Obstetrics and Prenatal Care

My OB Experience and Philosophy

* Although I do not attend homebirths, I support patients who choose this option and work with their midwives. I like a dark room for delivery but unfortunately, our labor rooms are not equipped for water births.

* I encourage birth plans which help patients organize their thoughts  about delivery before labor starts. There are few things I object to for healthy patients, but ultimately its your decision and we cannot force any care on you that you do not desire.

* Doulas and labor coaches are allowed & encouraged and are thought to be of great benefit to patients, partners and nurses.

* IV access during labor is optional in normal labor, but is strongly encouraged when there are risk factors such as hypertension, bleeding, VBAC etc, in case emergency medications need to be administered. Healthy women should be able to drink and do not always need IV fluids, which may hinder their mobility.

* Continuous monitoring of normal, healthy women has not been shown to improve outcomes, as long as there is an initially reassuring fetal heart tracing. Intermittent monitoring is however recommended during labor.

* Rupture of membranes may become helpful or necessary during your labor, but also carries some risks. The decision as to whether and when to perform this procedure will involve a discussion between us at that time.

* Epidural anesthesia is optional and available at all times. Although relatively safe, it does likely increase the rate of C sections as they often hinder movement which facilitates fetal descent and may cause drops in blood pressure which may result in fetal distress. Some women experience severe headaches afterwards requiring and injection into the spinal column to stop the leaking of spinal fluid.

* I perform most vaginal deliveries on a standard labor and delivery bed, however there are exceptions and depend on maternal comfort and labor progress. We try to find the position that benefits the mother and baby the most.

* Episiotomy is a surgical incision made at the vaginal opening just before the baby’s head is delivered in order to speed up delivery in an emergency situation, such as a prolonged drop in the fetal heart rate. It is not performed routinely.

* I will clamp the umbilical cord after it stops pulsating, unless there is an emergency which requires moving the baby for resuscitation.

* Normal pregnancies progress thru 42 weeks.  If it goes beyond this we will offer induction, or biweekly monitoring due to somewhat higher risks. Some studies also suggest that there may be a decreased risk of C section if inductions are done after 41 wks, so this option will be offered.

* Compared to the national average, I have a very low c-section rate. However, a c-section may become necessary at any time during labor due to maternal or fetal concerns.