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

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.