Author: Greenville Womans Care

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.

Whether you’re heading to the gynecologist for an annual checkup or to get help with a medical issue, there are several things you can do, or avoid, beforehand to make your visit as streamlined as possible. Having efficient and thorough appointments is important because many women use their OB-GYN as their primary care doctor.

1. Make sure you ask for the appropriate type of appointment.

Physicals can be quicker but if you are having concerns make sure you ask for adequate time with your doctor or ask for an additional problem visit another day.

2. Try not to schedule your appointment while you are on your period.

Many times a visit to the gynecologist will involve a pelvic exam, it is best to not be on your period for these exams. Blood may interfere with the results of tests, like a Pap test. Although, there are certain situations when making a visit on your period may be inevitable or necessary, for example if you have heavy or irregular periods. However, if you happen to be on your period during your scheduled appointment, do NOT cancel! While the situation may be a little ‘uncomfortable’ for you, remember it’s not for your OB-GYN – it’s what they do

3. Keep track of your cycle.

At some point during your appointment, your provider will ask you, “When was the first day of your last period?” Make it easier on yourself, and your gynecologist, by knowing the answer to this question. You can keep up with your cycle in a planner or in your phone, there are even period tracker apps!

4. Have health updates for your doctor.

It is important to tell your doctor about any medications you have begun or stopped taking. You should also note any changes in your health since your last visit. Bring up the “small” stuff too. Remember, the more your doctor knows about your health, the better! Don’t overlook family medical records, either. If your grandmother was just diagnosed with diabetes, your doctor should know. This will give your provider more information about your potential health risks, which will help give you a more thorough and focused checkup.

5. Come prepared with questions.

Do you ever think back on an appointment and kick yourself because you forgot to ask something you wanted to? Feel free to keep a list of questions for your provider. At Greenville Women’s Clinic we want to give women the knowledge and power to take control of their health.

6. There are certain things you should avoid doing before your appointment. 

It is advised to not have intercourse or douche before going to see your OB-GYN. Both can obscure or mask abnormal cells that the Pap test is screening for, which can lead to an erroneous result. You do not need to clean in any way outside of your normal routine before an appointment. You should be using a gentle cleanser daily.

While going to the gynecologist isn’t something many women look forward to, it is an important part of staying healthy. At Greenville Women’s Care, it is our goal to make every woman feel as relaxed as possible, no matter the reason they come to see us. Our doctors, nurses and staff are here to make sure you have a pleasant experience in our office. By following the above advice and with just a little preparation, you can help make your next appointment the most informative and productive yet! Are you due for your annual checkup? Call us today to schedule your appointment!

First things first. What is an infertility evaluation?
An infertility evaluation is a combination of exams and tests that are used to help determine the reason why you and your partner have not conceived. The goal of this evaluation is to find a cause, so that a possible treatment can be determined. In many cases, a successful treatment for infertility can be found even if a specific cause isn’t discovered during the evaluation.

Now, you may be wondering “When should I consider having an infertility evaluation?” If any of the following apply to you, you should talk to your healthcare provider at Greenville Women’s Clinic about considering an infertility evaluation:

• You have not become pregnant after 1 year of having regular sexual intercourse without the use of birth control.
• You are older than 35 years old, and have not become pregnant after trying for 6 months without using birth control.
• Your menstrual cycle is not regular.
• You or your partner have a known fertility concern.

What should I expect during my infertility evaluation?
In most cases, an infertility evaluation can usually be completed within a few menstrual cycles. During your first visit you can expect to answer questions about your medical history, menstrual periods, medication, past pregnancies and lifestyle habits. You will also receive a physical examination. During you first visit and subsequent visits you will have tests, including laboratory test, imagining test and certain procedures.

So, what causes infertility?
The most common cause of infertility in women is the lack of or irregular ovulation. The most common cause of infertility in men are problems associated with the testes that affect how sperm are made or function. There are other factors that can contribute to fertility problems in both women and men. After your infertility evaluation, your healthcare provider may be able to offer a more detailed explanation for your specific situation.

You may also have the concern, “Will age affect fertility?”
The short answer is, yes. A healthy couple in their 20s or early 30s, will have about a 25%-30% chance of conceiving in any menstrual cycle. Once a women reaches the age of 37, this percentage decreases rapidly. By the age of 40, a woman’s chances of getting pregnant drops to less than 10% per menstrual cycle. A man’s fertility also decreases, but is nowhere near as predictable.

Can lifestyle affect fertility?
Women who are overweight, underweight or exercise too much may have problems associated with infertility. In both men and women, moderate or heavy consumption of alcohol can also be a factor in infertility. In men specifically, smoking cigarettes can decrease sperm count and movement.

If you and your partner are experiencing problems associated with fertility, do not hesitate to contact your healthcare provider at Greenville Women’s Clinic. We are here to answer questions and help you determine your next steps. This can often be a hard time for couples, our staff is here to make the experience easier.  The journey to growing your family is possible.  The means by which you do so is our commitment to you to identify any obstacles, and work through them to realize the precious moment of welcoming a precious child into one’s life.