Getting to Know Siobhan Kubesh, CNM

What is your favorite way to exercise or where do you spend time outdoors in Austin?

I love walking my neighborhood with my girlfriends and spending time boating on Lake Austin and Lake Travis with my family.

How would your encourage women or what would you say to the about the process of pregnancy and delivery?

Surrender and trust. Years ago I was attending a birth with a midwife whom I greatly admire. The mother was laboring so peacefully and I whispered to my peer, “This is so beautiful! She is in complete control.” My wise friend said, “Siobhan, it is the opposite. She is not in control, she is completely surrendered.”  Educate yourself about options for birth, surround yourself with people who believe in you, create your plan, then emotionally surrender once labor starts. 

What was one of your favorite moments in a birth?

There was a beautiful birth recently at our birth center (and this mother knows how much I admire her!) As a first time mother she was on her hands and knees in the tub, gently blowing little puffs of air through her contractions. With no change in expression, she quietly said to me, “I think something is coming out.”  Since she was not visibly pushing, I reached under the water, expecting to feel the tip of the baby’s head. The entire head had gently emerged as this mother so peacefully welcomed her baby! As the baby arrived, the mother rotated so she could sit back in the tub, with just the baby’s head above the warm bath water. The baby let out two strong cries, cleared her lungs, then spent the next few minutes pink and healthy as can be, blinking up at her parents. It was truly one of the most peaceful births I have ever witnessed. 

How long have you been in practice?

I have been working with mothers and babies for 21 years, first as a registered nurse, and have been a nurse-midwife for 15 years.

What is the most interesting thing you have learned lately?

That crocodiles have a “v” shaped mouth, are brown and their dominant teeth protrude from the bottom jaw. Alligators on the other hand, have a “u” shaped mouth, are green and their dominant teeth protrude from the top jaw.  This I learned from my six year old nephew in the car drive to school.  It may not be accurate information, but it is tucked away in my brain, and now in yours. Someday it may be useful. 

How is your view on birth different now that you have experienced it so may times?

There are a million right ways to birth. I am reminded of that all of the time. Each woman has her own journey and each birth unfolds differently. 

What are some of the ways you strive for optimal health.I am a huge advocate for healthy eating and living life in moderation. Nurturing our emotional health is just as important as physical wellbeing. I try to create time to relax with friends and family and spend time outdoors. I am not always successful in creating this balance, but I try!

Getting to Know Dr. Piparia

When did you know you wanted to be a physician?

I knew I wanted to be a physician in my 7th grade biology class. I remember learning that there were 206 major bones in the human body and I remember thinking I wanted to know each and every one of them and how they all worked together. Little did I know that there was much more to human anatomy...when I found out, it made my desire to learn even stronger 

What is your favorite part of your job?

My favorite part of the job is knowing that I can motive women to push their bodies to show them what they were made to do, and to show them how amazingly we were created. 

What are your favorite resources for women in Austin?

I’m still a bit new to the city and I don't know Austin as well as I’d like to, but I love what the Milk Bank is able to do for our community of new Moms and their babies. 

What is your favorite way to exercise?

My favorite way to exercise is to dance! Bollywood style!  

What would you say to women about the process of pregnancy and delivery? 

Believe in your self. Your body got you to where you are in this moment, and you'll be amazed at what more it can do. Just stay positive and give your body a chance! 

How many babies have you delivered? 

More than you would expect. Even though I am young, I worked in one of the busiest centers in downtown Chicago and gained a lot of experience in a short amount of time! 

How is your view on birth different now that you’ve experienced it so many times? 

Although it seems like we only look at things though medical eyes, I really see birth as an experience that our bodies were created to perform. It is more natural than we realize regardless of what you are getting to help contractions along or what you might need for discomfort. I view birth as a celebration of a moment in someones life, rather than a medical event that is clouded by IV poles, hospital beds and monitors. 

What is something that surprises you about deliveries? I still get excited every time I see a new parents’ reaction to their newborn. The moment their baby is delivered surprises me every time, each individual reaction is so different. 

Getting to Know Lisa Carlile, CNM

When did you know you wanted to be a midwife? 

During my 3^rd pregnancy I was cared for by CNMs in the Air Force and got to work with some in the hospital where I worked.  I was already considering further education, but I began to discuss it with a CNM I enjoyed working with and she encouraged me to become a midwife. I also thought about becoming a nurse  anesthetist, but I felt like I would miss interaction with people and I knew I would very much miss birth.

What is your favorite part of your job?

I really enjoy seeing women year after year and getting to know them. And, I enjoy helping women work through problems. The relationships are what I love the most about my job.

How do you see the birth community changing in the years to come?

I hope to see the c-section rate drop and for women to gain more acceptance of alternative birth locations.

What is your favorite way to exercise or where do you spend time outdoors in Austin?

I work outside in my yard most weekends and mornings.  Digging up rocks and building gardens is one of my favorite things to do outside.

How many babies have you delivered? More than I can remember!

How long have you been in practice? I graduated midwifery school in 1997 and practiced for about 5 years before taking a job with a hospital. That was where I met Margaret Thompson, MD in 2001 (who previously owned this practice). In 2002 she hired me to work in her office but not to deliver babies.  When Christina Sebestyen, MD bought the practice in 2008 I began delivering babies again.

Getting to Know Dr. Sebestyen

When did you know you wanted to become a physician?

I thought I might want to be a physician in high school, so I got a job as a receptionist in a pediatric office to investigate the possibility. I ultimately decided with certainty in my senior year of college after completing my bachelors thesis on the manifestation of aggression in feral ponies. I loved the research but felt as though I was not helping the world with my gifts and that I would better serve others through medicine. 

What is your favorite part of your job?

I love the relationships I am able to develop with women over the course many years. Watching families grow and change offers a special window into their world which is precious. 

How do you see the birth community changing in the years to come?

I am hopeful that evidence-based medicine will prevail causing induction and c-section rates to decline. This will require a change in the financing of birth (which unfortunately is not apt to change soon). 

What are your favorite resources for women in Austin?

Special Addition 

Stroller Strides

Central Texas Doula Association

Hand to Hold

Planned Parenthood

What is your favorite way to exercise or where do you spend time outdoors in Austin?

I love to walk on Lady Bird Lake with my older son. 

What are some of the ways you strive for optimal health?

I wear a Fitbit which guilts me into walking more!

How would you encourage women or what would you say to them about the process of pregnancy and delivery?

Believe in yourself and your convictions. Surround yourself with people who share those beliefs and will hold you up throughout the process. 

How many babies have you delivered?

Lots :)

What was one of your favorite moments in a birth?

There is a couple who I have had the honor to assist twice in labor who have an uncanny rhythm with each other. It is their birth and I am just a helping hand. I hope for that type of relationship for all couples. 

How long have you been in practice?

Since 1999. 

What is the most interesting thing you’ve learned lately?

We choose our own path and need to embrace it or change the path. 

How is your view on birth different now that you’ve experienced it so many times?We shape our own birth experience through our preparation and attitude, and need to embrace that rather than blaming others or the world around us. 

2015 Childbirth Classes at OBGYN North

Prepared Childbirth (4 Classes)

6:30-9:00p.m.

Mondays 

January 5, 12, 19, 26

Tuesdays 

January 13, 20, 27 & February 3

Mondays 

February 2, 9, 16, 23

Tuesdays 

February 17, 24 and March 3, 10

Mondays 

March 2, 9, 16, 23

Tuesdays 

March 24, 31 & April 7, 14

Mondays 

April 6, 13, 20, 27

Tuesdays 

April 28 & May 5, 12, 19

Mondays 

May 4, 11, 18 (no class 5/25) & June 1

Tuesdays 

June 2, 9, 16, 23

Mondays
June 8, 15, 22, 29

Labor Skills (1 Class)

3:30-6:00p.m.

Sunday, January 4

Sunday, February 1

Sunday, March 1

Sunday, March 29

Sunday, May 3

Sunday, June 7

VBAC Preparation (1 Class)

12:30-3:00p.m.

Sunday, January 4

Sunday, March 1

Sunday, May 3

What is a Cesarean Section?

(Tips to Avoid) Cesarean Delivery 

According to legend, Julius Caesar was born surgically, thus lending his name to the well-known practice of Cesarean section or C-section for short. In this past, this was done for a truly life saving purpose for the mom or baby. Fortunately, today's modern C-section techniques are safer, but when do you really need one? At OBGYN North, our midwives and physicians strive to avoid c-sections unless medically necessary. We invite all mothers to be proactive throughout pregnancy by maintenance of a healthy weight, healthy diet, exercise, and childbirth preparation.

The national C-section rate is nearly 1 in 3 births.  At OBGYN North, we think this is too high of a number.  Our practice average is about 1 in 5, including planned repeat C-sections. For a first time c-section our rate is 1 in 7. Additionally, we are excited to support women with vaginal birth after C-section, known as VBAC with one or two prior cesarean deliveries. After obtaining the documentation of your previous cesarean scar(s), we provide consultation with our physicians to help you determine if this is a good option for you. (This is not common at many other practices). Our VBAC success rate is over 80%!

How is this possible? At OBGYN North, we will do our best to help you avoid a C-section. This blog post will focus on how we as a team (midwives, doctors, mothers-to-be, and their support team) help avoid this surgery.  

A common reason for a C-section is dysfunctional labor or failure to progress. One of the common reasons for a failure to progress is the result of induction of labor when the body is not ready. For this reason, we induce only for medical indications (fetal or maternal health risks). It is best to allow moms to labor without intervention when none is needed. To avoid a medical induction of labor we may suggest herbals, ambulation, nipple stimulation, and encouraging doula support of your labor. Should induction be medically necessary, we will walk you through the process and proceed slowly as the body intended helping you get into labor.

Labor preparation is also very important. We offer many options for preparation classes so that you will find one that fits your personality and philosophy of labor best. Our physicians and midwives want to help support your birth plan; therefore, we recommend discussing all your pain management options with your providers.  Epidurals are safe, but sometimes they slow the normal labor process. We have other options available.

Our next most common reason for a C-section is a breech delivery (baby's head not turned down). Our strategy to avoid this outcome is to identify the position of the baby early. Your assistance is important here: such as identifying where the baby is kicking and discussing any concerns to your providers during your visits. A quick ultrasound late in the third trimester can be very helpful as well.  Regular exercise, acupuncture, and the Webster technique (chiropractors typically perform this) are helpful to turn the baby's head down. Spinningbabies.com is great resource for mothers with breech babies and other less optimal positions for labor. Finally, at 37 weeks, about 5% of babies are still breech. At this point, our physicians will offer to turn the baby head down.

The majority of pregnancies are healthy and normal, and do not need intervention.  Our mission is to support our moms through a safe pregnancy and delivery. Sometimes in labor, contractions lead to baby heart rate changes. This is probably the result of cord compression or a problem with the placenta. To help avoid placental problems, we recommend a healthy diet and regular exercise throughout pregnancy.   If it is an issue of cord compression, then we may ask you to change positions as you labor to help your baby maintain heart rate and get enough oxygen.  Some other methods to improve the baby's situation include oxygenation, hydration, and an amnioinfusion (replace fluid around the baby). 

Unfortunately, there are times when C-sections are necessary for you and your baby.  If we can't resolve one of the above issues like persistent breech positioning or if your baby still doesn't tolerate labor, we may need to do a C-section. One other reason for a C-section may on occasion be a placenta previa (placenta over the cervix).  A suspected "large" baby is rarely an indication for a cesarean delivery in a low risk mother. If we are recommending a cesarean section, then we will counsel and involve you in the decision making process. If you are having a scheduled C-section, we can offer a family-centered (otheriwse known as a gentle C-section). See this link for more information.  

If we recommend a C-section, please know it is after we have exhausted all our other options.  Our physician midwife team will work together to help your birth experience to be a joyous occasion. At OBGYN North from the time of your pre-conception visit throughout your pregnancy, we strive to offer the highest quality pre-natal care. By doing so, we can reduce your risk of C-section and avoid unnecessary labor interventions. We want to encourage moms'-to-be and their family's participation throughout the process, leading to a healthy and happy outcome for you, your baby, and your whole family.

Best wishes for a happy and healthy labor! 

April Schiemenz, MD

Get to Know Dr. Maansi Piparia

Hi there everyone! I'm Dr. Maansi Piparia, and even though I have been here at the practice for a year now, I am still the newest doctor of the group!

I am sure some of you have met me already but just to give you a little background, I was born in Canton, Ohio but was mostly raised in Tulsa, Oklahoma. Growing up in Tulsa was great but Texas always seemed a little more appealing so I made it my goal to move here someday. I finished high school and was accepted to a six year combined BA/MD program in Kansas City, Missouri. The program is an accelerated path for young adults who a sure they want to become a physician, and I knew at a pretty early age! Although I didn't have a normal college experience, it was six years of bonding with friends who were also going to school all year-round with intensity and stress! After medical school, I journeyed up to Chicago where I completed my residency in Obstetrics and Gynecology. I found a love for teaching and laparoscopy and found my husband while we were early in training! 

After residency, my husband and I moved to Austin. We were starting fresh, as we didn't know anyone here, and just hopeful it would be a good experience. We have been extremely thrilled with our choice! Since we have been here we have had a great time in the city, experiencing the music, the culture and the amazing Mexican food!  We recently bought a house in Round Rock and we are hoping to start a family very soon!

If we ever get off topic in a clinic visit there's a good chance I might be talking about how much I love the OU Sooners (of course better than the Longhorns, haha) or about my big fat Indian wedding that I had almost 1 year ago!

I will never forget a quote that was presented to me in my early years, "Choose a job you love and you will never work a day in your life." Of course we all know that Obstetrics is hard work for all of us, the patient and physician, partners and families all included, but this quote is true. Essentially, if you are doing something you truly love in life, then even if it takes sleepless nights and stress, its still enjoyable and worth every second. That is in a nutshell why I am here and why I am doing what I do! I hope that I get to meet all of you sometime and thanks for reading a little about me!