OB-GYN NORTH is the practice of

Christina Sebestyen, MD, FACOG, Tesa Miller, MD, FACOG, April Schiemenz, MD,
Siobhan Kubesh, CNM, Lisa Carlile, CNM, Kathy Harrison-Short, CNM and Katherine Davidson , FPNP

Monday, December 16, 2013

The Importance of Folic Acid Before and During Pregnancy

Our bodies need folic acid all the time, but never more so than during the early weeks of pregnancy. Taking a daily prenatal vitamin with the recommended 400 micrograms (mcg) of folic acid before and during pregnancy can help prevent birth defects in your baby's brain and spinal cord. 

Folic acid, which is also called folate, is a B vitamin. Folic acid plays an important role in the production of red blood cells and helps your baby's neural tube develop into her brain and spinal cord.

Birth defects occur early in pregnancy, within the first 3-4 weeks, so it's important to have folic acid in your system during those early stages when your baby's brain and spinal cord are developing. The CDC recommends that you start taking folic acid every day for at least a month before you become pregnant, and every day while you are pregnant. However, the CDC also recommends that women of a childbearing age take folic acid every day, so you'd be fine to start taking it even earlier.

The recommended dose for all women of childbearing age is 400 mcg of folic acid each day. If you take a daily multivitamin, check to see if it has the recommended amount. While you're trying to conceive and throughout  pregnancy, women need 400 mcg of folic acid per day, It’s also recommended that breastfeeding women continue to take  folic acid.

Without enough folic acid in your body, your baby's neural tube may not close correctly and she could develop health problems called neural tube defects such as spina bifida . Getting enough folic acid may reduce your baby's risk of  neural tube defects by more than 50 percent. According to the CDC, if you've already had a baby with a neural tube defect, getting enough folic acid may reduce your risk of having another child with a neural tube defect by as much as 70 percent.

When taken before and during pregnancy, folic acid may also protect your baby against cleft lip and palate, premature birth, low birth weight, miscarriage and poor growth in the womb.

Folic acid has also been suggested to reduce your risk of pregnancy complications (one report found that women who took folic acid supplements during the second trimester had a reduced risk of preeclampsia), heart disease, stroke, some types of cancers and Alzheimer’s disease. 
Foods that can help you get more folic acid in your diet include fortified breakfast cereals, beef liver, lentils, spinach, egg noodles and great northern beans among many others. 

If you have questions about your prenatal vitamins or foods that contain folic acid, please don’t hesitate to ask us at your next appointment, we’d be happy to help ensure the best start for your baby!

Sunday, November 24, 2013

November is National Prematurity Awareness Month

November is National Prematurity Awareness Month and we wanted to provide a little more information about premature birth, as well as offer support for women facing certain risk factors. A premature birth refers to a baby that is born at least three weeks before their due date. Important growth and development milestones occur throughout pregnancy, but even more so in the final months and weeks. Our hope is that through proper care and education, our patients can see their due dates and go home with healthy, full-term babies.

Although babies born very preterm are a small percentage of all births, these very preterm infants account for a large proportion of infant mortality rates. More infants die from preterm-related problems than from any other cause. Some premature babies require special care and spend weeks or months hospitalized in a neonatal intensive care unit (NICU). Those who survive are at risk of facing lifelong problems such as intellectual disabilities, cerebral palsy, breathing and respiratory problems, visual problems including retinopathy of prematurity, hearing loss, feeding and digestive problems. 

Even if a woman does everything "right" during pregnancy, she still at risk of having a premature baby. There are some known risk factors for premature birth. For example, one risk factor is having a previous preterm birth. Additionally, race can be a risk factor. Although most African American women give birth at term, on average, they are about 50% more likely to have a premature baby compared to Caucasian women. The reasons behind racial differences remain unknown and are an area of intense research at this time. Other known risk factors for premature birth include carrying more than one baby (twins, triplets, or more), problems with the uterus or cervix, chronic health problems such as high blood pressure, diabetes, and clotting disorders, certain infections during pregnancy, cigarette smoking, alcohol use, or illicit drug use during pregnancy.

On the other hand, sometimes doctors need to deliver a baby early because of concerns for the health of the mother or the baby. An early delivery should only be considered when there is a medical reason to do so. If a pregnant woman is healthy and the pregnancy is progressing well, it is best to let the baby come on his or her own time. Although most babies born just a few weeks early do well and have no health issues, some may have more health problems than full-term babies. For example, a baby born at 35 weeks is more likely to have jaundice, breathing problems and a longer hospital stay than a baby born at 37 weeks and beyond. 

Its important, early on in your pregnancy to talk to us about ways to best control diseases such as high blood pressure and diabetes, how to pursue a healthy diet and which prenatal vitamins to include in your daily supplementation. It is also crucial to take 400 micrograms of folic acid daily before and during early pregnancy. Any concerns about pregnancy and any warning signs or symptoms of preterm labor will need medical attention and the care of a doctor or midwife. 

In most cases, preterm labor begins unexpectedly and with no known cause. Its important to seek care if you think you might be having preterm labor, because we may be able to help you and your baby delay the onset of preterm labor.

Warning signs include contractions every 10 minutes or more frequently, change in vaginal discharge (leaking fluid or bleeding from the vagina), pelvic pressure (the feeling that the baby is pushing down), dull backache, cramps that feel like a menstrual period or abdominal cramps with or without diarrhea.

Birth is a complex and wonderful process. Fortunately, the outcome for most women is a full-term, healthy baby. More research still is needed to understand the risk factors for premature birth, such as how family history, genetics, infections, race and ethnicity, nutrition, and environment may work together to put some women at greater risk for a premature delivery.

If you have any specific questions about the occurrence of premature birth, feel free to give us a call. 

Additional Resources:
Promotes optimal reproductive, maternal, and infant health. CDC scientists and their partners are collaborating with states, university researchers, and partners in health care to understand why preterm births occur, and what can done to prevent prematurity.

More information from the National Institute of Child Health and Human Development.

The National Library of Medicine provides links to the latest news and research on preterm birth.

Learn more information about the care of premature babies from the American Academy of Pediatrics.

Learn how to be healthy (before, during, and after pregnancy) and give your baby a healthy start to life.

Promotes the health of babies, children, and adults, and enhances the potential for full, productive living.

Wednesday, October 30, 2013

Dr. Sebestyen Named Best OB/GYN For the Third Year in a Row

On Friday, October 25, Dr. Sebestyen received the award for best OB/GYN (patient’s choice) at the Austin Birth Awards. This is the third year in a row she has received this honor and we’re so proud to share the news! A big thank you to all of our patients for supporting her nomination and voting for Dr. Sebestyen. This type of recognition is true confirmation that our efforts are appreciated and valued in our community.

The Austin Birth Awards feature a list of qualified professionals in many service areas related to birth and parenting. All finalists were nominated by those in the community who have personally experienced great service and outcomes from birth related service providers. This year nominations were accepted from June 1, 2013 through July 15, 2013 and final voting on the top four finalists ended on October 15, 2013 at midnight.
The 3rd Annual Awards Ceremony & Gala took place on October 25, 2013 at the Carver Museum Theater & Reception Area at 7p.m.

The Austin Birth Awards are a project of the Get Babied Foundation and the Central Texas Healthy Mothers Healthy Babies Coalition. Together, their mission is to recognize Austin area birth professionals that are going out of their way to provide quality care for the women of Austin. A result of the yearly poll is a list of the best referrals for pregnancy care in Austin, selected and voted on by real people to determine the best and brightest mother-friendly birth professionals the city has to offer.

Another highlight for our practice was cheering on St. David’s North Austin Medical Center, where our OBGYN North patients deliver, as they received the award for the best labor and delivery unit in Austin.

For more information about Austin Birth Awards, visit http://www.austinbirthawards.org/.

Monday, October 28, 2013

Natural Beginning Birth Center Welcomes Community for Public Open House

As many of you know, on September 2 we opened our new birth center, Natural Beginning. We’ve been busy with births and getting settled into our new space, but we wanted to take the opportunity to share this incredible new option with our current and future patients. 

On Friday, November 8th, we are opening our doors from 4p.m.-7p.m. and inviting the community into the birth center to see our new space and celebrate alongside our team of midwives as well as the physicians from OBGYN North. 

Please feel free to share this open invitation with your friends, we’ve been looking forward to opening our doors to the public and sharing Austin’s newest birthing option with the community! 

Thank you for your support and we’ll look forward to seeing you soon! 

Birth Statistics from June, July, August and September

Total Vaginal Deliveries - 55
Total C-Section Deliveries - 7
Total Deliveries - 62

Total Vaginal Deliveries - 46
Total C-Section Deliveries - 7
Total Deliveries - 53

Total Vaginal Deliveries - 41
Total C-Section Deliveries - 8
Total Deliveries - 49

Total Vaginal Deliveries - 40
Total C-Section Deliveries - 24 (8 were repeat C-Sections)
Total Deliveries - 64

Cumulative statistics for 1300+ deliveries
13% Primary C-Section
85% VBAC success rate

67% of patients planning birth without an epidural were successful

Monday, October 14, 2013

OBGYN North Highlights National Breast Cancer Awareness Month

October is National Breast Cancer Awareness Month and National Mammography Day is October 22. Our goal, as a practice, is to raise awareness through educating women and helping them by providing excellent preventative care. 

Protecting women against the dangers of late stage cancer begins with preventative measures that include regular screenings. Maintaining optimal health and choosing to make preventative care a priority can save a women’s life. The best way to do that is to do a monthly self exam and to schedule mammograms every one to two years  beginning at age 40, or earlier if there‘s a family history of breast cancer under 50 years old.

Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast. The mutated cells can invade surrounding tissue, but with early detection and treatment, most people can continue a normal life. Breast cancer is the most commonly diagnosed cancer in women, with one in eight women diagnosed in their lifetime. As the second leading cause of death among women, each year it is estimated that over 220,000 women in the United States will be diagnosed with breast cancer and more than 40,000 will die. 

Although breast cancer in men is rare, an estimated 2,150 will be diagnosed with breast cancer and approximately 410 men will die each year.  Male breast cancers are more often familial (hereditary) whereas breast cancer in women is more commonly sporadic (random). Screening recommendations can differ in women with many family members with breast cancer, and individual risk can be calculated with the Tyrer-Cuzick model (www.ems-trials.org/riskevaluator). 

In recent years, perhaps coinciding with the decline in prescriptive hormone replacement therapy after menopause, there has been a gradual reduction in female breast cancer incidence rates among women aged 50 and older. Death rates from breast cancer have also been declining since 1990, in part due to better screening, early detection, increased awareness, and improved treatments options. Thankfully only a small percentage of breast lumps turn out to be cancer, but women (and men) should see a physician if they discover a persistent lump in the breast or notice any changes in breast tissue such as dimpling, new inversion of nipples or nipple discharge.

Mammography is the best available method to detect breast cancer in its earliest, most treatable stage. In fact, mammography can detect cancer cells an average of one to three years before a woman can feel a lump. Mammography also identifies cancers too small to be felt during a clinical breast examination.

With awareness comes prevention, and in the end that alone is saving lives. If you would like more information about breast cancer, please contact us, we'd be happy to schedule an appointment with one of our physicians or midwives. 

Tuesday, October 1, 2013

Natural Beginning Shares Details on the First Delivery at the Birth Center

On Sunday, September 15, less than two weeks after Natural Beginning opened their doors, Stacy Smalley and Siobhan Kubesh delivered Baby Ivy, the first baby in our new birth center. 

We recently had a chance to chat with the mother about her experience and we wanted to share the Q&A session with our current and future patients. 

-Was labor and delivery what you expected based on the knowledge you had ahead of time? 
This being my second child, I was hoping that, like most anecdotes I’d heard, it would be an easier and faster birth than my first.  Indeed it was!  Labor was shorter, and delivery was much more straightforward.  I also got to deliver in the tub, which was just as marvelous as I’d built it up to be.

-What was your favorite part about birthing at NBBC? 
The tub was glorious!  Also, I had the utmost confidence in my two midwives, Siobhan & Stacy.  They directed me perfectly throughout the labor and delivery, and explained things to a high level as I like my health care professionals to do. They were extremely patient and resourceful and I felt great ease knowing I was in their hands.

-What was the experience like as a whole?
I labored at home for about 6 hours before coming in to the birth center at 8:30.  I think I had steeled myself up for the pain of natural childbirth enough that I almost waited at home too long!  When I arrived Stacy measured me at 8 cm.  After that exam and a quick check on baby’s heartbeat, I arrived in my beautiful room at about 8:45, with very intense contractions.  My water broke at 9:01, and Siobhan said the most glorious sentence to me: “Cate, with second pregnancies, when the water breaks the baby is usually very close to birthing”.  I had a couple contractions on the floor, hugging a birthing ball, before getting in the tub.  Unlike my first birth, where I never felt the urge to push, I felt strong urges to push this time around.  Stacy coached me in breathing techniques – I clung to her words as I focused intently on the window – and very shortly baby Ivy swooshed out into the water.  The warm water made it all feel very comfortable, and then there I was, lounging in a cozy tub with my baby girl on my chest.  What a great feeling, what a great birth.

-How is your daughter doing? 
Baby Ivy is doing great!  She took to nursing easily and vigorously, right at the birthing center.  She squeals and smiles and wiggles and smells great so all the bonding is happening right on schedule.  

We are thrilled to share her experience and look forward to many more beautiful births at the center. In fact, the second baby has already arrived. If you have any questions about our birth center, please give us a call. 

Friday, September 27, 2013

National Women’s Health and Fitness Week

The nation’s largest annual health promotion event targeting the health and fitness of women across the country takes place at the end of September. This national program focuses its attention on the importance of regular physical activity and overall awareness of healthy behaviors associated with women’s health.  

National Women's Health Week is a weeklong health observance coordinated by the U.S. Department of Health and Human Services' Office of Women’s Health. It brings together communities, businesses, government, health organizations, and other groups in an effort to promote women's health. It also empowers women to make their physical and mental health a priority, as well as to lower their risks of certain diseases. The following five initiatives are being promoted as the best ways to help improve overall health for women:

-Making regular visits to health care professionals for check ups and screenings. 

-Being active

-Eating healthy

-Paying attention to mental health (getting enough sleep and managing stress)

-Avoiding unhealthy behaviors (not smoking, not wearing a seatbelt or bicycle helmet, avoiding texting while driving, avoid excess amounts of alcohol, safe sexual practices, etc.)

We recognize the importance of this week because we care about the women we serve. Women often serve as caregivers for their families, putting the needs of their spouses, partners, children, and parents before their own. As a result, women's health and well-being often becomes secondary. As a healthcare provider, we have a responsibility to support women and do everything we can to help them take steps towards a longer, healthier, happier life. 

If there is any way we can help support your health goals, let us know. We’re happy to provide guidance on maintaining your best health throughout your life.

Friday, September 13, 2013

In Case You Missed Last Weekend’s Paper

As you know, OBGYN North recently moved into new offices and opened an adjoining birth center at 12221 Renfert Way Ste. 330. Here’s the article from the Austin American-Statesman on the opening and a little more about the birth center. The article is also available online: 

We’re so excited about this news and look forward to sharing this resource with our community!  Soon we’ll post more information about our upcoming open house for friends and families to see the new OGN office and Natural Beginning birth center.  

Doctor’s office opens birthing center in North Austin
Posted: 12:00 a.m. Friday, Sept. 6, 2013

Dr. Christina Sebestyen of OBGYN North envisioned a place where her patients could come and have a natural labor under the care of a midwife. A place that would feel more like a luxurious hotel room with large jetted tubs, comfortable queen beds and spacious bathrooms. It would have the comforts of home for the family: a living room with comfortable couches, a large-screen TV and a kitchenette.

It also would be a place where, if a patient had complications, the attending midwife could accompany her across the street to a hospital and continue to attend to her needs as well as have access to Sebestyen or her fellow doctors in the practice.

That place became a reality on Labor Day. OBGYN North opened the Natural Beginning Birth Center, connected to its new offices. Five certified nurse midwives will staff the center, working 24-hour on-call shifts, as well as nurses. The center has three birthing rooms. It’s designed for about 30 births a month.

This isn’t the first time OBGYN North has opened a facility for birth. The practice began in 1982 under Dr. Margaret Thompson, who coincidentally delivered my children, and was part of a group that had the adjoining Renaissance Women’s Center hospital from 1997 to 2001. Sebestyen bought the practice in 2008.

Most of the pregnant women in the practice won’t be candidates for Natural Beginning Birth Center. In fact, Jamie Cousins, the director of the center, estimates that about 10 percent of the practice’s patients will choose it. They have to agree to do a natural birth. There’s no going across the street for an epidural and going back to the birth center to deliver.

“It’s a commitment,” Sebestyen says. “It’s a real effort, and it’s a different experience.”

Even if a patient plans on having a natural birth, if she is high risk because of things like high blood pressure or having a vaginal birth after Cesarean, she’s not a candidate for the center. And her baby can’t be high risk, either. High-risk patients still can have a natural birth with a midwife, but they have to do it across the street at the Women’s Center of Texas at St. David’s North Austin Medical Center.
A mom will come into the birthing center when she is in active labor — about 4 centimeters dilated with regular contractions. She can walk around the center to help her labor or get into the jetted tub that is hospital-grade and sanitized. The center is designed to emulate a home birth but with a hospital across the street in case of emergency.

The practice already has tested out how quickly it can get a mom from the birthing center to the hospital. Recently Sebestyen had a woman pregnant with twins come into her office bleeding from the placenta abrupting from the uterine wall. They rolled the mom across the street in a wheelchair, which was faster than EMS. The time from when the woman walked into the office to the time her babies were delivered by Cesarean was 10 minutes.

During labor, while the mom can’t get an epidural, she can use nitrous oxide or laughing gas, which is a popular practice in Europe. She will have a mask she’ll have to fit to her face, and only then will it release the gas. No one else in the room is allowed to give her the gas. That’s a safety precaution to make sure that she doesn’t get too much, Sebestyen says, because if she is getting too much, she won’t physically be able to hold it to her mouth. A valve in the room will take away any errant gas.

The gas, Sebestyen says, is nice during transition, a time when many women will give up on natural childbirth. It keeps them relaxed yet doesn’t affect blood pressure or blood flow to the placenta. Plus it doesn’t cause the muscle weakness that an epidural does and allows the mom to still push effectively.
There’s no stirrups on the bed when it’s time to push, and the mom can chose to have a water birth in the tub if she wants. Fathers are encouraged to be involved and even help catch the baby if they want.
Once the baby is born, the family stays four to six hours before heading home. They see their pediatrician the next day.

“Birth is about family,” certified nurse midwife Siobhan Kubesh says. “What happened over time is it became medical and about the other people in the room.”

With the birth center, it becomes about the family again, she says.

The center will work with the mother’s insurance, but each mother will be charged a $4,500 facility fee they pay in advance and then get reimbursed by their insurance if the insurance will cover a birthing center.

Christy Connelly and her husband, Leon, are planning to use the center for the birth of their first child, Taylor Christienne Connelly, who is due in November.

“When we heard about OBGYN’s new birthing center, we were very excited because we feel like we’re getting the best of both worlds,” she says. “We love that it will be comfortable, like a home setting, with the support of the midwives, but that we have the security of St. David’s North right across the street and the added support of the doctors that we already have a relationship with, should we need them.”

Wednesday, August 28, 2013

OBGYN North Moves Locations and Natural Beginning Opens Doors on Labor Day

On Monday, September 2, 2013 our current office will officially be our old office and our new doors will be open at 12221 Renfert Way in Suite 330, which is conveniently located in the same parking lot as our current office. 

In addition to a new location for OBGYN North, our new birth center, Natural Beginning, will begin seeing patients and welcoming pregnant women for their labor and deliveries that day. 

We look forward to hosting all of our current and future patients at a public open house next month! Keep checking our blog for more updates on that event. 

Thank you for sharing in our excitement!

Wednesday, August 7, 2013

Natural Beginning to Open Next Month

After years of planning, we are thrilled to announce the recent progress of our new birthing center, Natural Beginning. We broke ground last month and expect to open in early September.

As the first tandem birthing center in Central Texas, Natural Beginning will have many distinct characteristics that will allow us to operate differently than other birthing centers in our area. 

Natural Beginning will operate alongside OBGYN North’s 31 year old practice and will be located at 12221 Renfert Way, adjacent to St. David’s North Austin Medical Center.

The opening of the birth center will be the culmination of our physician’s and midwives’ efforts over many years and will allow us to fulfill our mission of providing the highest quality maternity care both in and out of the hospital setting in a seamless fashion. 

OBGYN North was created from our  passion for women’s health both in the exam room and at the legislature. Our dedication towards providing the best evidence-based options for our patients is something we constantly work on through monthly provider meetings with review of current research. We pride ourselves on the consistent, quality, collaborative care that we offer. We educate our patients about their bodies and their options for optimizing their health. Natural Beginning will simply be an extension of our practice, allowing low-risk women the opportunity to birth their babies naturally, in a safe and comfortable setting outside of the hospital, but close enough to allow for a quick transfer to the hospital or NICU, in the rare circumstance where a transfer is needed or requested. 

Natural Beginning will operate in conjunction with OBGYN North. The birth center will have three rooms available for laboring women, each with a SaniJet birthing tub and full or queen-sized bed. It will be staffed by certified nurse midwives and registered nurses on-call 24 hours a day, 365 days a year. All of Natural Beginning’s midwives, as well as OBGYN North’s are certified nurse midwives (CNM), meaning they have completed a masters degree in nursing with a specialty in midwifery. This allows Natural Beginning’s midwives to be credentialed at the hospital as well, and to continue their patients' clinical care if transfer to the hospital should become necessary.   

Having experienced CNM’s on staff, as well as midwifery privileges at St. David’s North Austin Medical Center, allows the process to run much more smoothly. No other birth center in Austin has these exclusive hospital privileges.

Another feature unique to Natural Beginning will be the use of nitrous oxide, commonly known as laughing gas, for laboring women who request it. Natural Beginning will be the only birth center in Texas to use nitrous oxide, a safe, inexpensive and fairly simple option that helps to alleviate pain commonly associated with labor. While this form of pain relief in labor settings will be new to Texas, nitrous oxide is regularly used by laboring women in other parts of the world, but as of 2010, it was only used in 2 hospitals in the United States. Nitrous oxide is considered a safe form of pain relief in labor because it does not have the negative effects of narcotics nor does it reduce mobility like an epidural. 

Most notably, patients of OBGYN North and Natural Beginning will have the opportunity, at the beginning of their pregnancy, to decide whether they would like to birth at St. David’s North Austin Medical Center within the Women’s Center of Texas or at the birthing center. Across the country, there are similar practices who operate an OBGYN office delivering in both a hospital setting and a nearby birthing center, but they are few in number. Natural Beginning will truly be one of a kind for women in Central Texas, empowering them with education and confidence to help achieve their desired birthing plan.  

We look forward to serving our current patients in our new space and welcoming future patients as we open the door to the next chapter in the history of our practice. Until then, feel free to check out our Facebook page for more visual updates, we plan to post photos of our progress along the way.

Monday, August 5, 2013

OBGYN North Welcomes New Staff

In preparation for the opening of our new birthing center, Natural Beginning, OBGYN North has begun to hire additional providers to meet the growing demand in our community for additional natural birthing options. 

Last month we broke ground on the site for our new birthing center and offices, which will be directly across the street from St. David’s North Austin Medical Center. Our current practice and the birth center will be housed within the same facility in our new location, so right now we’re not only gearing up for a new birthing center, but we are making preparations for the upcoming move from our current office.

We’ll share more information about Natural Beginning in our next blog post, but first we wanted to take a moment to introduce some of the new staff members you’ll see beginning in August and September, Maansi Piparia, Natalie Carraras and Stacy Smalley. 

Maansi Piparia, M.D. joins OBGYN North with great experience in laparoscopy and high risk obstetrics, as well as a passion for teaching. Coming to Austin from Chicago, Piparia brings a background of research on the trend in cesarean sections versus neonatal outcomes, strengthening our practices’ devotion to evidenced based medicine.  Born in Canton, Ohio and raised in Tulsa, Oklahoma, Piparia completed both her bachelor of arts and doctor of medicine degrees in Kansas City, Missouri. 

Natalie Carraras joins OBGYN North from Atlanta, where she provided prenatal care and attended births working alongside physicians and midwives in a setting similar to OBGYN North. Carraras realized her passion for women’s health during a clinical rotation in nursing school and then worked as a postpartum nurse before entering graduate school. Growing up in Houston, Texas, Carraras relocated to Austin in July 2013 with her husband and three children. She completed both her bachelor of science in nursing and her master of science as a certified nurse midwife and family nurse practitioner at Emory University in Atlanta, Georgia. 

Smalley joins OBGYN North from the east coast, having worked with women of all backgrounds and in a variety of settings, including a birth center, a community hospital, and several large teaching hospitals. For the past 11 years she has also had the privilege of mentoring nursing, medical, and midwifery students while strengthening her knowledge base and skills as a midwife. Smalley earned a bachelors of arts with honors in anthropology from the University of Arizona and a master of science in nursing from Yale University. 

In the coming weeks we plan to include more updates and additional information about OBGYN North, Natural Beginning and women’s health in general, so make sure to keep up with our blog. 

Thank you for sharing in our excitement and we’ll look forward to showing off our new space soon! For additional information, feel free to give us a call at (512) 425-3825.

Thursday, August 1, 2013

International Group B Strep and Cord Blood Awareness Month

In honor of International Group B Strep Awareness Month and Cord Blood Awareness Month in July, OBGYN North wanted to take the time to share information about these two topics. For the sake of pregnant women and their unborn babies, OBGYN North believes it is critical to have proper care in pregnancy and to disseminate factual information to mothers ahead of labor and delivery. 

Our practice recognizes all of the risks and opportunities our patients can experience throughout the entire process of pregnancy and delivery. There are so many pieces of information to consider when we are pregnant, and it is important to have a strong team to decipher the overwhelming amount of data. We focus on all aspects of prenatal health which includes appropriately treating Group B Strep when it is present on the mother. Likewise, we work hard to communicate the latest research on cord blood to our pregnant mothers so they can make informed decisions on how to best utilize their child’s cord blood collected shortly after birth. Both of these topics are essential at the birth of a child, but prior education and preparation allow for decisions and plans to be made well ahead of delivery.

Information on Group B Strep (GBS)
Approximately 1 in 4 pregnant women carry GBS, the leading cause of sepsis and meningitis in newborns. GBS can also infect babies during pregnancy and the first few months of life. Not all babies exposed to GBS become infected, but, for those who do, the results can be devastating. GBS can cause babies to be miscarried, stillborn, born prematurely, become very sick, have lifelong handicaps, or die. Fortunately there are many ways to help protect babies from Group B Strep, such as adhering to the CDC guidelines on GBS screening and prophylaxis. 

Group B Streptococcus, or Streptococcus agalactiae, is a type of bacteria that is naturally found in the digestive tract and birth canal in up to 1 in 4 pregnant women. Unfortunately, babies can be infected by GBS before birth and even up to about 6 months of age due to their underdeveloped immune systems.

The manner in which Group B Strep germs invade the womb is becoming better understood. These bacteria have special attractant molecules that can take hold of vaginal tissues. Many Group B Strep germs also make special molecules that can dissolve through the cervix, or the mucous between the vagina and the cervix. Both the mother and the baby have powerful defenses against Group B Strep, but these can be overwhelmed by too many germs or not enough defensive factors, such as antibodies that can specifically attack Group B Strep. Uterine or womb contractions can move infectious fluids from the vagina up inside the womb.

GBS infections which occur within the first week of life are called “early-onset” GBS disease.   In 2002, the US Centers for Disease Control & Prevention recommended that all pregnant women should be screened for GBS and, if positive, given IV antibiotics during labor and delivery to help prevent early-onset GBS disease. Fortunately, this has resulted in a drastic decline in the incidence of GBS infections within the first week of life. However,  GBS remains the leading cause of sepsis and meningitis in newborns in the United States.

Late-onset GBS disease occurs in babies over 1 week of age up to several months old.  Babies can become infected with GBS by sources other than the mother. There are currently no prevention protocols in place to help avoid late-onset GBS disease. However, being able to recognize the symptoms of GBS infection in babies is imperative for prompt medical treatment and better outcomes.

We screen for Group B Strep towards the end of pregnancy and when there is a presence of it within the mother, we administer penicillin during labor to deliver antibiotic to the baby prior to birth to protect the newborn. We feel strongly about the importance of Group B Strep antibiotic prophylaxis as prevention is the key to lifelong health, and we are confident that proper care can protect against an unnecessary illness and hospitalization for a newborn child.

Information on Cord Blood 
Today, stem cells are mainly used in the treatment of rare diseases and in tissue regeneration. They largely come from one of three sources, cord blood, bone marrow and peripheral blood. Cord blood stem cells are found in the blood of the umbilical cord. With their instant availability at birth and demonstrated utility, cord blood is quickly becoming a well known source of stem cells by transplant physicians. 

After a baby is born, and the umbilical cord is clamped and cut, the blood left in the umbilical cord can be collected and the stem cells extracted and stored for potential use in a future medical application for that child or a sibling. Today, there are nearly 80 conditions that can be treated with cord blood and experimental treatments using cord blood for cerebral palsy and Type 1 diabetes are underway.

As a speaker for Viacord, one of the cord blood bank companies, Dr. Sebestyen receives updates on cord blood collection and research often. The developments in stem cell research are increasingly exciting and new advents in treatment for certain diseases are becoming promising. It’s important to have the facts about cord blood to make an informed decision about whether or not to bank. It is a unique insurance policy that cannot be collected again.

For more information about Group B Strep in pregnancy or about cord blood, ask one of our providers at your next appointment. 

Monday, June 24, 2013

May 2013

Total Vaginal Deliveries - 51
Total C-Sections Deliveries - 11
Total Deliveries - 62

April 2013

Total Vaginal Deliveries - 37
Total C-Sections Deliveries - 17
Total Deliveries - 54

March 2013

Total Vaginal Deliveries - 55
Total C-Sections Deliveries - 12
Total Deliveries - 67

February 2013

Total Vaginal Deliveries - 33
Total C-Sections Deliveries - 9
Total Deliveries - 42

Thursday, June 20, 2013

January 2013

Total Vaginal Deliveries - 48
Total C-Sections Deliveries - 14
Total Deliveries - 62

Here is the 2012 summary

Vaginal birth 82%
Csection 18% (13% primary, 5% repeat)
Vbac success 81%

Also, 52% of our patients are planning on natural childbirth. Of these, 66% are successful. 

December 2012

Total Vaginal Deliveries - 53
Total C-Sections Deliveries - 11
Total Deliveries - 64

November 2012

Total Vaginal Deliveries - 54
Total C-Sections Deliveries - 15
Total Deliveries - 69

October 2012

Total Vaginal Deliveries - 73
Total C-Sections Deliveries - 10
Total Deliveries - 83

September 2012

Total Vaginal Deliveries - 59
Total C-Sections Deliveries - 13
Total Deliveries - 72

August 2012

Total Vaginal Deliveries - 63
Total C-Sections Deliveries- 13
Total Deliveries - 76

Stay tuned for next month's stats..........