Pregnancy

Good outcomes for older women who give birth at home or in a birth center

Women with some characteristics commonly thought to increase pregnancy risks — being over age 35; being overweight; and in some cases, having a vaginal birth after a cesarean section — tend to have good outcomes when they give birth at home or in a birth center, a new assessment has found.

However, women with some other risk factors, a breech baby and some other cases of vaginal birth after cesarean or VBAC, may face an increased risk of poor outcomes for themselves or their babies, researchers at Oregon State University have found. The study is believed to be the first to examine these risks and the outcomes. About 2 percent of all births in the U.S., and about 4 percent in Oregon, occur at home or in a birth center, rather than in a hospital setting. Generally, women who are considered “low-risk” are good candidates for home or birth center births, also referred to as community births, if they are attended by a midwife or other trained provider and timely access to a hospital is available.

However, there is little agreement among health providers on what should be considered low- or high-risk, and some women choose to have a community birth despite potential risks, said Marit Bovbjerg, a clinical assistant professor of epidemiology at Oregon State University and lead author of the study.

Medical ethics and the tenets of maternal autonomy dictate that women be allowed to decide where and how they wish to give birth. That’s why it’s important to have as much information as possible about potential risks, said Bovbjerg, who works in the College of Public Health and Human Sciences at OSU.

There are also risks associated with hospital births, such as increased interventions, which means there aren’t always clear answers when it comes to determining the best and safest place to give birth, said Melissa Cheyney, a medical anthropologist and associate professor in OSU’s College of Liberal Arts.

The goal of the research was to better understand the outcomes for women and babies with some of the most common pregnancy risk factors, to see how those risk factors affected outcomes.

“There’s a middle or gray area, in terms of risk, where the risk associated with community birth is only slightly elevated relative to a completely low-risk sample,” Cheyney said. “We’re trying to get more information about births that fall in that middle zone so that clinicians and pregnant women can have the best evidence available when deciding where to give birth.”

The findings were published recently in the journal Birth. Other co-authors are Jennifer Brown of University of California, Davis; and Kim J. Cox and Lawrence Leeman of the University of New Mexico. Using birth outcome data collected by the Midwives Alliance of North America Statistics Project, commonly referred to as MANA Stats, the researchers analyzed more than 47,000 midwife-attended community births.

They looked specifically at the independent contributions to birth outcomes of 10 common risk factors: primiparity, or giving birth for the first time; advanced maternal age, or mother over age 35; obesity; gestational diabetes; preeclampsia; post-term pregnancy, or more than 42 weeks gestation; twins; breech presentation; history of both cesarean and vaginal birth; and history of only cesarean birth.

The last two groups are both considered VBACs and hospital policies and state regulations for midwifery practice usually make no distinction between the two types. However, the researchers found a clear distinction between the two groups in terms of community birth outcomes.

Women who delivered vaginally after a previous cesarean and also had a history of previous vaginal birth had better outcomes even than those women giving birth for the first time. On the other hand, women who had never given birth to a child vaginally had an increased risk of poor outcomes in community birth settings.

“That finding suggests that current policies that universally discourage VBAC should be revisited, as the evidence does not support them,” Bovbjerg said. “Women who in the past have successfully delivered vaginally seem to do just fine the next time around, even if they have also had a previous C-section. That’s really important because some medical groups totally oppose VBACs, even in hospital settings, and many hospitals don’t offer the option of a VBAC at all.”

Researchers also found that women whose babies were in breech position had the highest rate of adverse outcome when giving birth at home or in a birth center.

There was only a slight increase in poor outcomes for women over age 35, or women who were overweight or obese, compared to those without those risk factors. In some categories, there were not enough births in the data set to properly evaluate a risk’s impact, such as with gestational diabetes and preeclampsia.

“As is appropriate, women who face high complication risks such as preeclampsia tend to plan for and choose a hospital birth, rather than a community birth,” Bovbjerg said. “But even for these women, it’s important to remember that they can choose a community birth if their faith, culture or other considerations dictate that is the best choice for them.”

The researchers emphasized that the new information about risks and outcomes can serve as an important tool in decision-making for families making very personal choices about where to give birth. “These findings help us to put information and evidence, rather than fear, at the center of discussions around informed, shared decision-making between expectant families and their health care providers,” Cheyney said.

Researchers next plan to examine how the healthcare culture and standards of care in different locations within the U.S. affect outcomes of home and birthing center deliveries.


Story Source:

Materials provided by Oregon State University. Note: Content may be edited for style and length.


Journal Reference:

  1. Marit L. Bovbjerg, Melissa Cheyney, Jennifer Brown, Kim J. Cox, Lawrence Leeman. Perspectives on risk: Assessment of risk profiles and outcomes among women planning community birth in the United States. Birth, 2017; DOI: 10.1111/birt.12288

Read this article on Science Daily: www.sciencedaily.com/releases/2017/04/170413154439.htm.

Mother’s folic acid intake during pregnancy may decrease hypertension risk in children

Avocado – rich in folic acid.

A new article published in the American Journal of Hypertension finds that babies born to mothers with cardiometabolic risk factors were less likely to develop high blood pressure if their mothers had higher levels of folate during pregnancy.

Since the late 1980s, the prevalence of childhood elevated blood pressure has increased in the United States, in particular among African Americans. From a life course perspective, childhood high blood pressure can predict higher blood pressure values later in life, and people with higher blood pressure are at greater risk of developing cardiovascular, metabolic and kidney disease and stroke. Research has also shown that maternal cardiometabolic risk factors during pregnancy — including hypertensive disorders, diabetes, and obesity — are associated with higher offspring blood pressure.

Because controlling hypertension and cardiovascular disease in adults is difficult and expensive, identifying early-life factors for the prevention of high blood pressure may be an important and cost effective public health strategy.

There is growing evidence that maternal nutrition during pregnancy, through its impact on the fetal intrauterine environment, may influence offspring cardiometabolic health. Folate, which is involved in nucleic acid synthesis, gene expression, and cellular growth, is particularly important.

In young adults, higher folic acid intake has been associated with a lower incidence of hypertension later in life. Citrus juices and dark green vegetables are good sources of folic acid. However, the role of maternal folate levels, alone or in combination with maternal cardiometabolic risk factors on child blood pressure has not been examined in a prospective birth cohort.

In the current study, researchers analyzed the data from a prospective U.S. urban birth cohort, enriched by low-income racial and ethnic minorities at high risk for elevated BP, to examine whether maternal folic acid levels and cardiometabolic risk factors individually and jointly affect offspring blood pressure.

Researchers included 1290 mother-child pairs, 67.8% of which were Black and 19.2% of which were Hispanic, recruited at birth and followed prospectively up to age 9 years from 2003 to 2014 at the Boston Medical Center. Of the mothers, 38.2% had one or more cardiometabolic risk factors; 14.6% had hypertensive disorders, 11.1% had diabetes, and 25.1% had pre-pregnancy obesity. A total of 28.7% of children had elevated systolic blood pressure at age 3-9 years. Children with higher systolic blood pressure were more likely to have mothers with pre-pregnancy obesity, hypertensive disorders, and diabetes. Children with elevated systolic blood pressure were also more likely to have lower birth weight, lower gestational age, and higher BMI.

The study findings suggest that higher levels of maternal folic acid may help counteract the adverse associations of maternal cardiometabolic risk factors with child systolic blood pressure, although maternal folic acid levels alone were not associated with child systolic blood pressure. Among children born to mothers with any of the cardiometabolic risk factors, those whose mothers had folic acid levels above the median had 40% lower odds of elevated childhood systolic blood pressure. These associations did not differ appreciably in analyses restricted to African Americans, and they were not explained by gestational age, size at birth, child postnatal folate levels or breastfeeding.

“Our study adds further evidence on the early life origins of high blood pressure,” said Dr. Xiaobin Wang, the study’s senior corresponding author. “Our findings raise the possibility that early risk assessment and intervention before conception and during pregnancy may lead to new ways to prevent high blood pressure and its consequences across lifespan and generations.”


Story Source:

Materials provided by Oxford University Press USA. Note: Content may be edited for style and length.


Journal Reference:

  1. Hongjian Wang, Noel T. Mueller, Jianping Li, Ninglin Sun, Yong Huo, Fazheng Ren, Xiaobin Wang. Association of Maternal Plasma Folate and Cardiometabolic Risk Factors in Pregnancy with Elevated Blood Pressure of Offspring in Childhood. American Journal of Hypertension, 2017; DOI: 10.1093/ajh/hpx003

Cite This Page:

Oxford University Press USA. “High folic acid level in pregnancy may decrease high blood pressure in children.” ScienceDaily. ScienceDaily, 8 March 2017. <www.sciencedaily.com/releases/2017/03/170308081047.htm>.

Most Women of Child Bearing Age Lack Knowledge of Healthy Diet Says New Study

Dr. Lela Emad of the Women’s OB/GYN Medical Group discusses the latest findings on diet and nutrition among women and offers some guidelines for women planning for pregnancy.

A new study by the University of Pittsburgh Schools of the Health Sciences uncovers a national trend toward a less than optimal diet among women prior to pregnancy. “This information is particularly concerning for women who intend to conceive,” says Dr. Lela Emad of the Women’s OB/GYN Medical Group of Santa Rosa. “It’s imperative that prior to pregnancy, women follow a higher standard of nutrition for several reasons; to ensure healthy growth of the fetus, to reduce risks associated with premature birth, and to avoid the possibility of preeclampsia and maternal obesity – both of which carry added risks to the mother and baby.”

The study, published in the Journal of the Academy of Nutrition and Dietetics, assessed more than 7,500 women participants using the Healthy Eating Index-2010, measuring quality of diet including the intake for key food groups, while also measuring the consumption of less desirable aspects of a typical American diet such as refined grains, salt and calories from solid fats and sugars from food as well as from alcohol consumption.

Ultimately, more than a third of the calories the women in the study consumed came from ‘empty calories’ from such things as;

  • sugar-sweetened beverages,
  • pasta dishes
  • grain desserts
  • Soda
  • beer, wine and spirits

“This list consists of just about everything we would recommend a woman who was in a preconception phase to avoid,” Dr. Emad points out. “A healthy diet goes a long way toward ensuring a healthy pregnancy, and planning ahead for pregnancy by participating in a Preconception Healthcare Plan is one of the best things a woman can do both for her baby and for herself.”

What is Preconception Healthcare

Preconception healthcare describes medical care provided to a woman that is designed to increase the chances of having a positive pregnancy experience and a healthy baby. Preconception healthcare is uniquely designed for every individual, customized for personal needs and circumstances. It typically offers an introduction to guidelines for a healthy diet as part of the overall education and planning process.

“We encourage parents – that is, both parents – to begin making healthy lifestyle changes up to one full year prior to trying to get pregnant,” explains Dr. Emad. “This process improves a woman’s chances of becoming pregnant and prepares her body so it can provide the best environment for her infant.” During a preconception care visit, the OB/GYN healthcare provider will focus on lifestyle, medical and family history, previous pregnancies and currently prescribed medications. In addition to diet and exercise, topics may include alcohol, tobacco, and caffeine use; recreational drug use, birth control, family histories, genetics as well as health issues and other concerns (diabetes, high blood pressure, depression, obesity, etc.)

Healthy Diet and Supplements

“We also encourage our patients and their families to adopt a nutrient rich and calorie conscious diet prior to and during pregnancy. This is the best way to prevent excessive weight gain and cut the potential risk of obstetric complications,” says Dr. Emad. “Planning ahead and taking steps to ensure optimal pre-pregnancy health is a great way to create a healthy family.”

Learning how to make smart food choices as well as being mindful about food preparation is important, as is knowing which foods to avoid or limit during pregnancy. Foods that contain sources of folic acid (vitamin B9) are important nutritional elements to incorporate into both the preconception and pregnancy diet. Folic acid helps to prevent some birth defects – particularly those affecting the brain and spinal cord. Folic acid is best taken before pregnancy and in the very early stages of pregnancy.

Although the bulk of nutrients should ideally come from eating fresh healthy foods, it is generally recommended that women start taking a prenatal vitamin supplement before pregnancy. Prenatal vitamin supplements are specifically formulated to contain all the recommended daily vitamins and minerals needed before and during pregnancy.

About Women’s OBGYN Medical Group

The Women’s OB/GYN Medical Group strives to better the lives of all women with a holistic approach to women’s health. To learn more about these fine physicians and the many services provided by the Women’s OB/GYN Medical Group visit the website. Call for an appointment at (707) 579-1102.

Researchers find Vitamin B3 beneficial for pregnant women to treat preeclampsia, prevent strokes

Vitamin B3 nicotinamide may help treat pregnant women who suffer from preeclampsia by preventing strokes and in some cases, even stimulating the growth of their fetus, research indicates.

Scientists in Japan and the US have found that vitamin B3 nicotinamide may help treat pregnant women who suffer from preeclampsia by preventing strokes and in some cases, even stimulating the growth of their fetus.

Up to 8% of pregnant women suffer from preeclampsia, a deadly disease characterized by high blood pressure, blood vessel damage, high levels of protein in the urine and fluid retention that causes swelling in the legs and feet. In some cases, preeclampsia is also believed to restrict a fetus’ growth.

Blood pressure-lowering drugs do not improve blood vessel damage. In fact, they reduce blood supply to the babies, which could lead to fetal death.

Until now, the only treatment for preeclampsia-affected pregnant women has been delivery of the baby. Now, researchers at Tohoku University, in collaboration with US scientists, have found that nicotinamide — also referred to as Vitamin B3 — relieves preeclampsia in mouse models. Moreover, they have also discovered that nicotinamide can even improve fetal growth in mothers with preeclampsia.

“We had previously shown that endothelin, a strong vessel narrowing hormone, worsens preeclampsia. But inhibiting the hormone is harmful to the babies,” says Associate Professor Nobuyuki Takahashi of Tohoku University’s Graduate School of Pharmaceutical Sciences, who co-led the study.

“In contrast, nicotinamide is generally safe to mothers and babies, corrects the blood vessel narrowing effect of endothelin, and reduces stress to the babies. Accordingly, we evaluated the effects of nicotinamide using two mouse models of preeclampsia caused by different mechanisms.”

The researchers concluded that nicotinamide is the first safe drug that lowers blood pressure, reduces urine protein and alleviates blood vessel damage in preeclampsia-affected mice. The researchers went on to show that in many cases, nicotinamide also prevents miscarriage, prolongs pregnancy period and improves the growth of the babies in mice with preeclampsia.

“Nicotinamide merits evaluation for preventing and treating preeclampsia in humans,” says Oliver Smithies, a Weatherspoon Eminent Distinguished Professor at the University of North Carolina at Chapel Hill. Smithies is a Nobel Laureate in Physiology or Medicine, and co-leader of this study.

The research team hopes that if the treatment works in humans, nicotinamide could help treat preeclampsia and prevent fetal growth restriction associated with the disease in pregnant women.

Journal Reference:

  1. Feng Li, Tomofumi Fushima, Gen Oyanagi, H. W. Davin Townley-Tilson, Emiko Sato, Hironobu Nakada, Yuji Oe, John R. Hagaman, Jennifer Wilder, Manyu Li, Akiyo Sekimoto, Daisuke Saigusa, Hiroshi Sato, Sadayoshi Ito, J. Charles Jennette, Nobuyo Maeda, S. Ananth Karumanchi, Oliver Smithies, Nobuyuki Takahashi. Nicotinamide benefits both mothers and pups in two contrasting mouse models of preeclampsia. Proceedings of the National Academy of Sciences, 2016; 113 (47): 13450 DOI: 10.1073/pnas.1614947113

Read this article on Science daily:  “Potential treatment for pregnant women who suffer from preeclampsia found in a vitamin.” ScienceDaily. ScienceDaily, 19 December 2016. <www.sciencedaily.com/releases/2016/12/161219100556.htm>.

Introducing Kirsten Eckert, CNM – Women’s OB/GYN Medical Group’s Newest Provider

DrKirsten Eckert is a certified nurse midwife (CNM) and Women’s Health Nurse Practitioner (WHNP).  She graduated in 2010 from UCLA with a BS in paleo biology and geology.  While at UCLA, she taught sex education with the Los Angeles Unified School District and decided to pursue her interests in women’s health care and education.

Kirsten then received her MSN from Yale University in 2014 with a specialty in midwifery.  She is excited to be back in her home state providing full scope midwifery care with this group of outstanding women and providers.  She is honored and blessed to be able to help women be active and empowered decision-makers during their pregnancies and confidently give birth.

In her free time, Kirsten enjoys hiking, rock climbing, and throwing pottery.

A Mother’s High-fat and Sugar Diet Now Thought to Affect Generations

Dr. Lela Emad of the Women’s OB/GYN Medical Group shares some insight into a recent study pertaining to maternal nutrition and how a mother’s poor diet may predispose children to obesity

A new study from Washington University School of Medicine in St. Louis points to the likelihood that a mother’s high-fat, high-sugar diet can impact not just immediate offspring with genetic abnormalities and chronic health conditions, but as many as three generations into the future.

According to results of this research, regardless of whether offspring of an overweight mother opt to consume healthy diets themselves – their lifetime heath will be affected with potentials for obesity-related conditions such as heart disease and diabetes. The unique factor in this study revealed that even before becoming pregnant, a woman’s lifelong obesity can cause health issues for future generations. Researchers say that this study should serve as a wake-up call for U.S. women of child-bearing age as more than two-thirds are currently overweight or obese.

“Findings such as these help to point out that eating a healthy diet every day as well as during pregnancy is one of the best things women can do for themselves and their baby,” says Dr. Lela Emad of Women’s OB/GYN Medical Group in Santa Rosa, California.

When Eating for Two is Too Much

The amount of weight a woman should gain during pregnancy depends on what her body mass index (BMI) was before becoming pregnant. As a general rule, pregnant women need to consume more protein and calcium, take appropriate vitamins and mineral supplements (folic acid and iron in particular), and consume more calories.

But eating better doesn’t necessarily mean over-eating. Women who start off at a healthy weight need to consume only about 340 extra calories a day during the second trimester and about 450 extra calories per day during the third trimester. Women who are underweight or overweight at the beginning of pregnancy require some adjustment to the average, depending on individual weight gain goals. Consulting with an OB/GYN healthcare provider is the best way to determine projections for healthy weight gain during pregnancy.

“Obviously, the food a mother consumes while pregnant is the baby’s main source of nutrition. And by making healthy lifelong food choices combined with an eye toward eating nutritiously during pregnancy a woman can have a positive impact on her baby’s health as well as potentially; her grandchildren’s children,” points out Dr. Emad.

Women who are overweight or obese before pregnancy are also expected to gain a certain amount of weight during pregnancy, but according to recent studies – women who are obese can safely gain less weight than the guidelines recommend. A healthcare provider will determine what’s best for each case and will also help manage weight throughout pregnancy.

Overweight Mothers Are at Risk

In addition to affecting the health of a baby, women who are overweight before pregnancy are also at an increased risk of developing various pregnancy complications, including gestational diabetes and high blood pressure.  According to the Centers for Disease Control and Prevention pregnant women who are obese are more susceptible to complications including preeclampsia, GDM, stillbirth and cesarean delivery. CDC research shows that obesity during pregnancy is associated with an increase in the need for healthcare services, and can result in longer hospital stays for delivery. But the good news is; overweight women who lose weight before pregnancy are much more likely to have healthier pregnancies.

According to Dr. Emad, when women are thinking about having a baby it is best to begin making healthy lifestyle changes at least one full year prior to trying to get pregnant. This process improves the chances of becoming pregnant sooner and prepares a woman’s body to provide the best environment for her infant – nutrition, exercise and a healthy weight are all key factors in planning ahead. “Eating nutritiously is a good choice for any woman to make, but particularly important for a woman who is considering having a baby – one that can potentially impact the health of her family for generations to come,” says Dr. Emad.

About Women’s OBGYN Medical Group

The provider team of expert OB/GYN physicians, certified nurse midwives, family nurse practitioners, and medical assistants provides unmatched care to patients in our region. As women proudly serving women, we understand the needs and expectations of our patients. For more information, call (707) 579-1102 or visit our website.

World Health Day: Getting an early start on a lifetime of good health

Women should be very careful and observant of any change in their body. Any kind of abnormal hair growth on the face, chest or neck, sudden weight gain or weight loss, hair fall, irregular periods – all of these are warning signs, alerting a women that it’s time to see a gynecologist.

Being a woman is not easy. Not only is today’s woman fulfilling her traditional duties, but also taking up much more onto her plate. She is a mother, an entrepreneur, a dreamer, an achiever and also a support system for her family. In the constant flux of striking a balance between all her worlds, most often, it is her health which takes a hit.

Age plays a huge role for women’s health and well-being. As we grow older, the body undergoes many changes. But like the saying goes, there’s nothing like starting early, therefore, health experts always advice that twenties is a crucial time for women to start thinking of their health.

A woman is in her prime during her twenties, a phase where she has a chance to build her reservoir of good health and brace-up for the many challenging experiences later on in life, such as childbirth. It is the time when she needs to start making careful health choices, as how she fares in her later years depends hugely on her twenties or even earlier. In fact, recent research studies have reported that our adolescence plays an equally crucial role.

Read the full story …

Considering Pregnancy? Men’s pre-conception caffeine consumption may play a role in miscarriages …

For women, drinking more than two caffeinated drinks daily before getting pregnant was associated with a 74 percent higher risk of a miscarriage, according to the study published today (March 24) in the journal Fertility and Sterility.

But women’s caffeine consumption wasn’t the only factor: Among couples in which the male partner drank more than two caffeinated beverages daily before conception, there was a 73 percent higher risk of a miscarriage, according to the study.

“Our findings indicate that the male partner matters, too,” Germaine Buck Louis, the director of Intramural Population Health Research at the National Institute of Child Health and Development and lead author on the study, said in a statement. “Male pre-conception consumption of caffeinated beverages was just as strongly associated with pregnancy loss as females’,” Buck Louis said. Read the full story …

What to Expect with Routine Pregnancy Check-ups

Regularly scheduled pregnancy check-ups allow you and your physician to determine the best, personalized pregnancy care for your individual body and lifestyle, as well as to track both your health and the health of your baby. Like every woman’s individual body, every pregnancy is unique. Regularly scheduled pregnancy check-ups allow you and your physician to determine the best, personalized pregnancy care for your individual body and lifestyle, as well as to track both your health and the health of your baby. We understand that many women remain very active during their pregnancies and we are happy to work with you to schedule appointments with our physicians and midwives that will fit with your day.

Pregnancy Check-up Timeline

While no two pregnancies will ever be exactly the same, the following information will help prepare you for what to expect at your check-ups based on the stage of your pregnancy. Our physicians and certified nurse midwives will perform standard evaluations of you and your baby and check for abnormalities throughout your pregnancy, with heightened vigilance during stages of increased risk.

First Trimester: 0 to 12 Weeks

What to expect at your first visit:

  • A thorough physical exam and review of your medical history.
  • An ultrasound to confirm your due date (when to expect you will go into labor).
  • Blood work and standard cultures for Chlamydia and gonorrhea.
  • A pap smear, unless you’ve had one recently.
  • Arrangement to consult with a specialist (if certain risk factors are present).
  • A request to see your old medical records (if needed).

What to expect after your first visit (every three to four weeks during first trimester):

  • Documentation and tracking of your blood pressure and weight.
  • Testing your urine for protein and glucose.
  • Answers to some of your questions as your doctor will have more information about your baby.
  • An early ultrasound may be performed if there is suspected risk involved in your pregnancy

Second Trimester: 12 to 24 Weeks

Visits generally scheduled every three to four weeks:

  • An examination of fetal heart tones (your baby’s heartbeat)
  • Alpha-fetoprotein (AFP) screening between weeks 16 and 18. Your doctor will also determine fetal growth at this time. Your doctor will also refer you to prenatal classes at your hospital or through private instruction if you are not enrolled in them already.
  • The anatomy scan ultrasound is generally performed between 18 and 22 weeks of pregnancy, and the sex of the baby may be determined at this time.
  • If you require any surgery related to your pregnancy, your provider will most likely schedule it during this trimester.

Third Trimester: 24 Weeks to Delivery

Visits generally scheduled every two to three weeks:

  • A glucola screen for gestational diabetes at 26 weeks

Visits generally scheduled weekly from 36 weeks until delivery:

  • A group B strep vaginal culture (a test for Group B Strep bacteria) at 35-36 weeks. Your provider will also discuss signs of preterm labor and begin monitoring them if indicated.
  • At 36 weeks, your doctor will determine the fetal position (this is the time a baby usually locks into position). If the baby is suspected to be breech (head facing away from the vagina) in the third trimester, your provider may perform an ultrasound.
  • Your provider may perform an external cephalic version if your baby is breech, or recommend some home exercises that may help move the baby into a vertex (head-first) position.
  • Weekly cervical checks.
  • At 39 weeks your provider may offer birth induction.
  • 40 weeks marks a complete term. If you’ve not yet had your baby, expect more frequent visits with your provider. Your doctor may offer to induce labor if your cervix is ripe.
  • If labor has not occurred by 41-42 weeks, expect to be induced. Inducing labor at this point is necessary to minimize risks to yourself and the baby.

The Women’s OB/GYN Medical Group strives to better the lives of all women with a holistic approach to women’s health. Call for an appointment today: (707) 579-1102.

Northern California Medical Associates (NCMA) Proudly Welcomes Women’s OB/GYN Medical Group

In keeping with its goal of providing Northern California with a comprehensive network of state-of-the-art health services from leading specialists in a full-spectrum of medical fields, Northern California Medical Associates (NCMA) is proud to welcome Women’s OB/GYN Medical Group to its ever-growing practice.

For nearly 25 years, Women’s OB/GYN Medical Group has offered a full range of premier obstetrics and gynecology services to women of all ages in the North Bay region. The practice’s care team is made up of compassionate, expert doctors, midwives, nurses, and medical assistants that strives to meet all patients’ OB/GYN health care needs in a comfortable environment close to home. Services offered at Women’s OB/GYN include general gynecological health screenings, state-of-the-art diagnostics, contraception management, comprehensive pregnancy and postpartum care, minimally invasive laparoscopic surgery, uro-gynecological procedures, incontinence care, menopause care, laser hair removal and skin care.

Women’s OB/GYN Medical Group’s four elite physicians include Lela Emad, MD, Susan Logan, MD, Amita Kachru, MD, and Shazah Khawaja, MD. The doctors at this practice share in the whole-body care philosophy, meaning that they always strive to find the underlying causes of a woman’s health problems rather than simply treating the symptoms. The team of health professionals at Women’s OB/GYN is committed to both alleviating short-term ailments and maximizing long-term health.

Women’s OB/GYN Medical Group, located at 500 Doyle Park Drive, Ste. 103 in Santa Rosa, is an affiliate of Sutter Medical Center of Santa Rosa and Santa Rosa Memorial Hospital (SRMH). The partnership with NCMA strengthens Women’s OB/GYN’s network of experienced healthcare providers, directly benefitting patient access to healthcare specialists in the area. The practice is currently accepting new patients. For more information visit us at womensobgynmed.com. To start care with a knowledgeable OB/GYN physician who will always treat you with compassion and expertise, call 707-579-1102 to schedule an appointment today.