Patient Education : Frequently Asked Questions

Listed below are some of the most common questions patients have during pregnancy and for routine gynecological care. Our doctors have carefully evaluated these questions and answered them for you. We also know that you may have specific questions, so our doctors and qualified clinical staff are always available to speak with you by phone or during your next scheduled visit with our office.

OB

Q: Should I have a check up before I attempt to get pregnant?

A: It's always a good idea to plan ahead before attempting a pregnancy. You should make an appointment with your healthcare provider to have an exam and to make sure you are on schedule with your annual pap smear. Preconceptual counseling with your healthcare provider can also include assessment of individual risk factors including medication use, maternal age, and chronic health problems (such as high blood pressure and diabetes). You may also be offered preconceptual labs such as STD screening, labs to check for varicella (chicken pox) and measles immunity, or genetic testing for cystic fibrosis and/or sickle cell anemia. You should also start a prenatal vitamin with folic acid before attempting conception.

Q: Should I worry that I haven't gotten pregnant after 4 months of trying?

A: Most women are able to conceive if the desire (up to 95% within 1yr) and there are numerous medical advances available for couples that have difficulty achieving pregnancy. Couples attempting pregnancy should avoid smoking, drugs and alcohol, as these can actually decrease the chance of conception. Timed intercourse 11, 13, and 15 days after the start of your period is optimal. Couples who have been attempting pregnancy for more than 1 year (or more than 6 months if age 30 or above) should make an appointment with their healthcare providers

Q: Are there extra risks for pregnancies in women over 35 years old?

A: Age need not be a barrier to a safe and healthy pregnancy, but certain medical and obstetrical conditions do occur more often as women age. These can include decreased fertility, high blood pressure, gestational (onset during pregnancy) diabetes, and cesarean sections. The risk of certain chromosomal problems with your baby (such as Down's Syndrome) also increases with maternal age. You should make an appointment with your healthcare provider to discuss these issues prior to attempting pregnancy.

Q: How much weight should I expect to gain when pregnant?

A: A weight gain of 25-35 pounds is recommended by the American College of Obstetricians and Gynecologists for a woman of normal weight at the onset of her pregnancy.

Q: Can I take medicine if I am pregnant?

A: A pregnant women should not take medications before checking with her healthcare provider. Certain medications can be dangerous to an unborn child or pregnant woman. It is better to try other remedies first. For example, resting in a quiet dark room to alleviate a headache, or sipping clear liquids to combat nausea. Some medications such as Tylenol, Maalox, or Mylanta are considered okay for use in pregnancy; however, it is strongly recommended that you check with your healthcare provider before taking any medications during pregnancy.

Q: Can I take a flu shot if I am pregnant?

A: Yes, after the first trimester. The Center for Disease Control recommends that all pregnant women receive the influenza vaccine during the October-March flu season. Recent studies have shown that the vaccine is safe during pregnancy and can prevent serious complications for the illness. Also, a mom-to-be can pass her immunity to her baby in utero, offering protection in the first months of life.

Q: Is smoking dangerous for my unborn baby?

A: Yes. Tobacco smoke is a major source of carbon monoxide, which can interfere with the oxygen supply to the fetus. Studies have shown that smoking can result in miscarriage, smaller birth weight babies and prematurity. Increased incidences of birth defects, lower IQ, and Sudden Infant Death Syndrome have also been linked to smoking. These are all good reasons to stop smoking if you are pregnant are attempting pregnancy.

Q: What is Group B Streptococcus?

A: Group B Streptococcus is a type of bacteria commonly found in the vagina or rectum of women. In most cases, no symptoms or problem occur. However, some babies exposed to Group B Streptococcus during delivery can become infected. The Center for Disease Control recommends that all pregnant women be screened for this infection between 35-37 weeks gestation. Pregnant women who have this infection will be treated with antibiotics during labor to decrease the risk of transmitting this infection to their baby.

Q: Can I continue having sex while I am pregnant?

A: Sexual relations during normal pregnancies are not harmful. You should avoid intercourse if advised to by your healthcare provider, or if you are bleeding or leaking fluids.

Q: How can I tell if I am in labor?

A: Labor differs from patient to patient. Then usual signs and symptoms include one or more of the following:

Contractions 5-6 minutes apart for 1-2 hours
Blood tinged vaginal mucus
A gush or slow leaking of watery fluid from your vagina

Every pregnancy is different. Follow your healthcare provider's instructions and use your judgment. Remember, if you are less than 37 weeks pregnant and notice any signs or symptoms of labor you should be checked immediately.

Q: What is circumcision and is it necessary?

A: Circumcision is the practice of removing foreskin from the penis of baby boys. The American Academy of Pediatrics currently views circumcision not as a medical decision, but rather one of parental choice. Discuss the benefits and risks with your healthcare provider.

Q: What are the benefits of breastfeeding for my baby and me?

A: The substance found in colostrum (the milky or yellowish fluid present in the mammary glands a few days before and after birth) protects your baby against a number of infections. Breastfeeding is also more easily available and more economical. Studies have shown that breastfeeding helps reduce obesity in children. Nursing women describe breastfeeding as enjoyable, and it may help hasten maternal weight loss. Preparation for breastfeeding should begin during pregnancy by viewing tapes, discussing your options with your healthcare provider, and/or attending a breastfeeding class.

GYN

Q: Why do I need a pap smear?

A: A pap smear screens for precancerous or cancerous cells of the cervix. Often there are no obvious signs or symptoms of cervical cancer.

Q: Who needs a pap smear?

Women age 18 or older
Women younger than age 18 if sexually active.

Women who have had a hysterectomy or have gone through menopause may need regular pap smears depending on their past histories.

Q: Does a pap smear screen for other infections?

A: A pap smear only screens for precancerous or cancerous cervical cells. Other screenings such as wet smears, cultures, or lab work may be needed to screen for possible infections.

Q: Who is at risk for cervical cancer?

Women who are, or have been, sexually active are at risk
Women who smoke are at risk
Women who have never had a pap smear, or who have not had one in years, are at risk
Women with a personal history of past abnormal pap smears are at risk.

Q: What is HPV?

A: Human Papillomavirus (HPV) is an infection passed from one person to another through sexual contact. There are over 70 strains of HPV. Some strains cause external; warts, some cause precancerous or cancerous cervical changes, and some do nothing at all. Patients with abnormal pap smears can now have HPV testing to give the patient and healthcare provider more information and aid in planning care and treatment.

Q: What is a Bone Density test and why do I need one?

A: After menopause, a Bone Density Scan screens for osteoporosis, or low bone mass. This is a "silent" disease in which the body starts losing bone at a faster rate than it can replace it. As a result, your bones become thinner, weaker, and more likely to break. The test is non-invasive and somewhat similar to taking an x-ray.

Q: Who is most at risk for osteoporosis?

Post-menopausal women are at risk
Women with a family history (mother, grandmother, sister) of osteoporosis are at risk
Women who smoke are at risk
Women with thyroid disease are at risk
Caucasian women are at risk
Women who take bone-thinning medications (such as steroids) for long periods of time are at risk.

Q: Is there a treatment for osteoporosis?

A: Yes. Different treatments are available depending on the amount of bone loss. Sometimes calcium and hormones are recommended. Other times, certain medicines known as bisphonates are recommended to stop bone loss and strengthen bones.

Q: Do I need a mammogram?

A: The American Cancer Society recommends all women age 40 and over get annual mammograms. If you have a family history of breast cancer (even if you are younger than 40) you should discuss possible mammograms and other breast cancer screening tools with your healthcare provider.

Q: What should I do if I feel a breast lump?

A: All women age 20 and over should perform self breast examinations every month. By examining your breasts regularly you can become more aware of breast changes. If you notice a change in your breast, you should see your healthcare provider as soon as possible.

Q: What should I do about recurrent yeast infections?

A: Yeast is a fungus that lives on our skin and thrives in moist dark environments. People who get recurrent yeast infections should avoid irritants to their vaginas (douching, harsh soaps) and limit sugar intake. Sometimes people who complain of recurrent yeast infections actually have other types of vaginal infections. People who notice recurrence of infections should see their healthcare provider for further guidance.

Q: What is herpes and what should I do if I think I've been exposed?

A; Genital herpes is a sexually transmitted disease that can affect the sex organs, along with other parts of the body such as lips, finger, and eyes. It is best known for the sores or blisters it causes. One way to diagnose herpes is to examine the genitals and culture a sore to see if the virus is present. There are also blood tests available now to screen for herpes even if a sore is not present.

Q: Is there a cure of herpes?

A: There is no cure for herpes. However, there are oral medications to help control the disease. Some people take daily or suppressive medications for herpes to lessen their outbreaks and reduce transmission risks to their partners. See your healthcare provider to discuss your options.

Q: Do I need hormones?

A: Hormone therapy is a treatment for women who do not make enough estrogen or progestin. Low hormone levels can start the menopause process and produce symptoms such as hot flashes and vaginal dryness. Hormone therapy can improve these symptoms as well as provide osteoporosis prevention. There are also some risks associated with hormone therapy. You and your healthcare provider can decide together if hormone therapy is right for you.