OBGYNDoc
Minneapolis, MN
Female, 36
I am a practicing Obstetrician and Gynecologist, providing care for women in all stages of life. Approximately half of my practice consists of pregnancy-related care, including routine prenatal care, high risk obstetrics, and delivering babies at all hours of the day. The other half consists of gynecologic care, which ranges from routine annual check-ups to contraception and menopause. I perform many surgeries, including laparoscopies and hysterectomies.
I do believe that postpartum depression is a condition for which one can receive short term disability, provided your physician has recommended that you not work based on your diagnosis. Of course, it is essential that one uses this time to get better- to take medications, seek counseling, and keep in close contact with one's physician. If one simply uses this as an excuse to stay home and remain isolated, it is unlikely that she will improve.
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Yes. The active ingredient in marijuana, THC, crosses the placenta and enters the circulation of the baby. Use of marijuana in pregnancy can result in poor blood flow and growth of the baby. In addition, there have been studies that have shown cognitive delays, hyperactivity and behavioral disorders in babies born to mothers who abused marijuana.
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It is absolutely true that the risk of complications in pregnancy increase as maternal age increases. In particular, the risk of genetic disorders such as Down Syndrome, miscarriages, preterm labor, gestational diabetes, stillbirth and cesarean section rises with maternal age. However, if a patient is in good health and does not have a significant history of obstetric complications, then I support her in pursuing her pregnancy goals. As our society continues to delay childbearing to later ages, we see more and more patients beginning their families in their 40's. Advances in treatment of infertility have made it possible for these individuals to aggressively pursue childbearing. There certainly are examples of misuse of this technology- for example pregnancies that result in high order multiples, or pregnancies in patients with serious chronic medical problems. However, in general, this technology has allowed for countless women to conceive babies in the face of a heartbreaking struggle with infertility.
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Without becoming too political with this question, I'll simply say no. My responsibility to my patients is to provide them with counseling and the resources available to them when faced with a difficult decision about continuing or terminating a pregnancy. I always support my patients in their decisions. For every pregnant patient, I present the options for genetic screening available. Some people choose to be tested because they are looking for peace of mind, others choose to be tested because they would prefer to be prepared in the event that they are having a child with special needs. Others choose to be tested because they would terminate the pregnancy if there was an abnormality. All are valid options, and I want my patients to feel empowered to make their own decisions based on the education I provide and based on their own personal beliefs.
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Most couples do relax a bit with their second and subsequent pregnancies because most of the anxiety is related to the fear of the unknown. Just having had the experience of knowing what a labor room looks like, what it feels like to have an IV, what to expect when it is time to push, and how to cope with the sleepless nights of caring for a newborn can alleviate the stress that a first-time parent experiences.
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The practice of obstetrics is almost always a gratifying, life-affirming, joyous career. When things go badly, however, it can be devastating. Regardless of how meticulously and skillfully we perform deliveries, there will continue to be complications. Any time there is a complication, I feel the loss, grief and disappointment in a very personal way. I don't think "guilty" is the appropriate word- I always do my absolute best to "do no harm". But I think it is natural for any physician to replay any difficult delivery over and over again in his or her mind to see if there is anything that could have been done differently. While the answer is inevitably no, I hope that each challenging delivery can broaden the depth of my experience.
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When it comes to circumcision, I can only present the facts, and then the parents have to make their informed decision. The benefits of circumcision include decreased transmission of STDs such as HIV and HPV, and therefore decreased penile cancer; there are also decreased rates of urinary tract infections. However, the American Academy of Pediatrics states that there is no medical indication for circumcision. There are many reasons people choose to have their child circumcised- religious, cultural, and social. It is now standard to use local anesthesia during the procedure, but of course, there will be discomfort associated with the procedure.
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