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

Tuesday, January 28, 2014

Creating a Personalized Birth Plan for Your Delivery

A birth plan is a document that tells your healthcare provider and delivery team your wishes and preferences for your childbirth and early postpartum period.  The birth plan is not a legal contract but a written outline of your desires.  It serves as an opportunity for the expectant parents to consider and communicate their ideal birth experience.

Because childbirth doesn’t always go as planned, it is important to remain flexible and know that the plan may need to change for you and your baby’s health and safety.

There are many tools and sample birth plans available online and on our website to help you create your birth plan.

Some things you may wish to consider include:

Who will attend your delivery
Methods and medications preferred for induction or augmentation of labor
Methods, techniques and medications preferred for pain management
Fetal monitoring preferences
Eating and drinking during labor
IV access or saline lock
Position for delivery
Cutting the umbilical cord 
Cord blood banking
Any cultural or religious practices that you would like to incorporate

You may also like to consider care for yourself and baby after delivery.  Some considerations include:

Medications for baby after the birth
Bathing the baby
Rooming in
Exclusive breastfeeding
Pacifier use
Circumcision

It is a good idea to bring your birth plan to a prenatal visit during your third trimester to discuss your wishes with your doctor or midwife. And, if you have any questions, feel free to ask us at any of your prenatal visits!

-Kelly Hamade



Wednesday, January 15, 2014

OBGYN North and Natural Beginning Birth Statistics for 2013

In 2013 we saw 1500 births, of these only 13% were primary cesarean section.  Additionally we had an 82% VBAC success rate and 67% of patients planning birth without an epidural were successful.

4th Quarter Birth Statistics
October 68 deliveries 55 vaginal 13 c/s (7 repeats)
November 57 deliveries 46 vaginal 11 c/s (9 repeats)
December 66 deliveries 50 vaginal 16 c/s (6 repeats)

***Our December stats included 4 unsuccessful planned vaginal deliveries and 12 scheduled c-sections planned prior to labor for breech, placenta previa, repeat cesarean and other specific situations***



Saturday, January 4, 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. 

Febrary 4,11,18,25
March 4,11,18,25
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. 

Febrary 9
March 2
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. 

February 9
March 2
May 4


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

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. 

It’s 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. It’s 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/.