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Lessons from the Heart

heartWomen’s Specialists had the distinction of celebrating one of our employees recently. Tammy was honored at the Go Red for Women luncheon sponsored by the American Heart Association.  Her story is important because many women ignore the symptoms.  See Tammy’s story below.

 

“I had my heart attack on the evening of July 31, 2016 at 47 years old. In hindsight, I started having symptoms 48 hours prior. I left work on a Friday evening with shoulder blade pain. I figured it was a knot and had my husband rub it that night. It continued intermittently through Saturday and was starting to make my fingers tingle. I took Tylenol and Advil and that relieved a little of the discomfort but I had a dull ache that felt like it was in the bone. I woke up on Sunday feeling so much better. I relaxed most of the day and decided early evening I was going to vacuum the pool. That was all it took. I went inside, sat on the couch and had the most excruciating chest pain, down my arm, up my neck into my jaw. I fell to the floor. I knew exactly what it had to be. I realized with my first grandbaby just 6 weeks away and my family witnessing this that I had to go to the Emergency Room. I did not want to be a statistic. The EKG was normal but my labs were not. I went to the cath lab with a 90% blockage of my LAD artery and had a stent placed. I have no family history, no high cholesterol and no high blood pressure.  Very happily 6 weeks later I spent another night in the hospital and witnessed the beautiful birth of my grandbaby Brielle Mae.”

 

Tammy’s story is not unique as many women miss the warnings signs.  If you have any of the following symptoms, be proactive and seek help.

  • Shortness of breath.
  • Pain in the back, neck, jaw or one or both arms.
  • Cold sweat, nausea/vomiting or lightheadedness.
  • Uncomfortable pressure, squeezing, or pain in the center of your chest that lasts more than a few minutes. This pain can go away and then come back.

 

If you have any of these signs, call 9-1-1 and get to a healthcare facility right away.

By | March 6th, 2017|Categories: Education, News|

Tell Us the Woman You Are

TELL US THE WOMAN YOU ARE

We are looking for you to share in our ‘I AM WOMAN’ campaign.  Click the button to the right to share your three I AM WOMAN HEADLINES.  We are proud of the community and women we serve – we are devoted entirely to you.

SHARE YOUR HEADLINES WITH US
By | January 26th, 2017|Categories: News|

Waterbirth Q&A with Liz Withnall, CNM

It’s time for…..(drum roll please!)….ask the Midwife with Liz Withnall, CNM!

Q: I have heard that some women give birth in water. What are the advantages of doing this? Are there any risks to myself or my baby?

Liz says:

The use of warm water for relaxation and pain relief during labor is not a new idea. In the 1960’s, water birth became popular in Russia, and in the 1970’s and 1980’s thousands of water births occurred in Europe. Currently, birthing in water is a popular option in hospitals and birth centers across the U.S. Many benefits of immersion in water during labor and birth have been documented by research.

water birth questions answers

These benefits include reduction in the perception of pain; reduction in the need for pain medications; increased relaxation; shorter labor; decreased incidence of lacerations during birth; and increased satisfaction with birth experience. Women who experience water birth very often comment on what a positive experience it is, and how they would like to birth that way again with the next baby.

In order to experience the full benefits of water birth, full immersion is necessary, which means the mom is in a deep tub, with her belly covered with water, all the way up to the breasts. Being fully immersed promotes the hormonal responses of the body which aid in the relaxation of the woman and shortening of the labor. The recommended temperature of the water is between 98 F and 101F, in order to avoid chilling or overheating the baby. Most often, women will enter the pool during active labor and may stay in until the birth, or they may decide to get in and out of the tub. Sometimes getting out for a short period of time and then getting back in will cause a rapid increase in dilation. When the time comes to push the baby out, women will assume whatever position feels comfortable to them. Her partner can be behind her in the tub, supporting her, or at the edge of the tub, giving encouragement. Both mom and partner are encouraged to help guide the baby out and to the surface if they choose, with the assistance of the midwife. The placenta can be delivered in the tub, but often the woman will get out, which aids in assessing blood loss.

In our practice the baby is guided to the surface of the water promptly after delivery so that he/she can take that first breath. Often people ask what keeps the baby from breathing as soon as he/she is out of the birth canal. There are several factors involved that prevent baby from taking a breath while under water. One is a hormone called Prostaglandin E2 which comes from the placenta. When these levels are high, the baby’s muscles for breathing are inhibited, and prevent a breath from being taken. Also, the baby already has fluid in the lungs from being inside the amniotic sac for nine months; this fluid prevents other fluid, such as water, from entering the lungs. Additionally, babies are born with a reflex that causes the glottis to close if a substance such as water tries to enter, and effectively seals off the passage to the lungs. When the baby is brought up to the air, the nerves in the face respond and trigger the reflex to breathe. At that point, the circulation to the lungs begins. Remember, baby is getting oxygen through the umbilical cord up until that point.

Risks of water birth are rare. One potential complication is the umbilical cord tearing off the placenta at time of delivery. This would be more likely to happen if the cord were unusually short. In cases where the baby is stressed at birth, the reflex to not take a breath at delivery could be overridden, and there is potential for the baby to take a breath. This situation can be avoided by monitoring the baby’s heartbeat and having the mother get out of the tub for delivery if there are any concerns about fetal wellbeing. Additionally, if there is meconium in the amniotic fluid (the baby has had a BM in the water bag) the birth cannot take place in the tub.

Women who are having a normal, healthy pregnancy are ideal candidates for birthing in water. Those with risk factors such as prior cesarean delivery, high blood pressure, small for gestational age baby, preterm or post term (42 weeks or more) or other medical conditions requiring continuous monitoring of the baby’s heartbeat are not candidates for waterbirth due to safety concerns.

If you are interested in having a water birth, or have more questions, please talk to any of your midwife providers at Women’s Specialists of New Mexico! Water birth is an option for those of you delivering at Lovelace Women’s Hospital, who meet the screening criteria and agree to be part of an ongoing study. Remember, as with any birth experience, you might not end up delivering in the water for a variety of reasons which could include such a rapid labor that there is not time to get the tub filled; you could change your mind and jump out of the tub; you might decide you need an epidural; or concerns about fetal well being or infection could cause your provider to recommend you deliver out of the tub. Water birth is an excellent option for some women in labor, keeping in mind that labor is always an unknown and mysterious experience… which is what we love about it!

To make an appointment with Liz Withnall, CNM, call 843-6168.

By | September 7th, 2016|Categories: Education|Tags: , , , , , , |

Sexual Health Q&A with Levy, CNM & Knight, MD.

Powerful woman! You should be having sex whenever you feel safe and sexy and your partner desires the same!
  • Having an orgasm is such a personal experience. Some women experience orgasm as a rush of heat and pleasure. Others find the experience explosive. While others burst into laughter.
  • Orgasms are best reached when we feel safe and at ease with our partners.
  • Women are dynamic when it comes to finding pleasure. Our erogenous zones are elusive and often become more exposed as we feel more relaxed and aroused.
  • Most women require clitoral stimulation to reach orgasm. What is important to remember is that the clitoris is actually a very large section of tissue. Generally, we think of the clit (that tiny little nub beneath the front of our labia), but actually, clitoral tissue is like a glacier. The clitoris is just the top. Clitoral tissue actually extends like a wishbone shape along the labia minora and inside of the vaginal. As we become aroused, this tissue becomes swollen with blood and thus more sensitive to touch.
  • For some women, this swelling happens quite easily (lucky!), but for most women, this takes safe and sexy foreplay.
  • Many people have heard of the “G” spot. This is actually tissue along the front of the vagina. Just as the clitoral tissue becomes flush and swollen as we become aroused, so does this long, tube-like tissue along the front (anterior) wall of the vagina. Having an orgasm requires (for most) a sense of relaxation and security. Some women may experience a gush of fluid, while others notice pulsation a inside and around their vagina.
  • .. When we have orgasms, we secrete the hormone Oxytocin (also called the L-O-V-E hormone ☺️). This is the same hormone we secrete when we are in labor. Some women, when pregnant, may experience cramping, contractions and sometimes some spotting. Not to worry! Relax, drink some water, pee, and relax. Give your body a chance to relax. If you are bleeding more than a little spotting, contracting more consistently or the baby isn’t moving, call. If not, snuggle your partner (or your toy ☺️) and bask in the pleasure!
  • It can sometimes be difficult to pinpoint the cause of swelling and burning after intercourse. An allergic reaction could be a possibility. I would look at what you use during intercourse – latex condoms? Lubricants? Spermicide? Any one of these things can cause an allergic reaction. A semen allergy, while not common, could also be a possibility. One way to evaluate this would be to see if the symptoms fail to occur when you have sex with a condom, as a condom would prevent exposure to the semen and therefore would prevent the allergic reaction.
  • Local tissue trauma can also cause these symptoms. Rougher sex or sex without adequate lubrication may result in some minor trauma to vaginal and vulvar tissue. This can result in swelling and burning which typically resolves over the next few days. If this seems to be the issue, I would recommend an increase in foreplay prior to intercourse, and/or use of lubricants to decrease friction during intercourse.
  • There are a number of ways to treat the sensation of vaginal dryness.
  • Vaginal dryness is typically caused by thinning and drying of the tissue on the vaginal walls during times when your body has less estrogen. This decrease in estrogen can occur after having a baby (especially if you are breastfeeding), after having your ovaries surgically taken out, or while approaching and going through menopause. While vaginal dryness on its own can be bothersome, one of the biggest complaints women have is pain with intercourse.
  • Nonprescription treatment options include vaginal moisturizers (i.e. Replens, Lubrigyn) and vaginal lubricants. Moisturizers are more of a regularly-applied maintenance therapy while lubricants are typically only helpful during intercourse. Water based lubricants can result in a burning sensation when applied to postmenopausal tissue, so it may be worth looking for silicone based lubes (it should say what type of lubricant it is on the bottle). Please know though that silicone lubes can degrade silicone based sex toys, may stain fabrics, and are not safe in the shower because they make the floor very slippery.
  • Prescription treatment options include vaginal estrogen cream and oral medication. Lastly there is something call the MonaLisa touch, which is a CO2 laser treatment of the vaginal tissue that has shown some promise in long term treatment of vulvovaginal atrophy. If you are interested in any of these options, I would recommend an appointment with a physician for further discussion of pros and cons of each form of treatment. Importantly, every woman is different, so it can take time to figure out what treatment option is right for you.
  • Being intimate with your partner during pregnancy can be so special. I’ll bring up that LOVE hormone again, Oxytocin. When we secrete oxytocin, we feel at ease, relaxed and hopefully within a rush of pleasure ☺️. This hormone (and the feelings that come along with it) spreads throughout the body. In my hippie, midwife mind, (💆🏻) how beautiful to experience and share love and pleasure with your beloved when you are creating a new person! It’s like you’re bathing your baby (and yourself) in LOVE! So lovely. ☺️
  • According to a Cochrane review (a very reliable research database) evaluating sex (coitus) as a method of labor induction, the one finding that was found to be most reliable was that having sex during pregnancy had no influence on maternal or baby outcomes (basically, sex is safe).
  • However, it’s important to remember that Oxytocin can cause women to have contractions and cramping, and sometimes even spotting. This is why people believe that having sex (especially with orgasm) can help women go into labor. The truth is, unless your body is truly ready to go into labor, it’s not likely that you will go into labor just by having sex.
  • There are some times during pregnancy that having sex is NOT considered SAFE. One example would be if you have a history of preterm labor, preterm contractions and/or a shortened cervix. Although sex is considered safe for normal, healthy pregnancies, it is always a good idea to consult your provider about intercourse, especially if anything ‘abnormal’ has been noted about your pregnancy.
  • Remember, spotting, cramping and light Braxton Hicks contractions are common after sex. Don’t be alarmed! Make sure you hydrate, pee, eat and relax. Make sure the spotting doesn’t become a period and the cramping slowly goes away. Keep an eye on your baby’s movements. If you call with concern about anything, be sure to mention your recent intercourse, as that may be an easy explanation for your symptoms. ☺️
  • There are many things that can cause low libido, and it’s a problem that many women suffer. I can say with certainty, you are not alone!
  • When trying to figure out what’s causing your decrease in desire, you must ask yourself some questions. First, take a look at what’s going on in your life. Are you a new mom, suffering from the effects of sleep deprivation and demands of breastfeeding? Do you have work stresses that you bring home with you? Do you have concerns about your physical appearance that make it hard for you to be intimate? Are you and your partner having any turmoil in your relationship? Anything that affects your ability to relax and be intimate with your partner will affect your desire.
  • Second, look at at your physical wellbeing. Think about if you have had any changes in your medical history, or experienced any physical symptoms that make sex less enjoyable. Do you have any new medical or psychological diagnoses? Have you started any new medications? Do you have pain with sex, vaginal dryness, and/or incontinence? Sometimes something as simple as having a doctor adjust your blood pressure medication can affect desire. Or, if you are embarrassed to have sex because of vaginal dryness or leaking urine, your desire to have sex will certainly decrease.
  • Everything I have listed (and more!) can impact your libido and make sex less desirable. For management of low libido, you need to look at the cause. Sometimes all you need is an adjustment in your daily or weekly activities – exercise more to improve your self image and energy, plan a date night once every few weeks to improve intimacy with your partner, or increase stress-reducing activities. Other times, counseling may help. This could be either one-on-one counseling with a therapist, couples counseling, or sex therapy to identify any relationship issues that may be impacting your desire to be intimate.
  • If you find the cause may be a medical or physical issue, you may want to talk to your doctor. Sometimes adjusting medications can result in an improvement in symptoms. Or, getting better control of a psychological or medical issue may help you feel better physically, and with time result in more desire for sex. If the issue is pain with intercourse, vaginal dryness, or incontinence, evaluation and treatment of those issues may help you enjoy sex more, and as a result desire sex more.
  • If none of the above suggestions work, there are some medications or hormone formulations that can be used to try and improve libido. Scientific data on the effectiveness of these treatments may vary depending on what you try, and what’s appropriate for you as an individual will depend on your medical history and whether you are pre or postmenopausal. The important thing to know is that there unfortunately isn’t a magic pill to cure low libido, so it may take some trial and error to find the right treatment for you.
  • The bottom line is this – women are quite complex, and any disruption in our personal lives can easily spill over to affect our libido. It doesn’t mean there is something wrong with you – this problem affects women of all ages, and can have many causes. It’s just a matter of looking at your individual situation and identifying possible barriers that may be affecting your desire.
  • stephanie levy cnm
  • samara knight md
By | September 7th, 2016|Categories: Education|Tags: , , , , |

Q&A with Rebecca Leeman, CNM and Stephanie Philippides, MD

These two lovely ladies are Rebecca Leeman, CNM, and Stephanie Philippides, MD. They are located at our Jefferson office and attend births at Lovelace Women’s Hospital and I recently asked for their thoughts about how WSNM approaches pregnancy and birth.

leeman Philippides
Rebecca: Pregnancy is a time of big change for women and families. Getting to see the same person on the health care team throughout the pregnancy can help moms feel a little more grounded throughout the changes that are happening. A trust develops. Stories are shared. A woman can start to feel a little more known to her provider and pregnancy care goes beyond just what it takes to measure and listen to baby. Personalized pregnancy care happens when your care provider acknowledges and is curious about the setting into which this new baby is coming. It takes time to build relationships.

Dr. Philippides: Personal pregnancy care means individualized care. No two people experience pregnancy in the same way. We all have our own experiences, unique medical history, fears and worries, and our own hopes and dreams. To treat each person as an individual means that I want to make a connection to that person and really understand their needs.

Rebecca: Women’s Specialists practice allows me to give personalized pregnancy care and build relationships. I also have the confidence that when the women I see go into labor, there will be midwives and doctors who I trust there, who will carry that same respect for these women. I trust the providers in my practice in being able to give safe and satisfying care so that if I am not there at birth time, I still get to celebrate for my clients knowing it was one (or more) of the A team catching joy, catching baby.

Dr. Philippides: WSNM offers an outstanding team of people who specialize in caring for women. We offer our patients the opportunity to see the same provider during their prenatal care which is a critical element of personal pregnancy care. In addition, just because someone’s insurance changes it doesn’t mean you have to change providers, because we accept almost all insurance plans.

Rebecca: One of the reasons I was drawn to midwifery twenty-five years ago was because it allowed me to be a partner for women and families in a time of big change in their lives. Sometimes people make big shifts in their thinking about themselves through pregnancy and birth. Sometimes there is crisis. I feel strongly that a midwife is there not only to be a guardian of normal pregnancy and birth, but also to be there to shine the light on what the woman already knows to be her true best path. Besides making sure the pregnancy is going along safely, the week to week work I enjoy is the simple reassurances about the crazy stuff that happens physically and mentally, and how we trouble shoot together where to go with it.

Dr. Philippides: I have the best job in the world, I get to be part of one of the single most important events a person’s lifetime, the birth of their child. I like to say I host Birthday Parties for a living.

There you have it! Thoughts on pregnancy, birth and WSNM from two of our awesome providers.

Cheers,
Jen Williams, CNM

By | February 5th, 2016|Categories: Education|

MonaLisa Touch

Aging is inevitable.  For women, it can be unforgiving: wrinkles, gray hair, weight gain, sagging breasts, bone loss, and vaginal dryness.  Regular exercise, dietary modification with calcium and vitamin D supplementation can help some of these conditions.  Some of us will dye our hair and/or have cosmetic surgery.  Until recently, our only option to really “treat” vaginal dryness was topical estrogen – either as a cream, tablet or ring.  (more…)

By | September 21st, 2015|Categories: Education, Women's Issues|