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, March 24, 2014

Summer Breastfeeding Classes with Kelly Hamade

Empower yourself with the basics to get you and your baby off to the best start! Join us for a prenatal breastfeeding workshop (a one night session) on establishing milk supply, positioning and latching, pumps and equipment, common challenges and local resources. 

Class size is limited and the course is $40/couple for a 2.5 hour session.  

Classes will be offered:

May 21
June 18
July 30
August 27

Monday, March 17, 2014

In-House Childbirth Classes Exclusively for OBGYN North Patients

Get Ready for Birth! 


In-House Childbirth Classes exclusively for OBGYN North Patients 

Classes facilitated by Shelley Scotka, certified Childbirth Educator and Birth Doula

Prepared Childbirth    $200 for a four week series Tuesday evenings, 6:30-9:00pm
This class is perfect for first time parents who need a comprehensive preparation for childbirth. We'll cover the physiology of labor and delivery, recognizing signs of labor, when to call your care provider, and the normal stages of labor. We'll learn and practice with your support person a variety of methods to cope with labor pain including breathing, relaxation, visualizations/meditation, touch and massage, positioning, and water therapy. We'll discuss what happens at the birth both in a hospital and birth center setting. What if medical interventions become necessary? We'll look at the possible interventions that are common, and cover the risks and benefits of each, including cesarean birth. We'll also review the recovery and postpartum periods, and what to expect for both you and your baby during that time. It's recommended you begin the series by 32 weeks. 

April 1,15, 22, 29 (no class 4/8)
May 6, 13, 20, 27

Labor Skills   $50 for a one time 2.5 hour workshop Sundays 3:30-6:00pm
This workshop is designed for those who want to focus exclusively on natural ways to cope with labor pain, ideal for those who have birthed before and need a "refresher" or for those who just want to work on their labor skills with their partner. We'll discuss and practice relaxation, breathing, using visualizations/meditation, touch and massage, positioning and water therapy. We'll discuss the importance of the birth environment and creating an "oxytocin friendly" space for your labor. We'll give your support person plenty of ideas, tools and suggestions to help you get through labor, and review typical "challenging" scenarios during birth and how to get through them. Ideal anytime during the last trimester. 

April 6
May 4

Planning your VBAC   $50 for a one time 2.5 hour workshop Sundays 12:30-3:00pm
This class is designed for those planning a Vaginal Birth After Cesarean. We'll discuss the most up to date research on VBAC and review the benefits and risks. We'll look at ways to prepare for a successful VBAC both physically and emotionally, and offer you and your support person an opportunity to explore the emotions surrounding your previous birth experience. We'll talk about hospital protocols and learn what to expect during a VBAC labor. What if another cesarean becomes necessary? We look at the reasons why a repeat cesarean may become a necessity and ways to make that birth family centered. Ideal during the second trimester. 

May 4

To register, (512) 425-3825 or email: jcousins@obgynnorth.com

Tuesday, March 11, 2014

The History of Modern Obstetrics and Gynecology

Gynecology

Gynecology as a branch of medicine dates back to Greco-Roman civilization, if not earlier. In the early and mid-19th century, physicians became able to successfully perform a limited variety of surgical operations on the ovaries and uterus. The American surgeon James Marion Sims and other pioneers of operative gynecology also had to combat the violent prejudice of the public against any exposure or examination of the female sexual organs. The two great advances that finally overcame such opposition and made gynecologic surgery generally available were the use of anesthesia and antiseptic methods. The separate specialty of gynecology had become fairly well established by 1880; its union with the specialty of obstetrics, arising from an overlap of natural concerns, began late in the century and has continued to the present day.

Gynecologists make routine examinations of cervical and vaginal secretions to detect cancer of the uterus and cervix. They perform two main types of surgical operations: repairing any significant injuries caused to the vagina, uterus, and bladder in the course of childbirth; and removing cysts and benign or malignant tumors from the uterus, cervix, and ovaries. The first ovarian cystectomy was performed in 1809 in Kentucky and the first recorded vaginal hysterectomy, performed accidentally and unplanned was in 1812! Later, in 1853, the first successful abdominal hysterectomy was performed. The modern practice of gynecology requires skill in pelvic surgery; a knowledge of female urologic conditions, because the symptoms of diseases of the urinary tract and the genital tract are often similar; and skill in dealing with the minor psychiatric problems that often arise among gynecologic patients. Screening has also become a large part of gynecological practice, with the first screening test for cervical cancer developed in 1941 by George Nicolas Papanicolau: the pap smear! Most recently, laparoscopic and robotic procedures have infiltrated the world of gynecologic surgery which allows for surgeons and patients to have a minimally invasive major procedure with quick recovery time and less risk of infection. 

Obstetrics

Obstetrics had for a long time been the responsibility of female midwives, in fact, Obstetrix was the Latin word for midwife and it is thought to derive from obstare, to “stand before”, because the attendant stood in front of the woman to receive the baby. In the 17th century, European physicians began to attend on normal deliveries of royal and aristocratic families; from this beginning, the practice grew and spread to the middle classes. Interestingly, in 1668 it was a physician who pioneered primary suturing of the perineum after delivery, “cleansing .. with red wine then applying three or four stitches.” Then in the 20th century, medical schools changed the practice from midwifery to obstetrics.

The name “caesarean” is likely derived from the Latin word caedere, to cut. The Roman law Lex Caesare stated that a woman who died in late pregnancy should be delivered soon after her death, and if the baby died they should be buried separately. The first cesarean section of modern times (with survival of both mother and child) is attributed to a Swiss sow gilder, Jacob Nufer, who in 1500 gained permission from the authorities to operate on his wife after she had been in labor for several days. Nufer's wife subsequently had five successful vaginal deliveries. During this age, cesarean sections were performed without anesthesia. In the mid-19th century death rates remained high and cesarean section was often combined with hysterectomy. In the 1880s, with the introduction of asepsis, a conservative operation was developed and the “classical” operation—a vertical incision in the upper part of the uterus—became more frequently used. This incision did not heal well, however, and in 1906 the modern “lower segment” operation was introduced, which carried less risk of subsequent uterine rupture.

In 1827, fetal heart tones were auscultated for the first time. The invention of the forceps used in delivery, the introduction of anesthesia, and the discovery of the cause of puerperal (“childbed”) fever in 1847 with the introduction of antiseptic methods in the delivery room were all major advances in obstetrical practice. By the early 19th century, obstetrics had become established as a recognized medical discipline in Europe and the United States. Prenatal care and instruction of pregnant mothers to reduce birth defects and problem deliveries was introduced about 1900 and was thereafter rapidly adopted throughout the world. The first epidural for labor anesthesia was given in 1901 and oxytocin was first synthesized for labor augmentation in 1953. Beginning with the development of hormonal contraceptive pills in the 1950s, obstetrician-gynecologists have also become increasingly responsible for regulating women’s fertility and fecundity. With the development of amniocentesis, ultrasound, and other methods for the prenatal diagnosis of birth defects, obstetrician-gynecologists were been able to abort non-viable fetuses and unwanted pregnancies. At the same time, new methods for artificially implanting fertilized embryos within the uterus have enabled obstetrician-gynecologists to help previously infertile couples to have children. The first successful in vitro fertilization was performed in 1978.

With the new age of safe childbirth, the main focus for maternity care is now the quality of the birth experience for the woman and her partner. Services are encouraged to provide choice, including home or hospital delivery, epidurals, or water births.

If you have any more questions, feel free to ask us! We'd be happy to share as much information as we can with you.