Home Obstetrics

Obstetrics

Obstetrics focuses on all aspects of pregnancy, from the time you become pregnant to delivery of your little one. The physicians at CU Medicine OB-GYN - South Metro provide comprehensive prenatal care for you and your baby throughout your pregnancy.

  • Prenatal Care

    Prenatal care includes regular checkups, ultrasounds, diagnostic testing and maintaining a healthy lifestyle. Your obstetrician can provide you with guidance on how to best maintain a healthy lifestyle by eating a healthy and balanced diet and engaging in moderate exercise.

    Several prenatal appointments will be scheduled throughout your pregnancy. These prenatal checkups allow your obstetrician to monitor your pregnancy and ensure everything is going smoothly. During a prenatal visit, the physician will check such things as your blood pressure, the baby's heartbeat and your weight. A urine sample might also be collected at appointments to check for gestational diabetes and preeclampsia.

    An ultrasound will be performed during two different prenatal appointments, one between 8-10 weeks and another around 20 weeks. Ultrasounds present an exciting opportunity to take a peek at your developing baby. The first ultrasound helps determine how many babies there are, as well as an approximate due date. The second ultrasound is done to check the baby's growth and development. The sex of the baby can also be checked during this second ultrasound if desired.

    In addition to traditional ultrasounds, the obstetrics department at South Metro OB-GYN also offers 4-D ultrasounds. This type of ultrasound is performed between 25-27 weeks for parents who are interested in seeing a more detailed image of their growing baby. The 4-D ultrasound is not part of standard prenatal care is generally not usually covered by insurance. This type of ultrasound is available to patients able to pay out of pocket.

    At your prenatal appointments, your obstetrician can offer you dietary and exercise guidance to help you remain healthy throughout your entire pregnancy. Maintaining a balanced and healthy diet will nourish both you and your baby. Moderate exercise, such as walking, can help your body prepare for delivery. Your doctor can advise you about safe exercises you can perform during pregnancy.

    When it's time to deliver your baby, an obstetrics team of doctors and nurses will help you through labor and delivery. Your obstetrician can even help you develop a birthing plan during our prenatal appointments so that you'll feel more prepared when the big day arrives.

    Prenatal care is an important part of maintaining good health throughout pregnancy. The obstetric services provided by the physicians at CU Medicine OB-GYN - South Metro will help you enjoy a happy and healthy pregnancy.

  • Preconception Counseling

    Pre-conception counseling involves meeting with a doctor (typically an obstetrician or gynecologist) prior to becoming pregnant. If a woman or couple are planning to have a child, experts suggest initiating this sort of counseling approximately three to six months prior to attempting conception. This allows enough time for mental and physical preparation and to identify and treat any underlying problems.

    These counseling sessions primarily exist to identify any undetected illnesses or risk factors that could cause problems for both the mother and the fetus. Risk factors may include smoking, alcohol consumption or certain prescription or recreational drugs that can interfere with the fetus' growth and development. Potential obstacles are addressed in questionnaires about the woman's family history and current lifestyle. They include questions about the woman's health, prior pregnancies, medical conditions and genetic background.

    Laboratory tests such as blood work and urinalysis can identify other problems, such as anemia or a kidney infection, of which the woman may have been unaware. Other tests may include pelvic examination, screenings for sexually transmitted infections, and a mental health assessment.

    After the counseling is completed, the doctor will discuss the results and any recommendations for lifestyle changes to allow for the greatest level of safety and success in conception and fetal development.

  • Ultrasound

    CU Medicine OB-GYN - South Metro provides board certified Ultrasonographers on site so that your ultrasound can be performed in conjunction with your doctor's appointment. Our Ultrasonographers are highly trained in obstetrical ultrasounds as well as ultrasounds done to identify gynecologic abnormalities such as ovarian cysts and uterine fibroids. Routine obstetrical ultrasounds are performed at eight weeks, twelve weeks and twenty weeks. Additional ultrasounds may be necessary at your physician's discretion.

    Gynecologic ultrasounds can usually be done on the same day as your appointment with the doctor before or after a gynecologic abnormality has been suspected or identified. We pride ourselves in offering you the most comprehensive care possible so that you leave our office with the confidence that you have been well cared for.

    Obstetric ultrasound is a diagnostic test that allows parents to view their baby, and to even determine the baby's sex. During pregnancy, a woman may visit their doctor for multiple ultrasounds in order to ensure the baby's health, as well as the sex of the baby. To view the baby, doctors may use both 3D and 4D ultrasounds, but they are not standard prenatal tests.

    Ultrasounds in 3D and 4D
    Just like regular ultrasounds, 3D and 4D ultrasounds use sound waves to create an image of your baby in your womb. With 3D ultrasounds, you will be able to see a three-dimensional image of your baby. On the other hand, 4D ultrasounds create a live video effect that allows you to watch your baby smile or yawn.

    Some of the conditions and types of ultrasounds that our Ultrasonographers are trained to address include:

    Obstetrical Ultrasounds
    Pregnancy Confirmation
    1st Trimester Screening
    Anatomy and Growth
    Biophysical Profiles
    Pre-Term Labor/Cervix Check/Placenta check 3D and 4D

    Gynecologic Ultrasounds
    Abnormal Bleeding
    Ovarian Cysts/Masses
    Fibroids/Polyps
    Hysterosonograms (HSG)
    Ultrasound Guided Endometrial biopsies
    Ultrasound Guided IUD Insertions/removals ABBI procedure for fallopian tube patency

  • Ultrasound Exam

    Prenatal ultrasounds are common part of a new mother's prenatal testing. Using high-frequency sound waves, ultrasounds produce images of a fetus and the mother's reproductive organs. These sessions, which are usually performed in a doctor's office, track fetal growth and development and monitor for any ongoing problems.

    Standard ultrasounds are two-dimensional. A water-based gel is applied directly to the mother's abdomen, and a wand, also called a transducer, will be maneuvered around the area. Transvaginal ultrasounds may also be used, in which a smaller transducer is placed inside the vaginal canal.

    The images being captured will then be shown on a screen in black-and-white. These are used from the very beginning to pregnancy to confirm the gestational age and size of the fetus, monitor the fetal heartbeat, examine the mother's reproductive system, and diagnose any abnormalities. Doctors may also use ultrasounds to guide them as they perform other tests, such as an amniocentesis (an analysis of the amniotic fluid).

    Ultrasounds are usually performed as part of screening or medically recommended testing, and should not be performed solely to reveal the sex of the fetus. Doctors also do not recommend 'souvenir' ultrasounds, as these might pose as-yet unknown risks for the fetus.

  • First Trimester Screening

    What is a First Trimester Screening?
    A first trimester screening, performed roughly between 11-13 weeks of pregnancy, is used to detect chromosomal abnormalities such as Down's Syndrome, Edwards' Syndrome and Patau's Syndrome. It involves two parts, a blood test and an ultrasound screening referred to as a 'Nuchal Scan' or 'Nuchal Translucency Screening.' The screening helps your OB/GYN determine the fetus' risk of these abnormalities.

    How is a Nuchal Scan Performed?
    A nuchal scan is done by ultrasound. The ultrasound technician will measure the amount of fluid in the back of the baby's neck. While all babies have some fluid in the back of their necks, the presence of excess fluid in the back of a baby's neck can be a symptom of an abnormality.

    When is a Nuchal Scan Performed?
    Nuchal scans are generally performed between 11 and 14 weeks gestation. Tests completed before or after this range are not as accurate.

    How Accurate are Nuchal Scans?
    Nuchal scans are screening tests - not diagnostic tests. This means that they can be used to assess the risk or likelihood that your baby has an abnormality, but they cannot be used to diagnose a condition. If your nuchal scan does detect an abnormality, you will then have the option to pursue further diagnostic testing.

    First trimester combined screenings typically detect Down Syndrome 85 percent of the time. However, they also give a false positive 5 percent of the time, meaning that they indicate an abnormality that doesn't exist.

    What Should I Do If My Nuchal Scan Comes Back Positive?
    If your Nuchal scan indicates that there might be an abnormality, the first thing you need to do is try to relax. Just because the scan says something could be wrong with your baby's chromosomes does not necessarily mean that something is.

    At this point, you will likely have the option to pursue diagnostic testing such as chorionic villus sampling or amniocentesis for a better understanding of what is going on. These tests do come with increased risks, however, so you will want to talk to your doctor to find out which course of action is best for you.

    What Risks are Associated with Nuchal Scans?
    Nuchal scans themselves present no known risks. However, receiving a false positive can lead to undue anxiety, more testing and even terminating a pregnancy needlessly.

    Nuchal scans are routine and relatively risk-free, so if your doctor recommends one, do not be alarmed. He or she is likely just checking to be sure.

  • Prenatal Visits

    What is a Prenatal Visit?
    A prenatal visit is a routine visit you make to your doctor or midwife while pregnant. You should expect to make several visits to your doctor or midwife throughout the course of your pregnancy.

    When Should I Schedule My First Prenatal Visit?
    The date of your first visit depends on a number of factors, depending how far along you were when you found out about the pregnancy, your health history, and your doctor's policies. Generally, your best option is to call your ob-gyn as soon as you find out you are pregnant, and they will let you know when to come in.

    How Often Will I Have Prenatal Visits?
    Most doctors will have you come in every four weeks throughout your first and second trimester. During the third trimester, you will likely come in every two weeks at first, and then every week once you hit 36 weeks. Of course, if you have health concerns which put your pregnancy at greater risk, you may need to come in a little more frequently. Your doctor will let you know.

    Because of how frequently you can expect to see your doctor throughout the course of your pregnancy, choosing one you like and feel comfortable with is essential.

    What Happens at a Prenatal Visit?
    While each visit may differ slightly, here is what you can expect at a prenatal visit: At the first visit, the doctor or nurse will likely take your medical history and your vital signs, including your height, weight and blood pressure. The doctor will listen to baby's heartbeat and feel and measure your abdomen. Occasionally, you will give a urine or blood sample and you'll probably have an ultrasound or two. Toward the end of your pregnancy, your doctor will also check to see how far dilated you are.

    Your doctor should also talk to you about any questions or concerns you have and instruct you on how to best care for yourself and your growing baby. Don't be afraid to ask questions, especially if this is your first pregnancy or if something doesn't seem right.

    Prenatal visits are routine, so don't be surprised if they are fairly short after the first one. The doctor simply wants to check to make sure everything is looking okay, and if it is, you should be good to go until your next appointment!

  • Childbirth Settings

    While most people immediately think of giving birth in a hospital, you may be surprised to hear that you do have other options, including home births and birth centers. Read on to find out which birthing option is best for you!

    Hospital
    Pros: Hospitals have plenty of emergency personnel on hand, so if anything goes wrong, you are in good hands. If you or your baby have any complications, a fully stocked and staffed OR and NICU are generally just an elevator ride away. Hospitals are the only option for patients who require a C-section, and are recommended for patients who have a high-risk pregnancy. Hospitals also offer round-the-clock help.

    Cons: Hospitals often have many strict guidelines, policies, rules and red tape that can interfere with a mother's birth plan. Mother and baby are also often separated following the birth.

    Home Birth
    Pros: The mother is allowed to give birth in a familiar, relaxing environment. She has much more control over the birth process, and can move around, eat, drink, shower and dress as she pleases. Children are welcome to attend. The cost of home birth is typically lower than the cost of a hospital birth. A trained midwife is generally still present to make sure everything goes well.

    Cons: Home birth may not be an option for women who are having twins or who have health conditions or complications, including diabetes, hypertension or preeclampsia. It is not an option for women who need a C-section. If something goes wrong, the mother and baby will still need to be transferred to the hospital. There are also no at-home options for pain relief.

    Birth Center
    Pros: A middle ground between a hospital and a home birth, birth centers take a natural, family centered approach to birth, while still offering low-tech medical interventions. Mothers have more freedom to give birth as they want than in a hospital setting. Pain relief options are often available. Certified nurse-midwives will typically care for the mother during birth. Childbirth is viewed as a normal, safe, and healthy process, but precautions are taken just in case. Many birth centers are now located inside hospitals, meaning that transfer to the hospital proper in case of an emergency would be faster.

    Cons: Dedicated birth centers have rigid requirements and usually only accept low-risk pregnancies. Mothers must still be transported to the hospital in case of a serious emergency, and while birth centers are more comfortable and relaxed than a hospital, they still aren't home.

    Hospitals, home births and dedicated birth centers are all excellent choices for different women. Speak to your doctor about your risk level and birthing requirements to see which option is best for you.

  • Postpartum Care

    Giving birth is a beautiful, natural process, but it can also take quite a toll on your body. Thankfully, there are plenty of tips and products out there designed to make your recovery easier. Here is what nurses and experienced moms everywhere recommend.

    Pain Reduction
    Find out if your hospital offers special ice packs to new mothers, and if they don't, make your own. They are bulky, but they will help. Dermoplast pain spray helps immensely too. Line your sanitary napkin with a witch hazel pad to ease the itchiness of any stitches. Recline or lay down rather than sitting straight up. It is normal to feel contraction, similar in pain to menstrual cramps, after birth. These tend to worsen with every successive pregnancy.

    For the Bleeding
    You will bleed for several weeks after birth. Either wear the underwear the hospital provides or your own underwear you don't care about with a giant pad. Some women opt for adult diapers. Your bleeding should gradually slow and turn from bright red to brown. Call your doctor right away if you soak a pad within an hour, you pass clots larger than a golf ball or your vaginal discharge smells foul.

    For Your Breasts
    Your milk probably won't come in for a day or two after birth. If your breasts are painfully full, you may pump or feed a little for relief, but be careful not to overdo it as your body produces milk on a supply-and-demand basis.

    It is normal for breastfeeding to hurt at first. Make sure baby is latched on correctly and use Lanolin cream to help with any cracking or bleeding. Alternate which side you feed on and wear nursing pads to catch any leaking, especially at first.

    If you are not planning on breastfeeding, wear a compression bra and do not pump. Cold washcloths can help with the pain.

    Using the Bathroom
    Use a squirt bottle when you urinate for the first few days to relieve the stinging. If you find yourself leaking small amounts of urine throughout the day, doing Kegels can help. If you have hemorrhoids, witch hazel pads can soothe them. If your stools are hard and painful, be sure to drink plenty of water and consume enough fruits and vegetables. Your doctor may also recommend a stool softener. You may find it helpful to take a sitz bath afterwards.

    Other
    Rest as much as possible, and don't be afraid to ask for help. Do not drive or carry anything over 10 pounds for a week. Realize that mood swings are normal, but if you are worried you have postpartum depression, talk to your doctor right away. Worry about taking care of yourself and your baby before you worry about weight loss.

    After about six weeks, you'll check in with your healthcare provider. This is the time to discuss any symptoms still troubling you and look at your progress so far. All in all, take things at your own pace, and try to enjoy these first precious weeks after your delivery!

  • Postpartum Depression

    Considering the many chemical changes that happen before, during and after childbirth, it really should come as no surprise that many pregnant women and new mothers experience confusing mood swings. While this is normal, there does come a point when the sadness has lasted long enough and been severe enough to cause concern.

    What Sets Postpartum Depression Apart?
    It is completely normal for new mothers to have mood swings, sadness, irritability, trouble sleeping and anxiety - some people call these the “baby blues.” However, when a new mother's symptoms go on to include severe mood swings, withdrawal from friends and family, fatigue, intense anger and a lack of interest in life, something more serious may be the cause: postpartum depression. Postpartum depression can even cause thoughts about hurting yourself or your baby.

    Postpartum depression affects 10-15% of women every year, making it a very common condition. Postpartum depression isn't the mother's fault, but she and her family may suffer if she doesn't receive the treatment she needs.

    If you begin to see things that aren't there or feel confused and paranoid, you may be suffering from a more rare and severe postpartum psychological disorder, and should contact a doctor immediately.

    Causes of Postpartum Depression
    No one is 100 percent sure what causes some women to get postpartum depression while others slide into motherhood blissfully. However, doctors think that the condition can be worsened by:
    Hormonal changes
    Lack of sleep
    Anxiety
    Lifestyle changes while caring for a newborn
    Genetic predisposition

    Women who have a history of depression, who are undergoing a stressful period, who lack a strong support systems, or whose pregnancy was unintended are at an increased risk, though postpartum depression can happen to anyone.

    If you think you may be suffering from postpartum depression, you aren't alone, and there is hope. Call your doctor if your symptoms don't lessen within two weeks, if they are getting worse, or if you are having a difficult time doing routine tasks and caring for yourself and your baby. Call your doctor immediately if you are thinking about harming yourself or your baby.

    Treatment
    Treatments for postpartum depression range the gamut from counseling and talk therapy to medications such as antidepressants. Your doctor may also recommend simple lifestyle changes to improve your symptoms, but, make no mistake, postpartum depression must be treated by a doctor.

    Postpartum depression is a serious condition that can last for months or even years if not treated. There is nothing to be embarrassed about. If you think you may be experiencing symptoms such as those listed above, call your OB-GYN today.

  • High Risk Pregnancies

    While complications could potentially happen in any pregnancy, a high­-risk pregnancy is one in which there is a greater risk of complications. A pregnancy could be considered high-­risk whenever the mother has one or more of the following risk factors:

    Age: Women who are younger than 18 or older than 35.
    Medical History: Certain health conditions, or coming from a family with a history of those conditions. These include, but are not limited to, diabetes, anemia, cancer, mental health problems and high blood pressure.
    Pregnancy History: Women who have had pregnancy complications such as miscarriages, prior C­-sections and early labor.
    Pregnancy Complications: Women who develop certain pregnancy complications, including gestational diabetes, preeclampsia, too much or too little amniotic fluid, or restricted fetal growth.
    Number of Babies: While twins are a blessing, they also put a woman at greater risk for complications.
    Infections: Infections such as HIV, Hepatitis C, Rubella and chickenpox.
    Lifestyle Choices: Smoking, drinking, or using drugs.

    Just because your pregnancy is considered high-risk does not mean that you won't deliver a healthy and happy baby. It simply means that you will need to be even more careful, and that your doctor will want to monitor you a little more closely to make sure that both you and your baby stay healthy.

    If your pregnancy is considered high-risk, make sure to see your doctor regularly, eat a healthy, balanced diet, exercise in moderation and avoid risky substances. Be sure to also keep the lines of communication open between you and your doctor. Be truthful about your medical history and any symptoms that you have had or are having. Follow your doctor's advice and don't be afraid to ask questions.

    A pregnancy should be a time of excitement. Take care of yourself and your baby and work closely with your doctor, and chances are everything will turn out just fine!

  • Teen Pregnancy

    The Facts About Teen Pregnancy
    Teen pregnancy has decreased somewhat from previous years, but it is still more common than you might think. 2014 figures from the Centers for Disease Control (CDC) show that 249,078 babies were born to 15 to 19-year-old girls in the United States.

    The children of these girls are far more likely to have health problems, difficulty in school, and be a teenage mother themselves.

    The key is prevention, and it is one of the CDC's top priorities. Education is a cornerstone of prevention, and the CDC has outlined these questions you might ask your teenager:
    What do you know about sexual issues including HIV, STDs and pregnancy?
    Do you think you have a high risk of HIV?
    How do you view sex and abstinence?
    How do you feel about condoms, both positive and negative?
    What do your friends and peers think about sex?
    Can you refuse sex or use condoms?
    Can you abstain from sex or limit the number of partners?
    Can you talk to your parents or other adults about sex?
    Can you avoid risky behaviors?
    Can you avoid places and situations that might result in sex?
    Do you intend to use a condom or some form of birth control?

    The unintended consequences for your teenager of unprotected sex need to be addressed too. An HPV (Human papillomavirus) vaccination should be discussed to prevent cervical cancer in sexually active teens. Education about sexually-transmitted diseases is also vital to prevent the spread of STDs.

    Teenage girls need to have access to contraception methods and education about their use. Early discussion about contraception is a key to establishing values that won't lead to teen pregnancy.

    You and your teenager should not have to deal with prevention of teen pregnancy on your own. You need to partner with a compassionate obstetrician/gynecologist who can help you take care of your teenager.