Author: Greenville Womans Care

The American College of Obstetricians and Gynecologists (ACOG) and the American College of Nurse Midwives (ACNM) are both professional organizations that provide practice guidelines for health care professionals. They also are a resource for educational materials for patients. Both organizations strive to improve women’s health and support healthcare providers in their efforts to optimize maternal health.

ACOG and ACNM believe health care is most effective when it occurs in a system that facilitates communication across care settings and among clinicians. Ob-gyns and CNMs are educated, trained, and licensed independent clinicians who are experts in their respective fields of practice and work in mutual collaboration to optimize care for individuals they serve. Practicing to the full extent of their education, training, experience, and licensure, ob-gyns and CNMs support team-based care. ACOG and ACNM recommend utilization of interprofessional education to promote a culture of team-based care. Ob-gyns and CNMs, working collaboratively according to the needs of the patient, can optimize equitable care of patients and improve obstetric, sexual, and reproductive health outcomes.

What does this mean for you at Greenville Women’s Care?

This means that our Certified Nurse Midwife (CNM) and Obstetricians will be working together to make sure that you and your baby both receive safe and personalized healthcare to ensure both a healthy mom and baby during your pregnancy. Other healthcare team members could include Maternal Fetal Medicine Specialists, Nutritionists, Endocrinologists, Registered Nurses, and others depending on you and your baby’s specific needs during pregnancy.

Your OB team should have skills, resources and experiences that complement one another. At Greenville Women’s care we believe that collaboration amongst team members is essential to healthy birth outcomes for ALL!

Call us today at 252-757-3131, to schedule an appointment with our Certified Nurse Midwife, Sarah Sears.

Whether you heard it from a friend or read it on the internet, there’s a lot of misinformation about breastfeeding. So straight from the gynecologist’s mouth, we’re debunking the most common misconceptions about breastfeeding.

1. If you have smaller breasts, you won’t produce enough milk.

Breast size doesn’t affect how much milk you can produce. The amount of time you spend nursing your baby, the demand from your baby, and practicing healthy nursing habits will affect your production. There are many small-breasted women who produce enough milk to donate to milk banks.

2. Breastfeeding always hurts.

If you’ve never breastfed, or if it’s been a while since you breastfed, then your nipples may be a bit sore when you begin. However, this should go away after a couple of days. If your baby isn’t latching onto your nipple properly, the soreness can become debilitating. However, there’s an easy fix! With practice and assistance from a lactation consultant or midwife, you can achieve pain-free breastfeeding within weeks.

3. Some babies can’t latch.

It’s important to develop healthy nursing habits as soon as possible with a proper latching technique to avoid your baby getting into the habit of latching incorrectly. About 4% of the time, there’s something called “tongue-tie,” which can cause problems when latching – something that can easily be corrected in your doctor’s office.

4. You should wean your baby off breast milk after 12 months.

Interestingly enough, American culture is one of the few that pressures you to start weaning your baby at 12 months. Most babies will naturally begin to wean themselves between 12 and 24 months as they start walking and eating normal foods. Breastfeeding may become a ritual saved for waking up, taking a nap, going to bed, or for comfort. How long you choose to breastfeed is entirely up to you and your baby; however, experts recommend exclusively breastfeeding for at least four months.

5. Breastmilk doesn’t have enough water, vitamin D, or iron.

The beauty of breastmilk is that it contains everything your baby needs at that time in its life. Your body does this amazing thing where it changes with every feeding to match your baby’s needs. For example, if it’s hotter, your breastmilk will be more water-based. If your baby is growing, your breast milk will have more fats and proteins. Your baby is getting exactly what it needs from your breast milk.

6. It’s illegal to breastfeed in public.

Actually, there are laws in place in all 50 states, Washington D.C., Puerto Rice, and the Virgin Islands to protect people who breastfeed! You have the right to breastfeed in public and private locations, so don’t feel pressure to hold off feeding or use a public restroom. You can read more about breastfeeding in public here: https://www.ncsl.org/research/health/breastfeeding-state-laws.aspx#State

7. Breastmilk and formula are essentially the same thing.

While formula is made to mimic breastmilk, it doesn’t have the antibodies or versatility that breastmilk does. Breastmilk is able to adapt to your babies’ specific needs, whereas formula cannot. For most babies, breastmilk is the best source of nutrition and can provide antibodies that formula cannot. This past June, the American Academy of Pediatricians updated their guidance and recommends breastfeeding exclusively for the first 6 months of life and encourages breastfeeding for up to 2 years. There are situations where breastfeeding isn’t possible or is contraindicated. Formula and donor milk are viable options when breastmilk is unavailable. You can read more about breastmilk verses formula here: https://forms.lamaze.org/WhatsinBreastmilkPoster.pdf

8. If you’re taking medications, you should either “pump and dump” or not breastfeed at all.

Contrary to popular belief, most medications are considered to be safe while breastfeeding. Usually, medication levels are much lower in breastmilk than they are in your bloodstream. However, it’s advisable to contact a healthcare provider if you’re on medications while pregnant and/or lactating. You can read more about taking medications while breastfeeding here: https://www.acog.org/womens-health/faqs/breastfeeding-your-baby

If you have any questions about breastfeeding, what breastfeeding could look like for you, or any concerns, call Greenville Women’s Clinic at 252-757-3131 or visit our website to schedule an appointment with our midwife Sarah Sears. We’d love to help you focus on the joys of breastfeeding rather than the fears.

July is Group B Strep Awareness Month, but do you know what it actually is? The bacteria that cause Group B Strep (GBS) is Streptococcus, and commonly lives in the gastrointestinal and genital tracts. GBS is fairly common and comes and goes naturally in your body. It is typically not harmful but can cause serious illness in adults of all ages, so it is important to understand what it is and take preventative measures to avoid potential infection.

GBS can cause:

• Bacteremia (infection in the bloodstream)
• Sepsis (extreme reaction to infection)
• Bone infections
• Joint infections
• Meningitis (infection of the tissue covering the brain and spinal cord)
• Pneumonia (infection of the lungs)
• Skin Infection
• Soft-tissue infection

GBS is not spread through food, water or general contact. If you live with someone who has GBS, you are not at risk of getting it and it is unknown how people get or spread GBS.

However, we do know that the genital tract is a part of the body involved with reproduction. Therefore, GBS  can be spread by pregnant women to their babies during child birth. Approximately 1 in 4 pregnant women have the GBS bacteria in their body, making newborn babies at high risk for a GBS infection. When they have the infection, newborns are typically diagnosed with bacteremia, sepsis, pneumonia, and meningitis. These diagnoses can cause long-term complications, such as deafness, developmental delays, or disabilities.

Fortunately, there are ways to help protect your baby during birth. If you are pregnant, your doctor or midwife will make sure that you are tested for GBS between 36 and 38 weeks. GBS can come and go, which is why testing so late in a pregnancy is crucial. If you test positive for GBS, you are given antibiotics (called beta-lactams) which will help protect your baby. However, these antibiotics cannot be given before labor because the bacteria grow too quickly.

Early-onset GBS means that the infection starts in the first week of their life. Most babies who get GBS disease within the first week of their life are exposed to the bacteria through delivery. Late-onset GBS means that your newborn can seem healthy at birth and through the first week of their life, but symptoms can appear shortly after. The newborn could have gotten the bacteria from the mother during birth or from another source.

Here are some of the symptoms to look for in newborns:

• Fever
• Trouble feeding
• Irritability, continued fussiness
• Lethargy (limpness and/or difficulty waking up your baby)
• Difficulty breathing

Each year, approximately 930 babies are diagnosed with early-onset GBS and 1,050 with late-onset GBS.

Group B Strep can also affect adults who:

• Have diabetes
• Have heart disease
• Have congestive heart failure
• Have cancer or a history of cancer
• Are obese
• You are over 65 years of age

This blog is for informational purposes and does not serve as a consultation with a physician at Greenville Women’s Care. If you have questions about Group B Strep or any other questions regarding you or your baby’s health care, please schedule an appointment with us.

Call us at 252-757-3131 or visit our website to schedule an appointment with one of our physicians and advanced providers.

References: https://www.acog.org/womens-health/faqs/group-b-strep-and-pregnancy and https://onlinelibrary.wiley.com/doi/epdf/10.1111/jmwh.13125

The term midwife means “with woman”. Midwives are known for being present with women typically during labor and childbirth, but many people do not know that midwives are trained to care for women throughout the lifespan.

Historically and traditionally, women were present with other women during childbirth. This began to change when childbirth was moved into hospital institutions after Obstetrics as a medical practice began. Today, most midwives in the U.S. practice in hospitals, continuing to be with women during childbirth. Midwives have prescriptive authority, so YES, you can still get medications and/or an epidural with a midwife. And if you choose to have an unmedicated birth, the midwife is well trained on techniques to assist you.

The shortage of Obstetrical providers including midwives can be felt in many areas throughout NC, especially rural areas. I’m proud to say that I’m a graduate from ECU’s midwifery program, the only program for midwives in the state. I believe in the role of midwives in meeting the needs of the community. Eastern NC has such a gem in ECU, producing much of the midwifery care of NC and surrounding states.

Midwives typically function in a collaborative role with Obstetricians, working together as part of the healthcare team. This collaboration is essential in helping to reduce the cesarean rate, reducing infant and maternal mortality rates, and bridging the gap in healthcare. Midwives routinely are available for prenatal and postpartum care, annual exams, primary care, STI screening, Contraception and Gynecological evaluations.

As a midwife provider, and as a woman who has received midwifery care, my desire is to be with women, acting as an advocate and a bridge in helping them in meeting their healthcare needs. That may be in providing safe, professional and comfortable exams, or being in the labor room for one of the most monumental moments of a family’s life. It may be in providing education on contraceptive options or holding a hand when it’s needed. The role of a midwife isn’t defined by the task of the moment but by being present.

If you’d like to have a consult or schedule an appointment, call the Midwife, Sarah Sears, CNM at Greenville Women’s Care 252-757-3131.

If you would like to learn more about Midwives visit, http://www.midwife.org/

Each year it is estimated that 12,000 women are diagnosed with cervical cancer and of those diagnosed, one-third will die as a result of the cancer. But thanks to improved screening and vaccination, cervical cancer is highly preventable and treatable.

The American Social Health Association and the National Cervical Cancer Coalition have recognized January as Cervical Health Awareness Month to encourage women across the country to get screened and receive the HPV vaccine if they are eligible.

Cervical cancer was once one of the most common causes of cancer death for American women. But over the last 30 years, the cervical cancer death rate has gone down by more than 50%. The main reason for this change is the increased use of the Pap test. This screening procedure can find changes in the cervix before cancer develops. It can also find cervical cancer early − in its most curable stage.

Cervical cancer tends to occur in midlife. Most cases are found in women younger than 50. It rarely develops in women younger than 20. However, many older women do not realize that the risk of developing cervical cancer is still present as they age. More than 15% of cases of cervical cancer are found in women over 65. It is important to keep in mind though that these cancers rarely occur in women who have regular tests to screen for cervical cancer before they were 65.

Every women should be screened no matter their age, but some women are at greater risk than others for cervical cancer. Some of those risk factors include:

• Women with HPV, HIV or chlamydia
• Women who use tobacco products
• Women who are obese
• Women who have a family history of cervical cancer

Women with early cervical cancers and pre-cancers usually have no symptoms. Symptoms often do not begin until the cancer becomes invasive and grows into nearby tissue. When this happens, the most common symptoms are:

• Abnormal vaginal bleeding
• Bleeding after vaginal intercourse
• Bleeding after menopause
• Bleeding and spotting between periods
• Periods that are longer or heavier than usual
• Unusual discharge from the vagina
• Pain during intercourse

These signs and symptoms can also be caused by conditions other than cervical cancer. For example, an infection can cause pain or bleeding. Still, if you have any of these signs or other suspicious symptoms, you should see your health care professional right away. Ignoring symptoms may allow the cancer to progress to a more advanced stage and lower your chance for effective treatment.

Even better, don’t wait for symptoms to appear. Make sure to plan and attend your regular check-up appointments at Greenville Women’s Care for regular screenings. An additional step that women can take to prevent cervical cancer is to receive Gardasil, the HPV vaccine. Ask your doctor if this vaccine is right for you.

Breast cancer is the most commonly diagnosed cancer and the second-leading cause of cancer deaths in women. Because of this, it is no surprise that much research has been done to discover how women can reduce their risk of development.

Did you know that with just 25 minutes of physical activity a day your risk of developing breast cancer decreases? Sounds easy enough, right? Notice we said physical activity and NOT exercise! The word “exercise” can seem intimidating. But, being physically active doesn’t have to involve weights, treadmills or mile-long runs. Any activity that makes you breathe a little harder and gets your body warmer will help reduce your risk. Across numerous studies, evidence has shown that there was a 25% average breast cancer risk reduction amongst physically active women as compared to lesser active women. 

So how can you get moving? Everyday tasks can count as physical activity, like gardening and washing the car. Or, devote more time in your day to active hobbies you enjoy, like swimming, tennis, yoga or dance! The American Cancer Society recommends that all adults engage in at least 150 minutes of moderate intense activity a week. At just 25 minutes each day, you are exceeding this recommended amount.

In addition to just 25 minutes of physical activity, you can also get moving by taking small steps each day, like:

• Using the stairs instead of the elevator
• Parking farther away from the store
• Taking your pet for a longer walk
• Using a stationary bike or treadmill while watching TV

You may be wondering how being physically active can reduce your risk for breast cancer. Physical activity helps to maintain a healthy body weight, which decreases the risk of cancer development after menopause. It is also thought that physical activity helps to regulate hormones including insulin and estrogen and keeps the immune system healthier. By improving your immune system through exercise, a woman’s body will also be more effective at killing or slowing the growth of cancer cells.

Not only can physical activity decrease the risk of breast cancer, it can also improve your long-term health and reduce the risk of heart attacks and strokes. Additionally, exercise has been shown to reduce anxiety, stress and depression, and improve mood.

Remember, it is never too late to adopt a healthy lifestyle! In fact, studies have shown that women who increase their physical activity after menopause may have a lower risk of breast cancer than women who do not. So, no matter your age it is important to add physical activity to your lifestyle today. Start slow and gradually build up the amount of physical activity you do.

At Greenville Women’s Care, we are committed to encouraging women of all stages of life to lead a healthy and active lifestyle! To learn more about breast cancer risks and for regularly scheduled mammograms, contact us today!

For expectant mothers, pregnancy can be an overwhelming time in their life. There is a lot of information to absorb, like what types of food to avoid, how to stay fit while pregnant and how to prepare for baby’s arrival. In addition to the expertise from your obstetrician, there are many smartphone apps that can help mothers-to-be navigate the world of pregnancy. With the click of a button, you can track your pregnancy and get valuable information about your baby’s development.

Below are several of our top picks for FREE pregnancy apps.

Ovia Pregnancy Tracker and Baby Calendar (available on iTunes and Google Play)

Developed by Harvard scientists, pregnancy specialists and fit moms, the Ovia app has a high-tech, personalized approach to tracking your pregnancy and your baby’s development. This app connects with FitBit, which allows you to easily track your weight, sleep, symptoms, moods and more. Receive feedback completely tailored to you! All information is based on where you are in your pregnancy, BMI, age, personal goals and health data. As your baby grows, you can use the kick counter and contraction timer. Connect with other mothers in a private, anonymous community where you can share experiences.

Totally Pregnant (available on iTunes and Google Play)

Totally Pregnant was created by real mothers who have been where you are. This community of moms have gathered information that is tailored to your location, stage of pregnancy and needs. Personalize your experience by entering your name and due date. Watch 3D videos showing you the development of your fetus as your bump grows. Sign up and attend prenatal and birth classes online through the app. Shop for all the products you need during your pregnancy and for the first few months after you give birth. Join discussion groups and be supported by a community of Totally Pregnant moms.

What to Expect – Pregnancy & Baby (available on iTunes)

From the world’s most trusted pregnancy brand, What to Expect When You’re Expecting, this app guides you through pregnancy hour-by-hour. You’ll receive the latest parenting news and health information based on your due date. Find the right support group for you based on location, interest, medical condition, parenting style and more. Get the tools and support you need to help you prepare and feel in control every step of the way. Once your baby is born, you’ll get answers, advice and guidance as you navigate life as a new parent.

Baby Names (available on iTunes and Google Play)

One of the toughest decisions expectant parents face is what to name their new baby boy or girl. The Baby Names app by Sevenlogic is packed with more than 30,000 names and compiles suggestions in an easily sortable list. Check name popularity, meaning, origin and pronunciation all in one place. Save and rate your favorite names and share by email and Facebook for feedback from trusted family and friends.

There’s an app for everything these days, including pregnancy. They can offer a place for you to track your pregnancy, learn more about motherhood and connect with other pregnant women. Although, the internet and available apps are a great source of information they are not a replacement for prenatal care.  The information these sources provide isn’t specific for your own health and pregnancy.  The physicians and staff at Greenville Women’s Care remind you to always consult your obstetrician about anything that you read or even bring in articles to discuss how they could apply to you and your baby.

Yeast infections are fairly common. If you’re like three-quarters of women, you’re likely to get at least one during your lifetime, and fifty percent are likely to get two or more.

More times than not, a yeast infection is due to an overgrowth of Candida. Candida is a type of yeast that occurs naturally on the skin. Yeast is part of the fungi family and, in normal amounts, is harmless.

Women are more likely to get a vaginal yeast infection when they:

• Are pregnant
• Have a weak immune system
• Are taking an antibiotic
• Have diabetes
• Use vaginal sprays or douches
• Take birth control with high doses of estrogen

It’s not possible to completely prevent a yeast infection, but here are some things you can do to prevent your chances:

• Wear breathable underwear and change it regularly. We recommend cotton as it doesn’t hold heat or moisture, and it tends to keep you drier.
• Wear loose clothing. Tight jeans, skirts, underwear, yoga pants, tights, pantyhose, etc. can raise your body temperature and the amount of moisture and friction around your private parts. These things can increase your chances for a yeast infection.
• Change out of wet clothes, specifically this time of the year, wet bathing suits. When possible don’t sit in a wet bathing suit or gym clothes after working out, try to change into dry clothes right away.
• Hot and damp are not a girl’s best friend. Avoid hot tubs if possible, but if you indulge change into dry clothes as soon as possible.
• When using the bathroom, always wipe from front to back. Doing this will help prevent microorganisms from being pushed into the vagina or introduced into the urinary tract.
• We don’t recommend douching. Feminine hygiene products like this can alter the balance of bacteria in your vagina by removing bacteria that is there to prevent infections.
• When using feminine products, skip the scents. This includes soaps, sprays, bubble baths, tampons, and pads. Again, this can disturb the balance of bacteria in your vagina; and, cause a yeast infection.
• Change tampons, pads and liners frequently when you’re on your period.
• If you have diabetes, manage it. Be sure to keep an eye on your blood sugar levels and keep them under control.
• Use antibiotics only when prescribed and when needed. You shouldn’t take them for a cold, because they won’t do anything for a virus.

Keep in mind, some people are more prone to yeast infections than others. If you are more susceptible here are some additional things to keep in mind, specifically if you have a yeast infection:

• Avoid sexual activity. Yeast infections can be passed back and forth, and they can also be transferred to other areas of the body.
• Wash certain garments regularly and in hot water using a gentle detergent.
• Eat foods that help balance your microflora in the body, such as yogurts containing Lactobacillus acidophilus, a type of natural probiotic.

Even with preventive efforts, you can still get a yeast infection. So, how do you know when to give Greenville Women’s Care a call? You should consider calling for an appointment if:

• This is your first infection,
• Your symptoms won’t go away, and you’ve tried an over-the-counter product,
• You have recurrent infections,
• You have unrelated symptoms and finally,
• You’re not sure if you actually have an infection.

Osteoporosis is a condition of fragile, brittle bones, and if not prevented or treated, can lead to easily breaking a bone like your rib or hip after a fall.  Osteoporosis is a health threat for millions of Americans. It is estimated that 10 million people have the condition and over 30 million others have low bone mass, also known as osteopenia, placing them at risk for osteoporosis.

Although osteoporosis is more common in older people, and is thought of as an older person’s disease; it can strike at any age. Everyone loses some bone density (mass) as they age, however some will lose more, or lose it faster, than others.  The rate at which we lose bone density depends on hormonal status, medical conditions like thyroid disease and even diet. 

Approximately 80% of people affected by osteoporosis are women. This is due to the fact that women have lighter, thinner bones and can lose up to 20 percent of their bone density after menopause, which makes them more predisposed to the disease. A woman’s risk of osteoporosis is actually equal to her combined risk of breast, ovarian and uterine cancer. Other risk factors for osteoporosis include:

• older age
• a family history
• being petite and thin
• certain ethnicities, such as Caucasian and Asian
• a history of broken bones
• a poor diet, especially low in calcium, Vitamin D or if drinking numerous carbonated beverages
• low estrogen levels as in premature menopause or if ovaries are removed at a young age (< age 50)
• an inactive lifestyle
• smoking and excessive alcohol use
• certain medications, conditions & diseases

Since you cannot feel your bones getting weaker, you probably will not know you have osteoporosis until you break a bone. If you have osteoporosis, you can fracture a bone from a minor fall, or in extreme cases, from a simple sneeze. Spinal fractures may first be felt or seen in the form of severe back pain, loss of height, or spinal deformities. In many cases, a spinal fracture can even occur with no pain.

Because 85-90% of adult bone mass is acquired by age 18 in girls and 20 in boys, building strong bones during childhood and adolescence can help to prevent osteoporosis later in life. Several steps that you can take to optimize bone health and prevent osteoporosis are:

1. Get your recommended daily amounts of calcium and vitamin D
2. Participate in regular weight-bearing and muscle-strengthening exercise
3. Avoid smoking and excessive alcohol
4. Talk to your physician about bone health
5. If appropriate, have a bone density test and take medication.

The only way to diagnose and determine your risk for osteoporosis is a Bone Mineral Density (BMD) test.  A standard BMD screen is recommended at age 65 unless there are concerns sooner.  A BMD measures bone mass and is necessary to determine whether you need medication to help maintain your bone mass, prevent further bone loss and reduce fracture risk. A BMD is accurate, painless and noninvasive.

Since osteoporosis can be undetected for decades, sometimes not until a fracture occurs, early diagnosis is important. It is never too early or too late to start your prevention program, so consult your physician at Greenville Women’s Care to learn more about the prevention and detection of osteoporosis.