Teton Obgyn Idaho Falls
  • Home
  • About Us
  • Contact
  • Our Services & Treatments
    • Obstetrics
    • Office Gynecology
    • Advanced Gyn Surgery
  • Blog
  • Patient Resources
  • Home
  • About Us
  • Contact
  • Our Services & Treatments
    • Obstetrics
    • Office Gynecology
    • Advanced Gyn Surgery
  • Blog
  • Patient Resources

Helpful Tips to Recover From a C-Section

3/19/2019

0 Comments

 
We always strive for our patients to have an uncomplicated easy vaginal delivery with minimal tearing and discomfort.  However, sometimes a c-section is necessary to get both baby and mom safely through the labor and delivery process.  Some reasons for a c-section include the following: fetal distress in labor, problems with the placenta, position of the baby in the uterus, the cervix stops dilating or the baby stops moving down through the pelvis….
For many moms having their first c-section, a lot of times this is the first major surgery they have ever had.  They have lots of questions but have very little idea on the best way to get through the recovery.  Here are some tips that we hope can help you through the process.
  1. Use a belly band:  So, both hospitals will provide you with a belly band if you have had a c-section; if you don’t get one right away- just ask your nurse for one.  When you are walking and moving around this will really provide you with the back and abdominal support you need to make the recovery process easier. 
  2. Use a pillow when contracting your abs!  Anything that works your abdominal muscles, like coughing and laughing, can be pretty painful after a c-section.  We recommend placing a pillow on your abdomen before coughing and laughing to provide some support and help ease the discomfort your will feel when using your abdominal muscles. 
  3. Make sure you stay on top of the pain!  I’ve seen lots of patients try to tough it out and not take pain medication because they did not like the way it made them feel.  For the first 3 days, it is very important to use these medications to help with the pain.  Initially we want your body to focus on healing, not on fighting pain.  Everyday will get better, and once the pain has improved, then you can decrease the amount of pain medication that you are taking.
  4. Don’t compare your recovery to others.  I always hear family members talk about how they had a vaginal delivery without an epidural and toughed it out or stopped taking pain medication 1 day after the c-section.  Don’t let other people get to you.  This is not a contest.  If your family and friends are not being supportive, then you may have to consider temporarily limiting their access to you and the baby.  This time is about your recovery, not theirs!
  5. Do what you can to prevent constipation before it happens!  Make sure you drink as much fluid as you can.  Usually we will provide you with a stool softener after your deliver. Recovering from a c-section and constipation can make you pretty miserable- we are there to help if you are struggling. 
  6. Breastfeeding is hard, especially if you have just had a c-section!  This is a very anxiety provoking process for most new moms, especially if they had an unanticipated c-section.  Your milk probably has not come in and you are pretty sore from your c-section and your baby is not latching on- this is a pretty classic scenario.  Take a deep breath, utilize the nursing staff and lactation consultant and don’t fret- your milk probably won’t come in until the moment you’re are discharged.  Please let us know if you are struggling and need help.  If you decide breast feeding is not for you- that is ok- we are here to provide support, whatever your decision may be!
For most new moms, pregnancy is just the beginning of the baby challenge, and especially for those recovering from a cesarean section, the newborn time can seem even more daunting as you recover from surgery.  Please let others spoil you and take care of you while you are healing.  Try to take advantage of friends and family if they are available.  Utilize their help with the baby, meal planning, cleaning and whatever else they may offer and try to get some sleep!

​Dr. Pam
0 Comments

Pitocin: Magic Potion for Good or Evil?

2/19/2019

0 Comments

 
As I near the end of the prenatal visits with patients, I often hear “Whatever you do, I hope I don’t need pitocin,” but when I ask why, there’s never really a clear answer.  It’s usually that they heard from someone who had a friend who had a cousin, or they read online that someone said it was bad.  With this blog, I hope to help sort some of the fact from fiction.
​

What is pitocin?  Here’s the fancy answer:  “it’s a nonapeptide protein.”  That’s the one you can use to sound smart.  Here’s the simple answer:  it’s the synthetic form of oxytocin, which is a hormone released by your very own pituitary gland.  Oxytocin is produced in response to labor and helps stimulate contractions, and it also is released during breastfeeding.  Those cramps you have while breastfeeding?  You can thank pitocin.

Why does your ob/gyn use this medication?  There are 2 main reasons:  it can be used to increase the strength of contractions, and it can also be given after delivery to help prevent bleeding (it helps the uterus contract and squeeze blood vessels closed).  During labor, you might think, “My contractions are plenty strong on their own, thank you very much,” but occasionally they aren’t.  Generally, the ideal strength of contractions that are strong enough to change the cervix in a timely manner without being so strong as to stress out your baby is 200-300 MVUs.  The strength of the contractions can be measured with an internal monitor placed beside the baby called an IUPC, and this monitor helps the nurse adjust the medication into the appropriate range to achieve the contraction strength noted above.  This can help the labor progress in the optimal timeframe to help minimize the chance of intrauterine infection and decrease the  chance of cesarean section once your labor has started or your water has broken.  Pitocin can also be used to stimulate contractions in order to initiate labor when medically indicated.  During inductions when the cervix is unfavorable (ie closed and not thinned), this is the time when we may  see an increase in the need for cesarean delivery with pitocin.  However, sometimes deliveries are medically indicated in patients with an unfavorable cervix, such as in patients with certain blood pressure issues, diabetes or other situations where to continue pregnancy has greater risk to mom/baby than ending it.  Without pitocin, though, medically indicated deliveries in patients with an unfavorable cervix would almost certainly have to be via cesarean delivery.

Is it safe?  Oxytocin is unavoidable during labor and breastfeeding, and your body has been designed to utilize this hormone in both cases.  When used at doses to obtain appropriate strength of contractions, both mom and baby tend to tolerate this medication well.  Even if the baby shows some signs of stress, the half life of pitocin is only 3-5 minutes, so the effects end shortly after the medication is stopped.  Additionally, medications such as terbutaline can also be used to relax the uterus if needed.  Lastly, oxytocin used immediately after delivery decreases the chance of hemorrhage.  Postpartum hemorrhage is the leading cause of maternal death worldwide and the main reason that the maternal mortality rate is 239 per 100,000 in developing countries vs only 12 per 100,000 in developed countries.

Is it "natural"?  Pitocin is the synthetic form of oxytocin.  Oxytocin as actually produced by the posterior pituitary gland in your brain.  Your body makes large amounts of oxytocin during labor to help stimulate contractions, during breastfeeding to stimulate milk letdown, and even during orgasm.  Other less intense times of oxytocin release include hugging your significant other or cuddling a newborn.  Even men have oxytocin production, although less than women, and it plays a role in sperm motility and erection.


Are there any other options for labor induction?  At this time, pitocin tends to be the most effective and safest option that we have.  There are medications that can be used to help soften the cervix, but these are less effective in stimulating contractions.  Some researchers have looked into the use of nipple stimulation to release natural oxytocin to stimulate labor, but at this time, there has been limited success, probably due to the fact the nurses’ hands must have gotten really tired ;)  Besides, there’s really only so much that lanolin can do for the breasts after a long labor like that!

So, while not all pregnancies require pitocin, it may be required during labor or after delivery.  When dosage is titrated to the optimal contraction strength, pitocin is often the most effective method to help obtain a safe outcome for mom (vaginal delivery) and baby.  And for us, this helps us to reach our ultimate goal, which is to conclude the pregnancy with a healthy, happy mom and baby :)

Nick
0 Comments

Pain After Baby?!

10/30/2018

0 Comments

 
For many women, just “getting through” labor and delivering the baby should be the end of birth-related pain, right?  Unfortunately, that’s not always the case.  From vaginal tears to breastfeeding (yes, that can sometimes be pretty miserable, too), for some women the delivery is only the beginning of their postpartum discomfort.

​So, what can hurt so much compared to labor and delivery?  According to ACOG (the American Congress of Obstetricians and Gynecologists), somewhere between 53-79% of women experience tearing during childbirth whereas their British counterparts estimate that number to be as high as 90%.  Either way, chances are good that moms having vaginal births will have some type of laceration.  Not only can the repair process be extra uncomfortable for moms without an epidural, but suture in such a sensitive area can definitely cause some discomfort for some time after delivery.  We also know that some amount of labial swelling is also normal after delivery, and this is especially true for women who push for a long period of time.  In some cases, we can even see extra separation of the pubic bone where it stretches to accommodate a baby's head (pubic symphysis diastasis).  As for breastfeeding, pain can happen from the latch process, cracked nipples with thrush, mastitis and even the uterine contractions associated with breastfeeding.  Breastfeeding causes release of oxytocin, the same hormone used to stimulate labor, and this can result in pretty significant uterine contractions for some moms.  Lastly, moms who need cesarean delivery are expected to have pain after their surgery, too.

Is there anything to do about all this fun stuff?  During suturing of a vaginal tear, moms who have an epidural are already a little ahead of the game, although we certainly do our best to help numb the area with lidocaine for those who don’t have an epidural.  That being said, even with an amount of lidocaine injections that would be drool-inducing in the mouth, it’s quite a challenge for us to effectively numb the vagina.  Ice packs can be a big help for some of the labial swelling after delivery.  Occasional sitz baths may also be beneficial for women with tears as can stool softeners to help prevent constipation and straining in the area of a vaginal repair.  Pubic symphysis diastasis may require physical therapy or even a walker for a brief time.  With breastfeeding, moms are encouraged to take advantage of the knowledge of a lactation consultant to ensure proper latching and nipple care.  Thrush and cracked nipples often respond well to topical treatment whereas mastitis generally requires antibiotics to resolve.  Regrettably, there’s not much we can do to suppress contractions when breastfeeding.  Tylenol and Ibuprofen are also helpful for pain following a vaginal delivery, although postoperative pain from a cesarean delivery is likely to require something stronger.

For many fortunate moms, pain from labor and delivery fades soon after their baby is born; however, for others, some amount of discomfort may persist a bit longer.  Collaborating with your provider is generally the best way to ensure a satisfactory healing process, so if you are having issues, be sure to let them know.  The sooner you feel better after delivery, the more time you can focus on loving that new baby 😊

Dr. Nick
0 Comments

Epidural Shaming:  "I was 'shamed' for wanting pain relief during labor!"

9/18/2018

1 Comment

 
Lately, so many of my patients have confided in me that they are afraid of requesting pain medication during labor.  They have been told by friends or family members that by getting an epidural they are "wussing out", harming their baby, or depriving themselves of the true birth experience.  For thousands of years, women have had to endure pain during childbirth. Now that in 2016 we have the technology and options, it is ironic there is a childbirth culture that is determined to limit women's choices by shaming.  So let's review some basics about epidurals and their safety profile.  

1.  What is an epidural? An epidural is a regional anesthetic which means it does not affect your entire body. The goal of an epidural is to provide pain relief,rather than anesthesia, which is a total lack of feeling.  The anesthesiologist will inject medication through your mid back in order to numb the nerves that carry pain signals to your uterus and cervix during labor.  After that, a small tube or catheter is threaded through the needle into the epidural space. The needle is then carefully removed, leaving the catheter in place to provide medication either through periodic injections or by continuous infusion.The catheter is taped to the back to prevent it from slipping out.  

2.  Are epidurals harmful to my baby?  No.  As this medication does not cross the placenta it does not affect your baby.  Occasionally after epidurals are placed, it can affect your blood pressure, which can have effects on your baby's heart rate.  However, this is usually quickly corrected with medication.  A lot of women will request pain medication in their IV because they feel this is safer for their baby than an epidural, however what they don't realize is that these medications all cross the placenta and can cause the following: CNS and respiratory depression, impaired early breastfeeding, and decreased ability to regulate body temperature.  

3.  What are the other side effects of epidurals?  Hypotension (decreased blood pressure as discussed in the previous question), ringing in the ears, shivering, uneven anesthesia, numbness that can contribute to difficulty pushing and spinal headaches (this usually does not occur until a couple days after your epidural was placed). 

4.  If I get an epidural am I more likely to have a cesarean section?  No.  Currently the evidence does not show an increased incidence of cesarean section, use of forceps, or use of vacuum delivery with epidural anesthesia.

5.  If I get an epidural will it increase my time in labor?  It will not increase the first stage of labor (the time required for your cervix to dilate from 0 to 10 centimeters); however, studies have shown that it may slightly increase the duration of the second stage of labor (the time that you are pushing).  

Bottom line: labor hurts.  Embrace the pain management technique that works for you and make sure you talk to your provider about all your options.  I’m sure you’ve probably heard the story of the friend who went through 12 hours of labor and 2 hours of pushing without screaming once or even breathing hard, but for others, they may require more pain relief.  And that’s OK!  It is estimated that more than 60% of moms in the U.S. receive an epidural for pain control during labor, but you should not have to go through it with feelings of guilt or inadequacy.  Getting an epidural does not mean you are weak or a failure, nor does it mean you love your baby less than a mom who chooses not to use anesthesia.  While giving birth is the most incredible experience of your life, remember, you are pushing a watermelon through your vagina and there is no shame in asking for relief from the pain.  No matter how you deliver, with or without pain control, you'll be leaving the hospital with the same prize:  a brand new baby!

Dr. Pam
1 Comment

Since Your Baby Doesn't Come with an Owner's Manual Chapter 3:  The Third Trimester

9/4/2018

0 Comments

 
As we enter the latter part of pregnancy, a number of important milestones occur during the third trimester.  The one that patients are often most excited about is their due date (at 40 weeks)!  That being said, anytime after 37 weeks is considered a “full term” pregnancy, so once labor starts beyond that time, it’s “go time”!  Some babies are a little slower to make their grand entry (particularly for first-time moms), though, so don’t be discouraged if it takes a little longer for you.  If it seems to really be taking awhile for you (hello third trimester during the hottest part of summer!), then inductions can be considered at 39 weeks or beyond in most cases.

There are also a number of visit highlights in the third trimester.  At the beginning of the third trimester (28 weeks), we give any mom with an Rh negative blood type a medication called rhogam.  This medication can help prevent formation of maternal antibodies that can attack the growing baby’s blood and cause anemia.  It’s especially important for moms who are planning future pregnancies because if that interaction occurs, it’s often even more significant in later pregnancies (for those who are interested, you can check out our archives for more information on rhogam http://www.tetonobgyn.com/blog/archives/08-2016).  We also offer every mom vaccination for pertussis (whooping cough) between 27-36 weeks.  Maternal vaccination during this time can help provide your baby with protection until he/she starts their vaccination series.  This vaccine has become particularly important as there have been as many as 50,000 cases per year over the last few years, and this number is on the rise, particularly in the 0-3 month age range 
(http://immunizationforwomen.org/providers/pregnancy/pregnancy.php)

Next, we increase the frequency of your visits.  Instead of every 4 weeks, we now see you every 2 weeks until around 35-36 weeks, and then we see you on a weekly basis until you deliver.  As we begin the weekly visits, we begin checking for cervical dilation, and we also do a test for group B streptococcus (GBS).  Between 15-25% of women are carriers for GBS, and while it’s not harmful to mother’s, babies exposed to the bacteria can develop sepsis, pneumonia, meningitis, heart, GI or kidney problems that can require admission to the neonatal ICU.  Fortunately, mothers who receive antibiotics during labor dramatically decrease the risk for newborn infection with GBS.

Congratulations!  You’ve now entered the home stretch, and your baby is only about 3 months away!  While the third trimester may seem like the longest to many moms-to-be, there’s a lot to do to help you get ready for your new baby.  We generally suggest pre-registering at the hospital where you’re planning to delivery and also taking a tour of the facility.  During that tour, it’s often beneficial to bring your significant other, too, because the last thing you want is to take the “scenic route” to labor and delivery while you’re having contractions.  You may also find it useful to pack a bag of things you’ll need in the hospital (if you’re wondering what to bring, Dr. Pam did a blog with a list in the archives http://www.tetonobgyn.com/blog/archives/08-2016).  Good luck, and remember you’re almost there!  It sounds cheesy, but you’ll be bringing your bundle of joy home with you before you know it!

Dr. Nick
0 Comments

What to Pack for the Other "Labor Day"!

8/28/2018

0 Comments

 
We get this question from new moms all the time- what should I take to the hospital for me and my newborn?  There are hundreds of sample lists online and most are so long, it would probably require you to have to “check a bag”! In reality, your hospital room isn’t very large, and overpacking in a tiny room will likely be more of a hassle, not to mention make it less likely to find what you really need.  Here is a list of essentials of what moms really need for the big day:

1.       Most importantly, bring ID and your insurance card. Important phone numbers written down for your nurses are also very helpful. 

2.  If you are a first time mom, labor can be a very lengthy process. Unless you are okay with watching talk shows and reruns of The Big Bang Theory, bring your own entertainment: Ipads/Laptops- a way to watch movies, read books, music playlists and  keep friends and family updated on social media! Hospital guest wi-fi may be slow and unreliable, so you may want to download certain books and movies before your big day.  Also, decide how you are going to capture that special moment- if it is a special camera/video, make sure you bring chargers/extra batteries for ALL of your electronic devices. 

3.  Moms, the hospital already has a lot of pads and underwear, but bring a robe, comfy sweat pants or pajamas, and flip flops (They may also serve the purpose of shower shoes!).  Nursing tops and bras are good ideas, but the hospital already has breast pumps/nursing pillows if you need it.  Your milk may not come in until you leave the hospital, so bringing your own is likely unnecessary.

4. For your little one: The hospital will provide diapers/wipes/suction bulbs/blankets/bottles- pretty much everything you will need for your newborn, so don’t waste space or energy packing any of these.  All you really need is a couple of cute outfits that you want to take baby's first pictures in.

5. With that being said, don’t forget your toiletry/makeup bag so you can look great in those first pictures with your baby!

6. Also, you should pack at least one extra set of clothes that will fit you after you deliver.  After all, who wants to go home with their butt hanging out in the breeze from their hospital gown?

7. Last but certainly not least, the car seat!  Learn how to use the car seat before you leave for the hospital so you are not struggling the day of discharge.

Fortunately, no matter how hectic your “labor day” is, you won't forget the most important part of your list..your baby :)

Dr. Pam
0 Comments

Since Your Baby Doesn't Come with an Owner's Manual Chapter 2:  The Second Trimester

8/14/2018

0 Comments

 
For many women, the second trimester is often the favorite.  Nausea generally subsides (or at least lessens), moms can begin to feel their babies move, and the baby hasn’t yet become large enough to make you too uncomfortable :)  If you’re planning a “baby moons,” the second trimester is probably your best bet.​

The second trimester is often when you get to really see your newest family member for the first time.  While earlier ultrasounds can show some features, the ultrasound done around 20 weeks lets us look at all those little parts, from heart and lungs to fingers and toes.  And of course, if you haven’t learned already (or even if you have), this is usually the best time to confirm the gender of your baby.  At this point, if Pinterest and Etsy browsing for baby clothes hasn’t already become your favorite pastime, it probably will :)

From the OBGYN standpoint, with the exception of the 20 week ultrasound to assess your baby’s anatomy, our testing is generally pretty limited.  Visits continue every 4 weeks during the period, and each visit will include listening to your baby’s heartbeat.  After 20 weeks, we will begin to measure the fundal height (measurement from the pubic bone to the top of the uterus) in order to ensure your baby is growing well.

The only downside of the second trimester is that we do perform one of the 2 least favorite tests of pregnancy:  the screening for gestational diabetes.  It’s kind of a tossup as to whether this test or the check for group B strep in the third trimester is the least favorite of moms-to-be.  Since this test isn’t so fun, I’d like to take a minute to explain what it is and why we do it.

The way we do screening for gestational diabetes is as follows:  you get to drink a sugary drink provided by the lab and then have your blood drawn an hour after.  If you pass, you’re done, and if you fail above a certain level, we begin management for gestational diabetes right away.  If you fall in the middle, we do a second round of testing (a 3 hour version) to determine if you have gestational diabetes.  We know all moms have some element of insulin resistance during pregnancy (we want your blood sugar to be a little higher than your baby’s so that he/she can eat); however, some moms are over-achievers :)  For those moms, dietary modifications and in some cases medical management may be indicated.  Glucose control is one of the most important aspects of pregnancy as uncontrolled gestational diabetes can lead to larger babies, increased risk of birth trauma to baby/mom or need for cesarean section, and in severe cases, even increased risk of stillbirth.  So, yes, it’s not a fun test, but it is important.

The last important milestone for the second trimester is that around 23-24 weeks is the very earliest that babies have a chance to survive outside of mom’s body.  That being said, we much prefer that your little one gets to stay inside awhile longer.  Complications from prematurity can generally be minimized the further pregnancy progresses, so even if you’re finding that the second trimester isn’t a total breeze, remember that after 20 weeks, you’re over halfway to getting to see your baby in person and that cute little face will be totally worth it :) 

Dr. Nick
0 Comments

Since Your Baby Doesn't Come with an Owner's Manual:  Chapter 1 - The First Trimester

7/24/2018

0 Comments

 
Picture
After delivering babies for the last 10 years, I have yet to see the birth of a baby with an owner’s manual, and no matter how prepared new parents try to be, pregnancy and a new baby are undoubtedly a life-changing experience.  What I’d like to do over my next few blogs is cover the time leading up to and just after delivery.  So here it goes, what to expect from you physician’s perspective.

When do I need to start preparing?  The best pregnancy planning begins even before conception.  Prenatal vitamins are generally advised for several months before attempting to conceive to ensure adequate levels of folic acid during the critical time to prevent neural tube defects (essentially spinal problems) in the developing embryo.  As an added bonus, some studies suggest a decrease in the severity of morning sickness for those who have been taking prenatal vitamins for several months before conception.  Win for baby and win for mommy!

More importantly, how soon can I see my baby?  Unfortunately, despite our expectation of instant gratification, our technology hasn’t quite caught up to the demands of anxious mothers-to-be.  While we may be able to see a gestational sac (the sac the baby grows in) as early as 5-6 weeks, we generally aren’t able to see the 3 parts of a successful pregnancy until around 7 weeks.  We want to confirm: 1. Pregnancy inside the uterus, 2. The part that becomes the baby is present inside the sac, and 3. There is a heartbeat.  While we occasionally see moms before 7 weeks, they may leave even more worried than when they came because we can’t always guarantee that the pregnancy appears healthy.  Not to mention, who wants an extra vaginal ultrasound :( It takes until 7+ weeks for the baby to be even a centimeter long, and even though it’s the cutest 1cm you’ll ever see, we want to be able to reassure you that it’s also the healthiest!   Besides, as a doctor, the last thing we want to cause is more stress to expectant mothers.  That’s the baby’s job for after delivery -- “Liam, is that dirt-covered Hot Wheel really that tasty?" ;P

So, what else happens at that first visit?  Your doctor will likely check labs, probably chat with you about pregnancy expectations, possibly discuss genetic testing and may do an exam.  Your provider may also inquire about any medical conditions or previous surgeries that would affect your pregnancy.  He/she will also answer any questions you may have and discuss any symptoms you may be having to determine if those issues are pregnancy-related or require further evaluation/treatment.  Most importantly, it gives you the opportunity to meet the person who will be helping to bring your bundle of joy into the world!

Speaking of symptoms, which ones are common during pregnancy?  The number one complaint in the first trimester is nausea.  Generally, it’s worst during the second half of the first trimester and begins to subside as the HCG (pregnancy hormone) begins to go down towards the end of the first trimester.  Since no one likes to spend all day hugging the toilet, we do encourage notifying your doctor if you aren’t able to keep any food down, even if it’s before 7 weeks.  The one silver lining to all of that nausea is that women with hyperemesis gravidarum (not nearly as cool as the name sounds!) tend to have a slightly less chance of miscarriage.  Other common symptoms include breast tenderness or enlargement, change in skin pigmentation, increased urination, food aversions and of course, missed menses.  Light vaginal spotting or bleeding with pregnancy implantation can also be normal.  That being said, be sure to notify your doctor for abdominal pain that doesn’t go away with Tylenol, heavy vaginal bleeding (more than a pad per hour) and passing large clots or tissue.  These could be signs of either a failing pregnancy or even a pregnancy outside the uterus, which is potentially a life-threatening emergency.  
​

There you have it!  A quick look at the first trimester.  We’ll hit the high notes for second and third trimester in future blogs!  For all of those who are pregnant, congratulations, and for those seeking pregnancy, good luck!  Please give us a call at 208-523-2060 if you’d like our help in achieving a healthy, happy pregnancy for you and your baby!

Dr. Nick

0 Comments

Where Is My Pregnancy Glow:  Acne in Pregnancy

6/26/2018

0 Comments

 
When you found out you were pregnant, you were probably expecting that healthy pregnancy glow.  Unfortunately, not all pregnant women are so lucky, and instead, your face is littered with zits even worse than during those awful teenage years.  So, now what do I do?  

1. I have not had bad acne in years, so why now? Acne can be very severe in pregnancy.  The increased hormone levels (particularly androgens) in the first trimester increases the skin’s production of natural oils, and many women have severe outbreaks in the first trimester.  

2. What products can I use for acne while I am pregnant?  Using small amounts of salicylic acid, benzoyl peroxide, and finacea is safe in pregnancy.  Large amounts can potentially be absorbed in the bloodstream, so please limit your use to small quantities.  This is especially true of salicylic acid, which is related to aspirin.  In LARGE doses aspirin and aspirin containing products can increase the risk of miscarriage and cause heart problems for the baby (That being said, do not be alarmed if your provider places you on baby aspirin as this small dose will not have this effect). 

3. Is Proactiv safe? Yes.  Proactiv is just benzoyl peroxide, salicylic acid and glycolic acid.  Again, as long as you use it in small quantities, it is safe in pregnancy.

4. Can I get facials for my acne while I am pregnant? Yes, for the most part facials are safe in pregnancy, and after the fun of early pregnancy (nausea, zits, etc) you probably deserve one :)  However, please make sure that your technician is aware that your are pregnant, so they can avoid the following: Retinol or Retin A containing products, accutane and large amounts of salicylic acid.  Retinol, accutane and Retin A contain large amounts of vitamin A, and this substance can cause birth defects.  If your technician is going to use a peel, please avoid salicylic acid peels as large quantities are not safe in pregnancy.  Peels that use glycolic acid, TCA or lactic acid should be safe in pregnancy.  Extractions are safe in pregnancy, but be careful because your skin may be more sensitive while you are pregnant.

5. Are my prescription antibiotic creams that I use for acne safe in pregnancy?  It depends on which antibiotic you are using.  Clindamycin or erythromycin based creams are fine while pregnant.  However, you should avoid tetracycline, doxycycline, and minocycline because they can affect your baby’s teeth.  

6. If you use anti-wrinkle cream and are pregnant, please stop now because most of these creams all contain retinol based products.  These products contain high amounts of vitamin A and are not safe in pregnancy.

I promise you, your skin will get better!  Acne in pregnancy is usually worst during the first trimester and improves as the pregnancy goes on.  When washing your face, make sure you use a gentle, oil-free, alcohol-free, and non-abrasive cleanser.  Avoid over-cleansing as it can overstimulate your skin’s oil glands.  More than anything, resist the urge to pick or “pop zits”.  This can make your acne worse and cause unsightly blemishes or scarring to form.  ​ Just be patient, and you'll have your skin back back to normal soon :)

Pam
0 Comments

Your Due Date:  Why It Is What It Is

5/15/2018

0 Comments

 
Probably not a clinic day goes by that I’m not asked to move up someone’s due date.  Not to say all moms-to-be are naughty, but there may be a sense of “I’m so over this pregnancy,” especially as we enter the third trimester.  This question even comes up around the time of the 20-week ultrasound if the associated “due date” is sooner than has previously been assigned.  By this time, though, the due date should already be established and only changed in very rare circumstances.  Here’s why:

The most accurate dating we can use involves the day for either IVF or embryo transfer as this is a certain date.  In fact, we can even know the specific time of the procedure.  After IVF, the next most accurate criteria to use is a first trimester ultrasound (prior to 14 weeks) that shows a fetus with a heartbeat (one with just a sac and no fetus isn’t as accurate).  It is accurate to within 5-7 days.  As we move into the second trimester, ultrasound can vary as much as 2 weeks from the actual due date, and in the third trimester, we can variation from 21-30 days.  This can be a full month discrepant from when a patient is due!

If you think about it, this totally makes sense.  If asked to compare a bunch of 6 month olds to determine their age, you’d probably be within a few months of their actual age.  Looking at 6 year-olds, you might be within a year or two.  With 16 year-olds?  Good luck!  You’d probably be fortunate to be within 5 years for some of them.  For babies in-utero, the same holds true.  The earliest estimates of age are going to be the most accurate, so that’s what we go with.  The due date at each ultrasound is the average due date for a baby of that size.

So, even if your baby grows faster than average, that doesn’t mean we get to deliver early.  There are still developmental milestones for the brain and lungs and other parts of the body that we’d you’re your baby to reach before delivery.  To put it in perspective, you wouldn’t expect a 12 year-old to graduate high school just because he’s now 6 feet tall.  Whether the biggest kid in 6th grade or the smallest in 6th grade, they are still 6th graders.  They’re probably not quite ready for the college application process just yet 😊

Interestingly, I’ve yet to have a patient ask me to push back their due date.  No one’s ever said to me, “You know.  I just love being pregnant.  Do you think you could move my due date back a week or two?  Maybe a month?”  In fact, it’s more the opposite.  I can almost hear the nervousness of those whose baby is growing a little slower than average, and their thoughts seem to be going a little like this:  “Maybe Dr. Denson won’t notice my new due date is later than we thought.  If I don’t make eye contact and rush him through the report, then maybe I won’t have to stay pregnant any longer.”  Fortunately, for those moms (and the health of the doctors who would have to ask them to stay pregnant longer), pushing back the due date at that point would be like making a smart child stay in kindergarten because he or she is too short to go to first grade.

There you have it.  Earlier dating is best!  Once you’ve been assigned a due date after an ultrasound showing a fetus with a heartbeat, you can mark it on the calendar, and the countdown can begin!  So even though we can’t move up your due date, you don’t have to worry about us moving it back either 😊

​Dr. Nick
0 Comments
<<Previous
    Call Us

    Teton Women's 

    We address the topics you need to know about regarding pregnancy and women's health issues.

    Archives

    November 2019
    October 2019
    September 2019
    August 2019
    July 2019
    June 2019
    May 2019
    April 2019
    March 2019
    February 2019
    January 2019
    December 2018
    November 2018
    October 2018
    September 2018
    August 2018
    July 2018
    June 2018
    May 2018
    April 2018
    March 2018
    February 2018
    January 2018
    December 2017
    November 2017
    October 2017
    September 2017
    August 2017
    July 2017
    June 2017
    May 2017
    April 2017
    March 2017
    February 2017
    January 2017
    December 2016
    November 2016
    October 2016
    September 2016
    August 2016
    July 2016
    June 2016
    May 2016
    April 2016
    March 2016

    Categories

    All
    Babies
    Breast Feeding
    Contraception
    Cord Blood Banking
    Delayed Cord Clamping
    Diet And Exercise
    Diet And Exercise In Pregnancy
    First Trimester
    Genetic Screening
    Guest Blogs
    Gynecologic Surgery
    Health And Fitness
    Induction Of Labor
    Infertility
    Just For Fun
    Overview Of Pregnancy
    Ovulation Prediction
    Pain Management In Labor
    Pap Smear
    Postpartum Depression
    Pregnancy Planning
    Second Trimester
    Sexual Health
    Vaginal Discharge
    Women's Health
    Zika Virus

    RSS Feed

Location

Teton Women's Health Center
2001 S Woodruff Ave #10
Idaho Falls, ID 83404

Contact Us

Tel: 208-523-2060
​Fax: 208-523-9874

Office Hours

Mon - Thurs: 8:00 am - 12:00 pm & 1:00 pm - 5:00 pm
Fri - 8:00 am - 12:00 pm

Be sure to follow us on social media for the latest updates at Teton Women's Health Center!

**While we are excited to answer your questions, please be aware that the links below are not intended to provide urgent or emergent medical advice.  Thank you!