Friday, August 29, 2014

Heavy Periods or Abnormal Bleeding?  Novasure Endometrial Ablation may be the answer.

What is NovaSure Endometrial Ablation?

NovaSure® endometrial ablation is a quick, safe, and simple procedure to lighten or stop your periods, without the side effects of hormones or the risks of hysterectomy.

Why choose the NovaSure procedure for your heavy period?

  • The NovaSure procedure is safe: No pills. No hormonal side effects.
  • The NovaSure procedure is effective: For 90% of women, menstrual bleeding is dramatically reduced or stopped.
  • The NovaSure procedure is quick: NovaSure endometrial ablation is a one-time, five-minute procedure that can be done in your doctor’s office, usually for the cost of a copay.

How does NovaSure endometrial ablation procedure work to treat heavy periods?

NovaSure endometrial ablation, is a one-time, 5-minute in-office procedure trusted by over 2 million 1 women.  NovaSure® is an endometrial ablation (EA) procedure that can reduce or stop menstrual bleeding. It works by removing the endometrium, or the lining of the uterus (the part that causes the bleeding), with a quick delivery of radiofrequency energy.

NovaSure endometrial ablation procedure steps and how it works:

NovaSure: Heavy Period Treatment Step 1  Your doctor slightly opens your cervix (the opening to the uterus), inserts a slender wand, and extends a triangular mesh device into the uterus
NovaSure: Heavy Period Treatment Step 2 The mesh gently expands, fitting to the size and shape of your uterus
NovaSure: Heavy Period Treatment Step 3  Precisely measured radio frequency energy is delivered through the mesh for about 90 seconds
NovaSure: Heavy Period Treatment Step 4  The mesh device is pulled back into the wand, and both are removed from the uterus.

No part of the NovaSure endometrial ablation device remains inside your body after the NovaSure procedure.

Benefits and considerations of NovaSure procedure for heavy periods

NovaSure is Safe
No pills. No hormonal side effects.

NovaSure is Effective
For 90% of women, menstrual bleeding is dramatically reduced or stopped.

NovaSure is Quick
NovaSure endometrial ablation is a one-time, five-minute procedure that can be done in your doctor's office, usually for the cost of a copay.

NovaSure endometrial ablation can do more than just stop the menstrual bleeding. Many women who've had the NovaSure endometrial ablation procedure say they are now able to spend more time at work and daily activities, participating in more social and athletic outings now that they no longer suffer from heavy menstural bleeding. They also report improved energy levels, better moods, and a boost in self-confidence. And many also had a significant reduction in painful periods and PMS symptoms like irritability.*

Not all women are candidates for NovaSure Endometrial Ablation.

Your doctor will explain the risks of all treatment options. NovaSure endometrial ablation is for premenopausal women with heavy periods due to benign causes who are finished childbearing. Pregnancy following NovaSure can be dangerous. NovaSure endometrial ablation is not for those who have or suspect uterine cancer, have an active genital, urinary or pelvic infection or an IUD. NovaSure is not a sterilization procedure. Rare but serious risks include but are not limited to thermal injury, perforation and infection. Temporary side effects may include cramping, nausea, vomiting, discharge and spotting.

1.Hologic Inc., Data on file, 2014.
*Cooper J, et al. A randomized, multicenter trial of safety and efficacy of the NovaSure system in the treatment of menorrhagia. J Am Assoc Gynecol Laparosc. 2002; 9:418-428.

Tuesday, August 26, 2014

Make Way for Baby: 8 Tips for a More Comfortable Labor & Birth

People often track a woman’s labor progress by how much her cervix is dilating (opening), but much more is happening during labor.
With each contraction, a woman’s uterus pushes her baby down into her pelvis, and the baby tucks and turns to find its way through. A woman feels intense pressure and stretching as her baby moves down. Ligaments – loosened during pregnancy –allow the pelvic bones to move and make more room for the baby.
Most women worry about labor being long or difficult. Small minorities of babies become stuck in a tough position during labor, or have heads bigger than their mother’s pelvis, and are eventually born by cesarean. A majority of babies can and will fit through the pelvis, given enough time and support. If we look at labor from the baby’s perspective – as a challenging journey through a woman’s curvy, tunnel-like pelvis – there are several things women can do to enhance comfort and encourage their baby’s progress toward birth.
During pregnancy
Be active
Aim for at least thirty minutes ofmoderate activity daily – it doesn’t have to be all at once.  Walk, jog, or swim. Try yoga, which combines stretching and strengthening with breath awareness, a great a mind-body preparation for labor. Staying fit will give you the strength and flexibility to move around during labor to help your baby move through your pelvis.
Eat well
Healthy eating will help you grow a healthy-sized baby. Choose plenty of vegetables and whole grains, and beans, nuts, lean meat, dairy, eggs for protein. Try to eat smaller meals at meal times and snacks with protein in between. Ask your provider about recommended weight gain for the full pregnancy, and try to stick to your goal. If money is tight you may qualify for the Women, Infants and Children (WIC), a government program offering financial assistance for buying food.
Sit smart
Watch posture during long hours at your desk or in the car. When a woman sits lying back or hunched over with her pelvis tilted back, her lower back forms a comfy hammock for her baby and the baby is more likely to lie with its back against her back, looking up toward the ceiling. A baby who stays in this “posterior” position during labor has a harder time squeezing through the pelvis. You can encourage your baby to settle in an “anterior” position, facing down toward your tailbone, by sitting upright with hips above knee level and your pelvis and belly tilted forward. Tuck one pillow behind your lower back, and if necessary, another pillow under your buttocks.
Take a birthing class
Childbirth classes teach pain-coping practices, labor positions, and helpful comfort measures. This knowledge may help minimize stress and fear and provide you with tools for coping with pain and unexpected events during labor.
During labor
Walk, move around, and change positions
If you listen to your body, you will often choose the best position for your baby’s labor progress.  Sway back and forth leaning on a partner “slow dancing,” try hands and knees position, or bounce, or do figure eight circles on a birthing ball. Change positions every few contractions to create more space for the baby to navigate through the pelvis.
Rest, reenergize and hydrate between contractions
After each contraction take a deep breath, and on the exhale release tension and let the body soften. Sip a drink or some ice chips to stay hydrated. If you’re hungry ask your provider if you may have light snacks. When fatigued, try positions that allow for maximum rest during breaks. Relaxation allows the baby to settle lower into the pelvis as labor progresses.
Ask your provider about your baby’s position
A baby who is face down in the “anterior” position usually has an easier time fitting through the pelvis than a baby who faces “sunny side up” in the “posterior” position. Contractions push the back of a posterior baby’s head against the back of its mother’s pelvis (sacrum), rather than straight down through the pelvis and into her cervix. The baby takes longer to engage in the pelvis, the cervix takes longer to dilate, and the mother experiences more back pain. If a baby is “posterior,” nurses, midwives, and doctors can suggest positions that will help encourage rotation. Sometimes a provider can turn the baby by gently rotating its head during an internal exam.
As you are pushing
Keep changing positions and resting between contractions
Just like earlier in labor, try to change positions every fifteen minutes during pushing. Sitting on the toilet, squatting, hands and knees, lying on each side, or lying on your back with knees pulled wide and back can all be helpful positions to push your baby down and out.  Use your breaks between pushes to rest – some women even fall asleep for a moment!
A baby makes its final twists and turns with the final pushes, and at last emerges into the world.  Labor is hard work, it hurts, but women and babies are strong, and we know that with time, support and encouragement they can do it.
Author:  Cory Simon-Nobes, APRN, CNM, is a certified nurse midwife at Champlain OB/GYN and Fletcher Allen Health Care.

Monday, August 4, 2014

From the Midwife: What is Healthy Weight Gain in Pregnancy?

 Baby weight – it’s a topic that has worried expectant mothers and fueled celebrity magazines for years. How much weight is normal to gain? Let’s change the question. What expectant moms really need to be asking is: how much weight gain is enough for a healthy baby?It’s normal for all women to gain weight during pregnancy. Typically, you will put on 2-4 pounds in the first trimester. Weight gain picks up after this. You will want to aim to gain ¾ to 1 pound weekly from the second trimester on.
How much weight you gain depends on you. Every woman is unique and so too is every pregnancy. Taller women, for example, may be advised to gain more weight. Ask your midwife what is right for you.
Here are some general guidelines from the American College of Obstetricians and Gynecologists:
If you are…
  • Normal weight before conceiving, gain 25-35 pounds.
  • Overweight before conceiving, gain 15-25 pounds.
  • Underweight before conceiving, gain 28-40 pounds.
  • Carrying twins, gain 35-45 pounds.
Where does all that weight go?
It will ease your mind to know that weight gain is caused by the following:
  • Baby (approximate weight gain is 7-8 pounds)
  • Placenta (approximate weight gain is 1-2 pounds)
  • Amniotic fluid (approximate weight gain is 2 pounds)
  • Breasts (approximate weight gain is 1 pound)
  • Uterus (approximate weight gain is 2 pounds)
  • Increase in blood volume (approximate weight gain is 3 pounds)
  • Body fat (approximate weight gain is 5 pounds)
  • Increased muscle tissue and fluid (approximate weight gain is 4-7 pounds)
That adds up to 25 pounds!
Does that mean it’s OK to give in to food cravings?
Yes and no. Estrogen, an appetite stimulant, will rise in your blood stream around your 13th week of pregnancy. You will be hungry. Be sure to indulge your cravings, but keep it in balance so as not to crowd out more nutritious foods. You do not want to contribute to excessive weight gain.
How many calories should I consume?
A full-term pregnancy (forty weeks) requires about 80,000 calories, which comes out to an extra 300 calories per day. This may differ from woman to woman depending on age, activity level, and pre-pregnancy weight. Eating extra protein is also recommended way to get the extra calories in. Shoot for 70-80 grams of protein per day.
Author: Marti Churchill, CNM,  is a certified nurse midwife at Champlain OB/GYN and Fletcher Allen Health Care.