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OBSTETRICS…THE WAY IT WAS MEANT TO BE!
Written by: Dr. Jonathan Weinstein
Frisco Womens Health provides a full range of high and low risk Obstetrics care, advanced maternal age, twins, patients with the full gamut of pre-existing medical problems from diabetes, to high blood pressure and everything in between. We have the same electronic fetal monitoring and ultrasound technology as any hospital would have but more importantly, everyone who works in the office really cares about you and your growing family.
I practice according to the American College of Obstetrics and Gynecology (ACOG) practice guidelines, developed by experts in the field. I can perform an External Cephalic Version (ECV) at 36 weeks if your baby is breech; this will move the head down. External Cephalic Version is a very safe procedure, despite what other doctors may tell you. I have a success rate near 80%. If your doctor is waiting beyond 36 weeks pregnant, it will be too late. The baby will be too low in the pelvis and the amniotic fluid will be much lower, making it less likely to be successful.
I learned techniques such as External Cephalic Version, Forceps Delivery and letting the baby ride down on its own. Along with the importance of listening to the patient, the labor and delivery nurse, and why vacuum assisted vaginal deliveries are far more dangerous than almost anything else in the practice of Obstetrics, but this is a discussion for another time. All of this knowledge along with patience has kept my Cesarean Section rate well below the national average and kept me out of trouble.
You will find me to be a straight shooter. I will not lie to you, bend the truth, do any unnecessary testing and always try to give you options. I have quite a few patients that choose to have Natural Childbirth and at times, they hire a doula (a layperson that is a birth facilitator) who assists you in your goal of natural childbirth. I often get the same Labor and Delivery nurses to take care of my patients, as they are more supportive in reaching that goal.
For those who choose an epidural in labor, you can rest easy, as I do not like to see people in discomfort so if you choose epidural for labor there is no set number of centimeters dilated you have to reach to receive one, you just have to demonstrate that you are dilating. As a man, I greatly admire a women’s ability to go through childbirth. I know that if men were responsible for procreation, our society would be extinct!
The major change that for many years has been disheartening is the ever-increasing Cesarean Section (C/S) rate. As physicians, we are trained to do no harm yet in the United States the rate of C/S has topped 30%. Locally the C/S rate is closer to 50-60%, with some physicians and patients even suggesting a C/S is better for the mom and baby.
For physicians and patients it simply means that you will be thirty-five or older when you deliver. Why 35 years old? Remember as women put off childbearing to establish their own careers, it is now more common to deliver babies for women who are well into their forties. 35 is the long established age where the risk of miscarriage from an amniocentesis became higher than the risk of actually having a baby with a chromosome abnormality, like Down's syndrome. Nowadays the risk of amniocentesis is minuscule as it is all done under precise ultrasound guidance.
Do not let anyone tell you; "You are too old to have a baby," this is just not true. I have delivered many women in their mid-forties, some having their first child! This could easily be you. We just need to sit down and make a procreative management plan to insure a healthy pregnancy and birth.
As my patient, you can expect to be treated with the same dignity and compassion, as I would provide my own wife. I am comfortable taking care of high risk patients, know when the assistance of a Perinatologist (obstetrician with three years additional training who performs detailed ultrasounds and genetic testing/screening) is required and do everything needed to ensure your pregnancy, labor and delivery go well. I have no problem with twin vaginal deliveries as long as the first baby is head down. I take care of a number of patients with pre-existing medical problems like diabetes, high blood pressure, lupus, recurrent miscarriages and difficulty with conception.
I recommend at least one visit to a Perinatologist, to perform a detailed, Level II anatomy scan because ultrasounds are what they do all day, making them experts in detecting birth defects. I do perform ultrasounds and fetal testing in the office and have a 32-inch plasma screen television so everyone in the room can see.
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