True Birth

Cervical lacerations are cuts or tears that happen to the cervix during labor and delivery. These types of laceratsion are different from the typical 1st and 2nd degree lacerations that occur during labor and delivery normally. Generally they tend to have more blood flow and can be responsible for more blood loss. They also may have an effect in a subsequent pregnancy and labor.

Today's episode of True Birth is all about cervical lacerations.

A cervical laceration is a cut or tear on the cervix that can happen during delivery. Despite its intimidating name, it's certainly treatable, and we're here to explain some helpful information that will let you know what you might be dealing with.

The cervix almost always tears a little during labor, but if the tear reaches the blood vessels in the cervix, it's called a laceration, and a patient can have significant hemorrhaging.

Previously, the protocol included a check of the cervical angles (3 o'clock and 9 o'clock) in every vaginal delivery. Still, nowadays, a doctor will usually only examine the cervical angles if there's a complicated delivery or more bleeding than expected. It's unlikely to be coming from the uterus, and the placenta is already out.

If there's a significant cervical laceration, it should be sutured - which is usually done with dissolvable stitches. Making sure the cervix is intact after delivery is essential because a cervical laceration that doesn't heal well can lead to the issue of cervical insufficiency - which can be a cause of miscarriage in future pregnancies.

Recognizing cervical lacerations is the most significant factor in repairing them. And, if anyone has carried pregnancies to term and then begins to lose any, a thorough exam should be carried out to look for possible cervical insufficiency from previously undetected lacerations.

Previous use of a vacuum, forceps or even a history of precipitous (rapid) labor could increase the likelihood of having an issue with the shape of the cervical opening and therefore increase the chances of cervical insufficiency. Dr. Abdelhak proposes the theory that precipitous delivery is likely a mild form of cervical insufficiency.

Dr. Abdelhak also shares a few stories about times when using a cerclage (such as an abdominal or cervical cerclage) led to more success in carrying pregnancies to full term.

As always, we'd love to hear from you! Connect with us on our website at www.truebirthpodcast.com or send us an email at [email protected]

Maternal Resources' website is:

https://www.maternalresources.org/

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What happends when a cesarean birth is not planned. Gving birth is a life-changing experience, and while most women hope for a smooth vaginal delivery, some may end up having an unplanned Cesarean section (C-section). A C-section is a surgical procedure in which the baby is delivered through an incision made in the mother's abdomen and uterus. While a planned C-section can be a positive experience for some women, an unplanned C-section can be stressful and overwhelming.

After an unplanned C-section, it's essential to take steps to ensure that you're informed about what happened and what to expect during the recovery process. First and foremost, ask your healthcare provider to explain why the C-section was necessary and what happened during the procedure. Understanding the reasons for the C-section can help you process the experience and make informed decisions about future pregnancies.

It's also important to ask your healthcare provider about the recovery process and what you can expect in the coming weeks and months. You may need to stay in the hospital for a few days, and you may experience pain and discomfort as your body heals. Your healthcare provider can provide you with guidance on pain management, activity restrictions, and when it's safe to resume normal activities.

Additionally, consider seeking out support from other mothers who have had a C-section. Joining a support group or talking to other moms can help you feel less alone and provide you with tips and advice on how to manage the recovery process.

In conclusion, an unplanned C-section can be a stressful and unexpected experience, but taking steps to be informed and prepared can help ease some of the anxiety and uncertainty. By asking your healthcare provider questions, seeking out support, and being patient with yourself during the recovery process, you can make the best of this experience and emerge stronger on the other side.

As always, we'd love to hear from you! Connect with us on our website at www.truebirthpodcast.com or send us an email at [email protected]

Maternal Resources' website is:

https://www.maternalresources.org/

Remember to subscribe wherever you listen, and leave us a review!

Our Social Channels are as follows

Twitter: https://twitter.com/integrativeobYouTube: https://www.youtube.com/maternalresources IG: https://www.instagram.com/integrativeobgyn/ Facebook: https://www.facebook.com/IntegrativeOB

On today's episode of True Birth, we're talking about labor coaches, birth coaches, and doulas.

Dr. Yaakov Abdelhak and Certiied Nurse Midwife Kristin Mallon highly recommend having a birth coach during labor. They share some of their positive experiences with the recommended birth coaches and doulas on their site www.maternalresources.org.

It helps to have already a reputation of being practitioners that are C-section averse and always put their patients first because doulas come into the situation less wary.

Some doula certifications are more rigorous than others, and just like any coach or guide, it's essential to find one with plenty of expertise and high recommendations from trusted sources. Labor coaches and doulas should also have a good relationship with your physician, communicate with them well, and understand their reasoning, instead of having an unnecessarily antagonistic or mistrusting angle.

Coaches and doulas vary in how involved they are pre-labor; some do consultations, going over labor preferences and expectations, and others spend less time with patients until labor unless a question comes up or help is needed. However, once labor starts, they will all be present with the mother to explain what's going on and provide a familiar point of view about the everyday hospital happenings around them. Some labor coaches and doulas provide lactation and postpartum guidance as well.

What makes a bad labor coach? Someone who's inactive during labor or who taps out during long labors, increases anxiety in the room, or gives bad advice.

What makes a good labor coach? Someone who can spend hours with a patient during labor, be emotionally present, provide good information, and bring some extra confidence into an often difficult experience. If you're planning to avoid an epidural, a labor coach or doula is a must.

In this episode, you'll also hear about the costs of having a doula, the range of rates they usually charge, and even the different styles of some of the recommended doulas on MaternalResources.org.

As always, we'd love to hear from you! Connect with us on our website at www.truebirthpodcast.com or send us an email at [email protected]

Maternal Resources' website is:

https://www.maternalresources.org/

Remember to subscribe wherever you listen, and leave us a review!

Our Social Channels are as follows

Twitter: https://twitter.com/integrativeobYouTube: https://www.youtube.com/maternalresources IG: https://www.instagram.com/integrativeobgyn/ Facebook: https://www.facebook.com/IntegrativeOB

Today's episode of True Birth is all about circumcision. Circumcision often falls under the category of obstetrics, and many obstetricians are the ones who perform circumcisions at the hospital because it's considered surgical.

It's rare to need a suture or have bleeding complications after an infant is circumcised, but having someone familiar with surgery perform the procedure is an added advantage, just in case.

Historically, removing the foreskin of the penis was thought to prevent certain medical complications, but nowadays, many of those beliefs have been debunked. Many people choose to have their male children circumcised because of tradition. For instance, in the U.S., about 71% percent of biological males are circumcised, but in many other countries, that statistic is much lower.

Some medical considerations could delay the timing of the procedure: if the baby is premature or has any homeostasis issues, the procedure should be postponed until it's safer.

One common instrument used for circumcision is called the Gomco clamp, which lowers the amount of bleeding. Pain medication such as local, non-epi lidocaine is often given. Alternately, a Mogan instrument can be used, but Dr. Abdelhak doesn't necessarily prefer it because the shape of the cut often doesn't present as clean-looking initially.

The primary necessity in the procedure is knowing where on the skin to cut. Understand that for a few days before skin regrowth; the area will look quite bare and raw.

Jewish patients often choose to bring their baby back eight days after birth to make it a bris circumcision in accordance with religious tradition. When this is the case, Dr. Abelhak includes a special blessing and respectfully follows the Kosher protocol wherever applicable. We'll hear some of his accounts of times that Jewish patients came to the office for their child's bris and why this option might be culturally advantageous for many families.

We hope this episode clarifies some of the details of circumcision for you and adds to your ever-growing knowledge base on pregnancy and birth.

As always, we'd love to hear from you! Connect with us on our website at www.truebirthpodcast.com or send us an email at [email protected]

Maternal Resources' website is:

https://www.maternalresources.org/

Remember to subscribe wherever you listen, and leave us a review!

Our Social Channels are as follows

Twitter: https://twitter.com/integrativeobYouTube: https://www.youtube.com/maternalresources IG: https://www.instagram.com/integrativeobgyn/ Facebook: https://www.facebook.com/IntegrativeOB

What is the optimal timing for delivery when a pregnancy goes past the due date? How far past a due date is it recommened to go? Is it safe to go? Why are there different recommendations for each type of pregnancy?

A postterm pregnancy is when the pregnancy goes on beyond beyond 42 weeks (294 days) from the calculated first day of the last menstrual period.

A postdates pregnancy is a pregnancy that goes beyond the due date.

Relevant to this episode is our podcast on how to calcuate a due date, episode #85 linked here

In this episode, Dr. Abdelhak explains his rationale for why he prefers pregancies to end by the 41st week and someones even earlier.

As always, we'd love to hear from you! Connect with us on our website at www.truebirthpodcast.com or send us an email at [email protected]

Maternal Resources' website is:

https://www.maternalresources.org/

Remember to subscribe wherever you listen, and leave us a review!

Our Social Channels are as follows

Twitter: https://twitter.com/integrativeobYouTube: https://www.youtube.com/maternalresources IG: https://www.instagram.com/integrativeobgyn/ Facebook: https://www.facebook.com/IntegrativeOB

Cervical cerclage is a fantastic tool used to prevent preterm labor. The placement of a cerclage is a surgical procedure in which a synthetic suture or tape is used to reinforce the cervix. This mechanical enhancement of the tensile strength of the cerclage reinforces the cervix, keeps it closed and is very successful at lengthening many pregnancies.

This podcast covers the different types, why and when each is used.

As always, we'd love to hear from you! Connect with us on our website at www.truebirthpodcast.com or send us an email at [email protected]

Maternal Resources' website is:

https://www.maternalresources.org/

Remember to subscribe wherever you listen, and leave us a review!

Our Social Channels are as follows

Twitter: https://twitter.com/integrativeobYouTube: https://www.youtube.com/maternalresources IG: https://www.instagram.com/integrativeobgyn/ Facebook: https://www.facebook.com/IntegrativeOB

Molar pregnancies, also known as hydatidiform moles, are rare usually unviable pregnancies that develop when trophoblasts (the cells that normally develop into a placenta) grow abnormally. Today's episode is all about this rare issue in pregnancy, its treatment, and possible complications.

As you may know, human cells should contain 23 pairs of chromosomes; one set from the mother and the other from the father. In a complete molar pregnancy, an empty egg is fertilized by one or two sperm, so all of the chromosomes present are the father's. In a partial molar pregnancy, the mother's chromosomes are present but the father's are double present, meaning the embryo has 69 instead of 46 chromosomes.

Both categories of molar pregnancies require early intervention and care, followed by close monitoring of HCG levels. In cases of complete molar pregnancies, very rarealy, cancer can also be a concern.

Another possible complication is that molar tissue can continue growing even after a D&C procedure, which in very servere cases can prolonged monitoring, further intevention and very rarely chemotherapy.

Symptoms include bleeding, cramping, severe nausea, thyroid issues, and pain. It's hard to diagnose as a normal pregnancy can have all of these symptoms as well. Diagnosis is done by a blood test and ultrasound.

Did we mention these are rare? 1 in 1,000. Risk factors can include extreme ages (very young as well as what we like to call "adult pregnancies" because we don't use the word geriatric to describe pregnancies), a history of infertility, a previous diagnosis of molar pregnancy, and possibly a history of terminations. If a person has a molar pregnancy, there's a slightly elevated chance that they'll have another one, but the chances are still around 1 percent.

Women are strongly encouraged to avoid getting pregnant while they're watching their hormone levels return to normal (usually around 6 months to a year for complete molar pregnancies).

As always, we'd love to hear from you! Connect with us on our website at www.truebirthpodcast.com or send us an email at [email protected]

Maternal Resources' website is:

https://www.maternalresources.org/

Remember to subscribe wherever you listen, and leave us a review!

Our Social Channels are as follows

Twitter: https://twitter.com/integrativeobYouTube: https://www.youtube.com/maternalresources IG: https://www.instagram.com/integrativeobgyn/ Facebook: https://www.facebook.com/IntegrativeOB

Postpartum Depression (PPD) is a depressive period or series of depressive episodes that can happen after the birth of a baby. While there is some debate, most psychological and OB/GYN experts agree that any depression that occurs within the first 12 months after birth may be related to the birth. This type of depression affects 1 in 7 moms and 1 in 10 dads.

Postpartum Depression is not to be confused with postpartum anxiety or perinatal depression and anxiety which can occur shortly before or during pregnancy. These types of anxiety and depression are not covered in this episode.

The suspected incidence is hard to pinpoint and has a large range as some parents are now aware they are experiencing postpartum depression until months or even years later. The symptoms can be confused or confounded with sleep deprivation and new onset sleep disorders that often follow the birth of a baby. The rate of PPD is higher in low and middle income countries. Many studies have landed on the incidence of PPD to be around 10-20% and a parent is 50% more likley to end up in this staistic if they had a history of depression prior. More than 50% of PPD presents by 6 months postpartum.

This epsiode is a from the perspective of the OB/GYN on the first steps in identifying and beginning treatment and connection to resources.

A great resource for everything related to PPD including support groups nationwide can be found on this website https://www.postpartum.net

As always, we'd love to hear from you!. Please drop us a line on our website at www.truebirthpodcast.com or send us an email at [email protected]

Our practice website can be found at:

Maternal Resources: https://www.maternalresources.org/

Remember to subscribe wherever you get your podcasts. Please consider leaving us a review.

Our Social Channels are as follows

Twitter: https://twitter.com/integrativeob YouTube: https://www.youtube.com/maternalresources IG: https://www.instagram.com/integrativeobgyn/ Facebook: https://www.facebook.com/IntegrativeOB

We've included a list of the most common acronyms and short hand lingo used common in with medical professionals in labor and delivery. This is a great refrence for when you are surronded by new medical lingo and acronyms and you need some help naviating through.

We'd love to hear from you and hear what topics you would like us to cover.

If you are interested in more information about our practice love C/S delivery rate, VBACs, twins or breech deliveries. Our practice website can be found at:

Maternal Resources: https://www.maternalresources.org/

Remember to subscribe wherever you get your podcasts. Please consider leaving us a review.

Our Social Channels are as follows

Twitter: https://twitter.com/integrativeob YouTube: https://www.youtube.com/maternalresources IG: https://www.instagram.com/integrativeobgyn/ Facebook: https://www.facebook.com/IntegrativeOB

Obstetrics and Gynecology can be a wonderful beautiful experiene as a place to work but also have its fair share of challenges. In this episode, Dr. Yaakov Abdelhak, Maternal Fetal Medicne Specilaist, and Kristin Mallon, Certified Nurse Midwife, disucss why someone chooses the field of OB/GYN.

The choice of a medical specialty is a significant decision for physicians, influenced by a combination of personal interests, experiences, lifestyle considerations, and professional goals. Why someone might choose a particular field in medicine:

1. Personal Interest and Passion: Many doctors are drawn to a specialty because of a deep interest in the subject matter. For OB/GYN, this might include a fascination with reproductive health, pregnancy, childbirth, and women's health issues. Physicians in this field often feel passionate about providing care through the various stages of a woman's life, from adolescence through menopause.

2. Impactful Experiences: Experiences during medical school or early training can profoundly influence career choices. A medical student might be inspired by an OB/GYN rotation, finding the experience of delivering babies exhilarating and deeply rewarding. Positive mentorship by seasoned OB/GYNs can also play a crucial role.

3. Desire to Provide Comprehensive Care: OB/GYNs provide a unique blend of primary care and surgical care. This specialty allows physicians to form long-term relationships with patients, offering continuity of care through different life stages, and also to perform life-changing procedures like cesarean sections or gynecologic surgeries.

4. Interest in Women's Health Advocacy: Many OB/GYNs are motivated by a desire to advocate for women's health issues. This can include addressing health disparities, providing education on reproductive rights, and working in areas like family planning or fertility.

5. Diversity of the Field: OB/GYN offers a variety of subspecialties, including maternal-fetal medicine, reproductive endocrinology, gynecologic oncology, and urogynecology. This diversity allows physicians to focus on specific areas that match their interests and skills.

6. Personal Skills and Attributes: Physicians might choose OB/GYN because their skills and attributes align well with the demands of the specialty. Good manual dexterity for surgical procedures, strong communication skills for patient education and support, and the ability to handle high-pressure situations (like complicated deliveries) are valuable in this field.

7. Lifestyle Considerations: Although OB/GYN can be demanding with irregular hours (especially given the unpredictable nature of childbirth), some doctors are drawn to the dynamic and varied nature of the work. The balance between clinic hours, surgery, and delivering babies can offer a fulfilling mix of activities.

8. Desire to Make a Difference: Finally, many choose OB/GYN because of the profound impact they can have on patients' lives. Helping bring new life into the world, managing complex gynecological conditions, and supporting women's health are all aspects that can provide a deep sense of professional satisfaction.

The choice of a medical specialty like OB/GYN is often a blend of personal interests, life experiences, professional aspirations, and a desire to make a meaningful impact in a specific field of medicine. Each physician's journey to their specialty is unique, reflecting their individual passions and the experiences that shape their professional life.

Our practice website can be found at:

Maternal Resources: https://www.maternalresources.org/

Remember to subscribe wherever you get your podcasts. Please consider leaving us a review.

Our Social Channels are as follows

Twitter: https://twitter.com/integrativeob YouTube: https://www.youtube.com/maternalresources IG: https://www.instagram.com/integrativeobgyn/ Facebook: https://www.facebook.com/IntegrativeOB