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.
The studies on alcohol consumption in pregnancy are unequivocal- drinking alcohol while pregnant can result in many complications ranging from birth defects to growth restriction, mental retardation and stillbirth. There is a clear dose response relationship between alcohol and poor outcomes, which means that as higher quantities of alcohol are consumed, the risk of complications is higher. However, because every individual metabolizes alcohol differently, there is no "safe" amount of alcohol that can be consumed in pregnancy. Bottom line, I recommend abstaining from all alcohol while pregnant. The critical developmental period for vital organs (such as the brain) occurs in the first trimester. Therefore, it makes sense that most of the birth defects are related to drinking in the early part of pregnancy. However, drinking later in pregnancy can result in cognitive and developmental delays. Of course, if there is a special occasion or celebration, I tell my patients it's acceptable to have a rare glass of wine. But my overwhelming opinion is that drinking in pregnancy should be avoided- why take the risk?
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Plenty of physicans realize mid-career that they have chosen the wrong profession. It is a challenging road to change course because by the time you've finished your training, you are well into adulthood. ObGyn training requires 4 years of college, 4 years of medical school and 4 years of residency. In order to retrain in a different field, you would need at least 3 additional years of residency (long hours, inflexible schedule). But I can't imagine what it would be like to practice OBGyn and be unhappy with my decision- the work hours, the call, and the stress would be pretty hard to tolerate if I didn't love what I do!
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If you are an avid runner, then I think it is safe to continue running during pregnancy, with modifications. First of all, you need to stay well hydrated whenever you are exercising and avoid overheating. Secondly, listen to your body; if it hurts or is uncomfortable, don't do it. Thirdly, you are not trying to condition or train, just maintain. So decrease the intensity and never push yourself to the point of chest pains, extreme fatigue or weakness, dizziness or severe shortness of breath. In general, I tell patients if you were previously pushing yourself to 100%, then dial it back to 50%. At some point in the pregnancy, it is likely that you will need to decrease your distance and/or pace. Again, listen to your body. I don't think that extreme long distances, such as marathons, are a wise choice during pregnancy. In general, you shouldn't be running as fast as you can or as far as you can, so I ask my patients to use common sense when deciding whether to continue running during pregnancy. Of course, if you develop contractions, pain, bleeding or other worrisome symptoms, you should immediately stop and contact your physician.
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I can't imagine how one could do a pap smear on oneself. That being said, I think it is difficult for all physicians to choose the provider for themselves and their family. But, doctors are patients too, and we look for exactly the same traits that everyone else does- intelligence, a good beside manner, and empathy.
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Radio program/music director
Just how good of a radio host do you think Howard Stern is?
Bartender
How often would you date customers?
Employment Lawyer
Can a man sue if he's denied a job at Hooters?
I have never had to break the news to someone that she is HIV positive. I have told someone that she has hepatitis C, which in many ways, is a very similar chronic disease. Fortunately, the treatments for HIV and hepatitis C have advanced to the point where people have the potential to live healthy, normal lives despite having the virus. I have taken care of patients with HIV and hepatitis C in pregnancy. If the viral loads are suppressed enough, and if they take their medications as instructed, these patients can go on to have healthy pregnancies without transmitting the infection to their babies.
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Yes. In very rare circumstances, a "perimortem" cesarean section can be performed. The decision to proceed with the surgery needs to be made immediately, before the loss of maternal blood flow has caused a lack of oxygen to the fetus. In skilled hands, a baby can be delivered by cesarean section within minutes, which may just allow at least one life to be saved.
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Most of the time, when a baby is coming out so rapidly that you don't have time to make it to the hospital (or are on an elevator), the delivery will happen on its own without any need for assistance. Maternal instinct takes over, and the mother will begin pushing when the right time comes. Once the head is crowning, just try to support the head and body as it delivers. Look around you for something relatively clean to dry off the baby and to keep the baby warm. Newborn babies are not able to maintain their body temperatures initially and can develop hypothermia very quickly. The best way to keep them warm is to put them directly skin-to-skin on the mother's chest and cover both up with something dry. If you have a shoelace, you could tie off the umbilical cord. Hopefully by then, help will have arrived!
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