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What is Gestational Diabetes?

Gestational diabetes occurs only while a woman is pregnant. The disease usually develops in the second trimester, after the 24th week of pregnancy if the woman was not already diabetic. Studies reported by the Centers for Disease Control estimate anywhere from two to 10 percent of pregnant women in the U.S. develop gestational diabetes every year. The rate was 9.2 percent in the 2014 CDC report.

Woman Checks Blood Sugar Levels Managing Gestational DiabetesDiabetes, including gestational diabetes, occurs when the body does not efficiently process food into glucose, or blood sugar. The pancreas makes insulin, a hormone which helps the body do this efficiently or use glucose for energy like it should. When the pancreas produces insufficient insulin, or the body cannot use the insulin it creates in the way it should, diabetes is the result.

When a woman is pregnant, the placenta that supports her baby also secretes hormones. Some of these hormones block the action of insulin from the mother, creating a condition called insulin resistance.  Insulin resistance makes it harder for the mother’s body to use her insulin, and she may need up to three times the insulin she would otherwise. Without enough insulin, her body cannot take the glucose from the food she eats and turn it into energy. The glucose builds up in her blood to dangerously high levels, called hyperglycemia (high blood sugar).

What is Postpartum Depression

Postpartum depression, or postnatal depression, is a cluster of symptoms nearly identical to clinical depression but diagnosed only in women who are pregnant or who have recently delivered a baby or suffered a miscarriage. Postpartum depression symptoms can be so severe they impair the woman’s ability to care for herself, her baby, and her family. Without proper treatment, symptoms may last for months or years, and they may go on to become a chronic depressive disorder.

Symptoms can include:

  • Deep feelings of sadness, anxiety or despair
  • Chronic exhaustion
  • Constant worry or obsession about the health of the baby
  • Negative or ambivalent thoughts about the baby

Woman Experiencing Postpartum Depression with New Baby

Postpartum depression is a common medical condition, occurring in about 14 percent of births.  Any woman can get the condition. It happens after childbirth, stillbirth and miscarriage. It merely is a common complication of childbirth. Considering the enormous biological, physical, emotional and other changes a woman undergoes during pregnancy, labor, birth and motherhood; it is no wonder she is at risk for emotional disturbances.

Nearly 50 to 75 percent of women experience what is called the “baby blues” after delivery. These feelings of unhappiness, fatigue, worry, anxiety, sadness and crying spells usually start a day or two after birth and go away on their own after a week or two. They do not interfere with the woman’s ability to care for her baby.

However, at the other end of the spectrum, postpartum psychosis is a very rare condition affecting only 0.1 to 0.2 percent of women, or about one to two per 1,000 women after childbirth. It is a different disorder than postpartum depression and involves psychotic symptoms such as hallucinations and delusions. This disorder is a medical emergency and may place the life of the mother and her baby in immediate danger.

The Martin Family - Twins in Kansas CityMeet the Martin family, Sarah and AJ, who delivered their twin babies with Kansas City ObGyn on November 8, 2015. We followed up mom Sarah to find out how the babies and family are doing.

Kansas City ObGyn: Which physician delivered your babies?

Sarah Martin: Dr. Nichols has been my OB/GYN for about nine years and she was the doctor who delivered my twins via C-section. However, because it was twins, they had to have two obstetricians in the operating room, so Dr. Newby also helped deliver them.

KCO: How was your experience?

Sarah: Awesome! I seriously cannot say enough good things about Dr. Nichols! I just love her! Since I was having multiples, I had more frequent check-ups and sonograms throughout my pregnancy, and it was always so enjoyable to see Dr. Nichols and catch up and ask her my list of questions I always had. We found out we were pregnant at five weeks, and around seven weeks on a Sunday before my first obstetrician visit, I started bleeding. Fortunately having never experienced infertility or miscarriage, I was shocked and assuming the worst. The office got me in early the next morning for a sonogram and that is where we got the surprise of our lives. We hadn’t lost a heartbeat, we had gained two of them! So then they fit us in for an obstetrician appointment with Dr. Nichols that morning and just laughing with her about our state of shock and what was to come made it all seem less scary. Even though I know Dr. Nichols and all the other great staff at the office are so busy, I never felt rushed or like she was trying to hurry my visit. We chatted about life and laughed and went over any questions or concerns I had. She helped me be at ease through my pregnancy and also prepared me for the scheduled C-section, so once that day came, I was not apprehensive at all. She’s just a truly great physician!

What is preeclampsia?

Preeclampsia is a serious condition that develops only in pregnancy, usually after the 20th week of gestation.  In preeclampsia, the mother’s blood pressure rises to dangerously high levels, which can damage her blood vessels and arteries. This restricts blood flow throughout her body, including to her brain and her baby. If left untreated, preeclampsia can cause damage to multiple organs in the mother’s body.

When preeclampsia occurs before the 32nd week of pregnancy, doctors call it early-onset preeclampsia. Usually, the condition occurs later in the third trimester. The mother’s kidneys and liver are most prone to damage from the disease. If not treated, preeclampsia can result in severe or even fatal complications for the mother and the baby.

Obstetrician Monitoring Health of Mom & Baby During Pregnancy with Preeclampsia

What is eclampsia?

Eclampsia is a severe complication of preeclampsia, in which the swelling of blood vessels due to high blood pressure becomes so severe that it causes seizures and interferes with the mother’s brain function. Eclampsia occurs in approximately one in 200 cases of preeclampsia. It can happen even in women with no history of seizures.

The Presley Family - Twins in Kansas CityKansas City ObGyn: Which physician delivered your babies?

Samantha: We loved Dr. Arroyo. We were patients of Dr. Brabec’s at Reproductive Resource Center, as our kiddos were conceived through IVF, and we were worried about transitioning from seeing Dr. Brabec’s office often to being regular patients at our obstetrician’s office.  Dr. Arroyo made me feel so comfortable during my pregnancy.  He never made me feel rushed during our appointments, talked me through all of my concerns, and made sure I knew what to expect during the next weeks. He was also extremely calming during my delivery when I was anything but calm!

KCO: Did anyone else at the office stand out during your pregnancy and delivery?

Samantha: The nursing staff at Overland Park Regional was absolutely amazing. We checked in Wednesday, July 6 for induction and didn’t end up having the babies until late Friday night and early Saturday morning, so we went through multiple shift changes. The anesthesiologist staff was also amazing. My daughter was born first and was having some trouble with her breathing initially. My husband kept going back and forth between being with me and being with our daughter as the respiratory therapist came down from the NICU. Once it was clear that I would require a C-section for my son I got extremely nervous. The anesthesiologist stepped in and was extremely calming for me while they got me prepped and my husband was by our daughter’s side.

Meet the Oakley family, who delivered all three of their babies with Dr. Meghan Nichols at Kansas City ObGyn - including their son Baker, who was diagnosed with Down syndrome in utero. We caught up with mom, Mackenzie Oakley, to find out how their very special family is doing now!

Oakley Family in Kansas CityKansas City ObGyn: You mentioned Dr. Meghan Nichols delivered all three of your babies! How was your experience? What kept you coming back to Dr. Nichols with each pregnancy?

Mackenzie Oakley: Yes! She delivered all three! I started seeing Dr. Nichols before she helped establish Kansas City ObGyn and of course wanted to follow her to the new practice. I felt comfortable with Dr. Nichols from day one and when my husband and I decided it was time to start a family, I knew I wanted her support during pregnancy. Dr. Nichols isn't an alarmist, she always presents the facts and if there are issues or concerns, she always makes sure to follow up and give us the information we need to to have the best course of care in place.

KCO: When were your babies born? What are their names?

Mackenzie: My husband, Justin, and I welcomed our oldest daughter, Gracyn, in January 2013 followed by our daughter, Leighton, in December 2014. Our son, Baker, was born in August 2017. It's kind of crazy to think we had three kids in less than five years but we're enjoying the chaos so far!

The Lovell Twins in Kansas CityMeet the family of Kristin and John Lovell, who delivered their twin babies with Kansas City ObGyn on December 18, 2014. We followed up mom Kristin to find out how the babies and family are doing.

KCO: Which physicians delivered your babies?

Kristin Lovell: Dr. Arroyo, my obstetrician, and Dr. Newby delivered our baby girls via C-section. They were amazing!  They both were very calm and did a great job of explaining what was happening, what was next and how I might feel. My husband recorded the entire birth and we cherish it so much. We can’t wait to show our girls one day. Dr. Arroyo was awesome during my entire pregnancy experience. This was my first pregnancy and I had no clue what I was doing. He was resourceful, honest, calming and always so pleasant! We used a fertility clinic out-of-state and he was open and accepting to work with them throughout the pregnancy. We had so many ultrasounds I lost count because we were pregnant via in-vitro fertilization and had twins. We really got to know Kim, the ultrasound tech. She’s down to earth and fun, which made the experience that much better. She’s really great at her job; even our IVF clinic commented on the attention to detail of our ultrasound pics - you could clearly see hands and toes!

The Asher Family - Triplets in Kansas CityMeet the family of Becky and James Asher, who delivered their triplet babies with Kansas City ObGyn in July 2013. We followed up mom Becky to find out how the babies and family are doing.

Kansas City ObGyn: Which physicians delivered your babies?

Becky Asher: Dr. Nichols with Dr. Arroyo assisting. I was bummed that my doctor, Dr. Newby, was out of town and couldn’t be there because I loved her! However, Dr. Nichols and Dr. Arroyo did a fabulous job.

KCO: How was your experience?

Becky: Dr. Nichols and Dr. Arroyo were both outstanding. My nurse, Amber, was also great. She took some pictures for us in the delivery room that I will always cherish. We had a team of almost 20 people in there, as each baby had its own set of support staff. Our boys were born on the “4th of July night” (though it was actually July 5th because it was after midnight). But I very vividly remember one of the respiratory therapists, I think his name was Rusty, being decked out in American flag scrubs and thinking it was pretty awesome!

The Laster Twins in Kansas CityOne of the many families of multiples who have passed through the Kansas City ObGyn office is the family of Renee and Ben Laster, who delivered their babies on the morning of July 4, 2016. We followed up mom Renee to find out how the babies and family are doing.

KCO: Which physician delivered your babies?

Renee Laster: Dr. Heit delivered our twins, but Dr. Arroyo is my regular doctor. Since our girls were born the morning of July 4th, my husband's tee time was cancelled, Dr. Heit came straight from the golf course, and Dr. Arroyo was golfing too far away to make it to their birth in time. Two little girls cancelled two golf games that day - the first of many for their dad!

KCO: How was your experience?

Renee: Our experience with the Kansas City ObGyn doctors was top notch! Dr. Arroyo was extremely positive and supportive throughout my entire pregnancy while providing the most sound medical advice. My favorite thing about Dr. Arroyo is how calm he is. Babies come with a lot of hoopla, but Dr. Arroyo can shut all of that out. Dr. Heit provided wonderful delivery and labor advice during what was a very overwhelming day. I had not planned on delivering my twins via C-section, but our “Baby B” was breech. I had spent most of my pregnancy planning (ha!) on a vaginal birth. If I chose to deliver vaginally I ran the risk of laboring for who knows how long for “Baby A,” and then having a C-section for “Baby B” if they were unable to flip her. I was so overwhelmed with needing to make a timely decision in triage that I was crying. My husband was helping me weigh our risks, but it was ultimately my choice (smart man). When Dr. Heit said to me, “If you were my daughter, I would advise you not to take the risk of a vaginal birth and go with a C-section.” That was all he had to say, my mind was made up - C-section it was! Dr. Heit told me after the C-section that “Baby B” would have been nearly impossible to flip and that I'd made the right decision. I reminded him that it was his expert advice that had lead me to that good decision. Dr. Arroyo kept me and my babies healthy for nine months and Dr. Heit finished the job with a smooth and healthy delivery.

The Balwanz Twins in Kansas CityMeet the Balwanz family, Joanie and Josh, who delivered their twin babies with Kansas City ObGyn on September 30, 2016. We followed up mom Joanie to find out how the babies are doing now.

Kansas City ObGyn: Which physician delivered your babies?

Joanie: Dr. Heit delivered my baby girls.

KCO: How was your experience?

Joanie: We loved Dr. Heit. From day one, he made us feel so comfortable. He treated me as if I was his own family, and I felt he made decisions that put my and my twins’ safety first. He explained things well to my husband and me always, and never made us feel anxious about the pregnancy or birth. We always felt that he took his time during our doctor visits, and would recommend him highly!

KCO: Did anyone else who helped deliver your babies stand out to you?

We had an excellent experience from he moment we were admitted to the hospital. From the nursing staff and on, we felt well taken care of. As far as prior to the delivery, Kim the sonographer at Kansas City ObGyn was outstanding. She took her time and explained things well that were going on through the developmental stages of the pregnancy. She was a lifesaver.

What is preterm labor?

Preterm labor occurs when the contractions begin before the 37th week of pregnancy. Along with contractions, changes in the cervix occur which signal labor is beginning. The cervix begins to thin, a process called effacement, and it starts to dilate so that the baby can enter the birth canal. Normal pregnancies last around 40 weeks, so any labor that starts before then is called early labor or preterm labor.

The Centers for Disease Control and Prevention (CDC) reported that preterm birth occurred in about one out of every 10 deliveries in the United States in 2014. The rate peaked in 2006 when the rate was nearly 13%, more than one-third higher than the rate had been in the early 1980s. In most cases, no specific cause is known for early labor. Some risk factors have been identified that make a woman more likely to go into labor early. Besides the premature rupture of the amniotic sac, some of these major risk factors identified by the Mayo Clinic include the following:

Maternal factors for preterm labor:

  • Preeclampsia, or high blood pressure during pregnancy
  • Chronic medical problems, including diabetes and kidney disease
  • Infections, especially strep, urinary tract infections, vaginal infections, and infections of the fetal or placental tissues
  • Abnormal structure of the uterus
  • Cervical incompetence, or a weak cervix that cannot stay closed as the baby grows larger
  • Previous preterm births