What mom didn't tell you about birthing plans

The reality is, your mom probably didn’t have a birthing plan but, I wonder what mom would have to say about a birthing plan…

When I was laboring with my half dozen children, back in the day, my plan was to not feel any pain and push a baby out of me.  That was the basic gist of my hospital stay when I went into labor.  By the time the last one came along, my birthing plan evolved into milking it for all it was worth so I could just take a nap.   

Birthing plans are a relatively new thing to evolve over the past few years.  It’s good to be educated and knowledgeable on the birthing plans so you can decide if it’s right for you.  

So, what is a birthing plan?

A birthing plan is a document that allows your medical team to know your wishes when it comes to childbirth; managing pain, taking care of baby while in the hospital, and other important factors.  Your birthing plan should be simple and to the point.  Your medical providers, including nurses are busy people, they don’t have time to read a 6 page document, try to keep it to one page.

How to start writing a birthing plan?

The most important thing to do before starting a birthing plan is to do your homework.  Become familiar with the policies and practices of the hospital where you will be delivering.  Just because you want to room in with your new baby, doesn’t mean you will be allowed to, or vice versa.  Hospitals have rules in place to maintain continuity, order and safety so you must work within their boundaries.

Consider how you want to manage unexpected circumstances.  Perhaps you had planned on a vaginal birth but it becomes evident that you will be having a C-Section at the last minute, how will you manage that.  Creating a birthing plan, especially if it’s your first is something to start drafting well in advance so you have time to consider all the unexpected possibilities.

Some other things to think about:

                Who do you want in the room with you while you labor and deliver?

                Will you be using a Doula?

                How will you manage pain…massage, imagery, breathing techniques, jacuzzi, pain                                       medications, epidural?

                Do you want to be mobile while laboring or stay in bed?

                What position would you like to give birth in?  Make sure this point is well discussed with                           your doctor.

                What are your preferences for baby care?

With each consideration, make sure you discuss your plan with your doctor prior to and well in advance of your due date.  Listen to his/her ideas and incorporate them, even compromise.  Communication is one of the most important tools you have.  Don’t just focus on what you don’t want…remain positive and list the important things you do want.

How to execute the plan…

Take your plan to the hospital when you check in and go over it with your nursing team.  Remember, a birthing plan is an outline, merely a guideline.  You must be flexible since there are very few things you can count on when giving birth.  Anything can happen and rather than get frustrated that things aren’t going as planned, trust in your team to deliver safe and compassionate care.  If nothing else, a birth plan ensures that you have educated yourself on the birthing process and have realistic expectations.  The birth plan can help you maintain your focus.

Whether you choose to have a formal birthing plan or not is up to you.  The most important thing is that you, your partner and your doctor are on the same page with the same expectations.  And, at the end of the day, your baby will arrive in a surrounding of love and caring.

How Invigor-A will help you conquer your world!

Image:rightbalancehormonehealth.com

We hear all the time about how our hormones can drop off the charts as we age.  Most of the conversations regarding hormones, refers to the female hormone Estrogen.  We rarely hear about the drops in Testosterone and how that drop can negatively impact a woman's life...or a man's for that matter.

Madison Women's Clinic has an exclusive line of testosterone pellet implants called Invigor-A.  It is used for both men and women and for some, can change your life dramatically!  It has been called by some to be the greatest age fighting tool we have.  So, how do you know if testosterone pellets are right for you?

First, let's discuss some of the symptoms of hormone depletion that comes with the natural aging process.

• Aches and Pains
• Migraine headaches
• Sleep issues
• Bone density changes
• Increase in soft fatty tissue
• Depression and Anxiety
• Decreased memory and concentration
• Decreased muscle mass and strength
• Decreased libido
• Depression and Anxiety
• Hot Flashes
• Decreased Energy

Second, only you and your doctor can determine if pellet therapy is right for you.  As with any treatment, there are risks and side effects you must consider first.  Some women see amazing changes in their symptoms as listed above, yet some don't, and the same goes for men.  Coming in for a visit about your hormone needs is the best way to start the process. 

Third, some screening tests must be accomplished before starting Invigor-A therapy. For women, we thoroughly check your thyroid hormone levels, testosterone levels, estrogen and overall health.  With men, we check the level of testosterone as well as thyroid hormones and overall health. 

The pellet procedure is done every 3-5 months and is an in-office procedure, takes less than 10 minutes and a local anesthetic is used.  The tiny pellet is inserted just under the skin in the fatty part of the hip.  Once in place, it will slowly dissolve over time.

We would love to visit with you and see if Invigor-A is right for you.  Make an appointment today for our Rigby or Rexburg Office.

A Heart to Heart

It's time for a heart to heart.  You know what I'm talking about... the heart of a woman.

More specifically, women and heart disease.  Did you know it's one of the leading causes of death among women?  Did you also know it doesn't have to be that way?

Women are often under diagnosed when it comes to heart disease.  Sometimes, by the time the diagnosis is made, it's too late.  Deaths from heart disease between men and women each year are nearly the same.  With men, they typically have the tell-tale signs of chest pain and pressure but this isn't always the case with women.  Not to mention, heart disease isn't just a heart attack...it includes arrhythmias, stroke, heart failure and heart attack.

But...Take heart!  There are things you can do to ensure you aren't a statistic.  For starters, educate yourself on the disease and become more aware of your body and your health.

Screening:

• Be in the know...know your blood pressure and what those numbers mean.  High blood pressure doesn't always come with its own list of symptoms so check it regularly. 
• Are you a smoker...if you are, you've heard it before.  Smoking will increase your risk for heart disease.  Talk to your healthcare provider about the help and tools available to quit smoking.
• Cholesterol...check those numbers regularly. 
• Weight...obesity raises your risk for heart disease but you know that already I think.  If your pants are fitting a little tighter than before, take measures to course correct now.  A few pounds to lose is easier than many more.  
• How is your stress? If you are living anywhere but under a rock, deep in a cave, then it's probably safe to say...you are stressed!  
• Alcohol consumption...again, it's just not good for your heart.

Symptoms:

• Heart attack-   Here's where it gets tricky for women...sometimes, the symptoms of a heart attack are vague.  You could experience dull or sharp pain in your chest but not always.  The pain could be in the neck, jaw or throat, even the abdomen or back.  It can occur when you are resting, engaged in physical exercise or under a great deal of stress. 
• Stroke-  sudden weakness or numbness, especially on one side of the body, unbalanced, uncoordinated, difficulty speaking, vision problems, severe headache and loss of consciousness.
• Heart Failure- Shortness of breath, fatigue, swelling in the extremities.
• Arrhythmia- palpitations or a fluttering feeling in your chest...and not just when your handsome guy walks in the room. 

       

Solutions:

      Though it can be a heart breaking subject to discuss, it's not all bad.  There are many proactive things you can do today to keep the odds in your favor.  Schedule regular visits with your healthcare provider, especially if you are feeling symptoms.  Keep your bad habits and weight in check.  Do what you can to reduce stress. One of the best stress reducers is physical activity.  It's also important to keep other health problems managed.  Autoimmune diseases and even diabetes can create additional inflammation and stress on the heart, so make sure you are in the best health possible.  

Our New Additions

We want to officially welcome two new providers to Madison Women’s Clinic; Toni Frahm and Fay Call.  Each of these providers bring a fresh approach to medicine and a passion to care for women and their health.  They are very familiar with the unique challenges of good health that women face today and are ready to care for you in whatever stage of life you find yourself in.

Toni Frahm

Toni is our first Certified Nurse Midwife-  Toni came to Rexburg from Oregon.  She attended BYU-Idaho where she received her Associate of Science in Nursing as well as her Bachelor of Science in Nursing.  She worked for 12 years as a Labor and Delivery nurse at Madison Memorial Hospital.  Her passion as a nurse, led her to pursue her Master of Science In Nursing, with a specialty in Nurse Midwifery from Frontier Nursing University.  Toni is currently working on her Doctor of Nursing degree and is on track to complete her studies in December of 2017. 

Toni loves the outdoors including waterskiing, wake boarding, snow skiing, riding horses and running.

Not sure if a Midwife is for you?  Make an appointment with Toni and get to know all the benefits of having a Nurse Midwife.  She is highly trained and skilled to care for each phase of your pregnancy from family planning to postpartum.  Toni offers individualized care in ways that traditional physicians are not able to do. 

 Fay Call

Fay grew up in the Seattle Washington area and moved to Rexburg to attend BYU-Idaho where she earned her Bachelor of Science degree in Nursing.  She worked several years at Madison Memorial Hospital as a Labor and Delivery nurse.  Her love of caring for patients led her to pursue more education.  She attended Clarkson College and graduated with a Master degree as a Family Nurse Practitioner. 

Rexburg is home now to Fay, her husband and their two boys.  It’s the perfect place to raise a family.  Fay enjoys cooking, sewing, crafting, playing bass, shopping and being a little mischievous! 

You may not be familiar with a Nurse Practitioner but here is a little of what you should know.  A Nurse Practitioner doesn't just diagnose illness and treat conditions.  They are your health educator!  Their emphasis is on health and well-being.  They focus on making sure you get on a healthy track and stay on that healthy track.  Making an appointment today with Fay to discuss how you can be a healthier you in all phases of life would be a beneficial thing to do.  

We are so excited about our new additions and we know you will be too! 

Menopause

If you are in your mid-fifties, you don't need anyone describing the life and times of Menopause. You've been there and done that! Or you're doing that...

Hooray for YOU!!

CONGRATULATIONS...

You have survived the dreaded menopause! Not a disease, but a course of life that comes to one and all. Just another perk of being a woman. There is life after you get through the burning inferno of dropping estrogen.

For those of you just looking ahead to this incredibly, unsatisfying time of life, let's talk about what it is and what it isn't.

Menopause is...

A shift in hormone levels. Less estrogen, more testosterone.
A decrease in fertility due to decreased egg production.
A normal part of aging.

Menopause is NOT...

A disease.
Optional
Always as bad as you think...but sometimes it is.  Everyone is different!

So, if you are in pre-menopause, the erratic menstrual cycles warning you that change is on the way, or you have arrived at your last period here are some symptoms you many experience.

Hot Flashes- The hallmark symptom of menopause.  That sensation of burning up in a desert in peak of summer desert season.  If can be accompanied with flushing, heart palpitations and even anxiety.  It can be more intense at night.  They range in severity and frequency.

Mood Disturbances- You can thank the drop in estrogen for this.  This can be anything from general grouchiness to full on depression and anxiety.  You may cry for no real reason.  You may even feel like you are losing your ever loving mind but you aren't.

Difficulty Sleeping- This may be in part to the night sweats and hot flashes that keep you up too.

Memory Problems- This typically resolves after menopause.

Vaginal Dryness- The lower levels of hormones creates dryness and the tissue to become thinner. It can make intercourse painful.

Brittle Bones- Your bones can take a hit as well with the lowered estrogen.

There are ways to manage menopause so you don't completely lose your mind.  Consulting your provider at Madison Women's Clinic is the best place to start.  They will help you navigate these sometimes uncomfortable changes.

There are a few things you can do on your own to manage these symptoms and they are things you have heard before...Maintain a good healthy diet, weight and lifestyle.  Exercise is good for your mind and your bones and can also help you deal with the mood changes and anxiety you may feel.  Try to eliminate your bad habits such as caffeine consumption, smoking and drinking.  Your body is using all sorts of energy as these changes take place so give it a break and stay as healthy as possible.

When you understand what is happening to your body, you can try to stay ahead of the game.  There are often triggers that can throw you into a hot flash, like stress and anxiety, even some foods.  Pay attention to these triggers and take steps to eliminate them or at least control them better.

Above all else...remember you are not alone in this.  It happens to the best of us...all of us!  Most of these discomforts resolve after menopause.  If they become to troublesome, your doctor can prescribe estrogen replacement and provide you with other ways to manage the symptoms.

Gestational Diabetes

Glucose screening time!  The very words stir up anxiety in many women, not because we are afraid of the results but afraid to drink the horrifying, sweet, sugar substance intended to test for gestational diabetes.  

If you have been pregnant, you know!  It can be a challenge to get this tiny bottle to the back of your throat!

So, what is gestational diabetes exactly?  We all know we don't want to have it but how does it happen in the first place?

Gestational diabetes isn't always preventable and science isn't 100% certain why some women have more insulin problems while pregnant, than others.  Screening for gestational diabetes takes place between the 24-28th weeks of pregnancy, after the baby's body is formed.  According to the Center for Disease Control, gestational diabetes can affect up to 9.2% of pregnancies in this country. 

We know there are some risk factors that include - obesity prior to and during pregnancy, a history of diabetes in the family or in the mother, insulin resistance in the mother prior to pregnancy and Polycystic Ovary Syndrome.  There is another possible cause to gestational diabetes as well. 

The placenta is the life source for baby; it is how a baby is fed and nourished with vitamins, minerals, nutrients and hormones so that it can grow properly.  Some of the hormones in this process, can block or prevent insulin in the mother from doing its job for mom.  This result is insulin resistance.  The mother's pancreas works overtime to produce more insulin for the mother to take care of her own glucose so it can be turned into energy for her.  When it can't keep up with the glucose load, gestational diabetes is the result; too much glucose in the blood stream.  

While insulin doesn't cross the placenta, glucose does.  Not only does mom suffer from the extra glucose but the baby gets an extra dose as well.  This causes the baby's pancreas to work harder to control and convert the glucose to energy but, there's only so much a baby can do.  This added glucose is the reason mom's with gestational diabetes tend to have larger babies. 

Preventing the things we know cause gestational diabetes is the first thing a woman can do to make sure she experiences the best possible pregnancy. 

• Maintain a healthy weight before and during pregnancy
• Exercise regularly
• Make and keep all your prenatal and pregnancy doctor appointments and keep up on all screenings. 

Even the best prevention plan can result in gestational diabetes.  If this happens to you, make sure you begin treatment as quickly as possible and follow your doctor's advice.  

Treatment involves...

• Healthy nutritious diet with a variety of nutrients
• Focus on complex carbohydrates such as fruits, vegetables and whole grains
• Avoid simple sugars. 
• Do not skip meals, this causes peaks and valleys in your insulin levels.  Eat 3 small meals and 2-4 snacks
• Establish a regular exercise routine
• Test blood sugar as required and recommended by your doctor

Remember that gestational diabetes doesn't have any real symptoms in the beginning so make sure you do the screenings that comes with prenatal care. A little prevention and treatment, gestational diabetes can be effectively managed and mom and baby do well!  

Depression

Depression has often been defined in our culture as nothing more than a bad day or string of bad days. One person described it as “Anger without enthusiasm.”  With this over-simplistic notion, in a world that doesn’t slow down for a bad day, comes a stigma and shame, when the bad day never ends.

Depression is more than just a bad day or two.  It’s far more complex than that.  In fact, there are many different types of depression, some more chronic and critical than others but all the same, can make life difficult for you and those around you.  

Depression has a way of keeping you stuck and isolated.

Here is a list of just some of the sub-types of depression

·         major depression

·         dysthymia

·         manic-Depression

·         post-partum depression

·         seasonal affective disorder (SAD)

·         medication-induced depression

Depression is multi-faceted, and understanding the most common mental health disorder, is the first step in managing your life with depression.

The National Institute of Mental Health suggests that depression is caused from a combination of genetic, biological, environmental, and psychological factors.  Because there are so many variables to depression, treatment options are broad and varied as well. 

So, what can you do if you are feeling depressed…besides book a cruise with money you don’t have or take to the mall for some retail therapy? 

The first thing?

·         Be intent on getting better and finding relief.  Becoming the Queen of Denial is not a good life plan. So, make an appointment with your healthcare team to obtain an accurate diagnosis. Plan with your doctor to address any underlying genetic or biological treatments. Quiet the chemistry…or wake it up!  Your doctor will know the best medication for the type of depression you are experiencing.  Be a good patient.  If you don’t think you can be compliant on the medications, be honest with your doctor.

·         Practice good self-care. 

o   Get plenty of sleep.                                                                                                   

o   Exercise. Some is always better than none. Eat foods that support good general health.

o   Break some bad habits. 

o   Avoid isolation. 

o   Know your limits.  Did you know that the word “No.” can be a complete sentence?

o   Address other chronic or new health issues.  Depression can be caused by any number of other health conditions or depression can aggravate other existing health conditions.

o   Stress is unavoidable sometimes but there are many healthy ways to manage it.

o    Expect gradual change, not immediate, drastic change.

o   Psychotherapy may be a necessary intervention and very helpful under your circumstances.

·         Most importantly…do not just live with depression.  It can escalate quickly and leave you feeling despair and hopelessness, even suicidal.  Get help immediately and share your feelings with someone close to you. 

Depression is an illness of your mind and should be taken seriously.  If you or your friend broke their leg, you wouldn’t say, “Well, jump up.  Walk it off!  You’ll be okay.”  You would get them help.  Telling yourself or someone else who is depressed to shake it off is the equivalent. 

 

It’s time to start a little selfcare revolution with your emotional health.  It’s good for all of us, depressed or otherwise.