Author: Greenville Womans Care

What happens when labor begins?

As you begin to labor, your cervix will open or dilate. Your uterus, which contain muscles, will contact at regular intervals. This will cause your abdomen to become hard. Between contractions it will soften as your uterus relaxes.

Feeling as if the baby has dropped lower is a sign that labor is approaching in anywhere from a few weeks to a few hours. This movement, called lightening, is when the baby’s head has settled deep into your pelvis.

An increase in vaginal discharge (clear, pink or slightly bloody) is another sign that labor is approaching. During your pregnancy a thick mucus plug accumulated at the cervix. When the cervix begins to dilate, the plug is pushed into the vagina. This is called show and can happen several days before labor or at the onset of labor.

What is false labor?

False labor is when your uterus contracts off and on before “true” labor beings. These irregular contractions during false labor are referred to as Braxton Hicks contractions. They are normal, but often times can be painful and are noticed more at the end of the day.

How to tell the difference between true labor and false labor?

One way to tell the difference between true labor and false labor is by the timing of your contractions. True labor contractions come at regular intervals and get closer together as time goes on. Each of these contractions lasts about 30 to 70 seconds. False labor contractions are irregular and do not get closer together.

Another way to determine true labor versus false labor is by moving around. In true labor, contractions will continue even if you move around or change position. In false labor, the contractions may stop when you walk, rest or change position.

The strength of your contractions can also differentiate between the two. True labor contractions steadily increase in strength. False labor contractions are usually weak and do not get much stronger or they may start strong and get weaker.

Finally, note the pain of your contractions when trying to decide if it is true labor or not. True labor pain usually starts in the back and moves to the front – while false labor is usually only felt in the front.

If you have any questions about true versus false labor or contractions, do not hesitate to contact your healthcare provider at Greenville Women’s Clinic. We are here for you through every step of your pregnancy. The more you know about labor, the more prepared you will feel when the big day comes.

An ovarian cyst is a pouch or sac that forms in or on the ovary. It is filled with fluid or other tissue. Ovarian cysts are very common and can occur in women during childbearing years or after menopause. In the majority of cases, ovarian cysts are benign, meaning that are not cancerous, and they go away on their own without treatment. Rarely, a cyst may be malignant, or cancerous.

In many instances, ovarian cysts do not cause symptoms. This is why it is important to have routine pelvic exams. However, in those that do experience symptoms from ovarian cysts, they report a dull or sharp ache in the abdomen or pain during certain activities. Larger cysts can cause twisting of the ovary, which leads to pain on one side that comes and goes or starts suddenly. A cyst that bleeds or bursts may also cause severe, sudden pain.

There are different types of ovarian cysts that include the following:

Teratoma – a cyst containing different kinds of tissues that make up the body, such as hair and skin. These cysts may be present at birth and can grow during reproductive years. In rare cases, some teratomas may become cancerous.

Functional – the most common type of ovarian cyst. They usually have no symptoms and often go away without treatment, within six to eight weeks.

Endometrioma – a cyst resulting from endometriosis – a condition in which the tissue that lines the uterus is found on the ovaries, fallopian tubes and other pelvic structures.

Cystadenoma – cysts that form on the outer surface of the ovary. These can grow to be very large but are usually benign.

There are several treatment options for ovarian cysts. Your healthcare provider at Greenville Women’s Clinic can determine the best treatment for you based on the type of cyst and other factors. Common treatment options include watchful waiting and, if the cyst is large or causing symptoms, surgery.

Watchful Waiting – monitoring the cyst with repeated ultrasound exams to note any changes in appearance or size. Many cysts go away on their own after one or two menstrual cycles.

Surgery – may be recommended if the cyst is large, causing symptoms or is suspected to be cancerous. The type of surgery is dependent on several factors including, the size of the cyst, your age, your desire to have children, and your family history of ovarian or breast cancer. A cystectomy is the removal of the cyst from the ovary. In some cases, the ovary itself may need to be removed – this is called an oophorectomy.

If the cyst is benign and not too large, a minimally invasive surgery using a laparoscope is often recommended. In other cases, an open surgery may be required. This surgery involves making a small incision in the lower abdomen.

If you have questions or concerns regarding ovarian cysts, do not hesitate to contact your trusted healthcare provider at Greenville Women’s Clinic.

Although most young women don’t need to have a pap test until they are about 21 years old, there many reason why you should see a gynecologist before you reach that age.

1. Get advice on maintaining a healthy body weight and feel good about your body.
2. Start habits for keeping your bones healthy and strong.
3. Learn how to recognize, prevent and treat urinary tract infections.
4. Get treatment for any vaginal itching, odor and discharge.
5. Learn about what a normal period is supposed to look and feel like.
6. Get advice and relief if your periods are painful.
7. Find out why your periods may be heavy.
8. Find out why your periods are too close or too far apart and why bleeding may happen between them.
9. Discover ways to deal with premenstrual syndrome, commonly referred to as PMS.
10. Learn how to have a healthy relationship with romantic partners.
11. Know when a relationship may be threatening, abusive or harmful.
12. Talk about and think things through if you are considering sex for the first time.
13. Learn about how to have safe sex.
14. Discover the right birth control option, so you can choose to become pregnant when the time is right for you.
15. Plan ahead for a safe and healthy pregnancy.
16. Get tested for pregnancy.
17. Learn about your options if you become pregnant.
18. Protect yourself from sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV) by learning steps you can take to lower the risk of becoming infected.
19. Receive the human papillomavirus (HPV) vaccine.
20. Get tested for STDs of HIV if you are sexually active.
21. Have open and honest conversations about any body changes you may be experiencing.

Teenage years are the perfect time to find the right gynecologist. This healthcare provider will be there with you through some pretty important moments in your life. Greenville Women’s Clinic is committed to providing young women with the best care possible so they can live healthy, educated and safe – even before they turn 21. We encourage every young women to take charge of their health and body, and make an appointment at Greenville Women’s Clinic – even if it is just to ask questions.

Your quality of sleep directly affects your physical and mental health. Fall short of the amount of sleep you need and it can take a serious toll on your daytime energy, productivity, emotional balance and even your weight! There are steps you can take to have a better night’s sleep. The tossing and turning and struggling to fall asleep can become a thing of the past. Simple but important changes to both your daytime routine and nighttime habits can have a profound impact on how you sleep.

1. Try to go to sleep at the same time every night.

By going to sleep at a consistent time every night you help to set your internal clock and optimize the quality of your sleep. Choose a bedtime around the time you normally feel tired, so that you won’t lie awake for hours. If you are getting enough sleep, your body should wake up naturally without an alarm. If you find you need an alarm, you may want to consider setting an earlier bedtime.

2. Avoid sleeping in late – even on weekends.

The more your weekday and weekend sleep habits differ, the worse the “jetlag-like” symptoms will be. If you need to make up for a late night, opt for a daytime nap rather than sleeping in. This will allow you to pay off your sleep debt without interfering with your natural wake-sleep rhythm.

3. When it is time to go to bed, make sure the room is dark.

The blue light emitted from your phone, computer and TV all make it harder for you to fall asleep. Use heavy curtains or shades to block light from windows or try a sleep mask. Your brain secrets more melatonin when it is dark – making you sleepy!

4. Exercise during the day.

People who exercise regularly tend to sleep better at night and feel less fatigued during the day. Regular exercise also helps to improve the symptoms of insomnia and increases the amount of time one spends in the deep, restorative stages of sleep. Even if you are unable to exercise vigorously, just walking for 10 minutes a day can improve your overall sleep quality.

5. Limit caffeine.

Did you know that caffeine can cause sleep problems up to twelve hours after drinking it! Limit your caffeine intake throughout the day and especially at bedtime.

6. Wind down and clear your head.

Many people note that their sleeping problems are the result of residual stress, worry or anger from the day. Practice relaxation techniques before going to bed at night to wind down and prepare for sleep. Deep breathing, muscle relaxation and warm baths are all ways to unwind from the stress of the day. Take the time to discover the bedtime relaxation routine that works best for you.

7. Improve the comfort of your sleep environment.

Making sure you are completely comfortable in your sleep environment is important in achieving a quality night’s sleep. Make sure the room is quite and cool. Most people sleep best in a slightly cool room (65°F). A bedroom that is too cold or too hot can interfere with your quality of sleep.

8. Learn ways to fall back asleep.

It is normal to wake up briefly during the night, but if you are having trouble falling back asleep, avoid looking at your phone or turning on your TV. Keep the lights dim and focus on relaxing.

If you are having difficulty falling or staying asleep at night, do not hesitate to talk with your doctor at Greenville Women’s Clinic. Healthy sleep habits are the foundation of healthy lives.

If you’re sexually active, including oral, anal or vaginal intercourse and genital touching, you can get a Sexually Transmitted Disease (STD).

STDs often have no signs or symptoms, and even with no symptoms, you can pass the infection onto your partners. It’s important to use a condom during sex, and visit your doctor regularly for STD screenings, so you can identify and treat infections before passing it along.

If you are diagnosed with a STD, it’s important to get treated and inform your partner or partners so they can be evaluated and treated as well.

Left untreated, STDs can increase your risk of infertility or of acquiring another STD such as HIV. A STD can stimulate an immune response in the genital area which might raise the risk of HIV transmission.

Some of the following diseases can be transmitted without sexual contact, like hepatitis which can be transmitted by coming into contact with an infected person’s blood. Others, such as gonorrhea, can only be transmitted through sexual contact.

Common STD’s, their signs and symptoms

Chlamydia is a bacterial infection of your genital tract. It usually starts one to three weeks after being exposed. Signs and symptoms can often be mild and passing which makes them easy to overlook. Those may be:

• Painful urination
• Lower abdominal pain
• Vaginal discharge in women
• Discharge from the penis in men
• Pain during sexual intercourse in women
• Bleeding between periods in women
• Testicular pain in men

Gonorrhea is a bacterial infection of your genital tract. It can also grow in your mouth, throat, eyes and anus. The first gonorrhea symptoms usually appear within 10 days after exposure. However, it’s not uncommon for people to be infected for months before signs or symptoms occur. Signs and symptoms of gonorrhea may include:

• Thick, cloudy or bloody discharge from the penis or vagina
• Pain or burning sensation when urinating
• Heavy menstrual bleeding or bleeding between periods
• Painful, swollen testicles in men
• Painful bowel movements
• Anal itching

Genital herpes is highly contagious and caused by a type of the herpes simplex virus (HSV) that enters your body through small breaks in your skin or mucous membranes. Most people never know they have it, because they have no symptoms or the symptoms are so mild they go unnoticed.

When present, genital herpes signs and symptoms may include:

• Small red bumps, blisters (vesicles) or open sores (ulcers) in the genital, anal and nearby areas
• Pain or itching around the genital area, buttocks and inner thighs

The initial symptom of genital herpes is usually pain or itching, which begins within a few weeks of exposure. After several days small red bumps may appear. They then rupture, becoming ulcers which ooze or bleed, and eventually, scabs form and the ulcers heal.

In women, sores can erupt in the vaginal area, external genitals, buttocks, anus or cervix.

Ulcers can make urination painful. You may also have pain and tenderness in your genital area until the infection clears. During an initial episode, you may have flu-like signs and symptoms, such as headache, muscle aches and fever, as well as swollen lymph nodes in your groin.

In some cases, the infection can be active and contagious even when sores aren’t present.

Human Papillomavirus (HPV) infection is one of the most common types of STDs. Some forms put women at high risk of cervical cancer, and other forms can cause genital warts. HPV usually has no signs or symptoms, however the signs and symptoms of genital warts include:

• Small, flesh-colored or gray swellings in your genital area
• Several warts close together which take on a cauliflower shape
• Itching or discomfort in your genital area
• Bleeding during intercourse
  

Sometimes genital warts cause no symptoms. Genital warts may be as small as 1 millimeter in diameter or may multiply into clusters. In women, genital warts can grow on the vulva, the walls of the vagina, the area between the external genitals and the anus, and the cervix. In men, they may occur on the tip or shaft of the penis, the scrotum, or the anus. Genital warts can also develop in the mouth or throat of a person who has had oral sex with an infected person.

Hepatitis A, hepatitis B and hepatitis C are all contagious viral infections that affect your liver. Hepatitis B and C are the most serious of the three, but each can cause your liver to become inflamed. Some people never develop signs or symptoms. But for those who do, signs and symptoms may occur after several weeks and may include:

• Fatigue
• Nausea and vomiting
• Abdominal pain or discomfort, especially in the area of your liver on your right side beneath your lower ribs
• Loss of appetite
• Fever
• Dark urine
• Muscle or joint pain
• Itching
• Yellowing of your skin and the whites of your eyes (jaundice)

HIV is an infection of the human immunodeficiency virus. HIV interferes with your body’s ability to fight off viruses, bacteria and fungi that cause illness and lead to AIDS, a chronic, life-threatening disease. When first infected, you may have no symptoms. Some people develop a flu-like illness, usually two to six weeks after being infected. Still, the only way you know to know for sure is to be HIV tested. Some early HIV signs and symptoms may be:

• Fever
• Headache
• Sore throat
• Swollen lymph glands
• Rash
• Fatigue

These early signs and symptoms usually disappear within a week to a month and are often mistaken for those of another viral infection. During this period, you’re highly infectious. More-persistent or severe symptoms of HIV infection may not appear for 10 years or more after the initial infection.

As the virus continues to multiply and destroy immune cells, you may develop mild infections or chronic signs and symptoms such as:

• Swollen lymph nodes — often one of the first signs of HIV infection
• Diarrhea
• Weight loss
• Fever
• Cough and shortness of breath

Signs and symptoms of late-stage HIV infection include:

• Persistent, unexplained fatigue
• Soaking night sweats
• Shaking chills or fever higher than 100.4 F (38 C) for several weeks
• Swelling of lymph nodes for more than three months
• Chronic diarrhea
• Persistent headaches
• Unusual, opportunistic infections

If you suspect you have any of these or other STDs, or have been exposed to one, see your doctor for testing. Timely diagnosis and treatment are important to avoid or delay more-severe health problems and to avoid infecting others.

Having a baby is a big deal, and the birth of a baby can trigger many powerful emotions, from excitement and joy to fear and anxiety. But it can also result in something unexpected — depression.

Mothers often have a lot of different feelings and emotions in the weeks and months after they give birth. These feelings can change often, going from happy to sad to worried to scared and back again. These emotional changes are commonly known as the “baby blues.”

Many new moms experience the “baby blues” after childbirth. Baby blues can begin within the first two or three days after delivery, and could last up to two weeks. Common symptoms of the baby blues may include:

• Mood swings
• Crying spells
• Anxiety
• Difficulty sleeping
• Sadness
• Irritability
• Feeling overwhelmed
• Reduced concentration
• Appetite problems

However, some new moms may experience something more severe and longer-lasting, a form of depression commonly known as postpartum depression. Postpartum depression isn’t a flaw or a weakness; sometimes it’s simply a complication of giving birth.

Postpartum depression may be mistaken for the “baby blues” at first, but the symptoms are more intense, last longer and eventually interfere with your ability to care for your baby and handle other daily tasks. Symptoms usually develop within the first few weeks after giving birth, but may begin later — up to six months after birth.

Signs and symptoms of depression after childbirth vary, and they can range from mild to severe; some symptoms may include:

• Depressed mood or severe mood swings
• Excessive crying
• Difficulty bonding with your baby
• Withdrawing from family and friends
• Loss of appetite or eating much more than usual
• Inability to sleep (insomnia) or sleeping too much
• Overwhelming fatigue or loss of energy
• Reduced interest and pleasure in activities you used to enjoy
• Intense irritability and anger
• Fear that you’re not a good mother
• Feelings of worthlessness, shame, guilt or inadequacy
• Diminished ability to think clearly, concentrate or make decisions
• Severe anxiety and panic attacks
• Thoughts of harming yourself or your baby
• Recurrent thoughts of death or suicide

Contact your doctor immediately if your signs and symptoms of depression have any of these features:

• Don’t fade after two weeks
• Are getting worse
• Make it hard for you to care for your baby
• Make it hard to complete everyday tasks
• Include thoughts of harming yourself or your baby

If you’re feeling depressed after giving birth, you may be reluctant or embarrassed to admit it. But, it is important to talk with your doctor about all of your postpartum symptoms. If you have postpartum depression, prompt treatment can help you manage your symptoms — and enjoy your baby.

If you’re experiencing any of the symptoms of “baby blues” or postpartum depression, you should call Greenville Women’s Clinic and schedule an appointment with your doctor today. We are here to listen to any of your concerns or worries after giving birth.

Did you know that heart disease is the number one killer of women, causing one in three deaths each year? That’s about one women every minute! The latest findings from the American Heart Association also report that:

• around 44 million women in the U.S. are affected by cardiovascular diseases
• 90% of women have one or more risk factors for heart disease
• fewer women than men survive their first heart attack
• the symptoms of heart attack can be different in women vs. men
• 80% of heart disease events may be prevented by lifestyle changes and education

These finding are alarming which is why it is important for women to live a healthy lifestyle that positively influences their heart. Heart disease doesn’t appear overnight; it is the result of many years of heart-unhealthy choices. Here are a few tips that can help you live a more heart-healthy lifestyle.

1. Eat More Fruits and Vegetable

To give your heart the nutrients it needs to function optimally, it is important to eat a diet full of fruits and vegetables. Beans and legumes are a smart choice for a heart-healthy diet.

2. Get Active

Daily physical activity is a great way to live a healthier life. Just 30 minutes of exercise, five times per week can lower your risk of heart disease, stroke and diabetes.

3. Control Your Cholesterol

It is important to control your cholesterol to give your arteries the best chance to remain clear of blockages. Cholesterol is a waxy substance that our bodies use to make cell membranes and some hormones. But, when you have bad cholesterol it combines with white blood cells to form plaque in your veins and arteries. This plaque causes blockages that lead to heart disease. Ask your doctor for tips and diet ideas to help lower or maintain your cholesterol.

4. Manage Your Blood Pressure

High blood pressure is another major risk factor for heart disease, along with bad cholesterol. When you maintain a blood pressure within healthy ranges, you reduce the strain on your heart and arteries. If you have high blood pressure, also known as hypertension, it means that blood flows with too much force and puts pressure on your arteries, stretching them past their healthy limit and causing microscopic tears. To repair these tears, our bodies form scar tissue which can trap plaque and form blockages, blood clots and hardened arteries. If you have or are at risk of high blood pressure, ask your doctor about measures you can take to reduce it.

5. Stop Smoking

Those who use tobacco products have a higher risk of developing cardiovascular diseases. If you smoke, the best thing you can do for your heart is to quit. Smoking damages your entire circulatory system and increases your risk for hardened arteries and blood clots. Whatever it takes for you to stop smoking is worth it. Ask your physician for tips and advice on how to kick this unhealthy habit.

There are many other ways to live a heart-healthy lifestyle. We encourage you to ask your doctor at Greenville Women Clinic’s for advice on how to reduce your risk of cardiovascular diseases. As we mentioned previously, education is also important in preventing the disease. Share the information and tips you have learned with your friends and family and let’s all have healthier hearts!

Don’t become a statistic.  Know your numbers.  As we enter the month of February, it is time to put your best red dress on to help raise awareness and celebrate all the efforts to stomp out heart disease in women.  Please pay attention as what I am about to share with you can and will save lives, a life that could be your own.  Heart disease is the #1 killer for women, next to cancer however in recent studies they are now racing in a dead heat.  Do you know where you stand in this race?  It is a race you can hopefully sit out, so please read on. 

Heart disease represents just one of the 3 forms of cardiovascular disease that can adversely affect women.  In fact, the same process that causes a heart attack can also lead to stroke in the brain or body with serious lifelong disability and death.  We know women are different than men when it comes to cardiovascular disease.  It is a fact that women are not as easy to diagnose as men.  It is imperative to know your body well and to be your own advocate to evade the misdiagnoses that can occur due to our gender differences.  Are you at risk or ever experienced a heart attack?  Do you know for sure?  The fact is that about 35% of all heart attacks that occur in women go unnoticed or unreported.  It is not that we are oblivious or too busy; it is that we do not have the same symptoms as men.  We do not get that vice grip or elephant on your chest pain like our male counterparts.   We may instead experience extreme nausea with mild chest discomfort often mistaken as heartburn or a terrible stomach bug.  A woman will more often have pain in her neck, jaw or arms when a heart attack is happening.  A heart attack may even be as subtle as new onset of extreme fatigue, where family, work or stress may mistakenly be rationalized as to why one feels so badly.  Bottom line, unless you keep up with your well women’s health and numbers you may not ever know until it is too late.    

As women, our ovaries protect our cardiovascular health when it comes to that golden hormone produced called estrogen.  Up until about the age of 50 to 55, we have our angel wings, and estrogen helps promote the good cholesterol, called HDL that fights off the bad.  Bad cholesterol, being LDL, is what can block the vital vessels in our brain, heart or body resulting in a stroke or heart attack.  After age 50 to 55, when we officially enter menopause, the change of life, we are then a sitting duck!  Careful ladies, this is not just about menopause, as we know issues in our youth can lead to what happens later.  We know women who experience complications in pregnancy like high blood pressure or diabetes are certainly at risk for heart disease when they are older.  Further, medical conditions like obesity, high blood pressure, diabetes, polycystic ovarian disease, autoimmune disorders and even improper use of birth control or hormone replacement therapy can be a risk factor for a heart attack or stroke.  It is time that we take a stand, as we know the path it takes to fight and overcome this battle.   

Let’s talk numbers.  The American Heart Association has identified 7 areas that you should know and keep track to decrease your risk of heart disease or stroke. 

Absolutely no smoking!  I tell my patients to choose another bad habit!  I would rather you have that dark chocolate or glass of wine than a cigarette.  We know smoking accelerates the fatal process leading to heart attack or stroke. 

Get your physical activity.  Exercise can be wherever you choose as long as you get that heart pumping! I advise my Patients you can do whatever you want as long as you can sing a song and break a sweat – it is that great aerobic zone that trains your heart. 

Follow a heart healthy diet.  You should eat as much fresh fruit, vegetables and lean protein you can.  If it is in a box or doesn’t expire, then you don’t want it!  Processed foods are terrible for our health when it comes to heart disease and cancer prevention.    

Maintain a normal body weight.  Talk to your health care Provider to know where you stand. 

Control of cholesterol.  Have your levels checked now. 

Monitor your blood pressure.  High blood pressure damages your heart and body as it places undue stress on the blood flow and creates havoc on its way. 

Control your blood sugar.  High blood sugar and diabetes is known to damage every cell in our body.  Ask to be screened to know where you stand. 

Sounds easy enough?  In our present American culture, it has not proven to be so easy.  The fact is over 86-million Americans are affected by heart disease in some way and as a result, one person dies every 40-seconds in the United States.  We know what we need to do so save ourselves, but we somehow continue to fall prey to this disease. 

Get to your health care provider now and start the conversation.  Get your well women’s exam.  Ask to know your numbers and take this quiz as the life you save could be your own.  Go to https://www.goredforwomen.org/ for more information.  If you know your numbers, please plug them into this calculator and bring to your health care provider today.    http://www.cvriskcalculator.com/

Do you know your birth control options?  Contraception is currently a hot topic in our political and social media world.  With the election of President-elect Donald Trump, the threat of an appeal to Obamacare immediately brings focus whether access to contraception will remain.  Would access to contraception be a target of the appeal or would it be inadvertently taken away in the aftermath of a repeal of Obamacare as a whole?  There are many unanswered questions and this uncertainty is driving this heated discussion across the country.  We as Obstetrician Gynecologists support access to contraception for any person who desires this measure in their life.  Access should be open to all persons regardless of health insurance status.  You may be thinking, “Why would anyone want to argue about birth control?  If someone wants to avoid pregnancy, it is their own prerogative, right?”  Well, since the late 1800s, birth control and politics have had nothing less than an inflammatory relationship.  No matter your stance or political or religious beliefs, be informed and be a part of the conversation. 

Obamacare has opened the door to well woman’s visits and access, to what I call a buffet of contraceptive options. Under the Affordable Care Act, a physical exam and birth control consultation is considered a preventative service.  It is therefore offered without having to pay a copay for these services.  Mind you, there are grandfathered, religious and short-term health insurance plans that are exempt and result in out of pocket costs.  For the majority, it is estimated that Obamacare has afforded women nearly 50% savings in their birth control expense and has been said to equate to 1.4 billion dollars.  There are officially as follows:

• Sterilization surgery

• Surgical sterilization implant

• Implantable rod

• Copper intrauterine device

• IUDs with progestin (a hormone)

• Shot/injection

• Oral contraceptives (the pill), with estrogen and progestin

• Oral contraceptives with only progestin

• Oral contraceptives, known as extended or continuous use that delay menstruation

• The patch

• Vaginal contraceptive ring

• Diaphragm

• Sponge

• Cervical cap

• Female condom

• Spermicide

• Emergency contraception (Plan B/morning after pill)

• Emergency contraception (a different oral medication named Ella)

Thanks to Obamacare, we now have a buffet of options to discuss with women and have been able to take cost concerns off the table.  When exploring a Patient’s contraceptive needs, I advise them that choice depends on personality and lifestyle.  I often say, “You may find that you try one, but you may try them all until you decide which option works best for you.” 

With Obamacare, the category of “implantable” birth control has lifted barriers to this more effective option.  The intrauterine device and implantable rod placed in the arm are known as LARCs – long-acting reversible contraception.  They are proven to be 99% effective in preventing pregnancy.  Compare this to pills and condoms which prevent pregnancy only 92% of the time.  The use of LARC has increased from 2.4% to 11.6% of all women using contraception from 2002 to most recent studies as of 2013.  Once placed, the rod and IUD can provide effective birth control for 3-5 years depending on the device chosen.  The cost of the device is well over $1000 and with Obamacare is now completely free.  If and when it is time to remove the device, it may be replaced with a new one or removed at any time to become pregnant right away.  Why wouldn’t every woman choose such a reliable and modern device?  It is a “set it and forget it,” until one is ready to pursue a pregnancy.  Prior to Obamacare, cost was a major barrier, but now it is lack of awareness and a historical bias that has hindered the rise in women choosing a LARC.  The implantable devices of decades past resulted in serious side effects and consequences and were removed from the market.  The LARC devices we have at present have proven safety but the reputation of devices past have left distaste among older generations who may be influencing the present. 

With the current political climate and uncertainty of contraceptive coverage, however calls to question what happens if contraceptive coverage is eliminated or the cost increases?  Social media has seen thousands discussing this topic.  Some are asking, “Should I hurry and obtain a LARC to have long term contraception before Obamacare is repealed?  But if I do, what happens when I want or need it taken out?  What would be the cost to me?”  We cannot answer many questions as it stands now, but in my present knowledge, I counsel Patients that a LARC is a great choice per its effectiveness to prevent pregnancy and from a cost perspective long term if even Obamacare was lost.  The removal of a LARC device without insurance coverage averages around $300.  If you keep the device in place for more than one year, it averages to equal the cost of birth control pills that one would have paid for that year.  If you keep the LARC in place even longer, then costs are clearly in favor of choosing a LARC at this time. 

When it comes to contraception, I counsel Patients on a daily basis that no choice is a wrong choice.  It is what is best for you, your situation and fertility plans.  With Obamacare, there is a buffet of contraceptive options, however if access if called into question over the coming years, it may be wise to consider your long-term goals and options.  When choosing a LARC, it is ideal if there are no immediate plans for fertility.  No matter your current life stage, stay tuned and be informed to support all women.  We pray the landscape of the future maintains contraceptive access for all.