It's recommended.
Though many pregnant women use obstetricians/gynecologists to take care of their health care needs before the baby is born, there are significant benefits to getting to know a pediatrician before birth. Pediatricians can offer several services to new moms, including lactation services to help support breastfeeding.
Obstetricians and gynecologists are very similar - but there are some differences between the two.
Obstetrics deals specifically with all aspects of pregnancy, including prenatal and postnatal care. Obstetricians are responsible for delivering babies and treating pregnancy-related issues, such as fetal distress and ectopic pregnancies (the fetus grows outside of the uterus). Obstetricians, along with endocrinologists, can also provide therapy to help with fertility and pregnancy issues.
Gynecologists specialize in the female reproductive system and treat a broad array of women's health conditions.
Gynecologists help women with reproductive issues from their first period through menopause. Gynecologists will also perform a number of regular tests and exams, such as:
- Pap smear (to screen for cervical cancer)
- Breast exams (screening for breast cancer)
- Pelvic exams (screening for ovarian cysts, uterine fibroids, STIs, and cancer)
Gynecologists can also be consulted for:
- Contraceptive/ birth control counseling
- Endometriosis treatment
- Abnormal/ irregular menstruation
- Polyps in the reproductive system (usually in the cervix or vagina)
- Infection (such as UTIs or STIs)
Most doctors will undergo training to specialize in both obstetrics and gynecology. This allows the provider to offer more complete and comprehensive care to patients. Providers who specialize in both obstetrics and gynecology are known as OB/GYNs.
Gynecological visits can help address concerns you may have about your reproductive system. Some conditions or concerns an OB/GYN can help with are:
- Questions or concerns about the female reproductive system, including breasts, uterus, vulva, ovaries, and urological symptoms.
- Issues or concerns regarding fertility, pregnancy, menstrual health, and contraception.
- Issues regarding incontinence.
- Questions about sexual health, libido, and sexually transmitted diseases.
- Concerns about urinary tract infections (UTIs), and yeast infections.
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Video appointments offer you a convenient, affordable way to get care without leaving the house. Video OB/GYN consults can help address several questions and concerns about women’s health, and the health of the female reproductive system, including:
- Questions or concerns about the female reproductive system, including breasts, uterus, vulva, ovaries, and urological symptoms.
- Issues or concerns regarding fertility, pregnancy, menstrual health, and contraception.
- Issues regarding urinary incontinence.
- Questions about sexual health, libido, and sexually transmitted diseases.
- Concerns about urinary tract infections (UTIs), and yeast infections.
Note that in some cases, your doctor may recommend in-person follow-up care, if appropriate.
The American College of Obstetricians and Gynecologists (ACOG) recommends that women first see an OB/GYN between the ages of 13-15. Many issues and concerns before the age of 13 can be handled by a primary care physician.
A patient's first OB/GYN visit will often cover development. There may be personal questions about puberty, menstrual periods, and sexual activity. Most girls will not need a pap smear or pelvic exam on their first visit unless they are experiencing abnormal pain or bleeding. Often, the OB/GYN conducts a general health exam and an external genital exam.
A general health exam includes:
- Measurement of height
- Measurement of weight
- Blood pressure check
An external genital exam includes:
- An examination of the vulva
The external genital exam can help girls learn about pregnancy prevention, sexually transmitted infections (STIs), and understand more generally the anatomy of the female reproductive system.
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Yes! Reproductive endocrinologists (REs) are OB/GYNs who specialize in diagnosing and treating issues related to infertility, pregnancy issues, and hormone functions. Women or couples see REs for a number of reasons, including:
- Inability to conceive after a full year of trying
- Medical history of infertility or pregnancy loss
- Irregular or absent menstrual cycles
- Attempting to conceive when a woman is over the age of 35
- Medical history of reproductive conditions like endometriosis, fibroids, or gynecological cancer
- Trying to conceive with a medical history of sexually transmitted infections such as HIV/AIDS, and human papillomavirus (HPV); or complications from STDs like pelvic inflammatory disease (PID)
REs may conduct additional tests to assess reproductive health, including:
- Cervical mucus exams
- Hormone testing, including luteinizing hormone (LH tests)
- Blood tests to screen for human papillomavirus (HPV), hepatitis, and HIV/ AIDS
- Uterine and fallopian tube X-rays
In some cases, reproductive endocrinologists can help with assisted reproductive techniques like in vitro fertilization and reproductive counseling.
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Obstetric ultrasounds are diagnostic imaging scans used to produce images of a developing fetus in a pregnant woman, as well as the uterus and ovaries.
Ultrasounds are minimally invasive procedures that provide a wide range of health information to health care providers. Unlike X-Rays or CT scans, ultrasound scans can show images moving in real-time, giving doctors a firsthand look into the movement of organs and tissue in the body. To study blood moving through blood vessels, doctors may use specialized Doppler ultrasound sonography to examine blood flow through the internal organs by pinging sound waves off moving blood cells.
Obstetricians use the images produced by an ultrasound to monitor the health of an unborn baby, as well as the health of the mother.
After drinking 24-30 oz of water, you will be asked to change out of your street clothes and into a hospital gown.
In the exam room, you will be asked to lie on your back on a padded table. Your doctor will use a hand-held device known as a transducer, which directs high-frequency sound waves into the tissue being studied. After the area is gelled (gel helps conduct the ultrasound waves), the transducer is placed against the skin for imaging. If you are undergoing a transvaginal ultrasound, the transducer will be gently inserted into the vagina. The device will be covered in gel and a plastic or latex sheathe. You may experience some mild discomfort as the transducer is inserted into the vagina, but this should pass after a few moments.
As the sound waves echo off the tissue of internal tissue and organs, the transducer sends data to a computer that records the feedback and creates images. You may be asked to hold your breath for several seconds as images are being taken.
This procedure usually takes about 30 minutes. Unless further testing is needed, most individuals are free to resume daily activities after their ultrasound.
After your appointment, a radiologist will review the images produced by the exam. They will then present any findings to your health care provider, who will pass on the results to you. This may take 1-3 business days, depending on the clinic. Depending on what the images show, you may not need to schedule a follow-up appointment. However, if your obstetrician identifies any possible complications or abnormalities around your pregnancy, you may be asked to book an appointment for further testing and evaluation.
Consult your doctor about the specific preparation for your ultrasound. Depending on where you are at in your pregnancy, you may require a transabdominal (over the skin of the abdomen) or transvaginal ultrasound. Transvaginal ultrasounds are generally performed in the first trimester of pregnancy, while transabdominal imaging is done in the 2nd and 3rd trimesters.
Transabdominal obstetric ultrasounds may require that you drink 24-30 ounces of water an hour before the exam. After you drink this water, it is imperative that you do not use the restroom. Drinking water fills the bladder, making images of the area clearer during the ultrasound scan.
Transvaginal ultrasounds do not require a full bladder. Ask your doctor about specific preparation needed for this type of testing.
No other preparation is required. You will be asked to remove all metallic items from your person such as jewelry, piercings, eyeglasses, and dentures. Because of this, it is usually recommended that you leave most of these items (specifically jewelry and piercings) at home on the day of your appointment.
Ultrasounds are a non-invasive imaging technique that allows doctors to get a vantage point of the health of an unborn baby and the mother without surgery or exposure to ionizing radiation (present in X-ray scans).
Obstetric ultrasounds performed during the 1st trimester of pregnancy can help doctors:
- Confirm a pregnancy
- Evaluate the baby’s growth and size
- Determine the baby’s gestational age (this indicates how long the fetus has been developing, which may help establish a due date)
- Detect an ectopic pregnancy (a developing pregnancy located outside of the uterus)
- Detect and confirm a multiple pregnancy
- Evaluate the health of the placenta (the organ that provides a developing fetus oxygen and nutrients as it develops)
- Evaluate the amniotic fluid (the fluid that surrounds a fetus in the womb)
- Identify birth defects
- Examine and diagnose complications (such as irregular bleeding)
- Examine the cervix, uterus, ovaries, and bladder for complications or abnormalities
Ultrasounds are performed for medical reasons. Even though they do produce images of an unborn baby, these appointments are not intended to provide parents with keepsake pictures of their developing baby. If you would like an ultrasound for reassurance about the development of your baby, you may ask your health care provider or obstetrician about scheduling an ultrasound.
Ultrasounds are a non-invasive imaging technique that allows doctors to get a vantage point of the health of an unborn baby and the mother without surgery or exposure to ionizing radiation (present in X-ray scans).
Obstetric ultrasounds performed during the 2nd and 3rd trimester of pregnancy can help doctors:
- Determine the anatomy of the baby
- Evaluate the baby’s growth and size
- Evaluate the placenta and amniotic fluid - the fluid that surrounds the baby in the uterus - for complications and nutrient composition
- Identify birth defects
- Examine and diagnose complications (such as irregular bleeding)
- Examine the cervix, uterus, ovaries, and bladder for complications or abnormalities
Ultrasounds are performed for medical reasons. Even though they do produce images of an unborn baby, these appointments are not intended to provide parents with keepsake pictures of their developing baby. If you would like an ultrasound for reassurance about the development of your baby, you may ask your health care provider or obstetrician about scheduling an ultrasound.
Doppler ultrasounds are used to test blood flow to the uterus. Healthy circulation to the uterus is a good sign for a healthy fetus.
Restricted blood flow (placental insufficiency) during pregnancy can lead to complications for the baby, including:
- Cerebral palsy
- Low birth weight
- Insufficient blood calcium
- Low blood sugar
- Stillbirth or death
In mothers, restricted blood flow to the uterus can cause an elevation in blood pressure or premature labor, among other conditions.
Low blood flow to the uterus can be caused by:
- Diabetes
- Substance abuse
- High blood pressure
- Blood clots
- Anemia
- Tobacco use/ smoking
Doppler ultrasound exams during pregnancy can help keep both the fetus and mother safe and healthy. Ultrasounds use high-frequency sound waves instead of ionizing radiation, ensuring that they are safe for both mother and fetus alike. Ultrasounds are quick and painless tests that play a key role in detecting medical conditions. Doppler ultrasounds offer an even more detailed picture of what is happening in the body by measuring blood flow through blood vessels to the uterus and placenta.
Pelvic ultrasound sonography is a medical imaging technique that uses high-frequency sound waves to create images of the pelvic organs and lower abdomen. Ultrasound images help doctors see what's going on inside the body without having to use surgery. During a pelvic ultrasound, sound waves bounce off organs, tissue, and blood vessels and into a transducer that reads and interprets the waves. This procedure creates real-time images that can help doctors address conditions related to pelvic pain, reproductive organ health, and the wellness of a fertilized egg in utero (a baby growing during pregnancy).
There is more than just one type of pelvic ultrasound. The type of pelvic ultrasound your doctor orders depends on your sex, health history, and symptoms. Additional types of pelvic ultrasounds include:
Transvaginal/ endovaginal ultrasound (sonohysterography)
During a transvaginal ultrasound, the sonographer will insert a small transducer into the vagina while you lie on an exam table with your feet in stirrups. These scans are often done in an obstetrics-gynecology clinic (OB/GYN) by a certified sonographer. The transducer will emit sound waves which will create real-time images of the reproductive and pelvic organs, including the fallopian tubes, endometrium, ovaries, cervix, and vagina. Transvaginal ultrasounds can be used to address conditions such as:
- Infertility
- Ovarian cysts
- Abnormal vaginal bleeding
- Uterine fibroids
- Pelvic inflammatory disease (inflammation in the reproductive organs)
- Intrauterine device (IUD) displacement
Pregnant women may receive a transvaginal ultrasound to check the health of the uterus. This can be used to detect abnormalities in the uterus or diagnose conditions such as ectopic pregnancy.
Transrectal ultrasound
Transrectal ultrasounds are similar to transvaginal ultrasounds, but the transducer is inserted into the rectum instead of the vagina. Transrectal ultrasounds are commonly performed for men who are at risk of prostate cancer but may also help radiologists detect other medical conditions related to the bladder, prostate glands, and seminal vesicles. Transrectal ultrasounds may cause a mild amount of discomfort as the small transducer is inserted into the rectum, but the scan should only take about 30 minutes.
Transabdominal ultrasound
During a transabdominal ultrasound, a hand-held transducer is placed upon the lower abdomen to create images of the bladder, kidneys, liver, pancreas, and intestines. Transabdominal ultrasounds are used to detect abnormal growths (like tumors or cysts), aortic aneurysms, and masses (like an abscess). A special Doppler ultrasound may be used to test blood flow through blood vessels in the abdominal organs.
Pelvic ultrasounds can help doctors detect a wide range of health conditions inside the pelvis and lower abdomen. They are quick, only mildly uncomfortable, and do not use radiation. They can show real-time images of organs, soft tissue, and blood vessels in the body. The specialized Doppler ultrasound can be used to show blood flow by pinging sound waves off moving blood cells. In some cases, however, further testing may be needed. A doctor may order a biopsy, for example, if they suspect a growth inside the body may be cancerous.
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During pregnancy, your body will begin building up a milk supply in the mammary gland using progesterone, a natural steroid hormone that pregnant individuals have an extra supply of, to help prevent the breasts from prenatal milk secretion (lactogenesis) before the baby is born. This early milk, called colostrum, begins being produced as early as 16 weeks into pregnancy and will look and feel different than mature milk which often comes in within 2 to 5 days after birth. Both early milk and mature milk are very important to the wellness and development of your newborn.
Within the first few days after birth (postpartum), it is normal not to see a high volume of milk come in. And while many newborns lose weight during the first few days, this is to be expected. Your newborn only needs your colostrum until your mature milk comes in.
Your milk production will increase within the first week after birth. Many moms notice the later milk coming in due to signs such as breast engorgement, breast swelling, milk leakage (especially overnight), and/or flattened or firm nipples around the areolas. This discomfort will likely decrease especially as you adjust to a normal pumping and nursing routine.
For those who adopt a newborn baby, due to infertility or other personal reasons, it isn't out of the realm of possibility to induce lactation, though it does take major preparation and dedication. Milk from a human breast carries many antibodies which greatly help the infant's immune system.
In order to produce human milk, your body uses a complex system of three hormones interacting with each other. These hormones- estrogen, progesterone, and human placental lactogen- usually begin the process of milk production in the latter months of pregnancy, though can start as early as 16 weeks into gestation.
In order to induce lactation, your body will need to replicate the hormonal process that pregnant individuals experience pre and post-birth. You may consider speaking to your healthcare provider to discuss hormone therapy, which may include estrogen or progesterone and may have a treatment plan that lasts for months.
You are likely to stop hormone therapy and begin pumping around two months before you expect to begin breastfeeding. Doing so encourages the release of prolactin in the body, which must be present for milk synthesis.
It is possible to lactate (male or female) even if you've never been pregnant before. This is referred to as galactorrhea and may happen due to a number of different causes which include:
- Medications: such as antipsychotics, birth control, heartburn medicine, medicines containing hormones, and some pain killers.
- Medical conditions: such as chronic stress, thyroid problems, liver or kidney disease, hypothalamus tumors, trauma to the breast tissue, or high levels of estrogen
- Improper drug use: such as opiates, cocaine, and marijuana.
- Nipple stimulation: such as during sexual activity, clothing that rubs against the soft breast tissue, or even frequent breast exams.
Your doctor may treat your galactorrhea based on the cause of the lactation which may include bloodwork, a pregnancy test, a mammogram, and/or an MRI.
Rh incompatibility occurs when a mother has negative Rh content in her blood and her child has Rh-positive blood; for instance, the mother has A-negative blood, but the baby has A positive blood. If this blood mixes, the mother’s immune system will produce antibodies to combat the foreign blood (a process known as Rh sensitization). This does not cause problems during the first pregnancy, but if a mother has another child with Rh-positive blood, her plasma will begin to destroy the child’s red blood cells. If left untreated, this condition can lead to serious illness and the death of the unborn child.
If it is determined that a woman is Rh-negative before her pregnancy, she may have an Rh immunoglobulin shot. This prevents the symptoms and complications of Rh sensitization.
