Midwifery Musings: Understanding Elective Inductions

Jennifer Walker, CNM, is back with another installment of our “Midwifery Musings” blog series, sharing her expertise and providing an inside look at life here at Covington Women’s Health Specialists.

As your trusted partners in every stage of pregnancy, we’re shedding light on elective inductions —what they involve, how they’re evaluated, and the factors to consider when making this important decision.

At 39 weeks gestation, women have the option to choose an elective induction of labor, even without a medical reason. Elective induction means that labor has not started on its own, but methods or medications are used to encourage the body to begin labor.

Elective inductions have become a topic of interest in recent years, with numerous studies conducted to evaluate their effectiveness and benefits. According to the American College of Obstetrics and Gynecology (ACOG), “healthy women whose labor is induced at 39 weeks may have lower rates of preeclampsia and gestational hypertension than women who do not have induction at 39 weeks.”

Favorable vs. Unfavorable Cervix

Per the ACOG, the goal of an induction of labor is to achieve vaginal delivery by stimulating uterine contractions before labor begins spontaneously. Before scheduling an elective induction, your provider at Covington Women’s Health Specialists will perform a vaginal exam to assess the favorability of your cervix.

At our practice, we use the Bishop Scoring System* to determine whether your cervix is “favorable” or “unfavorable” for induction. Following the guidelines of the ACOG, a Bishop score of 6 or less typically indicates an unfavorable cervix, while a score of 8 or more suggests a similar likelihood of vaginal delivery as with spontaneous labor.

After assessing your Bishop score, your provider will discuss the risks and benefits of an elective induction to determine if it is the best option for you. If your Bishop score is 6 or less, your provider may recommend discussing or using cervical ripening methods to prepare your body for labor.

Considerations for Elective Induction

There are several advantages to scheduling an induction of labor at full term. These include:

  • A reduced chance of stillbirth.
  • Limiting further fetal growth, which can reduce the risk of delivery complications.
  • The ability to plan ahead, arrange childcare, organize transportation, or coordinate work schedules.

However, elective induction is not without potential drawbacks:

  • A longer labor and hospital stay.
  • The possibility of maternal exhaustion.
  • An increased likelihood of cesarean delivery, especially if the cervix is not favorable.

Studies have shown that nulliparous women (those who have never given birth to a live baby) face a two-fold increased risk of cesarean delivery when the cervix is unfavorable at the time of induction. Because cervical status is one of the most important predictors of successful vaginal delivery, it is crucial to have a thorough discussion with your provider when considering induction.

Looking Ahead

Understanding the benefits, risks, and factors that influence elective induction is key to making an informed decision. At Covington Women’s Health Specialists, we are here to guide you through every step of the process. In the next post of the “Midwifery Musings” blog series, I will delve deeper into cervical ripening agents and their role in preparing your body for labor.

The Benefits of Choosing a Midwife for Your Pregnancy and Birth

When preparing to welcome a new addition to your family, one of the most important decisions you’ll make is who will guide you through pregnancy and birth. Choosing a midwife is an option more families are exploring as they look for a supportive, personalized approach to pregnancy. But what exactly does a midwife do, and how can they support your journey to parenthood? We’ll answer all of your questions and more below.

What Is a Midwife and How Are They Different from Doctors?

Midwives are trained health professionals who specialize in helping expectant mothers through pregnancy, labor, and postpartum care. Unlike doctors, midwives often take a more holistic approach, prioritizing a close relationship with the family and focusing on the body’s natural abilities during childbirth.

“Midwifery is about empowering families to trust in their body’s strength while offering gentle support every step of the way,” says Dr. Meredith Delp, DO.

One common misconception is that midwives only attend home births. In reality, many midwives are certified to work within hospitals, giving families the option of a hospital birth with the compassionate, personalized care midwives are known for.

What a Midwife Does During Labor

Midwives play an active role in labor, providing emotional support, encouragement, and practical care. They help mothers manage discomfort, offer natural pain relief techniques, and work closely with you to develop a birth plan that aligns with your preferences and goals. Whether it’s breathing techniques, movement, or other methods, midwives are skilled at helping mothers navigate the stages of labor in a calm, supportive environment.

Can a Midwife Deliver a Baby in a Hospital?

Yes! In fact, many midwives work directly within hospitals and birthing centers. When you choose a midwife, you’re not limited to a home birth; instead, you have a range of settings where you can receive midwifery care. Having a midwife in a hospital setting can offer the “best of both worlds”—the natural, personalized approach of a midwife, with access to hospital facilities and staff if needed.

Is a Midwife a Nurse or a Doctor?

The title “midwife” can sometimes cause confusion since the term is neither doctor nor nurse. However, many midwives are trained as Certified Nurse-Midwives (CNMs), meaning they have both nursing and midwifery credentials. These midwives combine the clinical skills of nursing with specialized training in pregnancy and childbirth. Certified Professional Midwives (CPMs) and other licensed midwives may not be RNs but are still trained and licensed to provide excellent care.

Can a Midwife Deliver a Baby Without a Doctor?

Absolutely. A midwife is trained to deliver a baby independently, though there are often doctors or hospital staff available should any complications arise. In many cases, midwives collaborate with doctors, especially if the mother has a higher-risk pregnancy or requests additional medical support. However, many healthy pregnancies can be fully managed by a midwife alone, with no need for a doctor’s intervention during labor.

Our Midwives are experts in low-risk pregnancies and births, and they play an important role in patient-centered care.

How Midwives Support Family Planning

Midwives don’t just support pregnancy and birth; they’re also knowledgeable in family planning. Many people turn to midwives for guidance on reproductive health, contraception options, and even preconception planning. Because midwives often have an ongoing relationship with families, they can provide comprehensive support that extends beyond pregnancy, helping parents make informed decisions about their reproductive health for years to come.

“Family planning and reproductive health are part of the ongoing care we provide, supporting parents in making the best choices for themselves and their families,” explains Dr. Meredith Farrow, MD, FACOG.

How to Know if a Midwife is Right for You

Choosing a midwife is a deeply personal choice that depends on your own health needs, birth preferences, and the level of care you desire. Midwives are known for their ability to listen, support, and honor the birthing person’s preferences. If you’re looking for a provider who will offer personalized attention and view birth as a natural and empowering process, a midwife may be the perfect fit.

Schedule a Midwife Consultation With Covington Women’s Health Specialists Today

Our midwives are trusted experts in pregnancy, labor, and family planning, and their approach can be both empowering and calming for expectant parents. Whether you’re looking for guidance through labor or planning for future pregnancies, the Covington Women’s Health Specialists midwife team offer holistic, patient-centered care that can make the journey to parenthood a more positive experience. If you’re considering a midwife, reach out and explore the unique ways we can support your family during this special time..

Thanksgiving Hours for Covington Women’s Health Specialists

Get ready to mark your calendar! With the holiday season just beginning, we want to make sure you’re not caught unaware on a day you’re seeking care.

Take a look at our Thanksgiving hours below, and from all of us at Covington Women’s Health Specialists, happy Thanksgiving!

11/27: Closed starting at 12pm
11/28: Closed
11/29: Closed
12/2: Open starting at 8AM

Your Annual GYN Visit: Reasons for Changing Medications

Your annual visit with your women’s health provider starts with a discussion of how you have been feeling, including questions about your overall health and symptoms.  The way you describe your symptoms sometimes tells the provider how your current medication(s) are working.

Some reasons for recommending a medication change are:

  • Based on your symptoms, the medication is no longer working or helping
  • An increase or decrease the dosage may be needed
  • You may be experiencing side effects
  • You may be having an allergic reaction
  • You may be taking other medications that interact with the current medication

New medical information may also cause your provider to recommend a medication change. Since medical research is always taking place, publication of new information since you started the medication may be available.  You should also be informed when new, more effective, medications become available.

  • The medication may have been found to have side effects not known when you started it
  • The medication may have been found to not work as well as earlier research showed it did
  • New medications may be thought to be more effective
  • New medications may have beneficial side effects
  • New information about the health problem for which you are taking a medication may indicate that other medications will be more effective
  • Information concerning the safety of the medication may have changed

If your provider discusses a medication change with you at your annual exam visit, understand the reasons why the change is recommended.  Ask when the new medication should take effect and how you should stop your old medication so as not to be bothered by an uncovered time gap between when the old medication wears off and the new medication’s effects begin.  Some medications require weaning off the old medication before starting the new one. 

Medication changes, like all aspects or your care, should involve you and the provider in a shared decision.  For example, if you like the description of a new medication and how other women have been helped by it, you are sharing in the decision to change medications. However, if you tell the provider that you would rather not risk adjusting to a new medication, you are sharing in the decision not to change your medication even though a new medication may offer more relief.

Hormones are an important medication for many women.  A woman may trust and rely on her hormone medication to keep her feeling the way she wants to feel. New information concerning hormone safety and effectiveness are publicized often, even more than other types of medication.

Your women’s healthcare expert is obligated to discuss new information with you, as well as to make recommendations based on safety concerns.  Changing hormone medications may be hard to do if the new medication does not work right away or does not work as well.  Scheduling a time to change may be important if you are faced with a trying time for your family or big projects at work, so that you are not changing medications during a stressful time period. Again, your decision to change the medication and when to make the change are decisions shared with your provider. 

If you have concerns about your medications, especially hormonal medication, please contact Covington Women’s Health Specialists, LLC. Our providers will discuss your symptoms, medication concerns and answer your questions. Please don’t hesitate to give us a call at 770-385-8954.

Understanding the Connection Between Hormones and Mood Swings: How Your OBGYN Can Help

Calling them ”mood swings” sometimes feels like an understatement. It’s one thing when you can trace anger, frustration, or sadness to a specific source that’s easily ridden out. But when you’re in a foul mood with no identifiable reason, it can feel even more disorienting. You may feel helpless and confused over your emotions, which then amplifies their intensity.

If this sounds familiar, it’s possible your hormones are to blame. Here, we dig deeper into the connection between hormones and mood swings, and explore some strategies to help you cope.

How Are Hormones and Mood Swings Connected?

Hormones influence neurotransmitters, which are brain chemicals that regulate your mood. Women encounter many hormone fluctuations throughout different periods of their lives, and therefore, many mood swings — all for different reasons, with different results.

Puberty & Early Adulthood

As early as puberty — when your body is transitioning from “child” to “young adult” — hormones play a significant role in mood. Your brain has started strengthening the parts that enable intense and complex emotions, but the area responsible for regulating these emotions is still developing. As a result, moods may shift more frequently and intensely.

Once menstruation begins, you may experience other mood changes up to two weeks before your period arrives. Feelings like anger, anxiety, and irritability are attributed to fluctuating estrogen levels that occur during the luteal phase of your cycle. These symptoms fall under the broader condition known as premenstrual syndrome (PMS), which can also be accompanied by weight fluctuations, breast tenderness, and headache, among other physical symptoms.

For up to eight percent of women, the physical and mental symptoms of PMS are severe enough to interfere with their daily life. These intense mood and bodily changes are known as premenstrual dysmorphic disorder (PMDD), a condition that was first recognized in 1987.

Pregnancy & Postpartum

Pregnancy also brings an onslaught of hormone changes, which can be sudden and intense. For many women, mood swings peak at gestation of six to ten weeks, wane during the second trimester, and ramp up again as their due date nears. Afterward, the sudden decrease in estrogen and progesterone following childbirth can lead to intense feelings of sadness or anxiousness known as the “baby blues,” which are usually experienced two to three days following delivery.

Perimenopause & Menopause

Lastly, but certainly not least, perimenopause and menopause also lead to a decrease in estrogen, which can initiate more lasting mood changes, like depression. Experienced by approximately 40% of women, mood changes related to menopause may mimic those of PMS, and can include irritability, anxiety, and difficulty concentrating. Yet, unlike PMS, which lasts several days at a time, the menopausal transition lasts several years.

What Can You Do to Address Hormonal Mood Swings?

Sometimes, mood swings can be managed with lifestyle modifications. For example, mild mood changes might be alleviated with:

  • Exercising regularly
  • Getting plenty of rest
  • Talking to a loved one
  • Engaging in hobbies
  • Practicing self-care

But if your mood swings have begun to harmfully interfere with your daily life, there’s no need to suffer through them — especially if they’re intense or long-lasting. Your women’s healthcare provider can help you determine if your mood changes are indeed related to hormones, and if so, what treatment can alleviate them.

Schedule a Women’s Wellness Appointment With Covington Women’s Health Specialists 

As your partners in women’s wellness, our providers can help you address hormone imbalances experienced during any phase of life.  We’ll alleviate the symptoms of intense emotional changes or any other difficulties you may encounter. We’re also here to support you through non-hormonal challenges, whether it’s uncomfortable pregnancy symptoms, urinary incontinence, endometriosis, or a variety of other conditions or infections. Request an appointment with one of our providers using our online form or by calling (770) 385-8954.

Midwifery Musings: Navigating the Second Trimester

Jennifer Walker, CNM, is once again sharing her unique insights as one of our midwives, giving you an insider’s view of life at Covington Women’s Health Specialists in our next Midwifery Musings blog.

As your trusted partners in the pregnancy journey, we’re highlighting what to expect during your appointments leading up to the third trimester. Missed our earlier posts? Catch up on the Pregnancy Confirmation Appointment and the Initial Prenatal Exam.

Regular Check-Ups: Monitoring Your Baby’s Growth and Health

After your initial prenatal exam, we recommend seeing you every four weeks until you reach 28 weeks of pregnancy. At each of these follow-up visits, we’ll check your weight and vital signs. Depending on any preexisting medical conditions, we may ask for a urine sample to monitor for dehydration, infections, or elevated protein levels. Your provider will also use a fetal doppler to listen to your baby’s heartbeat. Starting at 20 weeks, we’ll measure your belly to ensure your baby’s growth is on track with your gestational age.

Genetic Testing and Anatomy Ultrasound

If you’ve opted for genetic testing, we’ll schedule blood work after 15 weeks to complete the second part of the screening. Around 18-20 weeks, you’ll also have an anatomy ultrasound to assess your baby’s development. This scan can often reveal your baby’s sex (if they’re in a good position!) and detect any potential birth disorders, such as cleft palate or clubbed feet, as well as check for any serious conditions related to the brain, heart, bones, or kidneys. Additional ultrasounds may be recommended based on your medical needs.

Preparation for the Third Trimester

Each appointment is an opportunity to ask questions or discuss any concerns you have about your pregnancy. These check-ins are just as important as any other part of your prenatal care, as they help us monitor your health and guide your care into the third trimester.

Once you reach 28 weeks, you’ll officially enter the third trimester, and we’ll see you more frequently for the final stretch of your pregnancy. Stay tuned for the next installment of Midwifery Musings, where we’ll cover what to expect in the third trimester!

After-Hours Care:

If you have any concerns outside of regular office hours, here’s what to do:

  • If you’re UNDER 20 weeks: Go to Piedmont Newton Emergency Department.
  • If you’re OVER 20 weeks: Head to Piedmont Newton Labor and Delivery.

However, please remember that we are always accessible via MyChart messaging or phone to address any questions or concerns you may have during business hours.

We’re proud to be your partners on this incredible journey, offering the compassionate care and expertise you can count on. Keep an eye out for more Midwifery Musings as we continue to explore the unique path of pregnancy together. Ready to schedule an appointment with one of our specialists? Call 770-385-8954 or book online.

Understanding Fibroids During Pregnancy

Fibroids, also known as uterine leiomyomas, are non-cancerous growths that frequently occur in women of childbearing age. These growths are particularly common among African American women, but they can affect any woman. At Covington Women’s Health Specialists, we have extensive experience caring for patients with fibroids both during pregnancy and at other stages of life. It’s essential to understand that while fibroids can be monitored, there are limitations to the treatments that can be provided during pregnancy.

During pregnancy, the hormonal changes can sometimes cause fibroids to grow, leading to discomfort or pain for the expectant mother. While this can be concerning, it’s important to note that neither obstetricians nor specialists can remove or shrink fibroids during pregnancy due to the potential risks to both the mother and the baby. Our approach involves careful monitoring and managing any symptoms to ensure the best possible outcome for both the mother and child. Specialists often assist obstetricians in this monitoring process, providing additional expertise and care when needed.

While pain is the most common symptom fibroids cause during pregnancy, fibroids are also associated with early miscarriages and bleeding during pregnancy.  Women with fibroids experience preterm delivery and cesarean section delivery more commonly than women without fibroids. For most women with fibroids, the baby’s growth progresses normally; however, fibroids can sometimes hinder fetal growth. Complications like early leakage of amniotic fluid or preterm labor are difficult to predict, even with close monitoring by an obstetrician or specialist.

While we cannot prevent the growth of fibroids during pregnancy, our team is dedicated to providing comprehensive care and support. We provide monitoring and when needed work closely with specialists to keep a close eye on the condition and address any concerns that arise. If you have fibroids and are pregnant or planning to become pregnant, schedule your prenatal or gynecological appointment online or by calling our office at (770) 385-8954 to discuss your condition with one of our providers to develop a tailored care plan.

Resources for Our Pregnant Patients at Piedmont Newton Hospital

At Covington Women’s Health Specialists, we deliver at Piedmont Newton Hospital, our trusted partner healthcare institution. Here are some resources that Piedmont Newton offers expected mothers as the preparation for their new baby:

Breastfeeding Basics

This class is offered on the first Wednesday of every month from 6:00 p.m. to 8:00 p.m.

Maternity Center Tour

This tour is every second and fourth Wednesday of the month from 6:00 p.m. to 7:00 p.m.

Childbirth Education Class

This class is every third Wednesday and Thursday of the month from 5:00 p.m. to 8:00 p.m.

Visit Piedmont Healthcare’s website for more information on how to register for its classes and events. 

The Benefits of Nerve Blocks Over Narcotics for Post-Surgery and Postpartum Pain Relief

At Covington Women’s Health Specialists, we prioritize the well-being and comfort of our patients. We take pride in our affiliation with Piedmont Newton Hospital and their anesthesiologists’ and anesthetists’ commitment to offering advanced pain management techniques to enhance patient recovery. One such technique is the use of nerve blocks, a method that has proven to be highly effective in reducing postoperative and postpartum pain while minimizing the reliance on narcotic medications.

Nerve blocks are a form of regional anesthesia that involves injecting medication near specific nerves to block pain signals from reaching the brain. This targeted approach provides significant pain relief in the immediate postoperative and postpartum periods. Unlike systemic narcotic medications, which can affect the entire body and cause a range of side effects such as drowsiness, nausea, and constipation, nerve blocks work locally, allowing patients to experience effective pain relief without these unwanted side effects.

The benefits of using nerve blocks over narcotics are particularly important in the context of obstetrics and gynecology. After surgery or childbirth, effective pain management is crucial for a smooth recovery. Nerve blocks not only reduce physical discomfort but also help new mothers stay alert and engaged during the crucial early bonding period with their newborns. Additionally, minimizing the use of narcotics helps prevent potential issues related to dependency and ensures a safer recovery process.

The skilled anesthesiologists and anesthetists at Piedmont Newton Hospital are highly trained in administering nerve blocks, ensuring that our patients receive the best possible care. By prioritizing patient comfort and recovery, we are striving to enhance the overall patient experience and ensure the best possible outcomes for our patients.

To schedule a prenatal visit to learn more, call our office at 770-385-8954 or request an appointment online.

Covington Women’s Health Specialists Opens New Location Offering Enhanced Patient Care

Covington Women’s Health Specialists, an all female OB-GYN and midwifery care practice, is now opening an additional new location (5165 Cook Street N.E., Covington) offering complete obstetrics and maternity services.

Conveniently located near the existing Cook Street gynecology office and our main office at the Piedmont Newton Hospital campus, our new third location will offer comprehensive obstetric care, including ultrasounds and advanced 3D imaging in a private environment. 

“It’s a privilege to expand our services with this new location,” says Dr. Cathy T. Larrimore, founder of Covington Women’s Health Specialists. “This facility allows us to enhance our offerings and continue delivering exceptional healthcare to the community.”

Covington Women’s Health Specialists provides a wide range of maternity and gynecology services focusing on promoting women’s reproductive health at every stage of life. Services include midwifery, cutting-edge surgical services, trans and nonbinary healthcare, multiple convenient locations, and on-site Quest diagnostics.

The location is now open for patient visits. Hours are 8 a.m. – 4:30 p.m. Mondays – Thursdays and 8 a.m. – 12 p.m. Fridays. 

Request an appointment online or by calling our office at (770) 385-8954.