continue

First Trimester Bleeding

Vaginal bleeding early in pregnancy is very common and usually not dangerous. If the bleeding becomes heavy, that can be a sign of an impending miscarriage. First trimester bleeding with […] Continue

C-Section Risks

A c-section is a very safe surgery and the risks of surgery are very few. The risks of any surgery are bleeding, infection, damage to other tissues, and anesthetic risks. […] Continue

Indications for a C-Section

There are several reasons that a woman may need to deliver by c-section. Breech or transverse position, fetal distress, previous uterine surgery, or failure to progress are all indications for […] Continue

Anesthesia for C-Section

The three main types of anesthesia that are used for c-sections are: spinal, epidural, and general anesthesia. Spinal anesthesia is the most common followed by epidural. General anesthesia is much […] Continue

House Visitors

I recommend keeping visitors to a minimum after having a baby. You will be tired and the baby is more prone to infections in the first month after birth. People […] Continue

Routine Followup

All women need to be seen 6 weeks after delivery by their obstetrician for a complete exam. If you had a c-section your doctor may want to see you at […] Continue

C-Section Recovery

A c-section is a major abdominal surgery and it will take time to recover. In addition to recovering from surgery, you also have a new baby to take care of. […] Continue


Preeclampsia is the triad of High blood pressure, protein in the urine, and swelling. Delivery of the baby will cure preeclampsia. Magnesium sulfate is often used to protect the woman […] Continue

Cervical Exam

Cervical exams check for fetal position, cervical dilatation, effacement, and station. Membrane stripping can also be done. There is usually a cervical exam at 36 weeks and again at the […] Continue

Gestational Diabetes

Gestational diabetes is diabetes that is diagnosed in pregnancy. It is treated with a low carbohydrate diet and exercise. Sometimes Insulin shots or oral medication will be needed. As long […] Continue

Pregnancy Disability

For uncomplicated pregnancies in the United States, most people go off work on disability at 36 weeks. Standard disability after delivery is 6 weeks for a vaginal delivery and 8 […] Continue

32 Week Wall

32 weeks of pregnancy is when normal symptoms of pregnancy tend to get worse. This is the point when many women stop enjoying being pregnant and just want to get […] Continue


Edema is the medical term for swelling and is very common in pregnancy. Swelling in just one leg could mean a blood clot in the leg which is an emergency. […] Continue

Group B Strep

The Group B Strep test or GBS is a Q-Tip swab to the vagina and rectum at 36 weeks. If it is positive, you will need to get antibiotics during […] Continue

Soft Signs of Labor

The baby dropping, passing the mucous plug, and bloody show are all soft signs of labor. They mean the body is getting ready but none of these are emergencies. You […] Continue

Labor Precautions

If you are at term and having contractions that are hard and coming every 3-5 minutes, it is time to go to the hospital. If your water breaks, go to […] Continue

Kick Counts

In the third trimester the baby should have a period of activity at least once per day in which you can feel at least 10 individual movements in 2 hours […] Continue

Fetal Position

When the baby is laying with the head down towards the vagina that is called vertex presentation. This is the position that is the safest for a normal vaginal delivery. […] Continue

Preterm Labor

More then 6 contractions in an hour before 37 weeks needs to be addressed. There are behavioral treatments as well as medications that can help treat preterm labor. Deliveries before […] Continue


If you have an Rh negative blood type you will need to get a shot of medicine called Rhogam at 28 weeks of pregnancy. When you deliver, the baby’s blood […] Continue

Feeling Movement

Most women are feeling the baby move by 20 weeks. Kick counts is a test done in the third trimester to test that the baby is doing well. The early […] Continue

Body Changes

It is during the second trimester that you will begin to “show”, that is, your tummy will begin to bulge out. The exact timing is different for each pregnancy. Generally […] Continue

Genetic Testing

There are several genetic screening tests available: blood tests, ultrasound, cvs, and amniocentesis. These are optional tests and all have advantages and disadvantages. The blood test goes by different names, […] Continue

Feeling Better

People tend to feel best during the second trimester. The nausea and vomiting is going away, energy is back, and you are not so uncomfortable as you may be in […] Continue

Cervical Incompetence

It is very rare to miscarry in the second trimester. Cervical incompetence is a rare condition that can cause second trimester pregnancy loss. Cervical cerclage is a procedure that treats […] Continue


Exposure to alcohol, cigarettes, or drugs very early in pregnancy is unlikely to cause birth defects. It may increase your risk of miscarriage but as long as that exposure is […] Continue


There are very few things that really need to be avoided early in pregnancy. For the most part women can continue to do all the normal activities they enjoyed prior […] Continue

Normal Symptoms of Pregnancy

Nausea, vomiting, breast tenderness and swelling, tiredness, mood swings, cramping, bloating, and of course no periods are all normal symptoms of early pregnancy. Nausea and vomiting are very common symptoms […] Continue

Fetal Heart Tones

The baby has a heart beat at 6 weeks. By 10-12 weeks the heart tones can be heard in the office. The most common reason for not hearing the heart […] Continue

Treatments for Miscarriage

Treatment options for miscarriage include: waiting for the body to pass the tissue on its own, using a medication called Cytotec, and having a procedure called a D&C. For most […] Continue

Miscarriage Overview

Miscarriages are common and not preventable. They can occur very early in pregnancy or much later. The bleeding may be like a period or more severe. They are not a […] Continue

Ectopic Pregnancy

Ectopic pregnancy is a pregnancy that occurs outside of the uterus. It is a potentially life threatening situation but it can be treated successfully with surgery or medication. Ectopic pregnancy […] Continue

Nausea and Vomiting

Nausea and vomiting are very common in early pregnancy but usually go away by the first trimester. There are behavioral and medical treatments for nausea and vomiting. People who have […] Continue

Dietary Restrictions

There are very few things that you should not eat or drink during pregnancy. Caffeine, lunch meats, cheese, fish, and sushi are all safe in moderation. There is currently no […] Continue

Physical Care

The body will undergo many changes after delivery of the baby. The uterus will go from the size of a baby back to the normal size in about 6 weeks. […] Continue

Postpartum Room

After having the baby you will be moved to another room called the postpartum room. This is where you will spend the rest of your time in the hospital Many, […] Continue

Nuchal Cord

When the umbilical cord is wrapped around the baby’s neck this is called a nuchal cord. This is very common and not dangerous. About 25-35% of normal deliveries have a […] Continue


Meconium is the baby’s feces (poop). Sometimes this will be passed before the baby is delivered. This will mix with the amniotic fluid and has the potential for causing some […] Continue

People in the Room

Ask your doctor what the hospital’s policy is regarding how many people are allowed in the room and if there is an age restriction for visitors in the hospital that […] Continue

Fetal Monitoring

Fetal monitoring helps us understand more about your labor and how the baby is handling the stress of labor. External monitors are initially used. They go on your abdomen and […] Continue

Baby at Delivery

After the baby is delivered it will usually be put on your chest but sometimes will be taken to a warmer at your bedside. The cord will be trimmed and […] Continue

Dilation, Effacement, Station

There are three important words to be familiar with to help understand the labor process. They are dilatation, effacement, and station. Dilatation is a measurement of how open the cervix […] Continue


Epidural anesthetic is very safe and will in most cases relieve all the pain of labor. It is given in a continuous drip so it will last during the entire […] Continue

Delivery of the Placenta

The third stage of labor is delivery of the placenta, also known as afterbirth. After the baby is delivered the placenta must come out. The placenta is an organ which […] Continue


An episiotomy is a cut in the bottom part of your vagina. The doctor may preform this just before the baby is born. This helps make more room for the […] Continue


Once the head of the baby comes out, you will stop pushing and the doctor will usually suction the nose and mouth of the baby so no unwanted substances enter […] Continue


Once you are completely dilated, it is time to start pushing. Pushing is considered a valsalva maneuver. Usually you will be asked to push 3-4 times with each contraction holding each […] Continue

Early Labor

The first part of labor (up till about 4 centimeters dilation), is known as early labor. This stage usually takes the most amount of time, from hours to even days. […] Continue

Arrival at the Hospital

When you think you’re in labor, it’s time to go to the hospital. Every hospital has a different procedure for admission to the hospital. You may be asked to stop […] Continue


Some hospitals give you a small room called a Triage where they can assess you to see if you’re really in labor. There are multiple ways to assess if you […] Continue

LDR Suite

LDR: Labor, Delivery, Recovery. LDR suites are rooms where you will labor and deliver your baby. It replaces the older system where women needed to be taken to a separate […] Continue

Pain Medicine

The three main options for pain management during labor include natural childbirth, IV pain medications, and epidural. The epidural is very safe and for most women will take away all […] Continue

Active Stage of Labor

The active stage is labor is between 4 cm and completely dilated. This is when the contractions are very strong and close together. Dilatation progresses at a much faster rate. […] Continue