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A Guide to Vulva Health: Essential Tips for Keeping Things Healthy Down There Maintaining vulva health is crucial for overall well-being and comfort. Despite being a topic often overshadowed by taboo, open discussions and proper knowledge can significantly contribute to the health and happiness of vulva owners. Here are some essential tips and best practices [&#8230;]


<p><strong>A Guide to Vulva Health: Essential Tips for Keeping Things Healthy Down There</strong></p>



<p>Maintaining vulva health is crucial for overall well-being and comfort. Despite being a topic often overshadowed by taboo, open discussions and proper knowledge can significantly contribute to the health and happiness of vulva owners. Here are some essential tips and best practices for keeping the vulva healthy:</p>



<p><strong>1. Maintain Proper Hygiene</strong></p>



<p>While it&#8217;s important to keep the vulva clean, over-washing can do more harm than good. The vulva is self-cleaning, thanks to vaginal discharge. Excessive washing or using harsh soaps can strip the skin of its natural oils, leading to irritation and dryness. Use warm water and a mild, unscented soap to gently cleanse the area. Avoid douching and harsh scented products, as they can disrupt the natural pH balance, leading to infections.</p>



<p><strong>2. Wear Breathable Fabrics</strong></p>



<p>Choosing the right underwear is more important than you might think. Opt for breathable fabrics like cotton, which allows air circulation and prevents moisture buildup. Tight, synthetic fabrics can trap moisture, creating an environment conducive to bacterial and yeast infections. Changing out of wet swimsuits and sweaty gym clothes promptly is also key to maintaining a healthy vulva.</p>



<p><strong>3. Practice Safe Sex</strong></p>



<p>Using protection during sexual activity is crucial for preventing sexually transmitted infections (STIs) that can affect vulva health. Condoms, dental dams, and other barrier methods can reduce the risk of STIs. Additionally, regular STI screenings are important, especially if you have multiple partners. Open communication with your partner about sexual health is equally vital.</p>



<p><strong>4. Stay Informed About Menstrual Products</strong></p>



<p>The type of menstrual product you use can impact vulva health. Some people may be sensitive to the materials in certain pads or tampons. Consider switching to organic cotton products or menstrual cups, which are often gentler on the skin. Change tampons and pads frequently to avoid irritation and potential infections.</p>



<p><strong>5. Hydrate and Eat a Balanced Diet</strong></p>



<p>Staying hydrated and consuming a balanced diet rich in vitamins and minerals can support overall health, including vulva health. Foods high in antioxidants, such as fruits and vegetables, can help protect against infections and inflammation. Probiotics, found in yogurt and other fermented foods, can support healthy vaginal flora.</p>



<p><strong>6. Avoid Tight Clothing</strong></p>



<p>Wearing tight pants or underwear for extended periods can cause friction and irritation. Opt for loose-fitting clothing whenever possible, especially if you’re prone to discomfort or infections. Giving your vulva some breathing room can prevent issues and promote comfort.</p>



<p><strong>7. Be Mindful of Irritants</strong></p>



<p>Many everyday products, such as laundry detergents, lotions, and perfumes, contain chemicals that can irritate the vulva. Opt for hypoallergenic and fragrance-free products to minimize the risk of irritation. If you experience frequent itching or discomfort, it may be worth reviewing the products you use and making necessary changes.</p>



<p><strong>8. Regular Check-ups and Self-Exams</strong></p>



<p>Regular gynecological check-ups are essential for monitoring vulva health. A healthcare provider can screen for infections, abnormalities, and other health concerns. Performing self-exams can also help you become familiar with your anatomy and recognize any changes that may require medical attention.</p>



<p><strong>9. Manage Stress</strong></p>



<p>High levels of stress can affect your immune system, making you more susceptible to infections. Practicing stress management techniques, such as yoga, meditation, and deep breathing exercises, can support both mental and physical health.</p>



<p><strong>10. Listen to Your Body</strong></p>



<p>Finally, always pay attention to what your body is telling you. If you notice any unusual symptoms, such as itching, burning, or unusual discharge, don’t hesitate to consult a healthcare provider. Early intervention can prevent minor issues from becoming major health concerns.</p>



<p>By following these tips and staying informed, you can maintain a healthy vulva and enjoy greater comfort and well-being. Remember, taking care of your vulva is a vital part of overall health, and it deserves your attention and care.</p>



<p>Love, </p>



<p>Dr. Wendy aka Dr. Every Woman <a href="https://dreverywoman.com/shop">(Learn more about products from Dr. Wendy by clicking here)</a></p>



<p></p>


A Guide to Vulva Health: Essential Tips for Keeping Things Healthy Down There
Maintaining vulva health is crucial for overall well-being and comfort. Despite being a topic often overshadowed by taboo, open discussions and proper knowledge can significantly contribute to the health and happiness of vulva owners. Here are some essential tips and best practices for keeping the vulva healthy:
1. Maintain Proper Hygiene
While it’s important to keep the vulva clean, over-washing can do more harm than good. The vulva is self-cleaning, thanks to vaginal discharge. Excessive washing or using harsh soaps can strip the skin of its natural oils, leading to irritation and dryness. Use warm water and a mild, unscented soap to gently cleanse the area. Avoid douching and harsh scented products, as they can disrupt the natural pH balance, leading to infections.
2. Wear Breathable Fabrics
Choosing the right underwear is more important than you might think. Opt for breathable fabrics like cotton, which allows air circulation and prevents moisture buildup. Tight, synthetic fabrics can trap moisture, creating an environment conducive to bacterial and yeast infections. Changing out of wet swimsuits and sweaty gym clothes promptly is also key to maintaining a healthy vulva.
3. Practice Safe Sex
Using protection during sexual activity is crucial for preventing sexually transmitted infections (STIs) that can affect vulva health. Condoms, dental dams, and other barrier methods can reduce the risk of STIs. Additionally, regular STI screenings are important, especially if you have multiple partners. Open communication with your partner about sexual health is equally vital.
4. Stay Informed About Menstrual Products
The type of menstrual product you use can impact vulva health. Some people may be sensitive to the materials in certain pads or tampons. Consider switching to organic cotton products or menstrual cups, which are often gentler on the skin. Change tampons and pads frequently to avoid irritation and potential infections.
5. Hydrate and Eat a Balanced Diet
Staying hydrated and consuming a balanced diet rich in vitamins and minerals can support overall health, including vulva health. Foods high in antioxidants, such as fruits and vegetables, can help protect against infections and inflammation. Probiotics, found in yogurt and other fermented foods, can support healthy vaginal flora.
6. Avoid Tight Clothing
Wearing tight pants or underwear for extended periods can cause friction and irritation. Opt for loose-fitting clothing whenever possible, especially if you’re prone to discomfort or infections. Giving your vulva some breathing room can prevent issues and promote comfort.
7. Be Mindful of Irritants
Many everyday products, such as laundry detergents, lotions, and perfumes, contain chemicals that can irritate the vulva. Opt for hypoallergenic and fragrance-free products to minimize the risk of irritation. If you experience frequent itching or discomfort, it may be worth reviewing the products you use and making necessary changes.
8. Regular Check-ups and Self-Exams
Regular gynecological check-ups are essential for monitoring vulva health. A healthcare provider can screen for infections, abnormalities, and other health concerns. Performing self-exams can also help you become familiar with your anatomy and recognize any changes that may require medical attention.
9. Manage Stress
High levels of stress can affect your immune system, making you more susceptible to infections. Practicing stress management techniques, such as yoga, meditation, and deep breathing exercises, can support both mental and physical health.
10. Listen to Your Body
Finally, always pay attention to what your body is telling you. If you notice any unusual symptoms, such as itching, burning, or unusual discharge, don’t hesitate to consult a healthcare provider. Early intervention can prevent minor issues from becoming major health concerns.
By following these tips and staying informed, you can maintain a healthy vulva and enjoy greater comfort and well-being. Remember, taking care of your vulva is a vital part of overall health, and it deserves your attention and care.
Love, 
Dr. Wendy aka Dr. Every Woman (Learn more about products from Dr. Wendy by clicking here)

A Guide to Vulva Health: Essential Tips for Keeping Things Healthy Down There Maintaining vulva health is crucial for overall well-being and comfort. Despite being a topic often overshadowed by taboo, open discussions and proper knowledge can significantly contribute to the health and happiness of vulva owners. Here are some essential tips and best practices […]

Your Guide to a Healthy Happy Vagine

New guidelines were recently released and implemented about the use of low-dose aspirin, also known as 81mg or &#8220;baby aspirin&#8221; for prevention of a serious pregnancy complication known as preeclampsia. It has long been known that people who developed preeclampsia early in a previous pregnancy could benefit from this prevention strategy in subsequent pregnancies but [&#8230;]


<figure class="wp-block-image size-large is-style-rounded"><img width="1024" height="697" data-attachment-id="7023" data-permalink="https://gyneco-blogic.com/2020/10/10/low-dose-aspirin-may-prevent-you-from-getting-preeclampsia/lubo-minar-lyhvax7k_8w-unsplash-small/" data-orig-file="https://gyneco-blogic.com/wp-content/uploads/2020/10/lubo-minar-lyhvax7k_8w-unsplash-small.jpg" data-orig-size="1388,945" data-comments-opened="1" data-image-meta="{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;1&quot;}" data-image-title="lubo-minar-lyHVAx7K_8w-unsplash small" data-image-description="" data-image-caption="" data-medium-file="https://gyneco-blogic.com/wp-content/uploads/2020/10/lubo-minar-lyhvax7k_8w-unsplash-small.jpg?w=300" data-large-file="https://gyneco-blogic.com/wp-content/uploads/2020/10/lubo-minar-lyhvax7k_8w-unsplash-small.jpg?w=616" src="https://gyneco-blogic.com/wp-content/uploads/2020/10/lubo-minar-lyhvax7k_8w-unsplash-small.jpg?w=1024" alt="" class="wp-image-7023" srcset="https://gyneco-blogic.com/wp-content/uploads/2020/10/lubo-minar-lyhvax7k_8w-unsplash-small.jpg?w=1024 1024w, https://gyneco-blogic.com/wp-content/uploads/2020/10/lubo-minar-lyhvax7k_8w-unsplash-small.jpg?w=150 150w, https://gyneco-blogic.com/wp-content/uploads/2020/10/lubo-minar-lyhvax7k_8w-unsplash-small.jpg?w=300 300w, https://gyneco-blogic.com/wp-content/uploads/2020/10/lubo-minar-lyhvax7k_8w-unsplash-small.jpg?w=768 768w, https://gyneco-blogic.com/wp-content/uploads/2020/10/lubo-minar-lyhvax7k_8w-unsplash-small.jpg 1388w" sizes="(max-width: 1024px) 100vw, 1024px" /></figure>



<p class="has-drop-cap">New guidelines were recently released and implemented about the use of low-dose aspirin, also known as 81mg or &#8220;baby aspirin&#8221; for prevention of a serious pregnancy complication known as preeclampsia. </p>



<p>It has long been known that people who developed preeclampsia early in a previous pregnancy could benefit from this prevention strategy in subsequent pregnancies but now there&#8217;s a whole new set of people for whom this could change their pregnancies for the better.</p>



<p>Now before I go on, I want to make this clear. This article and blog is strictly to provide information and support current standard of care medical advice between patients and their doctors. I am not YOUR doctor and I don&#8217;t recommend anyone start any treatment or medication without consulting your doctor.</p>



<p>Whew, had to get that out. Plus if anyone follows me on Instagram (@dreverywoman) you know that I&#8217;m getting a puppy soon so I wanted to write this article before MY new baby comes.</p>



<p>Preeclampsia is a syndrome that can occur in pregnancy and can be life threatening for mom and baby. It causes high blood pressure, sometime liver and blood cell abnormalities for mom. It can also lead to maternal seizure and stroke. For baby, preeclampsia can hinder growth and healthy blood flow. This can affect how much oxygen the baby gets and lead to the need for preterm or early delivery. </p>



<p>While science has yet to clearly understand WHY it happens, we know who it is more likely to happen to and have a better understanding of ways to help prevent it. One of those ways is low-dose or 81 mg aspirin.</p>



<p><strong><a href="https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/07/low-dose-aspirin-use-during-pregnancy" target="_blank" rel="noreferrer noopener">The people who could benefit from this prevention strategy are as follows:</a></strong></p>



<p>If you are high risk, meaning you have any ONE of the following conditions, aspirin should be a part of your prevention strategy. </p>



<ul class="wp-block-list"><li>A previous history of preeclampsia in a prior pregnancy</li><li>Being pregnant with multiple babies</li><li>Chronic hypertension (high blood pressure)</li><li>Diabetes prior to pregnancy</li><li>Kidney disease, or an </li><li>Autoimmune disease such as lupus</li></ul>



<p>If you have two or more moderate risk factors, aspirin should also be considered. Moderate risk factors include:</p>



<ul class="wp-block-list"><li>First time giving birth</li><li>Obesity</li><li>A family history of preeclampsia</li><li>Being of African descent</li><li>Low socioeconomic status</li><li>Age 35 years or older</li><li>Having birthed a low-weight baby</li><li>A 10-year interval between pregnancies</li><li>A previous adverse pregnancy outcome</li></ul>



<p>I had preeclampsia with my first pregnancy. Per these new guidelines, I would have been eligible to take low-dose aspirin because it was my first pregnancy and I&#8217;m African American.  </p>



<p>I&#8217;ve heard the argument, &#8220;Why should I take medication in pregnancy just because I&#8217;m black?&#8221; It&#8217;s a reasonable questions. Some of  the concerns arise from medical distrust, which has historic origins in the black community. That&#8217;s a whole separate article, book, hell MULTIPLE BOOKS.</p>



<p>But in the end, we have to pick a side. I can&#8217;t just be upset with the <strong><a href="https://gyneco-blogic.com/2020/07/12/what-every-black-expectant-mother-can-do-to-reduce-black-maternal-mortality-r-i-p-sha-asia-washington/" target="_blank" rel="noreferrer noopener">black maternal morbidity and mortality rates and healthcare disparities</a></strong> associated with them but NOT be willing to take extra steps to protect myself from some of the pregnancy complications that disproportionately affect me. I have to be ready to act when the science and evidence gives me advice that could protect me.</p>



<p>I can&#8217;t state this enough. I am NOT YOUR doctor, so please ask your healthcare provider before beginning any medication within or outside of pregnancy. Use this information to start the conversation with your provider if they haven&#8217;t brought it yet. We aren&#8217;t perfect . Being your own healthcare advocate starts with knowing your options and being prepared to discuss them.</p>



<p class="has-drop-cap">Before you go, please subscribe to my email list. You won&#8217;t be disappointed (I hope lol).</p>



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New guidelines were recently released and implemented about the use of low-dose aspirin, also known as 81mg or “baby aspirin” for prevention of a serious pregnancy complication known as preeclampsia. 
It has long been known that people who developed preeclampsia early in a previous pregnancy could benefit from this prevention strategy in subsequent pregnancies but now there’s a whole new set of people for whom this could change their pregnancies for the better.
Now before I go on, I want to make this clear. This article and blog is strictly to provide information and support current standard of care medical advice between patients and their doctors. I am not YOUR doctor and I don’t recommend anyone start any treatment or medication without consulting your doctor.
Whew, had to get that out. Plus if anyone follows me on Instagram (@dreverywoman) you know that I’m getting a puppy soon so I wanted to write this article before MY new baby comes.
Preeclampsia is a syndrome that can occur in pregnancy and can be life threatening for mom and baby. It causes high blood pressure, sometime liver and blood cell abnormalities for mom. It can also lead to maternal seizure and stroke. For baby, preeclampsia can hinder growth and healthy blood flow. This can affect how much oxygen the baby gets and lead to the need for preterm or early delivery. 
While science has yet to clearly understand WHY it happens, we know who it is more likely to happen to and have a better understanding of ways to help prevent it. One of those ways is low-dose or 81 mg aspirin.
The people who could benefit from this prevention strategy are as follows:
If you are high risk, meaning you have any ONE of the following conditions, aspirin should be a part of your prevention strategy. 
A previous history of preeclampsia in a prior pregnancy
Being pregnant with multiple babies
Chronic hypertension (high blood pressure)
Diabetes prior to pregnancy
Kidney disease, or an 
Autoimmune disease such as lupus




If you have two or more moderate risk factors, aspirin should also be considered. Moderate risk factors include:
First time giving birth
Obesity
A family history of preeclampsia
Being of African descent
Low socioeconomic status
Age 35 years or older
Having birthed a low-weight baby
A 10-year interval between pregnancies
A previous adverse pregnancy outcome




I had preeclampsia with my first pregnancy. Per these new guidelines, I would have been eligible to take low-dose aspirin because it was my first pregnancy and I’m African American.  
I’ve heard the argument, “Why should I take medication in pregnancy just because I’m black?” It’s a reasonable questions. Some of  the concerns arise from medical distrust, which has historic origins in the black community. That’s a whole separate article, book, hell MULTIPLE BOOKS.
But in the end, we have to pick a side. I can’t just be upset with the black maternal morbidity and mortality rates and healthcare disparities associated with them but NOT be willing to take extra steps to protect myself from some of the pregnancy complications that disproportionately affect me. I have to be ready to act when the science and evidence gives me advice that could protect me.
I can’t state this enough. I am NOT YOUR doctor, so please ask your healthcare provider before beginning any medication within or outside of pregnancy. Use this information to start the conversation with your provider if they haven’t brought it yet. We aren’t perfect . Being your own healthcare advocate starts with knowing your options and being prepared to discuss them.
Before you go, please subscribe to my email list. You won’t be disappointed (I hope lol).
Join my email list
			
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New guidelines were recently released and implemented about the use of low-dose aspirin, also known as 81mg or “baby aspirin” for prevention of a serious pregnancy complication known as preeclampsia. It has long been known that people who developed preeclampsia early in a previous pregnancy could benefit from this prevention strategy in subsequent pregnancies but […]

Low-dose Aspirin May Protect You From Preeclampsia

It is Breast Cancer Awareness month and Pink is for Prevention. Prevention of breast cancer can occur with a few actions. Don&#8217;t smoke tobacco products Keep alcohol consumption to a minimum (Less than one drink per day is ideal) Maintain a healthy weight Exercise regularly: 150 minutes per week of moderate exercise or 75 minutes [&#8230;]


<figure class="wp-block-image size-large is-style-rounded"><img width="1024" height="683" data-attachment-id="4329" data-permalink="https://gyneco-blogic.com/pablo-heimplatz-257570-small/" data-orig-file="https://gyneco-blogic.com/wp-content/uploads/2020/02/57f61-pablo-heimplatz-257570-small.jpg" data-orig-size="2000,1334" data-comments-opened="1" data-image-meta="{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;1&quot;}" data-image-title="pablo-heimplatz-257570 small" data-image-description="" data-image-caption="" data-medium-file="https://gyneco-blogic.com/wp-content/uploads/2020/02/57f61-pablo-heimplatz-257570-small.jpg?w=300" data-large-file="https://gyneco-blogic.com/wp-content/uploads/2020/02/57f61-pablo-heimplatz-257570-small.jpg?w=616" src="https://gyneco-blogic.com/wp-content/uploads/2020/02/57f61-pablo-heimplatz-257570-small.jpg?w=1024" alt="" class="wp-image-4329" srcset="https://gyneco-blogic.com/wp-content/uploads/2020/02/57f61-pablo-heimplatz-257570-small.jpg?w=1024 1024w, https://gyneco-blogic.com/wp-content/uploads/2020/02/57f61-pablo-heimplatz-257570-small.jpg?w=150 150w, https://gyneco-blogic.com/wp-content/uploads/2020/02/57f61-pablo-heimplatz-257570-small.jpg?w=300 300w, https://gyneco-blogic.com/wp-content/uploads/2020/02/57f61-pablo-heimplatz-257570-small.jpg?w=768 768w, https://gyneco-blogic.com/wp-content/uploads/2020/02/57f61-pablo-heimplatz-257570-small.jpg 2000w" sizes="(max-width: 1024px) 100vw, 1024px" /></figure>



<p>It is Breast Cancer Awareness month and Pink is for Prevention. Prevention of breast cancer can occur with a few actions.</p>



<ol class="wp-block-list"><li>Don&#8217;t smoke tobacco products</li><li>Keep alcohol consumption to a minimum (Less than one drink per day is ideal)</li><li>Maintain a healthy weight</li><li>Exercise regularly: 150 minutes per week of moderate exercise or 75 minutes per week of intense exercise</li><li>Eat a plant-based diet</li><li>Get genetic testing if your family history supports it</li></ol>



<p>What is a plant-based diet, you may ask? Well, I borrowed this definition from my husband&#8217;s blog, <strong><a href="https://thedocskitchen.com/dont-make-the-mistake-of-having-an-unhealthy-vegetarian-diet/" target="_blank" rel="noreferrer noopener">The Doc&#8217;s Kitchen</a></strong>:</p>



<blockquote class="wp-block-quote is-style-large is-layout-flow wp-block-quote-is-layout-flow"><p>&#8220;Whole Plant-based Diet Food- this refers to foods that come from plants that are minimally processed and manipulated&#8230;&#8221;</p><cite><a href="https://thedocskitchen.com/dont-make-the-mistake-of-having-an-unhealthy-vegetarian-diet/" rel="nofollow">https://thedocskitchen.com/dont-make-the-mistake-of-having-an-unhealthy-vegetarian-diet/</a></cite></blockquote>



<p>In addition to prevention, there are ways to reduce your chances or missing an early breast cancer diagnosis. If you catch breast cancer early, as in stage 0 or stage 1, 5-year relative survival rate is 100%.</p>



<p>Here are  few brief tips to catch breast cancer in early stages.</p>



<h2 class="wp-block-heading">1. If you feel a lump, don&#8217;t wait too long to follow it up</h2>



<p>I have had so many patients in my career who have found their own lumps. If are still having menstrual cycles and feel a lump just before your period, I recommend waiting until the period has left to see if it is still there. If it is, see your doc. Most lumps will not be cancer, but it&#8217;s worth following up to make sure everything is okay.</p>



<h3 class="wp-block-heading">The hallmarks of a concerning lump are: </h3>



<ul class="wp-block-list"><li>It usually doesn&#8217;t move well. &#8220;Frozen Pea&#8221; is that classic description.  It is a lump that feels frozen or scarred down.</li></ul>



<ul class="wp-block-list"><li>It usually does NOT hurt. Painful lumps could be related to hormonal breast gland changes. Caffeine can also make breast tender. Oh, and pregnancy too. </li></ul>



<p>Regardless of it&#8217;s characteristics, if a lump doesn&#8217;t go a way on it&#8217;s own, a mammogram or ultrasound is probably ideal.  Also check your insurance to see if you have a preferred imaging location. No one wants a big bill for prevention and early detection if they can avoid it.</p>



<h2 class="wp-block-heading">2. Get a mammogram, and consider a 3D mammogram if your breasts are dense</h2>



<p>A mammogram will detect signs of breast cancer before a lump can be felt. If you have dense breasts, a 3D mammogram with or without ultrasound will can see through the tissues even better. </p>



<h3 class="wp-block-heading">When should you start getting mammograms?</h3>



<p>According to ACOG, the <strong><a href="https://www.acog.org/patient-resources/faqs/gynecologic-problems/mammography-and-other-screening-tests-for-breast-problems" target="_blank" rel="noreferrer noopener">American College of Obstetrics and Gynecology</a></strong>,</p>



<blockquote class="wp-block-quote is-style-large is-layout-flow wp-block-quote-is-layout-flow"><p>For women at average risk of breast cancer, screening mammography is recommended every 1–2 years beginning at age 40 years. If you have not started screening in your 40s, you should start having mammography no later than age 50 years. Screening should continue until at least age 75 years.</p><cite><a href="https://www.acog.org/patient-resources/faqs/gynecologic-problems/mammography-and-other-screening-tests-for-breast-problems" rel="nofollow">https://www.acog.org/patient-resources/faqs/gynecologic-problems/mammography-and-other-screening-tests-for-breast-problems</a></cite></blockquote>



<h2 class="wp-block-heading">3. Get your mammogram results and follow up</h2>



<p>No news is NOT good news. <strong><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2959171/" target="_blank" rel="noreferrer noopener">A study conducted in South Carolina</a></strong> in 2000 noted that African American women were 29% more likely to die from breast cancer than Caucasian women. The same study reported that African American women were 12% less likely to complete follow up imaging. Some factors that appeared to impact the chances of following up were income and the number of prior procedures. </p>



<p>My take home point from <strong><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2959171/" target="_blank" rel="noreferrer noopener">that study</a></strong> was that even if you have had abnormal testing in the past, don&#8217;t let that stop you from getting follow up imaging THIS time. Get your results.</p>



<h3 class="wp-block-heading">If you don&#8217;t have insurance&#8230;</h3>



<p>Check with your local academic hospital or medical center. Many have programs that offer free mammogram and breast cancer screening to the uninsured or underinsured.</p>



<p>If you want to learn more about whether or not you may be a candidate for genetic testing, read an article that I wrote for Bright Pink. <strong><a rel="noreferrer noopener" href="https://www.brightpink.org/blog/2020/02/19/dr-wendy-mcdonald-live-that-prevention-life/" target="_blank">Click Here to read the article on Bright Pink and take a brief quiz.</a></strong></p>



<p>Before you go, don&#8217;t forget to sign up to our newsletter to always receive fun and informative health information. Also enjoy last years Breast Cancer Awareness music video and stay tuned for this years, loading!</p>



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<div class="jetpack-video-wrapper"><div class="embed-youtube"><iframe title="Press Parody- Press your breast for early detection, by Dr. Wendy and The Brave Chick" width="616" height="347" src="https://www.youtube.com/embed/o5PAEWlrWsA?feature=oembed" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin" allowfullscreen></iframe></div></div>
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It is Breast Cancer Awareness month and Pink is for Prevention. Prevention of breast cancer can occur with a few actions.
Don’t smoke tobacco products
Keep alcohol consumption to a minimum (Less than one drink per day is ideal)
Maintain a healthy weight
Exercise regularly: 150 minutes per week of moderate exercise or 75 minutes per week of intense exercise
Eat a plant-based diet
Get genetic testing if your family history supports it




What is a plant-based diet, you may ask? Well, I borrowed this definition from my husband’s blog, The Doc’s Kitchen:
“Whole Plant-based Diet Food- this refers to foods that come from plants that are minimally processed and manipulated…”
https://thedocskitchen.com/dont-make-the-mistake-of-having-an-unhealthy-vegetarian-diet/
In addition to prevention, there are ways to reduce your chances or missing an early breast cancer diagnosis. If you catch breast cancer early, as in stage 0 or stage 1, 5-year relative survival rate is 100%.
Here are  few brief tips to catch breast cancer in early stages.
1. If you feel a lump, don’t wait too long to follow it up
I have had so many patients in my career who have found their own lumps. If are still having menstrual cycles and feel a lump just before your period, I recommend waiting until the period has left to see if it is still there. If it is, see your doc. Most lumps will not be cancer, but it’s worth following up to make sure everything is okay.
The hallmarks of a concerning lump are: 
It usually doesn’t move well. “Frozen Pea” is that classic description.  It is a lump that feels frozen or scarred down.





It usually does NOT hurt. Painful lumps could be related to hormonal breast gland changes. Caffeine can also make breast tender. Oh, and pregnancy too. 




Regardless of it’s characteristics, if a lump doesn’t go a way on it’s own, a mammogram or ultrasound is probably ideal.  Also check your insurance to see if you have a preferred imaging location. No one wants a big bill for prevention and early detection if they can avoid it.
2. Get a mammogram, and consider a 3D mammogram if your breasts are dense
A mammogram will detect signs of breast cancer before a lump can be felt. If you have dense breasts, a 3D mammogram with or without ultrasound will can see through the tissues even better. 
When should you start getting mammograms?
According to ACOG, the American College of Obstetrics and Gynecology,
For women at average risk of breast cancer, screening mammography is recommended every 1–2 years beginning at age 40 years. If you have not started screening in your 40s, you should start having mammography no later than age 50 years. Screening should continue until at least age 75 years.
https://www.acog.org/patient-resources/faqs/gynecologic-problems/mammography-and-other-screening-tests-for-breast-problems
3. Get your mammogram results and follow up
No news is NOT good news. A study conducted in South Carolina in 2000 noted that African American women were 29% more likely to die from breast cancer than Caucasian women. The same study reported that African American women were 12% less likely to complete follow up imaging. Some factors that appeared to impact the chances of following up were income and the number of prior procedures. 
My take home point from that study was that even if you have had abnormal testing in the past, don’t let that stop you from getting follow up imaging THIS time. Get your results.
If you don’t have insurance…
Check with your local academic hospital or medical center. Many have programs that offer free mammogram and breast cancer screening to the uninsured or underinsured.
If you want to learn more about whether or not you may be a candidate for genetic testing, read an article that I wrote for Bright Pink. Click Here to read the article on Bright Pink and take a brief quiz.
Before you go, don’t forget to sign up to our newsletter to always receive fun and informative health information. Also enjoy last years Breast Cancer Awareness music video and stay tuned for this years, loading!
Join my email list

It is Breast Cancer Awareness month and Pink is for Prevention. Prevention of breast cancer can occur with a few actions. Don’t smoke tobacco products Keep alcohol consumption to a minimum (Less than one drink per day is ideal) Maintain a healthy weight Exercise regularly: 150 minutes per week of moderate exercise or 75 minutes […]

Breast Cancer Screening: Three ways to reduce your chances of missing the diagnosis

If you haven&#8217;t heard of this new birth control option that lasts a whole year and is NOT an intrauterine device, you are not alone. First, I need to make one thing clear. I do not have any partnership or sponsorship arrangement with any pharmaceutical company. When I learned about this contraceptive option, I felt [&#8230;]


<figure class="wp-block-image size-large is-style-rounded"><img width="1024" height="677" data-attachment-id="6994" data-permalink="https://gyneco-blogic.com/yash-raut-3hrzy5-at5a-unsplash-smaller-cropped-1/" data-orig-file="https://gyneco-blogic.com/wp-content/uploads/2020/09/yash-raut-3hrzy5-at5a-unsplash-smaller-cropped-1.jpg" data-orig-size="1743,1153" data-comments-opened="1" data-image-meta="{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;1&quot;}" data-image-title="yash-raut-3hrzy5-at5a-unsplash-smaller-cropped-1" data-image-description="" data-image-caption="" data-medium-file="https://gyneco-blogic.com/wp-content/uploads/2020/09/yash-raut-3hrzy5-at5a-unsplash-smaller-cropped-1.jpg?w=300" data-large-file="https://gyneco-blogic.com/wp-content/uploads/2020/09/yash-raut-3hrzy5-at5a-unsplash-smaller-cropped-1.jpg?w=616" src="https://gyneco-blogic.com/wp-content/uploads/2020/09/yash-raut-3hrzy5-at5a-unsplash-smaller-cropped-1.jpg?w=1024" alt="" class="wp-image-6994" srcset="https://gyneco-blogic.com/wp-content/uploads/2020/09/yash-raut-3hrzy5-at5a-unsplash-smaller-cropped-1.jpg?w=1024 1024w, https://gyneco-blogic.com/wp-content/uploads/2020/09/yash-raut-3hrzy5-at5a-unsplash-smaller-cropped-1.jpg?w=150 150w, https://gyneco-blogic.com/wp-content/uploads/2020/09/yash-raut-3hrzy5-at5a-unsplash-smaller-cropped-1.jpg?w=300 300w, https://gyneco-blogic.com/wp-content/uploads/2020/09/yash-raut-3hrzy5-at5a-unsplash-smaller-cropped-1.jpg?w=768 768w, https://gyneco-blogic.com/wp-content/uploads/2020/09/yash-raut-3hrzy5-at5a-unsplash-smaller-cropped-1.jpg 1743w" sizes="(max-width: 1024px) 100vw, 1024px" /></figure>



<p>If you haven&#8217;t heard of this new birth control option that lasts a whole year and is NOT an intrauterine device, you are not alone. </p>



<p>First, I need to make one thing clear. </p>



<h2 class="wp-block-heading">I do not have any partnership or sponsorship arrangement with any pharmaceutical company. </h2>



<p>When I learned about this contraceptive option, I felt compelled to write about it because it seemed perfect for the COVID-19 era for those who are also trying to avoid pregnancy. </p>



<p>This article is also NOT a reflection of my opinion on trying to conceive or being pregnant during the COVID-19 pandemic. I have multiple opinions about that but my summary thought is that a person needs to do whatever is best for themselves and their family while considering risks and benefits. </p>



<h2 class="wp-block-heading">Back to this new birth control ring.</h2>



<p> It is a vaginal ring that lasts an entire year. It is NOT Nuvaring. For those who are unfamiliar with Nuvaring, it is a small, plastic ring that you place in the vagina once per month. It stays inside the vagina for three weeks and is removed for one week and discarded. While inside the vagina, it slowly releases the same hormones that the combined oral contraceptive pill (COC) contains, estrogen and a progestin.  Nuvaring is great for people who aren&#8217;t uncomfortable inserting and removing it on their own and who want an easier, option than the pill. You can pretty much set it and forget it for three weeks.</p>



<p>This new option is called <strong><a href="https://www.annovera.com/" target="_blank" rel="noreferrer noopener">Annovera</a></strong>. If I&#8217;m honest, I don&#8217;t love the name. But I DO really like how it works. </p>



<h2 class="wp-block-heading">Annovera is a vaginal ring that you can REUSE for an entire year.</h2>



<p>It contains estrogen and a progestin, just like the pill and just like Nuvaring. You insert it in the vagina for 21 days, then remove it, wash it with mild soap and store it in a case for 7 days. After 7 days, you reinsert the SAME ring. It lasts for an entire year, 13 cycles. This is so cool to me because it eliminates the need to go the pharmacy or receive a package in the mail. (Judging by the number of Amazon packages I receive, I have no issue with the mail, but I&#8217;m just saying.)</p>



<p>If you&#8217;ve followed me long enough, you know how much I love my IUD, however I know that some people take issue with the fact that it is inside the uterus, needs a whole procedure to be placed and has to be removed by a healthcare provider. Vaginal rings don&#8217;t require a healthcare provider for placement and can be removed easily. You decide if you continue it or not. It is not implanted in your body.</p>



<p>I know what you&#8217;re thinking. I borrowed this frequently asked question straight from the <strong><a href="https://www.annovera.com/faq" target="_blank" rel="noreferrer noopener">Annovera website</a></strong>:</p>



<h2 class="wp-block-heading"><br>CAN YOU USE ANNOVERA DURING SEX</h2>



<p>Yes, it is designed to be worn during sex. If you prefer, you can remove it for up to 2 hours. If ANNOVERA is out of your vagina for more than 2 hours at one time or at different times that add up to more than 2 hours over the 21 days of continuous use, then you will need to use another method of birth control (such as male condoms or spermicide) until ANNOVERA has been in your vagina for 7 consecutive days.</p>



<p>There are precautions of course. They include any precaution against a combined estrogen-progestin pill. I also have to stress the importance of recording when you place it and remove it. I personally used Nuvaring for years. It is easy to forget since it&#8217;s so hands off.</p>



<p>Talk to YOUR healthcare provider if you think this new ring may be right for you. If you want to learn <strong><a rel="noreferrer noopener" href="https://gyneco-blogic.com/2017/01/28/my-iud-is-not-the-devil/" target="_blank">more about IUDs, check out this post</a></strong>. </p>



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<p>Oh, and check out what I found on the YouTube&#8230;</p>



<figure class="wp-block-embed is-type-rich is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio"><div class="wp-block-embed__wrapper">
<div class="jetpack-video-wrapper"><div class="embed-youtube"><iframe title="Cardi MD takes on WAP (Parody for Birth Control Awareness and Childhood Chores)" width="616" height="347" src="https://www.youtube.com/embed/SbbNWbMpFzc?feature=oembed" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin" allowfullscreen></iframe></div></div>
</div></figure>


If you haven’t heard of this new birth control option that lasts a whole year and is NOT an intrauterine device, you are not alone. 
First, I need to make one thing clear. 
I do not have any partnership or sponsorship arrangement with any pharmaceutical company. 
When I learned about this contraceptive option, I felt compelled to write about it because it seemed perfect for the COVID-19 era for those who are also trying to avoid pregnancy. 
This article is also NOT a reflection of my opinion on trying to conceive or being pregnant during the COVID-19 pandemic. I have multiple opinions about that but my summary thought is that a person needs to do whatever is best for themselves and their family while considering risks and benefits. 
Back to this new birth control ring.
 It is a vaginal ring that lasts an entire year. It is NOT Nuvaring. For those who are unfamiliar with Nuvaring, it is a small, plastic ring that you place in the vagina once per month. It stays inside the vagina for three weeks and is removed for one week and discarded. While inside the vagina, it slowly releases the same hormones that the combined oral contraceptive pill (COC) contains, estrogen and a progestin.  Nuvaring is great for people who aren’t uncomfortable inserting and removing it on their own and who want an easier, option than the pill. You can pretty much set it and forget it for three weeks.
This new option is called Annovera. If I’m honest, I don’t love the name. But I DO really like how it works. 
Annovera is a vaginal ring that you can REUSE for an entire year.
It contains estrogen and a progestin, just like the pill and just like Nuvaring. You insert it in the vagina for 21 days, then remove it, wash it with mild soap and store it in a case for 7 days. After 7 days, you reinsert the SAME ring. It lasts for an entire year, 13 cycles. This is so cool to me because it eliminates the need to go the pharmacy or receive a package in the mail. (Judging by the number of Amazon packages I receive, I have no issue with the mail, but I’m just saying.)
If you’ve followed me long enough, you know how much I love my IUD, however I know that some people take issue with the fact that it is inside the uterus, needs a whole procedure to be placed and has to be removed by a healthcare provider. Vaginal rings don’t require a healthcare provider for placement and can be removed easily. You decide if you continue it or not. It is not implanted in your body.
I know what you’re thinking. I borrowed this frequently asked question straight from the Annovera website:
CAN YOU USE ANNOVERA DURING SEX
Yes, it is designed to be worn during sex. If you prefer, you can remove it for up to 2 hours. If ANNOVERA is out of your vagina for more than 2 hours at one time or at different times that add up to more than 2 hours over the 21 days of continuous use, then you will need to use another method of birth control (such as male condoms or spermicide) until ANNOVERA has been in your vagina for 7 consecutive days.
There are precautions of course. They include any precaution against a combined estrogen-progestin pill. I also have to stress the importance of recording when you place it and remove it. I personally used Nuvaring for years. It is easy to forget since it’s so hands off.
Talk to YOUR healthcare provider if you think this new ring may be right for you. If you want to learn more about IUDs, check out this post. 
Join my email list
Oh, and check out what I found on the YouTube…

If you haven’t heard of this new birth control option that lasts a whole year and is NOT an intrauterine device, you are not alone. First, I need to make one thing clear. I do not have any partnership or sponsorship arrangement with any pharmaceutical company. When I learned about this contraceptive option, I felt […]

There’s a New Ring In Town, and It’s Very Quarantine Friendly

I recently had a conversation with a patient who needed an induction of labor for a medical reason affecting the safety of her and her unborn child. I explained the circumstance to the patient and she seemed to understand. Shortly after she left my office she called back. She had talked to a friend about [&#8230;]


<figure class="wp-block-image size-large is-style-rounded"><img loading="lazy" width="1024" height="682" data-attachment-id="6980" data-permalink="https://gyneco-blogic.com/2020/09/17/5-reasons-why-you-shouldnt-fear-induction-of-labor/francisco-de-legarreta-c-6-xcia_btro-unsplash-small/" data-orig-file="https://gyneco-blogic.com/wp-content/uploads/2020/09/francisco-de-legarreta-c-6-xcia_btro-unsplash-small.jpg" data-orig-size="1320,880" data-comments-opened="1" data-image-meta="{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;1&quot;}" data-image-title="francisco-de-legarreta-c-6-XciA_bTRo-unsplash small" data-image-description="" data-image-caption="" data-medium-file="https://gyneco-blogic.com/wp-content/uploads/2020/09/francisco-de-legarreta-c-6-xcia_btro-unsplash-small.jpg?w=300" data-large-file="https://gyneco-blogic.com/wp-content/uploads/2020/09/francisco-de-legarreta-c-6-xcia_btro-unsplash-small.jpg?w=616" src="https://gyneco-blogic.com/wp-content/uploads/2020/09/francisco-de-legarreta-c-6-xcia_btro-unsplash-small.jpg?w=1024" alt="" class="wp-image-6980" srcset="https://gyneco-blogic.com/wp-content/uploads/2020/09/francisco-de-legarreta-c-6-xcia_btro-unsplash-small.jpg?w=1024 1024w, https://gyneco-blogic.com/wp-content/uploads/2020/09/francisco-de-legarreta-c-6-xcia_btro-unsplash-small.jpg?w=150 150w, https://gyneco-blogic.com/wp-content/uploads/2020/09/francisco-de-legarreta-c-6-xcia_btro-unsplash-small.jpg?w=300 300w, https://gyneco-blogic.com/wp-content/uploads/2020/09/francisco-de-legarreta-c-6-xcia_btro-unsplash-small.jpg?w=768 768w, https://gyneco-blogic.com/wp-content/uploads/2020/09/francisco-de-legarreta-c-6-xcia_btro-unsplash-small.jpg 1320w" sizes="(max-width: 1024px) 100vw, 1024px" /></figure>



<p class="has-drop-cap">I recently had a conversation with a patient who needed an induction of labor for a medical reason affecting the safety of her and her unborn child. I explained the circumstance to the patient and she seemed to understand. Shortly after she left my office she called back. She had talked to a friend about what was about to happen and her friend told her not to do it because she was going to end up with a c-section.</p>



<blockquote class="wp-block-quote is-style-large is-layout-flow wp-block-quote-is-layout-flow"><p>&#8220;Doc, we&#8217;re going to have to induce you.&#8221;</p></blockquote>



<p>They were talking to me. I was &#8220;Doc.&#8221; I was 36 weeks with my first child. If you are interested in learning more about my birth story,<strong><a rel="noreferrer noopener" href="https://gyneco-blogic.com/2018/08/18/a-birth-story-from-the-ob-herself-it-may-help-you-through/" target="_blank"> click here</a>.</strong> But do it AFTER you read this one, lol. You just got here. </p>



<p>Yes, I was induced with my first and my third pregnancies. And yes, I delivered all of my children vaginally. I don&#8217;t say &#8220;naturally&#8221; because All Birth Is Natural. But my point in starting off this article with that information is actually my first reason why you shouldn&#8217;t fear being induced.</p>



<h2 class="wp-block-heading">One: Induction doesn&#8217;t equal c-section.</h2>



<p>What is induction of labor? Induction of labor, also known as being &#8220;Induced&#8221; means that you receive medication and sometimes procedures to start labor. It could include medication to dilate or open the cervix, physical dilation of the cervix with a balloon, breaking the bag of water and often Pitocin, a medication the mimics our own bodies Oxytocin which causes contractions to occur. </p>



<p>A lot has been said in the news, and literature over the years about inductions increasing a person&#8217;s risk for having a c-section. Hearsay from family and friends can also add to a person&#8217;s concerns about medical intervention. Here are a few facts about induction of labor as it relates to c-section.</p>



<p>-&gt; Seventy-Five Percent of people whose labor is induced have a vaginal delivery. (<a rel="noreferrer noopener" href="https://www.mayoclinic.org/tests-procedures/labor-induction/about/pac-20385141" target="_blank">https://www.mayoclinic.org/tests-procedures/labor-induction/about/pac-20385141</a>)</p>



<p>-&gt; C-section rates are lower in people who are induced at 39 weeks as compared to people who remain pregnant and wait for spontaneous labor. (<a rel="noreferrer noopener" href="https://www.nih.gov/news-events/news-releases/induced-labor-39-weeks-may-reduce-likelihood-c-section-nih-study-suggests" target="_blank">https://www.nih.gov/news-events/news-releases/induced-labor-39-weeks-may-reduce-likelihood-c-section-nih-study-suggests</a>)</p>



<p>And while I don&#8217;t make it a point to induce people at 39 weeks without cause, if life or logistics warrant it, I don&#8217;t discourage people who make that decision, as long as the understand the risks. </p>



<h2 class="wp-block-heading">Two: If an induction is medically indicated, the benefits often outweigh the risks.</h2>



<p>Take my own circumstance for example. I was induced at 36 weeks because I developed severe preeclampsia (now known as preeclampsia with severe features for the medical professionals in the room).  Preeclampsia can be life-threatening for mom and baby. No, my body wasn&#8217;t ready, but our mutual safety rested on getting this baby out of my body.</p>



<p>With my third child, I was induced because I had developed cholestasis of pregnancy. I was 37 weeks that time. Again, not ready but cholestasis is a condition that can lead to stillbirth without notice or abnormal signs. It was super important for her to be delivered as soon as she was old enough to be outside of me safely and at term. </p>



<p>While both of those scenarios seem super dramatic, most of the time when your doctor suggests an induction (speaking for myself), it is because something is happening with you or your baby that makes delivery safer than staying pregnant. Some indications could be diabetes, high blood pressure, age over 39, preeclampsia, if the baby is too small or isn&#8217;t growing normally, if the baby has too little fluid.  These are just a few examples. If you are unsure of what the reason is that your doctor offers an induction, ask them. You deserve to know and understand the reasons.</p>



<h3 class="wp-block-heading">So what are the risks of induction? </h3>



<p>Risk can include increased blood loss, infection, and c-section in 25% of inductions. Those risks vary based on how dilated a person is at the start of the induction, as well as the overall health status of mom and baby at the start of the induction. Remember, there are multiple reasons why a person could end up with a c-section, most of which are not related to how the labor starts or is started. <strong><a href="https://gyneco-blogic.com/2020/08/21/i-know-you-dont-want-one-but-here-are-8-things-you-need-to-know-about-c-section/" target="_blank" rel="noreferrer noopener">Read more about things you should know about c-section here.</a></strong></p>



<h2 class="wp-block-heading">Three: Waiting for spontaneous labor comes with it&#8217;s own set of risks.</h2>



<p>Keep in mind, the baby doesn&#8217;t decide when they are ready to come out. If babies actively and conciously made that decision, people wouldn&#8217;t go into preterm labor. I think that that fact is important because some people will stay pregnant well beyond their due date. They do that, not because baby isn&#8217;t &#8220;ready&#8221; but because the sequence of events/hormones etc to start their labor hasn&#8217;t started.</p>



<p>As a person waits beyond their due date for labor to commence, a few things are happening. Their placenta is getting older and possibly less functional. Their risks for developing hypertension and preeclampsia in the pregnancy begin to rise, and babies can start to get less oxygen. </p>



<p>We don&#8217;t let people go beyond 42 weeks (2 weeks past the due date) because then they are at risk for something called<strong><a href="https://www.uptodate.com/contents/postterm-pregnancy-beyond-the-basics#:~:text=%22Dysmaturity%22%20or%20%22postmaturity%22,the%20placenta%2C%20leading%20to%20malnourishment." target="_blank" rel="noreferrer noopener"> &#8220;Postmaturity&#8221; syndrome or Postterm Pregnancy.</a></strong> Babies are at higher risk for:</p>



<ul class="wp-block-list"><li>Stillbirth</li><li>Large birth weight</li><li>Malnutrition</li><li>Meconium aspiration</li><li>C-section due to size and inability to tolerate labor</li></ul>



<p>In my practice, as long as monitoring is within normal limits, I will let people stay pregnant into the 41st week, but I am ready and willing to induce before 42 weeks because of the above.</p>



<h2 class="wp-block-heading">Four: In the age of COVID-19, planning can play a role, especially if a person has other children in the home.</h2>



<p>Sometimes, an induction is offered just so that all parties know where they&#8217;ll be.  With COVID-19, children are almost universally not allowed at the hospital. And while first babies can take hours to days to come out after labor starts, sometime second or third babies come out in the kitchen or on a highway because it is so fast. Prep time to get childcare and get to the hospital in a pinch is more challenging for some. </p>



<p>I almost always at least discuss induction with my second or third time moms who have delivered vaginally in the past, simply to relieve some of the anxiety of what they&#8217;ll do with their first child. Most want their partner in the room too. Planning can sometimes help make that more feasible. </p>



<h2 class="wp-block-heading">Five: Regarding pain, inductions aren&#8217;t necessarily worse than spontaneous labor. All labor hurts.</h2>



<p>Speaking from experience, I can&#8217;t say that my second labor, which started spontaneously, wasn&#8217;t any easier or less painful that the ones before or after. Keep in mind, some people gradually go into labor over hours or says. I&#8217;ve had ladies begin to experience labor pains on a Monday and not deliver until Friday or Saturday. Inductions don&#8217;t usually take that long so the intensity of contractions may ramp up over a matter of hours, rather than days. Regardless, labor hurts. </p>



<p>Some make the argument that Pitocin makes things so much worse. Think about it like this though: I only give Pitocin to a person whose labor isn&#8217;t progressing on its own. If the labor isn&#8217;t progressing, meaning you aren&#8217;t dilating or contracting regularly, the contractions are likely not strong enough or frequent enough to allow labor to progress. Of course Pitocin is going to make things hurt worse because it makes contractions stronger and more frequent. With my second baby, I didn&#8217;t need pitocin and I progressed fine on my own, but that $&amp;#$ HURT!</p>



<h3 class="wp-block-heading">Mild labor isn&#8217;t a thing.</h3>



<p>Pitocin may be the method to getting a person in labor, but it is the contractions that are causing all of the pain. If pain freaks you out, plan for an epidural. But I personally think it is unrealistic to think a human will come out of your body and it&#8217;s not gonna make you cringe, with or without Pitocin.</p>



<p class="has-drop-cap">In conclusion, if your doctor or provider offers you an induction, the first thing I would want to know is why. You can elect for an induction (meaning ask for one even without a medical reason), but you should also know risks, benefits and alternatives or that decision as well. </p>



<p>Ask questions. Get a clearer understanding.  But I&#8217;ll tell you what you shouldn&#8217;t do. Don&#8217;t just listen to Dr. Google or your play (or real)-Auntie when it comes to making decisions for yourself or your unborn child. </p>



<h3 class="wp-block-heading">That&#8217;s my two cents. Follow me for more general women&#8217;s health and pregnancy breakdowns here on The Gyneco-bLogic!</h3>



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I recently had a conversation with a patient who needed an induction of labor for a medical reason affecting the safety of her and her unborn child. I explained the circumstance to the patient and she seemed to understand. Shortly after she left my office she called back. She had talked to a friend about what was about to happen and her friend told her not to do it because she was going to end up with a c-section.
“Doc, we’re going to have to induce you.”




They were talking to me. I was “Doc.” I was 36 weeks with my first child. If you are interested in learning more about my birth story, click here. But do it AFTER you read this one, lol. You just got here. 
Yes, I was induced with my first and my third pregnancies. And yes, I delivered all of my children vaginally. I don’t say “naturally” because All Birth Is Natural. But my point in starting off this article with that information is actually my first reason why you shouldn’t fear being induced.
One: Induction doesn’t equal c-section.
What is induction of labor? Induction of labor, also known as being “Induced” means that you receive medication and sometimes procedures to start labor. It could include medication to dilate or open the cervix, physical dilation of the cervix with a balloon, breaking the bag of water and often Pitocin, a medication the mimics our own bodies Oxytocin which causes contractions to occur. 
A lot has been said in the news, and literature over the years about inductions increasing a person’s risk for having a c-section. Hearsay from family and friends can also add to a person’s concerns about medical intervention. Here are a few facts about induction of labor as it relates to c-section.
-> Seventy-Five Percent of people whose labor is induced have a vaginal delivery. (https://www.mayoclinic.org/tests-procedures/labor-induction/about/pac-20385141)
-> C-section rates are lower in people who are induced at 39 weeks as compared to people who remain pregnant and wait for spontaneous labor. (https://www.nih.gov/news-events/news-releases/induced-labor-39-weeks-may-reduce-likelihood-c-section-nih-study-suggests)
And while I don’t make it a point to induce people at 39 weeks without cause, if life or logistics warrant it, I don’t discourage people who make that decision, as long as the understand the risks. 
Two: If an induction is medically indicated, the benefits often outweigh the risks.
Take my own circumstance for example. I was induced at 36 weeks because I developed severe preeclampsia (now known as preeclampsia with severe features for the medical professionals in the room).  Preeclampsia can be life-threatening for mom and baby. No, my body wasn’t ready, but our mutual safety rested on getting this baby out of my body.
With my third child, I was induced because I had developed cholestasis of pregnancy. I was 37 weeks that time. Again, not ready but cholestasis is a condition that can lead to stillbirth without notice or abnormal signs. It was super important for her to be delivered as soon as she was old enough to be outside of me safely and at term. 
While both of those scenarios seem super dramatic, most of the time when your doctor suggests an induction (speaking for myself), it is because something is happening with you or your baby that makes delivery safer than staying pregnant. Some indications could be diabetes, high blood pressure, age over 39, preeclampsia, if the baby is too small or isn’t growing normally, if the baby has too little fluid.  These are just a few examples. If you are unsure of what the reason is that your doctor offers an induction, ask them. You deserve to know and understand the reasons.
So what are the risks of induction? 
Risk can include increased blood loss, infection, and c-section in 25% of inductions. Those risks vary based on how dilated a person is at the start of the induction, as well as the overall health status of mom and baby at the start of the induction. Remember, there are multiple reasons why a person could end up with a c-section, most of which are not related to how the labor starts or is started. Read more about things you should know about c-section here.
Three: Waiting for spontaneous labor comes with it’s own set of risks.
Keep in mind, the baby doesn’t decide when they are ready to come out. If babies actively and conciously made that decision, people wouldn’t go into preterm labor. I think that that fact is important because some people will stay pregnant well beyond their due date. They do that, not because baby isn’t “ready” but because the sequence of events/hormones etc to start their labor hasn’t started.
As a person waits beyond their due date for labor to commence, a few things are happening. Their placenta is getting older and possibly less functional. Their risks for developing hypertension and preeclampsia in the pregnancy begin to rise, and babies can start to get less oxygen. 
We don’t let people go beyond 42 weeks (2 weeks past the due date) because then they are at risk for something called “Postmaturity” syndrome or Postterm Pregnancy. Babies are at higher risk for:
Stillbirth
Large birth weight
Malnutrition
Meconium aspiration
C-section due to size and inability to tolerate labor




In my practice, as long as monitoring is within normal limits, I will let people stay pregnant into the 41st week, but I am ready and willing to induce before 42 weeks because of the above.
Four: In the age of COVID-19, planning can play a role, especially if a person has other children in the home.
Sometimes, an induction is offered just so that all parties know where they’ll be.  With COVID-19, children are almost universally not allowed at the hospital. And while first babies can take hours to days to come out after labor starts, sometime second or third babies come out in the kitchen or on a highway because it is so fast. Prep time to get childcare and get to the hospital in a pinch is more challenging for some. 
I almost always at least discuss induction with my second or third time moms who have delivered vaginally in the past, simply to relieve some of the anxiety of what they’ll do with their first child. Most want their partner in the room too. Planning can sometimes help make that more feasible. 
Five: Regarding pain, inductions aren’t necessarily worse than spontaneous labor. All labor hurts.
Speaking from experience, I can’t say that my second labor, which started spontaneously, wasn’t any easier or less painful that the ones before or after. Keep in mind, some people gradually go into labor over hours or says. I’ve had ladies begin to experience labor pains on a Monday and not deliver until Friday or Saturday. Inductions don’t usually take that long so the intensity of contractions may ramp up over a matter of hours, rather than days. Regardless, labor hurts. 
Some make the argument that Pitocin makes things so much worse. Think about it like this though: I only give Pitocin to a person whose labor isn’t progressing on its own. If the labor isn’t progressing, meaning you aren’t dilating or contracting regularly, the contractions are likely not strong enough or frequent enough to allow labor to progress. Of course Pitocin is going to make things hurt worse because it makes contractions stronger and more frequent. With my second baby, I didn’t need pitocin and I progressed fine on my own, but that $&#$ HURT!
Mild labor isn’t a thing.
Pitocin may be the method to getting a person in labor, but it is the contractions that are causing all of the pain. If pain freaks you out, plan for an epidural. But I personally think it is unrealistic to think a human will come out of your body and it’s not gonna make you cringe, with or without Pitocin.
In conclusion, if your doctor or provider offers you an induction, the first thing I would want to know is why. You can elect for an induction (meaning ask for one even without a medical reason), but you should also know risks, benefits and alternatives or that decision as well. 
Ask questions. Get a clearer understanding.  But I’ll tell you what you shouldn’t do. Don’t just listen to Dr. Google or your play (or real)-Auntie when it comes to making decisions for yourself or your unborn child. 
That’s my two cents. Follow me for more general women’s health and pregnancy breakdowns here on The Gyneco-bLogic!
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I recently had a conversation with a patient who needed an induction of labor for a medical reason affecting the safety of her and her unborn child. I explained the circumstance to the patient and she seemed to understand. Shortly after she left my office she called back. She had talked to a friend about […]

5 Reasons Why You Shouldn’t Fear Induction of Labor

The other day, a patient and I were chatting and she hit me with &#8220;I have one more question.&#8221; Now, usually that phrase comes before something that the person is super embarrassed to ask. I usually respond with, &#8220;Go for it. There is no such thing as TMI with a gynecologist.&#8221; Because there isn&#8217;t. Or [&#8230;]


<figure class="wp-block-image size-large is-style-rounded"><img loading="lazy" width="1024" height="945" data-attachment-id="6950" data-permalink="https://gyneco-blogic.com/2020/09/16/this-obgyns-favorite-vaginal-moistuizer/brooke-lark-kvcrp3uilie-unsplash-smaller/" data-orig-file="https://gyneco-blogic.com/wp-content/uploads/2016/12/brooke-lark-kvcrp3uilie-unsplash-smaller.jpg" data-orig-size="1179,1089" data-comments-opened="1" data-image-meta="{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;1&quot;}" data-image-title="brooke-lark-kVCRP3uiLiE-unsplash smaller" data-image-description="" data-image-caption="" data-medium-file="https://gyneco-blogic.com/wp-content/uploads/2016/12/brooke-lark-kvcrp3uilie-unsplash-smaller.jpg?w=300" data-large-file="https://gyneco-blogic.com/wp-content/uploads/2016/12/brooke-lark-kvcrp3uilie-unsplash-smaller.jpg?w=616" src="https://gyneco-blogic.com/wp-content/uploads/2016/12/brooke-lark-kvcrp3uilie-unsplash-smaller.jpg?w=1024" alt="" class="wp-image-6950" srcset="https://gyneco-blogic.com/wp-content/uploads/2016/12/brooke-lark-kvcrp3uilie-unsplash-smaller.jpg?w=1024 1024w, https://gyneco-blogic.com/wp-content/uploads/2016/12/brooke-lark-kvcrp3uilie-unsplash-smaller.jpg?w=150 150w, https://gyneco-blogic.com/wp-content/uploads/2016/12/brooke-lark-kvcrp3uilie-unsplash-smaller.jpg?w=300 300w, https://gyneco-blogic.com/wp-content/uploads/2016/12/brooke-lark-kvcrp3uilie-unsplash-smaller.jpg?w=768 768w, https://gyneco-blogic.com/wp-content/uploads/2016/12/brooke-lark-kvcrp3uilie-unsplash-smaller.jpg 1179w" sizes="(max-width: 1024px) 100vw, 1024px" /></figure>



<p class="has-drop-cap">The other day, a patient and I were chatting and she hit me with &#8220;I have one more question.&#8221; Now, usually that phrase comes before something that the person is super embarrassed to ask. I usually respond with, </p>



<blockquote class="wp-block-quote is-style-large is-layout-flow wp-block-quote-is-layout-flow"><p>&#8220;Go for it. There is no such thing as TMI with a gynecologist.&#8221;</p></blockquote>



<p>Because there isn&#8217;t. Or at least there shouldn&#8217;t be. </p>



<p>To my surprise, this one was a lightweight. She asked,</p>



<blockquote class="wp-block-quote is-style-large is-layout-flow wp-block-quote-is-layout-flow"><p>&#8220;Is it okay if, when I feel a little dry down there, I use a little coconut oil to moisturize?&#8221;</p></blockquote>



<p>I happily exclaimed, &#8220;Absolutely. I love coconut oil for vulvar moisture. It&#8217;s one of my favorite things.&#8221; She was so surprised and relieved that I jotted down the topic to share here. </p>



<p>Coconut oil is not only an excellent moisturizer with skin conditioning qualities, but it also has anti-fungal properties for those who may be prone to skin irritation and yeast infections. I do not specifically recommend using coconut oil to <em>treat </em>yeast infections, but I don&#8217;t discourage it either. </p>



<h2 class="wp-block-heading">I also like Coconut Oil as a Body Moisturizer</h2>



<p>Coconut oil is a mild but effective moisturizer for even the most sensitive of skin. I use it on myself and my infant because I don&#8217;t have to worry about unhealthy additions (like parabens) found in many lotions. </p>



<p>It contains antioxidants which help keep skin healthy. Don&#8217;t look for it to keep you glossy all day, it absorbs well into the skin for real hydration. If your degree of ash is profound, you may need repeated applications.</p>



<h2 class="wp-block-heading">Coconut Oil as Hair Oil</h2>



<p>Hair Oil: The same qualities that make coconut oil great for skin, also make it great for hair. This oil is a non-greasy moisturizer that will penetrate your tresses without breaking the bank.</p>



<h2 class="wp-block-heading">Coconut Oil to Prevent Diaper Rash</h2>



<p>I kept a jar of coconut oil on my changing table for the my last two children. Not only did it make stool and meconium easier to wipe away, it seemed to reduce the amount and frequency of diaper rash that I dealt with before I started using it. </p>



<p>All in all, I&#8217;m a fan. My only precautions is Don&#8217;t Double Dip. Keep your vulvar use coconut oil clean and separate for oil used for anything else. Listen, you may think that&#8217;s obvious, but I&#8217;m a gynecologist. I take NOTHING for granted.</p>



<p>I prefer extra-virgin coconut oil. In it&#8217;s natural state, it is white and thick at room temperature and becomes clear and, well, oily when heated up, even in your hands. I love the subtle coconut aroma. Try it and leave a comment about your thoughts!</p>



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<p>For more trusted and interesting information about the health implications of consuming coconut oil, check out <a href="http://www.health.harvard.edu/staying-healthy/coconut-oil">Harvard Health Publications</a>,</p>



<p>For other sources about the antifungal properties of Coconut Oil:</p>



<p><a href="https://www.medicalnewstoday.com/articles/302809#Coconut-oil-research" target="_blank" rel="noreferrer noopener">https://www.medicalnewstoday.com/articles/302809#Coconut-oil-research</a></p>



<p><a href="https://msphere.asm.org/content/1/1/e00020-15" target="_blank" rel="noreferrer noopener">https://msphere.asm.org/content/1/1/e00020-15</a></p>


The other day, a patient and I were chatting and she hit me with “I have one more question.” Now, usually that phrase comes before something that the person is super embarrassed to ask. I usually respond with, 
“Go for it. There is no such thing as TMI with a gynecologist.”




Because there isn’t. Or at least there shouldn’t be. 
To my surprise, this one was a lightweight. She asked,
“Is it okay if, when I feel a little dry down there, I use a little coconut oil to moisturize?”




I happily exclaimed, “Absolutely. I love coconut oil for vulvar moisture. It’s one of my favorite things.” She was so surprised and relieved that I jotted down the topic to share here. 
Coconut oil is not only an excellent moisturizer with skin conditioning qualities, but it also has anti-fungal properties for those who may be prone to skin irritation and yeast infections. I do not specifically recommend using coconut oil to treat yeast infections, but I don’t discourage it either. 
I also like Coconut Oil as a Body Moisturizer
Coconut oil is a mild but effective moisturizer for even the most sensitive of skin. I use it on myself and my infant because I don’t have to worry about unhealthy additions (like parabens) found in many lotions. 
It contains antioxidants which help keep skin healthy. Don’t look for it to keep you glossy all day, it absorbs well into the skin for real hydration. If your degree of ash is profound, you may need repeated applications.
Coconut Oil as Hair Oil
Hair Oil: The same qualities that make coconut oil great for skin, also make it great for hair. This oil is a non-greasy moisturizer that will penetrate your tresses without breaking the bank.
Coconut Oil to Prevent Diaper Rash
I kept a jar of coconut oil on my changing table for the my last two children. Not only did it make stool and meconium easier to wipe away, it seemed to reduce the amount and frequency of diaper rash that I dealt with before I started using it. 
All in all, I’m a fan. My only precautions is Don’t Double Dip. Keep your vulvar use coconut oil clean and separate for oil used for anything else. Listen, you may think that’s obvious, but I’m a gynecologist. I take NOTHING for granted.
I prefer extra-virgin coconut oil. In it’s natural state, it is white and thick at room temperature and becomes clear and, well, oily when heated up, even in your hands. I love the subtle coconut aroma. Try it and leave a comment about your thoughts!
Join my email list
For more trusted and interesting information about the health implications of consuming coconut oil, check out Harvard Health Publications,
For other sources about the antifungal properties of Coconut Oil:
https://www.medicalnewstoday.com/articles/302809#Coconut-oil-research
https://msphere.asm.org/content/1/1/e00020-15

The other day, a patient and I were chatting and she hit me with “I have one more question.” Now, usually that phrase comes before something that the person is super embarrassed to ask. I usually respond with, “Go for it. There is no such thing as TMI with a gynecologist.” Because there isn’t. Or […]

This OBGYN’s Favorite Natural Vaginal Moisturizer is…

Singer Maren Morris recently shared with People Magazine her experience having an unexpected c-section. She said, &#8220;I labored for 30 hours, wanted to do it naturally, but I stopped having contractions and it was just time to call it and get him out safely,&#8221; says Morris. &#8220;So I just wish I had done&#160;a better job [&#8230;]


<figure class="wp-block-image size-large is-style-rounded"><img loading="lazy" width="1024" height="682" data-attachment-id="6884" data-permalink="https://gyneco-blogic.com/jonathan-borba-p4gml53btbw-unsplash-small/" data-orig-file="https://gyneco-blogic.com/wp-content/uploads/2020/08/jonathan-borba-p4gml53btbw-unsplash-small.jpg" data-orig-size="1872,1248" data-comments-opened="1" data-image-meta="{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;1&quot;}" data-image-title="jonathan-borba-p4gml53btbw-unsplash-small" data-image-description="" data-image-caption="" data-medium-file="https://gyneco-blogic.com/wp-content/uploads/2020/08/jonathan-borba-p4gml53btbw-unsplash-small.jpg?w=300" data-large-file="https://gyneco-blogic.com/wp-content/uploads/2020/08/jonathan-borba-p4gml53btbw-unsplash-small.jpg?w=616" src="https://gyneco-blogic.com/wp-content/uploads/2020/08/jonathan-borba-p4gml53btbw-unsplash-small.jpg?w=1024" alt="" class="wp-image-6884" srcset="https://gyneco-blogic.com/wp-content/uploads/2020/08/jonathan-borba-p4gml53btbw-unsplash-small.jpg?w=1024 1024w, https://gyneco-blogic.com/wp-content/uploads/2020/08/jonathan-borba-p4gml53btbw-unsplash-small.jpg?w=150 150w, https://gyneco-blogic.com/wp-content/uploads/2020/08/jonathan-borba-p4gml53btbw-unsplash-small.jpg?w=300 300w, https://gyneco-blogic.com/wp-content/uploads/2020/08/jonathan-borba-p4gml53btbw-unsplash-small.jpg?w=768 768w, https://gyneco-blogic.com/wp-content/uploads/2020/08/jonathan-borba-p4gml53btbw-unsplash-small.jpg 1872w" sizes="(max-width: 1024px) 100vw, 1024px" /></figure>



<p class="has-drop-cap">Singer Maren Morris recently shared with <strong><em><a rel="noreferrer noopener" href="https://people.com/parents/maren-morris-c-section-son-hayes-lonely-isolated-feelings/" target="_blank">People Magazine</a></em></strong><strong><em> </em></strong>her experience having an unexpected c-section. She said,</p>



<blockquote class="wp-block-quote is-layout-flow wp-block-quote-is-layout-flow"><p>&#8220;I labored for 30 hours, wanted to do it naturally, but I stopped having contractions and it was just time to call it and get him out safely,&#8221; says Morris. &#8220;So I just wish I had done&nbsp;<a rel="noreferrer noopener" href="https://www.youtube.com/watch?v=yCw9DxMtMYc" target="_blank">a better job at preparing myself</a>&nbsp;for the shock of a c-section, because the postpartum of a c-section is so brutal.&#8221;</p><cite><a href="https://isthisnormal.littlespoon.com/maren-morris-c-section-recovery-0820/" target="_blank" rel="noreferrer noopener">https://isthisnormal.littlespoon.com/maren-morris-c-section-recovery-0820/</a></cite></blockquote>



<p>I sympathized with her experience as someone who performs c-sections. Very commonly pregnant ladies will ask me during their prenatal visits, &#8220;Doc, how will I know if I need a c-section?&#8221; My response?</p>



<h2 class="wp-block-heading">You usually won&#8217;t know you need a c-section until you go into labor.</h2>



<p>So what do you need to do to prevent or prepare for a possible c-section? That&#8217;s what I&#8217;ll share in this post. </p>



<p>In this post we will discuss:</p>



<ul class="wp-block-list"><li><a href="#first-heading-power">Power, Passenger and Passage, the Path to a Vaginal Delivery</a></li><li><a href="#second-header-reduce">How can I reduce my chances of needing a c-section?</a></li><li><a href="#third-header-maren">What are some myths about c-section? (Let&#8217;s examine Maren Morris&#8217;s story)</a></li><li><a href="#header-four-gentle">What is a Gentle C-section?</a></li><li><a href="#fifth-header-vbac">What about VBAC?</a></li><li><a href="#sixth-header-twins">What about twins and other multiples?</a></li><li><a href="#seventh-header-herpes">If I have Herpes, will I need a c-section?</a></li><li><a href="#eight-header-elective">Can I ask for a c-section even if I have no medical need for one?</a></li></ul>



<p>A cesarean delivery, or c-section, is a surgical delivery of an infant through an abdominal incision. This is in contrast to delivery through the vagina. In the <em><a rel="noreferrer noopener" href="https://www.cnn.com/2018/10/11/health/c-section-rates-study-parenting-without-borders-intl/index.html" target="_blank"><strong>United States, about 32% of babies are born via c-section</strong></a></em>, with some <strong><em><a rel="noreferrer noopener" href="https://www.cdc.gov/nchs/pressroom/sosmap/cesarean_births/cesareans.htm" target="_blank">statistical variations by state. </a></em> </strong></p>



<p>Reasons for c-section are numerous. </p>



<h2 class="wp-block-heading" id="first-heading-power">I usually break down baby delivery into three parts. Power, Passenger and Passage</h2>



<h3 class="wp-block-heading">The Power </h3>



<p>Uterine contractions need to be strong enough and frequent enough for a baby to be forced out of the uterus. Many people go into labor and initially the contractions are mild. Over time, sometimes hours to days, those contractions will increase in frequency and intensity, transitional a person from latent to active labor. </p>



<p>Eventually these muscle contractions of the uterus should be enough to eject the baby. If they aren&#8217;t sometimes Pitocin is required to make the contractions stronger and more frequent. I needed Pitocin for all 3 of my labors.<strong> <a rel="noreferrer noopener" href="https://gyneco-blogic.com/2018/08/18/a-birth-story-from-the-ob-herself-it-may-help-you-through/" target="_blank"><em>Click here to read one of my birth stories.</em></a></strong></p>



<h3 class="wp-block-heading">The Passenger</h3>



<p>First, the baby needs to be head down rather that breech (feet down).  The baby also needs to tolerate labor. Every time the uterus contracts, the blood supply to the placenta is restricted for about 30 seconds to a minute. A fetus in the uterus needs to have enough oxygen flowing to allow for that intermittent interruption in oxygen flow. </p>



<p>If either the placenta is not functioning well, possibly due to being older or too small or because of hypertension, diabetes, or preeclampsia, baby may not be able to get enough oxygen to sustain repeated contractions for hours on end. The fetal heart beat monitor will show signs of that. </p>



<h3 class="wp-block-heading">The Passage</h3>



<p>For a baby to come out of the vagina, the pelvis has to be large enough to allow that transport. Actually, the passenger comes into play here too because the pelvis needs to large enough and the baby has to be small enough to fit. </p>



<p>The cervix opening (which is the opening of the uterus) also has to stretch and mold from the size of a pin to the size to 10 centimeters, the size of a grapefruit. If the cervix can&#8217;t enlarge to 10 centimeters or the baby can&#8217;t fit through the pelvis, that baby can&#8217;t come out.</p>



<h2 class="wp-block-heading" id="second-header-reduce">How can I reduce my chances of needing a c-section?</h2>



<p>First, you need to understand why some women end up needing a c-section. Some <a rel="noreferrer noopener" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3515046/" target="_blank"><em><strong>risk factors for needing a c-section</strong></em> </a>are:</p>



<ul class="wp-block-list"><li>Age greater than 25 (messed up right?)</li><li>Being obese- BMI greater than 30</li><li>Diabetes diagnosed before or during pregnancy</li><li>Baby size extremes: Size estimates greater than 4 kilograms (8.8 lb) or less than 2.5 kilograms (5.5 lb)</li><li>Having previously had a c-section (We&#8217;ll talk more about this in the VBAC section)</li></ul>



<p>Many of those risk factors are unfortunately out of your control, but regular exercise if deemed safe by your doctor, maintaining a healthy weight pre-pregnancy and, if diabetic, keeping good control of your blood sugars will be super helpful. </p>



<p>When it comes to labor, the power, passenger and passage need to work together to get the baby out. If the power can&#8217;t be increased enough to lead to cervical dilation, or if the baby won&#8217;t fit through the pelvis or tolerate labor, or if an infection develops and a vaginal delivery is not in the near future, a c-section may be necessary. These are only a few reasons.</p>



<h2 class="wp-block-heading" id="third-header-maren">What are some myths about c-section? (Let&#8217;s examine Maren Morris&#8217;s Story)</h2>



<p>While I sympathized with Maren&#8217;s story, I disagreed with some of the things she said happened to her because of her c-section.  She said that her husband,</p>



<blockquote class="wp-block-quote is-layout-flow wp-block-quote-is-layout-flow"><p>&#8220;would have to lift [her] out of bed&#8221; before she could do so safely herself. &#8220;You can&#8217;t use any of your abdominal muscles,&#8221; she says. &#8220;I had to army crawl to get out of bed to use the bathroom in the middle of the night.&#8221;</p><cite><a href="https://isthisnormal.littlespoon.com/maren-morris-c-section-recovery-0820/" target="_blank" rel="noreferrer noopener">https://isthisnormal.littlespoon.com/maren-morris-c-section-recovery-0820/</a></cite></blockquote>



<p>I am not challenging the validity of her story. That was her truth. HOWEVER, I will say that most women can get themselves in and out of the bed and walk to the bathroom, through the halls of the hospital, up and down stairs at home, etc. I have NEVER seen someone army crawl on the floor after a c-section, and many a partner are tending to the baby while the new mom makes her way, slowly and carefully, wherever she needs to go.</p>



<p>We don&#8217;t cut the abdominal muscles during a c-section. We separate them like curtains to delivery the baby. When the baby is out and the uterus is closed, they go back to their normal position without any assistance. Although we recommend new moms not resume exercise until 6 weeks or when cleared by your doctor, these muscles aren&#8217;t damaged. Everything around them needs to heal. </p>



<p>Another thing she said in the article:</p>



<blockquote class="wp-block-quote is-layout-flow wp-block-quote-is-layout-flow"><p>&#8220;And you&#8217;re also wanting to hold your baby&nbsp;and breastfeed and pump and&nbsp;all this other s&#8212;, so that was crazy,&#8221;&nbsp;</p></blockquote>



<p>She didn&#8217;t say that she couldn&#8217;t breast feed, but just for clarity, women who have c-sections<strong><em><a href="https://gyneco-blogic.com/2020/08/03/its-world-breastfeeding-week-live-your-breast-life/" target="_blank" rel="noreferrer noopener"> can sti</a><a href="https://gyneco-blogic.com/2020/08/03/its-world-breastfeeding-week-live-your-breast-life/" target="_blank" rel="noreferrer noopener">ll breastfeed</a></em></strong>. They can also still do skin-to-skin, sometimes even DURING the c-section. </p>



<p>I do want to highlight one super important thing Maren said:</p>



<blockquote class="wp-block-quote is-layout-flow wp-block-quote-is-layout-flow"><p>&#8220;All that mattered was that he got here safely.&#8221; </p></blockquote>



<p><strong><em><a href="https://gyneco-blogic.com/2018/03/18/youve-been-asking-for-a-birth-plan-i-have-the-secret-to-the-best-birth-plan-ever/" target="_blank" rel="noreferrer noopener">If you are looking for Birth Plan advice, click here.</a></em></strong></p>



<h2 class="wp-block-heading" id="header-four-gentle">What is a Gentle C-section?</h2>



<p>I&#8217;ll be honest, I didn&#8217;t really know before writing this article, but I was pleased to see with my reading about it that it is basically all the things we already do, at least at my hospital, Prentice Women&#8217;s Hospital. </p>



<p>The idea of a <strong><em><a href="https://www.parents.com/pregnancy/giving-birth/cesarean/an-all-natural-c-section/" target="_blank" rel="noreferrer noopener">Gentle C-section</a></em></strong> appears to be one that more closely mimics the birthing experience of a vaginal delivery. Women&#8217;s arms aren&#8217;t strapped down. EKG leads are placed more to the side of women&#8217;s chest so as to allow for baby to lay for skin-to-skin. Warm blankets are provided. </p>



<p>Some hospitals even offer clear drapes so that the c-section can be witnessed. I have mixed feelings about the clear drape because everyone isn&#8217;t cut out to see surgery as it is happening. I even like to play music in the operating room, mother&#8217;s choice of course. </p>



<p>Ask your provider if you can do skin-to-skin in the operating room if you desire, in the event that you end up needing a c-section.</p>



<h2 class="wp-block-heading" id="fifth-header-vbac">What about VBAC?</h2>



<p>VBAC stands for Vaginal Birth after Cesarean. The term we clinically use more often is actually TOLAC, which stands for Trial of Labor after Cesarean section. A person can attempt a vaginal delivery after one c-section if it was done the standard Low Transverse fashion. If a person has a &#8220;classical&#8221; cesarean section, they can&#8217;t labor after that. </p>



<p>VBAC/TOLAC increases a persons risk for something called uterine rupture, which is a complication that can be life-threatening for mom and baby. Thankfully that risk is very low in most circumstances. The decision to try a TOLAC vs opting for a repeat c-section is one that should be discussed between you and your doctor.  </p>



<p>Your doctor may even use a TOLAC success calculator to help to guide their advice to you.  The calculators give a probability of successful vaginal delivery based on factors like age, delivery history, BMI etc. Ultimately this is a decision between a patient and their provider.</p>



<h2 class="wp-block-heading" id="sixth-header-twins">What about twins and other multiples?</h2>



<p>Many twins are delivered via c-section for reasons like position, if they share an amniotic fluid sac or placenta. Some twins can be born vaginally depending on the position of the twins, size and mother&#8217;s medical history. There are always risks with twins that one twin will come out vaginally and the second will need to be delivered via c-section. This is another one that needs to be discussed with your provider, including risks, benefits, and alternatives for each choice.</p>



<h2 class="wp-block-heading" id="seventh-header-herpes">If I have Herpes, will I need a c-section?</h2>



<p>No. Not unless you have an active outbreak at the time of labor. If you have a history of herpes, you provider may ask you to take antiviral suppression like Valacyclovir twice daily in the final month of pregnancy to help reduce the chance of an outbreak during labor. </p>



<p>The highest risk of transmission of herpes to baby is if a baby is born through an active outbreak vaginally, especially if it is the first outbreak. This can be life-threatening for a newborn. If you are having pain or bumps in the vaginal or vulvar area toward the end of pregnancy, show the area to your provider. This information can be life-saving.</p>



<h2 class="wp-block-heading" id="eight-header-elective">Can I ask for a c-section even if I have no medical need for one?</h2>



<p>Yes, but their are risks. All c-sections come with three main risks. </p>



<ol class="wp-block-list"><li>Risk of bleeding more that what would be expected with a vaginal delivery</li><li>Risk of infection</li><li>Risk of damage to surrounding organs like the bowel or bladder.</li></ol>



<p>Also with each subsequent delivery, distorting scar tissue can increase risks for complications. The placenta can also adhere abnormally to a previous scar on the inside and cause something called <a href="https://www.brighamandwomens.org/obgyn/maternal-fetal-medicine/pregnancy-complications/placenta-accreta-myths" target="_blank" rel="noreferrer noopener"><strong><em>placenta accreta</em></strong></a>. This severe condition can, in extreme cases, lead to the need for a hysterectomy. The risk for placenta accreta increases with each delivery, so ideally c-section would be avoided. </p>



<p>However, as long as a person understands the risks, benefits and alternatives of their decision, a c-section as a preferred delivery method, known as an elective c-section, is a reasonable route of delivery. All birth is natural.</p>



<h2 class="has-text-align-center wp-block-heading">I said, ALL BIRTH IS NATURAL</h2>



<p>I had to say it again for the people in the back. </p>



<p class="has-drop-cap">In conclusion, some c-sections are planned, some are emergent (like<strong><em> <a rel="noreferrer noopener" href="https://gyneco-blogic.com/2018/04/17/serena-williamss-delivery-teaches-us-some-valuable-lessons/" target="_blank">Serena Williams</a></em></strong>) and some come after long, arduous labor. Never be afraid to ask your provider to explain why you need or needed a c-section. Clarity and understanding are extremely important in my opinion. Hopefully, you gained some clarity from this article.</p>



<p>Thank you, all as always for reading. Please subscribe to join our email list and to be informed of future articles and information for all humans with vaginas. Also, comment below with topics you&#8217;d like to see us cover here at The Gyneco-bLogic. </p>



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<h2 class="has-text-align-center wp-block-heading">Happy birthing!</h2>


Singer Maren Morris recently shared with People Magazine her experience having an unexpected c-section. She said,
“I labored for 30 hours, wanted to do it naturally, but I stopped having contractions and it was just time to call it and get him out safely,” says Morris. “So I just wish I had done a better job at preparing myself for the shock of a c-section, because the postpartum of a c-section is so brutal.”
https://isthisnormal.littlespoon.com/maren-morris-c-section-recovery-0820/
I sympathized with her experience as someone who performs c-sections. Very commonly pregnant ladies will ask me during their prenatal visits, “Doc, how will I know if I need a c-section?” My response?
You usually won’t know you need a c-section until you go into labor.
So what do you need to do to prevent or prepare for a possible c-section? That’s what I’ll share in this post. 
In this post we will discuss:
Power, Passenger and Passage, the Path to a Vaginal Delivery
How can I reduce my chances of needing a c-section?
What are some myths about c-section? (Let’s examine Maren Morris’s story)
What is a Gentle C-section?
What about VBAC?
What about twins and other multiples?
If I have Herpes, will I need a c-section?
Can I ask for a c-section even if I have no medical need for one?




A cesarean delivery, or c-section, is a surgical delivery of an infant through an abdominal incision. This is in contrast to delivery through the vagina. In the United States, about 32% of babies are born via c-section, with some statistical variations by state.  
Reasons for c-section are numerous. 
I usually break down baby delivery into three parts. Power, Passenger and Passage
The Power 
Uterine contractions need to be strong enough and frequent enough for a baby to be forced out of the uterus. Many people go into labor and initially the contractions are mild. Over time, sometimes hours to days, those contractions will increase in frequency and intensity, transitional a person from latent to active labor. 
Eventually these muscle contractions of the uterus should be enough to eject the baby. If they aren’t sometimes Pitocin is required to make the contractions stronger and more frequent. I needed Pitocin for all 3 of my labors. Click here to read one of my birth stories.
The Passenger
First, the baby needs to be head down rather that breech (feet down).  The baby also needs to tolerate labor. Every time the uterus contracts, the blood supply to the placenta is restricted for about 30 seconds to a minute. A fetus in the uterus needs to have enough oxygen flowing to allow for that intermittent interruption in oxygen flow. 
If either the placenta is not functioning well, possibly due to being older or too small or because of hypertension, diabetes, or preeclampsia, baby may not be able to get enough oxygen to sustain repeated contractions for hours on end. The fetal heart beat monitor will show signs of that. 
The Passage
For a baby to come out of the vagina, the pelvis has to be large enough to allow that transport. Actually, the passenger comes into play here too because the pelvis needs to large enough and the baby has to be small enough to fit. 
The cervix opening (which is the opening of the uterus) also has to stretch and mold from the size of a pin to the size to 10 centimeters, the size of a grapefruit. If the cervix can’t enlarge to 10 centimeters or the baby can’t fit through the pelvis, that baby can’t come out.
How can I reduce my chances of needing a c-section?
First, you need to understand why some women end up needing a c-section. Some risk factors for needing a c-section are:
Age greater than 25 (messed up right?)
Being obese- BMI greater than 30
Diabetes diagnosed before or during pregnancy
Baby size extremes: Size estimates greater than 4 kilograms (8.8 lb) or less than 2.5 kilograms (5.5 lb)
Having previously had a c-section (We’ll talk more about this in the VBAC section)




Many of those risk factors are unfortunately out of your control, but regular exercise if deemed safe by your doctor, maintaining a healthy weight pre-pregnancy and, if diabetic, keeping good control of your blood sugars will be super helpful. 
When it comes to labor, the power, passenger and passage need to work together to get the baby out. If the power can’t be increased enough to lead to cervical dilation, or if the baby won’t fit through the pelvis or tolerate labor, or if an infection develops and a vaginal delivery is not in the near future, a c-section may be necessary. These are only a few reasons.
What are some myths about c-section? (Let’s examine Maren Morris’s Story)
While I sympathized with Maren’s story, I disagreed with some of the things she said happened to her because of her c-section.  She said that her husband,
“would have to lift [her] out of bed” before she could do so safely herself. “You can’t use any of your abdominal muscles,” she says. “I had to army crawl to get out of bed to use the bathroom in the middle of the night.”
https://isthisnormal.littlespoon.com/maren-morris-c-section-recovery-0820/
I am not challenging the validity of her story. That was her truth. HOWEVER, I will say that most women can get themselves in and out of the bed and walk to the bathroom, through the halls of the hospital, up and down stairs at home, etc. I have NEVER seen someone army crawl on the floor after a c-section, and many a partner are tending to the baby while the new mom makes her way, slowly and carefully, wherever she needs to go.
We don’t cut the abdominal muscles during a c-section. We separate them like curtains to delivery the baby. When the baby is out and the uterus is closed, they go back to their normal position without any assistance. Although we recommend new moms not resume exercise until 6 weeks or when cleared by your doctor, these muscles aren’t damaged. Everything around them needs to heal. 
Another thing she said in the article:
“And you’re also wanting to hold your baby and breastfeed and pump and all this other s—, so that was crazy,” 




She didn’t say that she couldn’t breast feed, but just for clarity, women who have c-sections can still breastfeed. They can also still do skin-to-skin, sometimes even DURING the c-section. 
I do want to highlight one super important thing Maren said:
“All that mattered was that he got here safely.” 




If you are looking for Birth Plan advice, click here.
What is a Gentle C-section?
I’ll be honest, I didn’t really know before writing this article, but I was pleased to see with my reading about it that it is basically all the things we already do, at least at my hospital, Prentice Women’s Hospital. 
The idea of a Gentle C-section appears to be one that more closely mimics the birthing experience of a vaginal delivery. Women’s arms aren’t strapped down. EKG leads are placed more to the side of women’s chest so as to allow for baby to lay for skin-to-skin. Warm blankets are provided. 
Some hospitals even offer clear drapes so that the c-section can be witnessed. I have mixed feelings about the clear drape because everyone isn’t cut out to see surgery as it is happening. I even like to play music in the operating room, mother’s choice of course. 
Ask your provider if you can do skin-to-skin in the operating room if you desire, in the event that you end up needing a c-section.
What about VBAC?
VBAC stands for Vaginal Birth after Cesarean. The term we clinically use more often is actually TOLAC, which stands for Trial of Labor after Cesarean section. A person can attempt a vaginal delivery after one c-section if it was done the standard Low Transverse fashion. If a person has a “classical” cesarean section, they can’t labor after that. 
VBAC/TOLAC increases a persons risk for something called uterine rupture, which is a complication that can be life-threatening for mom and baby. Thankfully that risk is very low in most circumstances. The decision to try a TOLAC vs opting for a repeat c-section is one that should be discussed between you and your doctor.  
Your doctor may even use a TOLAC success calculator to help to guide their advice to you.  The calculators give a probability of successful vaginal delivery based on factors like age, delivery history, BMI etc. Ultimately this is a decision between a patient and their provider.
What about twins and other multiples?
Many twins are delivered via c-section for reasons like position, if they share an amniotic fluid sac or placenta. Some twins can be born vaginally depending on the position of the twins, size and mother’s medical history. There are always risks with twins that one twin will come out vaginally and the second will need to be delivered via c-section. This is another one that needs to be discussed with your provider, including risks, benefits, and alternatives for each choice.
If I have Herpes, will I need a c-section?
No. Not unless you have an active outbreak at the time of labor. If you have a history of herpes, you provider may ask you to take antiviral suppression like Valacyclovir twice daily in the final month of pregnancy to help reduce the chance of an outbreak during labor. 
The highest risk of transmission of herpes to baby is if a baby is born through an active outbreak vaginally, especially if it is the first outbreak. This can be life-threatening for a newborn. If you are having pain or bumps in the vaginal or vulvar area toward the end of pregnancy, show the area to your provider. This information can be life-saving.
Can I ask for a c-section even if I have no medical need for one?
Yes, but their are risks. All c-sections come with three main risks. 
Risk of bleeding more that what would be expected with a vaginal delivery
Risk of infection
Risk of damage to surrounding organs like the bowel or bladder.




Also with each subsequent delivery, distorting scar tissue can increase risks for complications. The placenta can also adhere abnormally to a previous scar on the inside and cause something called placenta accreta. This severe condition can, in extreme cases, lead to the need for a hysterectomy. The risk for placenta accreta increases with each delivery, so ideally c-section would be avoided. 
However, as long as a person understands the risks, benefits and alternatives of their decision, a c-section as a preferred delivery method, known as an elective c-section, is a reasonable route of delivery. All birth is natural.
I said, ALL BIRTH IS NATURAL
I had to say it again for the people in the back. 
In conclusion, some c-sections are planned, some are emergent (like Serena Williams) and some come after long, arduous labor. Never be afraid to ask your provider to explain why you need or needed a c-section. Clarity and understanding are extremely important in my opinion. Hopefully, you gained some clarity from this article.
Thank you, all as always for reading. Please subscribe to join our email list and to be informed of future articles and information for all humans with vaginas. Also, comment below with topics you’d like to see us cover here at The Gyneco-bLogic. 
Join my email list
Happy birthing!

Singer Maren Morris recently shared with People Magazine her experience having an unexpected c-section. She said, “I labored for 30 hours, wanted to do it naturally, but I stopped having contractions and it was just time to call it and get him out safely,” says Morris. “So I just wish I had done a better job […]

I Know You Don’t Want One, But Here Are 8 Things You NEED To Know about C-section

A friend recently shared with me a story that troubled me to my core. A friend of hers was diagnosed with anemia, also known as a low blood count. She saw her gynecologist for evaluation and ultimately underwent a hysterectomy, even though her menstrual bleeding, from the little bit of the story I know, did [&#8230;]

A friend recently shared with me a story that troubled me to my core. A friend of hers was diagnosed with anemia, also known as a low blood count.  She saw her gynecologist for evaluation and ultimately underwent a hysterectomy, even though her menstrual bleeding, from the little bit of the story I know, did not appear to be excessive. Ultimately, the source of her anemia was found to be from another source, as in NOT her uterus.
She was still left without a uterus.
This story troubled me because a hysterectomy is a big deal, and I wondered if she received appropriate counseling and evaluation before that decision was made. A large study from 2009 involving over 5000 participants followed over 15 years revealed the following as it relates to hysterectomy rates by demographic:
“… hysterectomy among Black compared with White participants were almost four times higher.”
 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2622766/
 A more recent study published in 2019 revealed similar findings, reporting “African American, Hispanic, and Asian/Pacific Islander women eligible for minimally invasive hysterectomy were more likely than white women to receive abdominal hysterectomy. ” Click here for the source.
Now this story is not just potentially one of healthcare disparities or racial inequity. After all, the size of the uterus and the number of fibroids can impact a person’s potential need for a hysterectomy and the type of hysterectomy that is done. 
Generally speaking, I fight tooth and nail to preserve a person’s uterus.
I will only perform a hysterectomy if I have explored or exhausted other options. In the story I heard above, I was thinking, was she offered this? Did her doctor check that? What else could have been done? AND, why did she allow this to happen without asking more questions? 
Welp, she may not have known which questions to ask. 
Use this article as a reference and share it with those who may be considering a hysterectomy. My goal is to ensure that we are aware of our options and are making the best choice, given the circumstance we are presented.
#1: If you are anemic, have all causes for anemia been explored?
Heavy menstrual bleeding is a plausible cause of anemia. Heavy menstrual bleeding is defined as loosing greater than 80ml of blood during a menstrual cycle. Quoting another Gyneco-bLogic article that breaks down what that means: 
The average blood loss during a period is 35 ml. The average regular tampon or pad takes 5 ml before it is soaked. So if during your entire period you use 7 tampons or pads, SOAKED ones, you’re about average. If you are soaking more than 16 regular pads or tampons during your cycle, you may be bleeding too much.





Let’s run through a scenario…





Day 1, you change a liner or minimally soaked tampon twice during the day. Day 2, you change a soaked tampon every 4 hours, like 3 times during the day and once at night. Day 3 you change a half soaked pad/tampon twice. Day 4 and 5, you are barely bleeding.





Total= about 6 total soaked tampons. Normal, no problem





Scenario #2: Day 1, you change a soaked tampon every 4 hours (3). Day 2, you change a soaked tampon AND pad (to catch overflow) every 2 hours (8), Day 3, same thing, oh and you messed up your bedsheets, which happens sometimes. Day 4, you can get away with a tampon every 3-4 hours. Day 5-7, same but every 5-6 hours.





Total= Okay, I lost count, but you hit 16 just on days 2 and 3, so you’re definitely bleeding too much.
https://gyneco-blogic.com/2019/02/24/about-my-period-how-much-is-too-much-and-how-little-too-little/
If you aren’t bleeding excessively, could blood loss be coming from another source? I would advise you to see a primary care provider and determine if you may need a GI scope to look for an ulcer or polyp that could be bleeding in the GI tract. Are your blood cells normal? Could you have sickle cell trait or thalassemia trait that could cause anemia that is not related to blood loss? What other factors may be in play? These are questions that you can consider asking your provider to ensure other causes are being ruled out.
# 2: If you ARE bleeding excessively from the uterus, is the source structural or hormonal?
A checklist for possible structural causes of heavy bleeding or anemia could include:
An up-to-date Pap test to ensure the cervix is healthy. If you had a pap recently, you shouldn’t need another one, but I would consider it if it’s been over a year.
A pelvic exam and ultrasound looking for signs of polyps, fibroids, ovarian cyst or masses, etc.
Suppose fibroids or polyps are suspected near the inside of the uterus. In that case, a saline ultrasound, or sonohysterogram could be relevant to determine if either of these structures are projecting into the inside of the uterine cavity.




More on the management of those particular structures below, but what if the cause is hormonal? 
Hormonal  or other blood related causes of abnormal or heavy bleeding can include thyroid abnormalies, anovulatory bleeding like Polycystic Ovarian Syndrome or PCOS, and blood clotting abnormalities like Von Willebrand disease  or other hemophilias. It is reasonable to ask your healthcare provider is any of these causes have been evaluated. Also, take note if you frequently bleed from your gums when brushing your teeth or bruise easily. That could make hemophilia more  of a suspect in the cause of your abnormal bleeding.
# 3: If the source appears to be structural, can that problematic structure be dealt with specifically?
Fibroids or polyps that are intracavitary, or submucosal, can cause significant bleeding. Removal of these structures can significantly improve bleeding if they can be reached easily. If a fibroid is located in that cavity of the uterus, it may be able to be removed using a minimally invasive procedure called hysteroscopy. The ones that can be removed hysteroscopically are represented by the (d) in the picture below, know as submucosal fibroids. Some of the (c)s can be removed this way too.




I NEED to take a moment to shout out Senator Kamala Harris for a new Bill introduced about a week ago:
U.S. Senator Kamala D. Harris (D-CA) on Thursday introduced the Uterine Fibroid Research and Education Act, legislation to initiate crucial research and education in relation to uterine fibroids and ensure women get the information and care they need.
https://www.harris.senate.gov/news/press-releases/harris-introduces-legislation-to-support-uterine-fibroids-research-and-education#:~:text=WASHINGTON%2C%20D.C.%20%E2%80%93%20U.S.%20Senator%20Kamala,information%20and%20care%20they%20need.
This is huge. Multiple times EVERY WEEK, I am asked what can be done to prevent fibroids or shrink them or reduce their growth rate. Not a lot is known about why so many people are affected by fibroids- 70-80% of women by the age of 50. We do believe that few lifestyle changes can reduce the growth and symptoms caused by fibroids.
Reduce the consumption of simple sugars
Reduce the consumption of processed foods
Reduce consumption of red meat
Exercise regularly
Maintain a healthy weight




WebMD has a very well-sourced article about the subject of managing fibroids with behavior choices. Click Here to read it. Even with all of these actions, though, some fibroids will require medical or surgical intervention to improve a person’s quality of life. This legislation and research will undoubtedly help us understand more and affect better changes.
Some fibroids can be treated or removed hysteroscopically. Some can be ablated laparoscopically with a procedure called Acessa. Some can be remove by laparoscopic or abdominal myomectomy. There are many ways to deal with fibroids other than a hysterectomy depending on an individual’s symptoms and circumstances.
# 4: If the individual structure can’t be fixed, are you a candidate for other minimally invasive medical or surgical procedures?
Before we get to surgical management, some medication options for managing anemia or symptomatic fibroids can include:
Hormonal birth control can reduce blood loss and cramping
NSAIDs like Ibuprofen work chemically to minimize cramping and blood loss, in addition to pain control. 
Tranexamic acid, which is a medication that slows blood loss by basically controlling the speed in which blood clots.
Elagolix is a new medication that creates a reversible menopause-like scenario in your body. This can decrease blood loss, reduce pain and even shrink fibroids.




If none of those are right for your circumstance or don’t work well, some can benefit from other minimally invasive surgical options.
Endometrial ablation is a procedure that burns the inside of the uterine lining. When used appropriately, this can reduce or eliminate blood loss from the uterus for an extended period of time, often years. Another procedure is uterine artery embolization– which is a procedure performed by interventional radiology.  This involves blocking the blood supply to the uterus, reducing the size and symptoms caused by fibroids. Neither of these procedures are for everyone, but both have their place as options to control symptoms and avoid major surgery.
# 5: This one is super important. Is the tissue in the uterus normal without any signs of pre-cancer or cancer?
Sometimes the tissue on the inside of the uterus can become pre-cancerous or cancerous. Anyone who is 40 or older or experiencing irregular menses should, in my opinion, undergo an endometrial biopsy or dilation and curettage to sample the uterine lining. I say, “in my opinion” because the American College of Obstetricians and Gynecologists (AGOC) recommends endometrial biopsy for those 45 and older. Some benefit from sampling earlier, and I have detected abnormalities in people younger than 45. 
If certain types of pre-cancer or if cancer or found, that uterus needs to go. Certain types of pre-cancer, or atypia, can be managed with medication, especially if fertility is still desired. Make sure that you have had some form of assessment of the uterine lining.
If a hysterectomy is the best option for you, know that there are different types of hysterectomies.
Abdominal hysterectomy
Vaginal hysterectomy
Laparoscopic-assisted vaginal hysterectomy
Total laparoscopic hysterectomy




The type that is best for you may be chosen based on your particular uterine status and size, your surgical history, and the skill of your surgeon.  Also, whether or not your ovaries, tubes and cervix should be removed should be a part of your pre-operative discussion.  There are pros and cons to each decision depending on age and preferences.
“Whether or not your ovaries, tubes or cervix are removed are choices that should be discussed.” – Dr. Wendy
Yes, I just quoted myself, to drive home the point. Lol. 
Anywho, I’m sure you’re tired of this article by now, but I hope I’ve left you with some tools and questions to bring to your provider. My goal isn’t to complicate your care or create an uncomfortable or second-guessing relationship between you and your provider. I just want to give tools so that you don’t end up undergoing a procedure that could have been avoided if you had tried another option.
I’m happy to remove a uterus, but only if my patient and I agree that it is our best option considering all risks, benefits, and alternatives. It’s the patient’s decision, but I try to make sure that she understands all of the options.
Thanks, as always, for reading and please follow The Gyneco-bLogic for more. 
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A friend recently shared with me a story that troubled me to my core. A friend of hers was diagnosed with anemia, also known as a low blood count. She saw her gynecologist for evaluation and ultimately underwent a hysterectomy, even though her menstrual bleeding, from the little bit of the story I know, did […]

5 Things to Consider BEFORE You Decide To Have A Hysterectomy

August 1-7 this World Breastfeeding Week. This is a national campaign that takes place every year in over 120 countries with the mission to inform, educate and support people with knowledge and resources to support breastfeeding as a global culture. The&#160;World Health Organization&#160;(WHO) and the&#160;American Academy of Pediatrics&#160;(AAP) emphasize the value of breastfeeding for mothers [&#8230;]


<figure class="wp-block-image size-large is-style-rounded"><img loading="lazy" width="1024" height="698" data-attachment-id="6846" data-permalink="https://gyneco-blogic.com/2020/08/03/its-world-breastfeeding-week-live-your-breast-life/eibner-saliba-zhwul24kf5a-unsplash-1-cropped/" data-orig-file="https://gyneco-blogic.com/wp-content/uploads/2020/08/eibner-saliba-zhwul24kf5a-unsplash-1-cropped.jpg" data-orig-size="1978,1349" data-comments-opened="1" data-image-meta="{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;1&quot;}" data-image-title="eibner-saliba-zhWUl24kf5A-unsplash (1) cropped" data-image-description="" data-image-caption="" data-medium-file="https://gyneco-blogic.com/wp-content/uploads/2020/08/eibner-saliba-zhwul24kf5a-unsplash-1-cropped.jpg?w=300" data-large-file="https://gyneco-blogic.com/wp-content/uploads/2020/08/eibner-saliba-zhwul24kf5a-unsplash-1-cropped.jpg?w=616" src="https://gyneco-blogic.com/wp-content/uploads/2020/08/eibner-saliba-zhwul24kf5a-unsplash-1-cropped.jpg?w=1024" alt="" class="wp-image-6846" srcset="https://gyneco-blogic.com/wp-content/uploads/2020/08/eibner-saliba-zhwul24kf5a-unsplash-1-cropped.jpg?w=1024 1024w, https://gyneco-blogic.com/wp-content/uploads/2020/08/eibner-saliba-zhwul24kf5a-unsplash-1-cropped.jpg?w=150 150w, https://gyneco-blogic.com/wp-content/uploads/2020/08/eibner-saliba-zhwul24kf5a-unsplash-1-cropped.jpg?w=300 300w, https://gyneco-blogic.com/wp-content/uploads/2020/08/eibner-saliba-zhwul24kf5a-unsplash-1-cropped.jpg?w=768 768w, https://gyneco-blogic.com/wp-content/uploads/2020/08/eibner-saliba-zhwul24kf5a-unsplash-1-cropped.jpg 1978w" sizes="(max-width: 1024px) 100vw, 1024px" /></figure>



<p class="has-drop-cap">August 1-7 this World Breastfeeding Week.  This is a national campaign that takes place every year in over 120 countries with the mission to inform, educate and support people with knowledge and resources to support breastfeeding as a global culture. </p>



<blockquote class="wp-block-quote is-layout-flow wp-block-quote-is-layout-flow"><p>The&nbsp;<a href="https://en.wikipedia.org/wiki/World_Health_Organization">World Health Organization</a>&nbsp;(WHO) and the&nbsp;<a href="https://en.wikipedia.org/wiki/American_Academy_of_Pediatrics">American Academy of Pediatrics</a>&nbsp;(AAP) emphasize the value of breastfeeding for mothers as well as children. Both recommend exclusive breastfeeding for the first six months of life and then supplemented breastfeeding for at least one year and up to two years or more.</p><cite><a href="https://en.wikipedia.org/wiki/World_Breastfeeding_Week">https://en.wikipedia.org/wiki/World_Breastfeeding_Week</a></cite></blockquote>



<p>I too have some advice and tips for breastfeeding mothers. I wrote this article for <a href="https://www.jetmag.com/life/5-tips-successful-breastfeeding/" target="_blank" rel="noreferrer noopener">Jet Magazine</a> a few years back, but the messages ring true even today.</p>



<h2 class="wp-block-heading">5 TIPS FOR SUCCESSFUL BREASTFEEDING</h2>



<p>As a board-certified practicing Obstetrician/Gynecologist and mother of three, breastfeeding is a topic that comes up in my conversations practically every day. This food source is truly “liquid gold,” offering growing babies nutrition, protection and long-lasting health benefits. It’s also advantageous for women. They can experience faster weight loss, lower rates of postpartum depression and a stronger bond between mother and child.</p>



<p>Moms labor to get their babies here, but breastfeeding is truly a labor of love. Though often challenging initially, it is worth every drop babies get. So in honor of Breastfeeding Month, here are 5 tips to practice successfully.</p>



<h2 class="wp-block-heading"><strong>1. Provide yourself with the proper fuel</strong></h2>



<p>If you hope to produce a food source for another human being, you should take in the proper building blocks to create it. Continue taking prenatal vitamins and drink water frequently, even when you aren’t thirsty. Eat nutritious foods: lean meats, beans, whole grains, well-washed or organic fruits and vegetables and dairy. Also, avoid excessive sugar.</p>



<h2 class="wp-block-heading"><strong>2. Don’t get discouraged</strong></h2>



<p>Breast milk can take up to five days to come in for first-time mothers. Until then, the baby is getting colostrum, a valuable nutritional source with antibodies for fighting infection. Your pediatrician will use your baby’s weight and wet diapers to ensure the baby is getting enough food. Remember, newborns survived those first few days of life long before formula existed. Supply depends on demand. Let your baby nurse!</p>



<h2 class="wp-block-heading"><strong>3. Those who can, do; those who can’t, pump</strong></h2>



<p>Not every baby will latch onto the breast, even after using multiple techniques. Using a breast pump on each breast for at least 15 minutes every 2-3 hours will usually express enough milk to supply a newborn’s needs. Working moms can breastfeed, too. Having a breast pump can allow you the ability to nurse at home and pump at work. If your production is not enough to supply the baby’s needs, something is better than nothing. Give your baby breast milk in addition to formula. Your baby won’t know the difference but will reap the benefits.</p>



<h2 class="wp-block-heading"><strong>4. Trouble doesn’t last always</strong></h2>



<p>Breastfeeding is often uncomfortable in the beginning. This discomfort should get better. If it doesn’t, seek help from a lactation consultant or your doctor. Clogged milk ducts, mastitis, and engorgement can cause severe pain. Massage, warm compresses and expressing milk every 1.5 to 2 hours when painful nodules arise can help to prevent the development of infection.</p>



<h2 class="wp-block-heading"><strong>5. Know when enough is enough</strong></h2>



<p>If you have tried every trick in the book and are still unable to breastfeed, sometimes the healthiest thing for a mother’s emotional well-being is to accept this reality and let it go. As valuable as breast milk is, it is not worth the negative effects on one’s psyche when it just doesn’t work out.</p>



<h2 class="has-text-align-center wp-block-heading">If you are more of a visual learner, check out a music video I made a while back when Cardi B first had her baby girl, Kulture. </h2>



<p>Also stay tuned for more articles to come. I&#8217;m in the process of writing about the benefits of period tracking, my advice about the use of washcloths, everything you&#8217;ve wondered about egg freezing, and the things that pregnant people can and cannot due, for the Aunties in your life. </p>



<p>If you have topics you&#8217;d like to see us write about, drop them in the comments. All topics related to humans with vaginas are welcome. Thanks for reading and stay tuned for more.</p>



<figure class="wp-block-embed-youtube wp-block-embed is-type-rich wp-embed-aspect-16-9 wp-has-aspect-ratio"><div class="wp-block-embed__wrapper">
<div class="jetpack-video-wrapper"><div class="embed-youtube"><iframe title="Best Life Cardi B Parody, Living My Breast Life" width="616" height="347" src="https://www.youtube.com/embed/RU-sqbximX4?feature=oembed" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin" allowfullscreen></iframe></div></div>
</div></figure>



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August 1-7 this World Breastfeeding Week.  This is a national campaign that takes place every year in over 120 countries with the mission to inform, educate and support people with knowledge and resources to support breastfeeding as a global culture. 
The World Health Organization (WHO) and the American Academy of Pediatrics (AAP) emphasize the value of breastfeeding for mothers as well as children. Both recommend exclusive breastfeeding for the first six months of life and then supplemented breastfeeding for at least one year and up to two years or more.
https://en.wikipedia.org/wiki/World_Breastfeeding_Week
I too have some advice and tips for breastfeeding mothers. I wrote this article for Jet Magazine a few years back, but the messages ring true even today.
5 TIPS FOR SUCCESSFUL BREASTFEEDING
As a board-certified practicing Obstetrician/Gynecologist and mother of three, breastfeeding is a topic that comes up in my conversations practically every day. This food source is truly “liquid gold,” offering growing babies nutrition, protection and long-lasting health benefits. It’s also advantageous for women. They can experience faster weight loss, lower rates of postpartum depression and a stronger bond between mother and child.
Moms labor to get their babies here, but breastfeeding is truly a labor of love. Though often challenging initially, it is worth every drop babies get. So in honor of Breastfeeding Month, here are 5 tips to practice successfully.
1. Provide yourself with the proper fuel
If you hope to produce a food source for another human being, you should take in the proper building blocks to create it. Continue taking prenatal vitamins and drink water frequently, even when you aren’t thirsty. Eat nutritious foods: lean meats, beans, whole grains, well-washed or organic fruits and vegetables and dairy. Also, avoid excessive sugar.
2. Don’t get discouraged
Breast milk can take up to five days to come in for first-time mothers. Until then, the baby is getting colostrum, a valuable nutritional source with antibodies for fighting infection. Your pediatrician will use your baby’s weight and wet diapers to ensure the baby is getting enough food. Remember, newborns survived those first few days of life long before formula existed. Supply depends on demand. Let your baby nurse!
3. Those who can, do; those who can’t, pump
Not every baby will latch onto the breast, even after using multiple techniques. Using a breast pump on each breast for at least 15 minutes every 2-3 hours will usually express enough milk to supply a newborn’s needs. Working moms can breastfeed, too. Having a breast pump can allow you the ability to nurse at home and pump at work. If your production is not enough to supply the baby’s needs, something is better than nothing. Give your baby breast milk in addition to formula. Your baby won’t know the difference but will reap the benefits.
4. Trouble doesn’t last always
Breastfeeding is often uncomfortable in the beginning. This discomfort should get better. If it doesn’t, seek help from a lactation consultant or your doctor. Clogged milk ducts, mastitis, and engorgement can cause severe pain. Massage, warm compresses and expressing milk every 1.5 to 2 hours when painful nodules arise can help to prevent the development of infection.
5. Know when enough is enough
If you have tried every trick in the book and are still unable to breastfeed, sometimes the healthiest thing for a mother’s emotional well-being is to accept this reality and let it go. As valuable as breast milk is, it is not worth the negative effects on one’s psyche when it just doesn’t work out.
If you are more of a visual learner, check out a music video I made a while back when Cardi B first had her baby girl, Kulture. 
Also stay tuned for more articles to come. I’m in the process of writing about the benefits of period tracking, my advice about the use of washcloths, everything you’ve wondered about egg freezing, and the things that pregnant people can and cannot due, for the Aunties in your life. 
If you have topics you’d like to see us write about, drop them in the comments. All topics related to humans with vaginas are welcome. Thanks for reading and stay tuned for more.








	
Join my email list
			
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August 1-7 this World Breastfeeding Week. This is a national campaign that takes place every year in over 120 countries with the mission to inform, educate and support people with knowledge and resources to support breastfeeding as a global culture. The World Health Organization (WHO) and the American Academy of Pediatrics (AAP) emphasize the value of breastfeeding for mothers […]

It’s World Breastfeeding Week: Live your Breast life

The death of Sha-Asia Washington on July 3rd, 2020, has sparked outrage in Brooklyn and attention from the entire country regarding the safety, or lack thereof of black women during childbirth. As a practicing OBGYN and as a black woman, I feel the need to address this particular case and examine not only the possible [&#8230;]

The death of Sha-Asia Washington on July 3rd, 2020, has sparked outrage in Brooklyn and attention from the entire country regarding the safety, or lack thereof of black women during childbirth.
As a practicing OBGYN and as a black woman, I feel the need to address this particular case and examine not only the possible causes of death, since one has yet to be reported, but how ANY expectant mother can protect herself as much as humanly possible.
According to 2018 CDC statistics, 
… of the 658 women who died of maternal causes in 2018, black women fared the worst, dying 2½ times more often than white women (37.1 vs 14.7 deaths per 100,000 live births)…
https://www.cdc.gov/nchs/data/nvsr/nvsr69/nvsr69_01-508.pdf
While this was actually a slight improvement from the 42.8 per 100,000 Black women who died according to reported data between 2007 and 2016, this stark contrast is still disturbing. It can spark fear in any Black expecting mother. 
I think it is important to revisit the top causes of maternal death.  This list is from an article I wrote in The Gyneco-(b)Logic last year: 
According the Center for Disease Control, and looking at the years 2011-2014, the most common causes of death were as follows:
Cardiovascular diseases (heart disease), 15.2%.
Non-cardiovascular diseases (like diabetes), 14.7%.
Infection or sepsis, 12.8%.
Hemorrhage (excessive blood loss), 11.5%.
Cardiomyopathy (heart malfunction), 10.3%.
Thrombotic pulmonary embolism (blood clot), 9.1%.
Cerebrovascular accidents (aka stroke), 7.4%.
Hypertensive disorders of pregnancy, 6.8%.
Amniotic fluid embolism (it’s like a clot), 5.5%.
Anesthesia complications, 0.3%.




We don’t know what Sha-Asia died from at this time. The most that I could find as a cause of death was “Child Birth,” which is NOT a cause of death. I did find a report about the scenario that preceded her death and speculated from it. This is from TheCITY.NYC:
In an interview with Rolling Stone, Juwan Lopez and Williams said that Washington was admitted to Woodhull on July 2nd for a routine stress test. The hospital kept her for observation because she was several days past her due date and her blood pressure was unusually high, they said. Doctors asked Washington if she wanted an epidural and she agreed after some hesitation, Williams told the magazine.





Washington went into cardiac arrest, prompting doctors to perform an emergency C-section. Her daughter, Khloe, was healthy.




Now, the following statements are COMPLETELY speculative. I have no knowledge of the details of Sha-Asia’s medical care. Still, I am going to speculate what could have happened in an effort to deduce how her death could have been prevented.
Sha-Asia’s Possibly Story




If Sha-Asia was admitted on July 2nd because of blood pressure elevation, the diagnosis of preeclampsia should have been suspected. That is the life-threatening medical condition that I had when I was pregnant and that Beyonce had during her delivery. Any pregnant person with a blood pressure of 140/90 at least 4 hours apart needs to be evaluated for preeclampsia.  A person can look completely normal and feel completely normal (present) and yet have preeclampsia.
Even without preeclampsia, elevated blood pressures in pregnancy, known as gestational hypertension, carries a significant risk of leading to stroke in pregnancy. Blood pressures need to be closely monitored and sometimes treated with medication. They don’t always need to be treated because, depending on the level, your provider may not want to bring the blood pressure too low. After all, that could compromise blood flow to the baby. It is a delicate balance.
Advice #1: Watch Your Blood Pressure




Keep track of your blood pressure in your prenatal appointments and in the hospital. If you notice that it is elevated, inquire about whether or not further evaluation can be done. Some people with severe preeclampsia will also have headaches, vision changes, or upper abdominal pain that won’t go away. People with high blood pressure diagnosed before 20 weeks of pregnancy, people with gestational diabetes, and Black women are at increased risk of developing preeclampsia.
Consider bringing a notebook to prenatal visits. Ask questions if you see values higher than 140/90, either number during labor. Find out what blood pressure numbers would warrant treatment in your particular case and watch for those.
Gestational hypertension and preeclampsia can be managed in labor. Still, the cure for both is delivery, especially at term when the baby is old enough. Let’s get back to Sha-Asia’s possibly story.
Sha-Asia’s Possible Story Continued…




If Sha’Asia was offered an epidural, I could speculate that a few things were happening. 1) She was likely being induced, possibly because of suspected gestational hypertension or preeclampsia, and 2) She was probably not progressing normally in labor.
I believe that she was being induced because the reports that I read said that she was admitted after fetal testing because of her high blood pressure, not because of labor. However, labor would be the only reason for her to need an epidural. Therefore she must have been being induced.
I think that she may not have been progressing in labor because, at least in my practice, the only time that I recommend that a person gets an epidural if they don’t request it themselves is if their labor is stalling and we need to add interventions that are not tolerated well.
Said differently, if a person is contracting and not dilating and I need to add more assistance to help their cervix dilate further, that will also hurt more. Also, if I offer to break a person’s bag of water to help labor to progress, that often leads to stronger contractions that hurt more. Someone who is having difficulty tolerating labor at its present level will likely benefit from pain relief if I have to level up their labor intensity.
Advice #2: If your doctor offers an intervention, ask why.




Understanding the reason for proposed interventions may help you better understand and decide whether or not you want to take that advice. When you ask why, be sure to include that you are interested in understanding. Humans are humans. Many professionals of various careers are more likely to respond positively to a request for clarification than a perceived challenge of their knowledge or expertise.
Feel free to also ask what the alternative is. In medical training, we are trained to offer risks, benefits, and alternatives. A healthcare provider should be able to explain those upon request for any intervention proposed.
Sha-Asia’s Possible Story Part 3…
The third part of the story from the article above states, “Washington went into cardiac arrest, prompting doctors to perform an emergency C-section.” Considering epidurals account for less than 1 percent of deaths, I do not think that the epidural was the cause of her death. 
Cardiac arrest during labor is likely to be due to one of three causes, heart disease, a blood clot causing a pulmonary embolism (which is what Serena Williams had), or an amniotic fluid embolism, which behaves like a blood clot.




Heart disease, like the heart defects that can cause young athletes to die suddenly, can also affect people in labor in the same way. Blood clots are significantly more likely to form during pregnancy and labor. Black women, people with a genetic predisposition, pregnant women, and those who are obese are significantly more likely to develop a blood clot. This can be small enough to be caught and treated with blood thinners, or they can be big enough to cut off oxygen to your body and cause you to die practically immediately. Preeclampsia also increases this risk.
Amniotic fluid embolism is one of those rare but very random and spontaneous things that can also lead to sudden death if severe. 
Considering my speculation that Sha-Asia had preeclampsia, she may have also been on IV Magnesium, which is one medication given to treat this condition. Magnesium can be life-saving if appropriately used but threatening if not monitored properly. If a person’s blood Magnesium level is too high, it can lead to depressed reflexes, sedation, and cardiac arrest. If levels are too low, a person is at risk for Eclampsia, which is manifested as seizures that can lead to coma, brain and organ damage and death.
Magnesium levels can be monitored by blood levels or physical exams- checking alertness, reflexes, etc. The IV containing Magnesium has to be correctly labeled and monitored to ensure that it is not confused with other fluid infusions and isn’t stopped or given in large quantities by mistake.
Advice #3: Know what you are receiving through the IV.




Intravenous (IV) fluids can also be life-sustaining during labor since maternal hemorrhage (excessive rapid blood loss) is among the more common causes of death and damage during delivery. If your labor also necessitates antibiotics, say because of Group B Strep colonization or infection, or other types of infections that can occur in labor, you should be informed. If you also need Pitocin, you should be aware of that too.
If you develop preeclampsia and need IV Magnesium, know where it is, as in where it is hooked up. Ask how your levels will be monitored. Keep notes of any information you are told so that you can be aware of things that are happening properly and when questions may need to be raised.
We know that having a healthcare advocate or caregiver can improve outcomes for the elderly and people undergoing surgery. I propose that the same MUST be valid for pregnancy. If the expectant mother can’t be her own advocate, a family member or friend can keep notes and ask questions even as the joys of welcoming a new baby into this world are unfolding.
Preeclampsia is cured by delivery, but that doesn’t mean it’s over. Blood pressure abnormalities and the risk of Eclamptic seizures can occur even as far as 6 weeks or more after delivery. If you have access to a blood pressure monitor at home, continue to check your blood pressure periodically in those first few days and weeks to ensure that it is normal and contact your healthcare provider immediately if it’s not.
What is the take-home?




Prayerfully, a healthy, happy baby and mother are the primary take-homes.
As for this article, while I wait for more information about Sha-Asia’s story to surface, I want to see each maternal death investigated. Not just for wrong-doing either. I want them all investigated to determine the exact cause of death and the events leading up to identify if anything could have been done differently.
I also want all healthcare providers to receive formal, vetted implicit bias training. We HAVE to examine the role of systemic racism in not only access to quality care, but in the manner care is dispensed to different people from different backgrounds, even if blatant racist practices do not appear to be in place. 
Obesity, hypertension, diabetes, and lifestyle choices like smoking also contribute to the risks of having babies. We cannot ignore those. Regular exercise, access to healthy dietary choices, and regular prenatal care are ESSENTIAL.
I’ll tell you what I WON’T accept…
I will NOT accept the cause of death as “Child Birth.” The delivery of a baby is not what is killing these ladies. Complications surround that delivery, even up to a year post-delivery, are what are to blame. Prevention and reduction of these outcomes have to come from all sides, even the expectant mothers.
Thanks for reading and don’t forget to like, share and follow The Gyneco-(b)Logic for more health with the occasional humor. 




R.I.P. Sha-Asia Washington
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The death of Sha-Asia Washington on July 3rd, 2020, has sparked outrage in Brooklyn and attention from the entire country regarding the safety, or lack thereof of black women during childbirth. As a practicing OBGYN and as a black woman, I feel the need to address this particular case and examine not only the possible […]

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