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by Dr. Meghan A. Nichols, MD

The Benefits to Cord Blood BankingJuly is Cord Blood Awareness Month. There are often many questions when it comes to cord blood, its benefits, and why people choose to donate or store it. In this article you can learn more about cord blood and help make an informed decision on what to do with your own cord blood after birth. 

What is Cord Blood Banking?

Before deciding if you want to bank cord blood, it’s important to know what it is. Cord blood is the remaining blood from the baby that’s left in the umbilical cord and placenta after birth. Cord blood is unique in that it has a high concentration of stem cells. Stem cells have the ability to become mature blood cells including red blood cells, white blood, cells and platelets.

Cord Blood Uses

Cord blood and its use is at the discretion of you and your family. Usually for a yearly fee you can store your cord blood privately, to be used if and when it is needed by you or a family member. Private cord blood banking can be beneficial if you or a family member have an existing condition that can be treated using stem cells. Medically, it is unlikely that a child will develop a condition that can be treated with the child’s own stem cells.

by Dr. J. Anthony Heit, MD

staying cool in the summer heat while pregnantWhile pregnancy in the summer can have its fair share of benefits, including fun, airy maxi dresses and delicious snacks of fresh fruit, the season can also cause its fair share of negatives. Pregnancy during summer can be an uncomfortable affair, as many pregnant women experience a spike in their body temperature during their pregnancy. Staying cool in the summer can be an important task to prepare for in advance.

Why Does a Woman’s Body Temperature Spike During Pregnancy?

While not every woman experiences a spike in body temperature during pregnancy, it is very common. Pregnant women have an increased amount of blood in their bodies that can cause them to feel warmer than they regularly might. In addition, hormonal changes and warmth generated by the baby can lead to an uncomfortable radiation of heat and hot flashes. While some of these symptoms are unavoidable there are many things you can do to stay cool during the toasty summer months. 

Stay Hydrated

It should come as no surprise that staying hydrated is at the top of the list for staying cool during your pregnancy. Traveling with a reusable water bottle is an easy solution to make sure you’re drinking 8-12 cups of water a day. If you’re prone to forgetting, consider adding a reminder on your cell phone to stay on track. If you’re out in the hot sun, sweating will lead to dehydration much faster. Replenishing the electrolytes you lose while sweating is important in staying hydrated and avoiding any dizzy spells. Many foods can also help with hydration and electrolytes, including pickles, cucumbers, bananas and spinach. 

by Dr. J. Anthony Heit, MD

is tubal ligation right for youTubal ligation (“tubes tied”) is a surgical procedure that many women elect to have done after they have decided they are done having children. It is categorized under permanent birth control, making the decision to have your tubes tied not a light or easy decision for many. 

In the procedure, your fallopian tubes are either cut, tied or blocked to prevent pregnancy. This process prevents an egg from traveling from the ovaries to the uterus, where it could potentially be fertilized by sperm. Tubal ligation can be done anytime, including after childbirth and in combination with other abdominal surgeries, such as C-section. Once it has been performed, reversal/reversibility is quite difficult and, at times, impossible, requiring major surgery.

The Pros and Cons of Tubal Ligation

Many of the pluses and minuses of this permanent birth control are the same. For example, if you are done having children the permanence is a huge benefit over other birth control methods. However, if you still want to expand your family, that tubal ligation is permanant removes it as a birth control option. Unlike many other forms of birth control, tubal ligation is non-hormonal and once you recover from the low-risk surgery, there are very few risks. Additionally, this procedure may also decrease your risk of developing ovarian cancer, particularly if your fallopian tubes are removed, making it an attractive option to women at higher risk. 

by Dr. Crystal M. Newby, MD

what do pregnancy cravings meanThe stories about odd food cravings while you’re pregnant are true. While they may not be as humorous as movies and television shows make them out to be, cravings, as well as food aversions, are very common during pregnancy. In the U.S. alone, 50-90% of pregnant women experience cravings for specific foods, according to research. While there is no one specific cause tied to food cravings, researchers and doctors contribute the cravings to a few different factors.

Why Does Pregnancy Cause Food Cravings?

Some of the most common theories as to why pregnancy causes food cravings include hormonal changes, sensory changes, a change of nutritional needs, and desires for comfort. Pregnancy is accompanied by a plethora of hormonal changes. Hormones can also affect a person’s senses, leading to new food experiences involving taste and smell. This leads to the second theory – sensory changes. Oftentimes, pregnant women will report that their sense of smell is stronger than before. A stronger sense of smell can work both ways for cravings. Stronger delightful smells can lead to cravings just as unpleasant, pungent smells can lead to food aversions.

by Dr. Meghan A. Nichols, MD

vbac how to predict your chance of successCesarean sections can be a life-saving procedure for mother, baby or both. However, there are many reasons why vaginal birth is preferable when possible. More and more women are able to successfully give birth naturally after a cesarean (VBAC), however, there are many factors that go into calculating the odds of success.

Benefits and Risks of Vaginal Birth After Cesarean

C-sections account for almost a third of all first births in the United States. The success rate of VBACs is between 60 to 80 percent. VBAC often carries fewer risks than a repeat cesarean and can offer a shorter recovery time and hospital stay, and a higher chance of successful breastfeeding. If you plan on having more children, being able to have a successful VBAC will also decrease your risks of placental problems associated with multiple c-sections. 

However, a failed trial of labor that results in an emergency c-section is often riskier than a repeat planned c-section. Emergency c-sections carry a risk of uterine rupture, which can be life-threatening. The risk is low, occurring in about 1% of women attempting a vaginal birth after cesarean.

by Dr. Errick Y. Arroyo, MD

Non-Invasive Prenatal Tests are Done Through Drawing Blood

A Non-Invasive Prenatal Test (NIPT, for short) can also sometimes be called a Non-Invasive Prenatal Screening (NIPS). This is a method used to determine the risk of a fetus being born with certain genetic abnormalities. 

How Does a NIPT or NIPS Work?

This testing method analyzes small fragments of DNA that are circulating in the pregnant woman’s blood. During pregnancy, a mother’s blood contains a mixture of cell-free DNA (cfDNA) that comes from both her cells and the cells from the placenta. The placenta is tissue in the uterus that links the mother’s blood supply to the fetus. Cell-free DNA, is a certain type of DNA that is free-floating and not within a cell, unlike most DNA which is found inside a cell’s nucleus. Throughout a woman’s pregnancy, cell-free DNA is often shed into the mother’s bloodstream. These placental cells contain DNA usually identical to the fetus’ DNA. By analyzing this cell-free DNA from the placenta, expecting mothers are provided an opportunity to find early detection of certain genetic abnormalities.

How is the NIPT Administered?

A pregnant woman at 10 to 13 weeks, can get a Non-Invasive Prenatal Test by getting their blood drawn. This test poses no risk to the mother or their baby. The blood sample is then sent to a lab where technicians analyze the results and report the findings back to the ObGyn. Results can be expected within 8 to 14 days from when they are sent. 

by Dr. Crystal M. Newby, MD

Winter Weather and Your PregnancyExpectant mothers often become very familiar with looking after their body throughout their pregnancy and preparing for childbirth. It’s common for all pregnant women to experience some discomfort and difficulties at points during their pregnancy but this can be aggravated in the erratic weather characteristic of the Kansas City winter. As well as staying warm, it’s also important to keep your body healthy and your mind happy during the cold winter months.

Here are six tips to prepare for the winter weather and your pregnancy.

1. Stay Safe On the Ground

The icy, snowy or wet ground poses a falling risk to pregnant women. Always stay alert when walking around, using steps and even getting in and out of the car. In extremely icy conditions, you might want to consider staying in, when possible, until the weather improves. You can best prepare for the hazardous, wintery conditions by investing in some high-quality winter boots with traction, and having deicing salt handy to use on your driveway, sidewalk and home entrance.

Sometimes falls can happen even when careful, so if you fall, don’t panic.  In most cases, it won't cause damage to you or your baby, but be sure to check with your doctor if you’re concerned.

Though it can be difficult to ask for help, don’t be afraid to ask for a hand where you need it!

by Dr. Emily S. Minderman, MD

Cervical Cancer Awareness

January is Cervical Cancer Awareness MonthCervical cancer was a common disease in women in the past, but routine Pap smear screening has reduced the incidence of cervical cancer dramatically. A well-woman visit is a great opportunity for a female patient and their Ob/Gyn provider to review her health, conduct screenings, and discuss preventive health care steps. Since January is Cervical Cancer Awareness Month, this article will discuss facts you should know about cervical cancer and the importance of screening and its protocols.

What is Cervical Cancer?

Cervical cancer occurs in the cells of the cervix, which is the lower part of the uterus that connects with vagina. Various strains of HPV (Human papillomavirus) which is a sexually transmitted infection (STI) play a role in causing most types of cervical cancer. It is commonly seen in women who smoke and those who engage in high-risk sexual activities. Other risk factors are multiple sexual partners, early sexual activity, a weak immune system, and having other STIs.

Following exposure to HPV, the immune system fights the virus. However, in a small percentage of females, this virus may survive for years, later converting the cervical cells into cancer cells. The symptoms of cervical cancer include vaginal bleeding following intercourse, intermenstrual bleeding, heavy vaginal discharge which may be bloody with a foul odor, pelvic pain, or pain during intercourse. HPV infection, however, has no symptoms.

by Dr. Emily S. Minderman, MD

seven reasons to consider IUDWhen women in the US think about contraception, most only think of pills. However, worldwide, intrauterine devices are by far the most commonly used forms of reversible contraception, in stark contrast with the US where pills are still commonly used and intrauterine devices rarely are; in fact, estimates from the Guttmacher Institute indicate significantly more US women use pills and condoms than IUDs. Here we present seven reasons to consider an intrauterine device:

IUDs can prevent worry or surprises

The statistics from the US in regards to contraceptive choices are rather puzzling considering the many advantages of IUDs in comparison to pills and condoms. For starters, they are much more effective. The effectiveness of contraception is commonly expressed in terms of the failure rate, namely “if 100 couples used that method for a year while engaging in regular PIV sexual intercourse, how many would be expected to get pregnant?”

Usually two numbers are given, one with “perfect use” and one with “actual use out in the real world.” These two numbers reflect the difficulty couples have in precisely following contraception instructions – for example, “perfect use” of the pill is rather unrealistic, according to “SOURCE”

In the US, estimated failure rates for methods of contraception are:

  • No contraception: 85
  • IUD: 0.2
  • Birth control pill: 1 perfect use; 9 normal use
  • Condom: 2 perfect use; 15 normal use

by Dr. Meghan A. Nichols, MD

family planning in a covid 19 worldYou had baby names to consider, crunched the numbers financially and were already decorating the nursery in your head. 2020 was going to be your year to begin trying to get pregnant. 

And then COVID-19 struck. 

Pondering the “best” time to get pregnant is a personal decision but as the global pandemic continues, couples are left wondering if this is really the safest time to get pregnant. Many have argued that a pandemic is no time to get pregnant. In fact, in May, a survey of 2000 women found that 34% wanted to delay pregnancy or have fewer children because of COVID-19. Others have argued that we will have a baby boom due to the pandemic and couples being stuck at home, potentially having more time and energy for intimacy.

While the decision to try to conceive may be more elusive due to COVID-19, this decision is absolutely personal, and there are no right or wrong answers. However, it is important to discuss your specific health history with your ob/gyn. Underlying health conditions, such as obesity, diabetes or heart disease, can increase your risk of pregnancy complications as well as the risk of poor outcomes with COVID-19. Fertility challenges also cannot be ignored and no one can guarantee that if you do choose to wait months, or years, for the pandemic to be over, that you will still be able to conceive. It is important to reflect on the urgency of your family planning. If you do decide that trying to conceive is the right choice for you - naturally or with fertility treatments - we have answered a few major pregnancy-related health questions to help guide your decision.

Would I Be High-Risk Because of My Pregnancy?

There is still a lot we don’t know about COVID-19 when it comes to pregnancy. As of now, there is no evidence that pregnant women are more likely to become seriously ill if they contract COVID-19. So far, COVID-19 infections don’t appear to cause congenital complications to the fetus. However, according to the Center for Disease Control and Prevention (CDC), pregnancy alone might increase your risk for severe illness.

by Dr. J. Anthony Heit, MD

What Is Pelvic Prolapse?

what you need to know about pelvic organic prolapseYour pelvic tissues and muscles cradle and support your pelvic organs. Pelvic organs consist of the uterus, bladder, rectum, cervix and vagina. When pelvic prolapse occurs, the muscles and tissues of the pelvic become weak or damaged and can no longer support the organs. As a result, one or more of the organs of the pelvis drop (prolapse). Prolapse of the pelvic organs can be extremely uncomfortable and requires medical diagnosis and treatment. Although rare, prolapse can occur after a hysterectomy procedure when any part of the vaginal wall may collapse and bulge into or beyond the vaginal opening.

Prolapse of the pelvic organ is just one type of pelvic floor disorder. The most common disorders are:

  • Urinary incontinence - the leaking of urine
  • Fecal incontinence - the leaking of stool
  • Pelvic organ prolapse - the loss of support of the organs in the pelvis

What are the Different Types of Pelvic Prolapse?

Anterior Vaginal Wall Prolapse (Cystocele or Urethrocele) is the most common type of pelvic prolapse and occurs at the top of the vagina when the bladder’s supportive tissue stretch or detach and the bladder falls into the vagina.  Posterior Wall Prolapse (Rectocele or Enterocele) occurs when the supportive tissues of the rectum stretch or detach from the pelvic bones and the rectum bulges into the vagina. Uterine prolapse occurs when the pelvic muscles and tissue weaken, allowing the uterus to drop into the vagina. Uterine prolapse can sometimes be associated with prolapse of the small bowel, called enterocele. When enterocele occurs, the small bowel or small intestine may bulge into the vagina.