From Dr. Sarah Whitehead—Optimizing Your Chance of Becoming Pregnant, an Obstetrician’s View

You’ve decided you’re ready to start a family. In fact, you’ve decided that the next few months would be “ideal” to begin a pregnancy. But a month goes by, and then another, and no little + sign appears on the magic stick. You’re not exactly worried, nor should you be. Statistics say that around 20% of couples who will eventually have a spontaneous pregnancy do not conceive during the first six months that they attempt getting pregnant.  Obstetricians define infertility as the inability to achieve a successful pregnancy after twelve months of regular, unprotected intercourse. So, during this time we usually reassure young couples that most likely everything is normal. For older couples (beyond about 35) we may suggest some testing after about 6 months.

Still, you are just a little disappointed. Now and then, one of my patients in this situation will ask what she can do to “increase the chances” of becoming pregnant. It’s a good question. I am delighted to help you sort through the facts and myths that you’ve found on the Internet. Read more

What I learned in the NICU

In 1978 I had just completed medical school and moved from Birmingham to Washington DC to begin my OB/GYN residency training. Within a few weeks, I felt fairly confident on labor and delivery. I had already accomplished several dozen deliveries as a medical student. But my training program required each OB resident to spend a month in the Neonatal Intensive Care Unit. We were expected to learn basic newborn emergency care to support an infant in the delivery room until a pediatrician arrived. The NICU is an overwhelming place, certainly for parents, and even for a young doctor. Back then one room—not nearly large enough—housed warming tables, mechanical ventilators, beeping monitors, and what seemed like miles of plastic tubing. On my first day in that place, it also held a dozen or more little lives. Read more

Physician News

 

We proudly share this announcement and congratulate Dr. Sparks:

“The North American Menopause Society (NAMS) is pleased to announce that Dr. Jimmy M. Sparks has successfully met the criteria and has passed the examination necessary to become a NAMS Certified Menopause Practitioner (NCMP). Founded in 1989, NAMS is North America’s leading nonprofit organization dedicated to improving health and quality of life through an understanding of menopause.Those who hold the NCMP certification have demonstrated special interest and competency in the field of menopause. We congratulate Dr. Sparks on achieving this important certification.”

Dr. Sparks has long maintained an active interest in the special issues affecting women during the menopausal transition, including perimenopause, premature menopause, menopause symptoms, and hormone replacement therapy. The topic has created much controversy in in recent years, but scientific research continues to provide new perspectives. Dr. Sparks’ achievement of the NCMP certification signals his commitment to up-to-date scientific knowledge and clinical practice in these areas.

Dr. Sparks encourages women to make their own health and well-being a priority during the menopause transition and, especially, to seek high-quality information. He reminds patients that, on average, the years after menopause occupy about a third of a woman’s life. Although each woman’s experience is unique, the mid-life years should be comfortable and enjoyable ones. He welcomes the opportunity to discuss bothersome symptoms and offer a choice of low-risk options for improving your quality of life.

Update from Dr. Favor–“Genetic Testing for Breast and Ovarian Cancer”

October is Breast Cancer Awareness Month! Although most breast and ovarian cancers are sporadic—meaning they do not appear to be hereditary—women who carry genes known as BRCA1 and BRCA2 have a much greater risk of developing these cancers. At your annual well-woman exam, your physician will review the family history you provide. Your “new patient” or “return visit” forms ask you to provide or update your family . We offer genetic testing when appropriate based on your risk factors.

Should I be tested for the cancer genes? Read more

New Information from your Obstetrician–the Flu Shot and Pregnancy

From the American College of Obstetricians and Gynecologists (ACOG)

“Influenza is more likely to cause severe illness in pregnant women than in women who are not pregnant. Changes in the immune system, heart, and lungs during pregnancy make pregnant women more prone to severe illness from influenza as well as hospitalizations and even death. Pregnant women with influenza also have a greater chance for serious problems for their unborn babies, including premature labor and delivery. Read more

Ask Your Ob-Gyn: “What’s New in Hormone Replacement Therapy? (HRT)”

In the early 1990s, 40% of American women who had reached menopause used hormone replacement therapy (HRT) to treat disagreeable symptoms like hot flashes, sleep problems, and discomfort during intercourse. At one time, Premarin® (brand name for oral estrogen) was the most commonly prescribed drug in the U.S.

In 1993 the U.S. government invested over $600 million to study whether hormone replacement protected women from heart disease. That study, the Women’s Health Initiative (WHI), changed women’s lives for sure. But was this a change for the better? Read more

Episiotomy—A Birmingham Obstetrician’s View

Episiotomy—the small surgical incision made to enlarge the vaginal opening shortly before a baby is delivered—was not a commonly accepted birth procedure until the twentieth century.  But by mid-century, over half of vaginal deliveries included an episiotomy. The idea was that making a small incision would reduce the risk of a large spontaneous tear in the tissues surrounding the vagina (the perineum), as the infant’s head delivered.

As physicians, we want to offer our patients only medical interventions that—based on solid evidence—actually benefit them. By the 1980s, we began to realize that the medical benefits of routine episiotomy were uncertain.  According to recent data, less than 12% of women delivering vaginally now have an episiotomy. We do not consider episiotomy a routine part of childbirth. Read more

Gynecologic Cancers–Recognize What’s Not Normal for You

Research tells us that Americans fear cancer more than any other health event, even though heart disease is the leading cause of death. Much of this fear comes from the belief that cancer or cancer death is just a matter of random chance, something we are powerless to prevent. But let’s look at the actual facts about gynecologic cancers.

We refer to any cancer that begins in a woman’s reproductive organs as a gynecologic cancer. About 100,000 women are newly diagnosed with a gynecologic cancer each year, and these cancers cause nearly 40,000 deaths annually.  A woman’s risk for gynecologic cancer increases with age. As we see you each year for your well-woman visit, we want to help you understand what you can do to prevent these cancers or discover them early. Read more

The Thin, Fuzzy Line between Medical Science and “Alternative” or “Complementary” Medicine

As physicians we try to draw a clear line when we make recommendations to our patients. Is the treatment choice based on strict, evidence-based medical science, is it based on the doctor’s years of experience, or is there really nothing factual to support a recommendation? Is it just an opinion, or worse, part of the darker side of health care, a profit-driven option?  By explaining these differences, we help our patients to make informed choices. Recently one of the U.S.’s most prestigious medical research and teaching hospitals, the Cleveland Clinic, promised disciplinary action against the Medical Director of its own Wellness Institute, Dr. Daniel Neides.. Read more

A Brief “Thank You” from Dr. Sparks

Now and then, most of us think about the people to whom we wish we said “thank you” much more often.  For the physicians at Sparks & Favor, it’s a long list, but the RNs who care for our patients during labor and delivery surely rank near the top.

Our nurses make an important difference for our patients every day. Sometimes they anticipate a mom’s rising need for comfort measures and offer suggestions early, allowing mom to remain in control of her labor. There are also difficult moments when a nurse’s timely recognition of a true obstetric emergency is critical to the wellbeing of mom and baby.

Over my career as an obstetrician, I have practiced in quite a variety of situations from my years as a young army doctor where four of us delivered nearly 1200 babies a year to my time on the faculty at UAB supervising residents first learning to deliver a baby. I have seen trends come and go. My confidence in my nursing colleagues here comes from a years-long positive working relationship, but also from a number of specific commitments Brookwood has made over these years to maternity care. I’d like to share some of these with our patients. Read more