Postpartum Depression

Postpartum depression occurs in women that have just had children and can often be debilitating and completely confusing for a new mother to understand. It happens as the body’s hormones adjust back to regular levels and often is characterized by signs and symptoms similar to traditional depression. The mother may lose interest in everything around her, including her new baby. It can be challenging for a women to overcome, however, with help from your Arizona OBGYN Affiliates provider, there are ways to treat this form of depression.

 

Signs of postpartum depression include feelings of sadness or hopelessness that don’t go away after a few days; lack of appetite; an inability to sleep; among other signs. New mothers may feel discontent or resentment towards their new baby and have a lack of understanding for why they feel that way. This is very common for first time mothers, although postpartum depression can affect a woman every time she has a child. In severe cases, women may need to take antidepressants or other medications to stave off the depression, particularly if it gets too bad. An Arizona OBGYN Affiliates provider may prescribe medication to help with the shifts in mood, though if it gets severe he may also prescribe counseling and more extensive treatment since postpartum depression can often manifest into full blown depression that lingers longer after having a baby.

 

The more important component of dealing with this type of depression is to take it seriously. Severe cases can cause mental instability when it is not treated. Talking to an Arizona OBGYN Affiliates provider and recognizing the symptoms as they occur is key to catching postpartum depression before it gets to the point where it is affect your life. There are also support groups available in most areas, which can be a part of an overall treatment plan, where women come together to talk through coping mechanisms for postpartum depression. Sharing tips on how to overcome it can be very helpful since the experience is different for everyone.

 

Postpartum depression can rob you of your experience and time with your new baby, so getting help early keeps it from becoming more severe than necessary. Talk with your Arizona OBGYN Affiliates provider the minute you start to feel down or hopeless and notice that it is not passing. SHe or he may be able to make recommendations that ensure you get your life back and start to feel more balanced so you can enjoy your precious little one.

Common OBGYN FAQ’s

How often should you be giving your gynecologist a visit? Once a year? Once every three years? It seems that the rules are constantly changing, and once a study comes out letting you know that you only have to go once every three years, another comes out saying that you need to go every year. So, let’s take a look at when you should be seeing your gynecologist.

What is a Pelvic Exam?

During a pelvic exam, your physician will check for signs of illness or abnormalities. The uterus, cervix, fallopian tubes, ovaries, and bladder are checked during this pelvic exam. Unlike a Pap test, this is suggested to be performed once a year. A Pelvic Exam is not a Pap test, it’s important to remember this.

 

What’s a Pap smear?

A Pap smear, or Pap test, is a type of screening that checks for cancer of the cervix or any cervical abnormalities that might lead to cancer. During a Pap test, your gynecologist will look at the vulva as well as the cervix with a speculum. Your physician will check internal organs and will take a small sample of cells to examine for abnormalities.

How Often Should You Have a Pap and/or a Pelvic Exam?

As a general rule, all women should have a pelvic exam at least once per year.  According to the American College of Obstetricians and Gynecologists, if you’re over 21 but under 29, you should have a pelvic exam once a year. This yearly visit should include a General Women’s Wellness Exam including a Pap smear. If you are between the ages of 30 to 64, it is recommended that you should have a pelvic exam every year, A Pap smear would be done every other year, or as often as your physician recommends at each appointment.

If you are 21 and older, you’ll want to visit your gynecologist for what’s called a pelvic exam and Pap Smear.  If you are younger than 21, we still recommend that you meet with your gynecologist to start a relationship with them, getting comfortable with any questions you might have and topics you want to cover.  Many times, for young women who are just entering puberty, pelvic exams are not required.  We encourage family members to come with you on these first visits as well.

Keep in mind that the guidelines on when to get a Pap smear, a pelvic exam, and how often to see your gynecologist are always changing. Your best bet is to always consult with your OB GYN directly to see what their office guidelines are.

What is the Difference Between a Pap Test and Pelvic Exam?

While a Pap test will show abnormal cells and signs of cervical cancer, a Pelvic exam can check for skin cancers, diseases of the vulva, STD’s and different forms of cancer. While your Pap test can be performed every other year in some cases, your Pelvic exam absolutely must be performed every single year.

What is a General Women’s Wellness Exam?

At AOA, a Wellness Exam is recommended yearly, and includes not only breast and pelvic exams and pap smears, but addresses your individual needs, any concerns or questions you might have regarding sexuality, stress, parenting, family planning, and/or hormones.

Why Does My Recommended Visit Schedule Change After 30 Years Old?

If you’ve had normal Pap smears throughout your last three visits after the age of 30, do not have a history of dysplasia, is not HIV positive, and has not been exposed to diethylstilbestrol before birth, your physician might suggest a Pap smear every two years.

However, these recommendations are also based on your physician’s suggestion, how sexually active you are, and your overall health. You should also be aware of the following conditions that would warrant a call to your gynecologist:

  • Changes in menstrual cycle
  • Abnormal bleeding
  • Vaginal pain or discomfort

Labor and Birthing Myths

Oftentimes, what you don’t know is what scares you the most, especially when it comes to pregnancy and labor. You’ve heard all of the horror stories; the labor that lasted three days, the tearing, the recovery. It always seems like when you tell family and friends that you are pregnant, sure they are excited and congratulate you, but then inevitably comes the horror stories. Let’s take a look at those horror stories, those fears of the unknown, and lay it out there. The reality might not be as scary as others make it out to be.

Labor Horror Stories vs Reality

Why is it that whenever you talk about labor, everyone and their mom feels the need to tell you the worst parts about it? And, since you’ve never gone through it before, it’s easy to get sucked into that fear of the unknown.

Myth #1 – Complications that aren’t really complications are always an issue. What I mean by that is often times people will find something wrong with the situation and claim that it will lead to complications. For example, if you’re over 35 and considered AMA (advanced maternal age) there will be complications. This simply isn’t true anymore.  Another quite common one is that if you have a prolonged pregnancy (past 40 weeks) there will be complications. In fact, times have changed greatly and it is still considered ‘normal’ for a pregnancy to last between 37 and 42 weeks from ‘last menstrual period.’

Myth #2 – Moms love to talk about how scary it was when their labor failed to progress, which led to a C-section. While failure to progress is a clinical reason for C-section, only 8 percent of all labor complications are due to failure to progress. If this is something that you’re genuinely concerned about, there are things that you can do to lower your risk, exercise, gaining no more weight than is recommended, and remaining at home in a relaxing environment until your contractions are five minutes apart (with physician approval).

Myth #3 – Moms also love to tell the ‘heroic’ tale of how they fought through the pain to have an ‘all natural childbirth.’ They’ll tell you that it’s the only way to go, no drugs and no risk for having a groggy feeling or putting the baby at risk. Everyone experiences childbirth differently, and each situation is different. Having an epidural or natural birth can be a tough decision for many mommies to be. Speak to your physician to find out the best birthing option for you. Read the studies, do your homework, and make an informed decision for yourself.

Myth #4 – Lacerations and tearing is a topic that really no one wants to hear about, but somehow it makes its way into birthing conversations all of the time. This is one of a new mom’s greatest fears during labor, but we’re here to say that it doesn’t happen as often as you’d think. Even the most minor lacerations only occur in roughly 16 percent of all labors. Second-degree tears, which require stitches, only occur in 17 percent of all labors.

Myth #5 – Everyone has a natural fear of complications such as umbilical cord issues or heart rate issues, so let’s take a look at these. Out of all labors across the U.S, only 23 percent have umbilical cord issues. This can be where the cord is wrapped around the neck or entangled around the baby in some way making labor and birth a bit more complicated. As trained labor and delivery physicians and nurses, this is something that we are well versed at. With simple maneuvering and/or manipulating, most of these situations can be remedied quickly. As for heart rate issues, this only occurs in 15 percent of all labors.

If you have questions or concerns about any of these issues, or need some clarification on other topics, don’t hesitate to contact us immediately or visit our Facebook Page to ask the community of moms.

AOA Family in View

At Arizona OBGYN Affiliates, we take pride in our AOA Family. Besides raising the bar in women’s healthcare, we are raising the bar in terms of patient relationships and family inclusion. Our AOA Family does not just consist of amazing, ‘Top Docs,’ staff and nurses. When we want you to join the AOA Family, were talking about our beautiful patients as well.

AOA Family History

We’ve spent many years establishing and assembling an integrated family of physicians who’s core values include providing high quality care and meet the highest level of clinical, technical and ethical standards in healthcare. If you’ve been to our Philosophy Page on the website, you’ve probably seen this line; “We believe in the power of family, the strength of unity, the importance of listening and the respect that comes from understanding.”

The AOA Family in View

In our latest newsletter we featured a very special part of our AOA Family that has spanned three generations. We love featuring a new AOA Family member in each addition of our monthly newsletter, connecting people not just with our physicians but with our patients as well. This month we introduced you to Lisa Taylor and her wonderful family.

Taylor is the first of three generations to become an AOA Family member. She first started seeing Dr. Michael Rockwell over 24 years ago, before seeing Dr. Brock Jackson. Impressed with the friendliness and quality of service, Taylor invited her mother and her daughter to join the AOA Family as well.

Today, grandmother, mother and daughter are AOA Family members at our Maricopa OBGYN offices. We have been lucky enough to welcome Taylor’s two sons and many grandchildren into the world.

“My mother has been a patient for at least 22 years and my daughter has been a patient for 10 years. We have had nothing but great experiences with the physicians and staff at MOGA. The physicians really take the time to get to know you as a person. They have always been friendly, caring, knowledgeable and most importantly they listen!

 

We couldn’t be where we are today without our amazing AOA Family members like our three generations of Taylors. It’s our commitment to providing quality care and literally treating you as we would treat our own family that makes our physicians some of the best in the valley.

Tips for Creating Your Birth Plan

Creating your birth plan gives every new mom a sense of control at a time when it seems nothing, not even her own body, is controllable. It often seems like absolutely everything is out of a new mom’s control, and if nothing else creating a birth plan is a necessary step to feeling in control of something. Birth plans are also a wonderful way to really sit down and prioritize what will be important to you on your day of labor, and what thing you could do without.

Creating Your Birth Plan

The very first thing that you need to know about a birth plan is that when the time comes, even if you have expressed a great determination to stick to the birth plan and all of your physicians and nurses know this, there is a strong possibility that birth plan will go right out the window. Every nurse will do their best to stick to that plan and follow every aspect of that birth plan, but when it comes right down to it your ideas of labor might change, your partner’s ideas might change, and the entire birthing and labor circumstances could cause the birth plan to be completely void.

With that said, creating a birth plan is wonderful exercise that includes both you and your partner. It will bring you closer together at a time when intimacy and an emotional connection is extremely important. It will also require you both to express feelings, anxieties, excitements and fears about the upcoming birth of your new baby.

When creating your birth plan, follow these simple steps:

  1. Start Early and Add – Creating a birth plan is usually not at the top of your list early on in your pregnancy. You’re too busy thinking about names, cribs, clothes, and decorating the nursery. However, it is helpful to always have the birth plan available and to always have it in the back of your mind should something come up that you’ll want to add and discuss with your partner.
  2. Work Together – This is a joint exercise and it’s crucial that you do it with your partner or individual who will be in the delivery room with you. You’ll need to be on the same page with everything on that list.
  3. Keep It Updated – As the birth date comes closer, review your birth plan making sure that everything on there is up to date. If you’ve discovered that there might be some complications, update your birth plan to reflect that. If you’ve decided on an epidural or not an epidural, update that. If you’ve changed your mind about music, lighting, or who will be allowed in the room, update that as well. This is your chance to have control over something. Take advantage of that fact and keep the birth plan updated to reflect anything and everything you want, right up to the last second as you’re heading to the hospital.
  4. Understand It’s Not Binding – Lastly, when creating your birth plan keep in mind that it’s not a binding contract. While the nurses and physicians will respect your wishes and do their best to stick to the plan, there are circumstances and situations that can greatly alter the plan.

When creating your birth plan, think about these topics:

  1. How will you be handling the pain? Will you want an epidural? Will you want to walk around? How about a birthing ball or light music? Think about how you’ll want to manage the pain.
  2. Who will be in the room and for how long? Do you want family in the room? Do you want them helping with the birth or standing in the distance? At the head of the bed or taking pictures?
  3. How do you want your baby treated after he or she is delivered? Immediate skin-to-skin contact or cleaned up and wrapped up first?
  4. Are you breastfeeding or bottle feeding?
  5. How will you handle unexpected circumstances?

There are many resources available on the internet to assist you with creating your birth plan. See the following for ideas:

http://pregnant.thebump.com/pregnancy/pregnancy-tools/articles/tool-birth-plan.aspx

http://www.babycenter.com/calculators-birthplan

New HPV Guidelines

ACOG has not commented on the new guidelines so pap frequency discretion could be different with your AOA provider.

The HPV vaccine is not without controversy, however ‘a new study suggests that the vaccine against human papillomavirus can significantly cut the likelihood of virus-related disease even among women who have had surgery for cervical cancer caused by HPV,’ according to the New York Times. There have been many studies over the years regarding the HPV vaccine, however this new study also takes a look at how the vaccine affects those who have had an HPV-related infection in the past.

During the study, of the women who received the HPV vaccine, 46 percent were ‘less likely to suffer subsequent HPV-related disease.’ And for those who had a bout with HPV-related infections in the past, the HPV vaccine reduced their overall risk for future bouts by 64 percent.

Experts not involved with the research told ABC News that the research is significant because it suggests for the first time that the HPV vaccine may offer benefits beyond prevention, according to ABCNews.com.

HPV-Related Cancers

On a related note, the HPV virus in relation to head and neck cancers is rising in the United States, which is another reason why the above study is so important. As we find out more and more about the importance of getting the HPV vaccine for prevention benefits, we are also well aware of the fact that the human papillomavirus contributes to a great many other illnesses and cancers.

In January, a study was published documenting the ability for the HPV vaccine to reduce the recurrence of abnormal cell growths in men, directly correlating with this recent study out of the Louisiana State University Health Sciences Center and its findings. According to the study, the incidence of head and neck cancers related to the human papillomavirus (HPV) is rising in the United States, with the greatest increase among middle-aged white men.

About HPV

Over 6 million men and women in the United States become infected with HPV every year, and according to the Centers for Disease Control about 20 million people are currently infected. HPV comes in many forms, over 40 different strains in fact, many of which clear up on their own. However, HPV types 6, 11, 16 and 18 can lead to many health issues, including genital warts, cervical cancer and many other forms of cancer including head and neck cancers.

Recently new screening guidelines were released (from the U.S. Preventive Services Task Force):

  • Women aged 21 to 65 should get Pap tests no more than every three years; previous guidelines, issued in 2003, recommended that women be screened “at least” every three years, allowing for annual screens
  • Women aged 30 to 65 may extend the interval between screens to five years if they use HPV tests in conjunction with the Pap test; the HPV test should not be used in younger women because many of them will have HPV infection that they will naturally clear without treatment
  • Women under 21 should not be screened for cervical cancer, regardless of sexual history; previous advice recommended that women begin cervical cancer screening within three years of becoming sexually active
  • Women over 65 should not be screened, as long as they have had consistently normal Pap tests and are not at high risk for cervical cancer

    Read more: http://healthland.time.com/2012/03/16/new-cervical-cancer-screening-guidelines-include-hpv-tests/#ixzz1rBQpPeTT

For more information on the HPV vaccine, HPV-related issues and complications, or any other questions you might have regarding STD’s, please contact us.