Category Archives: Pregnancy

black and white photo of pregnant woman sitting on a couch

Hematomas During Pregnancy

In the medical world, hema means blood and toma means swelling. A hematoma, then, is an area of the body where blood pools in tissue instead of in the blood vessels where it is supposed to be.  This can be caused by a severe injury that breaks a lot of blood vessels.

During pregnancy, a hematoma can form between the chorion, a membrane surrounding the embryo and the uterine wall. This is called chorionic hematoma and it occurs in about 3 percent of all pregnancies (3 in 100). This condition is the most commonly seen pregnancy-related hematoma and is the most common cause of first trimester bleeding. Hematomas during pregnancy have no known cause. One theory is that the egg might slightly separate from the uterus during development, which can lead to a tear.

There are other places in the womb where hematomas can occur. Most of the time, women don’t realize they are experiencing a problem. Most women have no symptoms of pregnancy-related hematomas. If they do have symptoms, they are likely to notice blood in the vagina and abdominal pain. Later in pregnancy, women may experience premature labor.

Diagnosis of hematomas during pregnancy

Since hematomas often have no symptoms, an ultrasound exam which shows bleeding leads to diagnosis. If you experience vaginal bleeding during your pregnancy, let your doctor know. He or she will likely request ultrasound imaging.

During pregnancy, it is easy to feel like there are so many things that can go wrong with the developing baby and their health. One of the most important things to remember is that there is a wide range of what is normal for women to experience during pregnancy. This can mean physical sensations and even pain, emotional and mood changes, and health-related concerns.

Talk to your doctor about what is normal during pregnancy. If you have a good sense of what the normal range is, you can begin to notice if you are experiencing something that does not seem to fall within that normal range. The doctors at Pacific Women’s Center strive to develop the kinds of relationships that their patients always feel comfortable talking about anything that she may be experiencing.

Treatment of hematomas during pregnancy

Treatment varies and depends on the doctor and the severity of the hematoma and the stage of pregnancy. Refraining from sexual intercourse and bed rest are possibilities. Also, you may be able to continue your normal routine. There is no surgical treatment for hematomas during pregnancy. Blood thinners may be requested. Or, the doctor may have a “wait and see” approach and not prescribe treatment until it truly seems like it is needed.

There is low to medium low to medium risk to the pregnancy with this condition. In most cases, the body absorbs the hematoma and the pregnancy continues on normally.

Doctor and patient consulting on a table about women health. Medical concept. Selective focus at patient's hands.

Severe Morning Sickness – What is Hyperemisis Gravidarum?

Some nausea and vomiting during the earlier stages of pregnancy is common. The discomfort is caused by levels of pregnancy hormones, specifically hCG, (human chorionic gonadotropin, the hormone responsible for helping to build your baby’s placenta) and estrogen in a woman’s body. Both of these increase rapidly during pregnacy. Hyperemisis Gravidarum is known as severe morning sickness. It is nausea and vomiting that goes beyond what is considered a normal level.

It might be Hyperemisis Gravidarum if:

  • You are vomiting multiple times per day
  • Food or liquid comes back up
  • You feel lightheaded
  • You show signs of dehydration (not urinating, dark yellow urine)
  • You’re losing weight
  • You see blood in the vomit
  • You have low blood pressure or a high pulse rate

Hyperemisis Gravidarum occurs in less than one in 200 pregnancies. For those women, severe and continuous nausea and vomiting that becomes debilitating because it interferes with a woman’s ability to eat, drink, sleep, and work. Like most medical conditions, its Latin name describes what it is: The term comes from the Greek hyper-, meaning excessive, and emesis, meaning vomiting. Gravidarum means “pregnant woman.” The grav- part of the word means “heavy,” as in the English word “gravity.”

Severe cases can lead to extreme weight loss, malnutrition in both the mom and baby, and dehydration. Since the baby is affected by the mother’s inability to eat, hospitalization may be needed.

When does Hyperemisis Gravidarum start?

Severe morning sickness usually starts in the first trimester at around week 4 or 5 of pregnancy. Typical morning sickness usually starts around week 6. Hyperemisis Gravidarum can sometimes clear up on its own between weeks 12 and 20. In some cases, though, it can continue throughout a pregnancy.

Severe morning sickness seems to be most common in first-time mothers, very young mothers, and mothers carrying multiple babies. If a woman has had Hyperemisis Gravidarum with a previous pregnancy, she is more likely to have it with subsequent pregnancies. Also, women whose mothers had severe morning sickness are also more likely to have it themselves.

How can you avoid severe morning sickness?

Although it’s a mystery why some women get this and others don’t, there are some things that research tells us contributes to severe morning sickness. Severe emotional stress can be a factor. If you are experiencing an extremely stressful life situation, let your doctor know. Your doctor will be able to make suggestions on how to deal with or possibly improve the situation to remove the stress.

Hormonal imbalances or diseases that cause hormonal imbalance, such as polycystic ovarian syndrome, can increase your risk of severe morning sickness. Vitamin deficiencies or a bacterial stomach infection can also play a role. Looking at a woman’s overall physical and mental health is an important part of diagnosing and treating Hyperemisis Gravidarum.

How can you treat Hyperemisis Gravidarum?

Try traditional treatments for nausea first. This may include eating ginger or drinking ginger tea. Any foods or drinks that are disagreeable to you (make you feel sick) should be avoided. Although with Hyperemisis Gravidarum it can seem like everything makes you feel sick! Drink fluids regularly to avoid becoming dehydrated. There are some prescription medications for anti-nausea that you and your doctor can talk about.

Cropped image of beautiful pregnant woman stroking her tummy and holding a sonogram, on gray background

Pregnancy Back Pain

While some women are lucky enough to not have many problems with nausea or morning sickness during pregnancy, nearly all women experience pregnancy back pain. It’s almost unavoidable, since a woman’s body is changing so much during pregnancy and the growing baby offsets a woman’s center of balance. She holds her body differently, carries bags or car seats differently, and may not be able to get comfortable during daily activities, which can make the pregnancy back pain worse.

Back pain during pregnancy often starts during the late second trimester, when the baby is larger. A few different factors cause pregnancy back pain. Fortunately, there are numerous ways to help deal with and treat pregnancy back pain.

Causes of Pregnancy back pain

Weight gain: As your baby grows and your body responds, your spine must support whatever extra weight you gain. Weight gain is natural and normal during pregnancy. If your doctor says it is ok for you to exercise, getting regular activity and stretching your muscles can help. A healthy weight can help keep your back pain in check.
Posture: You are carrying your body differently during pregnancy. Your doctor can talk with you about how to move your body when going about your daily activities that will put the least amount of strain on your back and help you move most efficiently. Your doctor can recommend stabilization exercises where your body can strengthen certain key muscles that influence back pain.

Changes to your pelvic muscles and ligaments: As your body slowly prepares itself for delivery, the muscles and ligaments relax and change. Massage or other tissue work can help with the pain of pregnancy back pain that is caused by this.

Hormonal changes: During pregnancy, the body makes a hormone called relaxin. This hormone allows the ligaments in the pelvis to relax and loosen in preparation for delivery. Everything is connected to the spine, so this relaxation in combination with increased weight change the shape of the spine and can make it harder for the spine to support the torso and keep your body stable.

Treatments for pregnancy back pain

Luckily, back pain during pregnancy is temporary! It will go away after delivery. Pain relievers should be used carefully during pregnancy and your doctor will need to speak with you about that. You can self-treat pregnancy back pain in ways that are similar to ways that you might treat menstrual cramping.

Hot pads, hot water bottles and cold packs could be used. Paying attention to good posture can help. Healthy, safe exercise can help. Managing your stress in ways that help you feel better can also help. Acupuncture can help. Talk with your doctor about the ways that you can treat your back pain in ways that will not have an affect on your pregnancy.

At our office in Eugene, Oregon, we can educate you on everything you can do to ease your back pain. Our incredible staff of obstetricians at Pacific Women’s Center has years of experience helping women enjoy their pregnancy as much as possible.

Give us a call at 541-342-8616 or Contact Us online today to make an appointment. Pregnancy is an incredible experience and you deserve to feel your best throughout every moment.

Husbands and their pregnant wives at a prenatal class

Childbirth Classes in Eugene

For future moms and dads, the knowledge that nine months into the future a baby will arrive can be a happy and exciting time. It can be a confusing and uncertain time. Pacific Women’s Center offers childbirth classes in Eugene, and these classes are a great way to learn and prepare for the birth.

We hold our childbirth classes in Eugene at Pacific Women’s Center on Coburg Road. Throughout the course of the class, we will explain what your body will experience as your time of pregnancy ends. You will learn to identify the signs of labor. After the class, you should feel confident about knowing when it is time to go to the hospital.

Participants in the childbirth class will get to discuss options for pain relief that might include medications and how they work, relaxation and breathing techniques, how to position your body, and more. This is not a “specific” type of birthing classes for breathing techniques and labor exercises. As in, we don’t teach any specific “method” of labor and delivery. We cover both vaginal and abdominal births in a way that answers your questions and leaves you feeling informed. It is our hope for you to feel relaxed and ready for your exciting adventure.

Two-part Childbirth Classes in Eugene

The childbirth classes in Eugene are in two parts. It allows both mothers- and fathers-to-be to share their hopes and expectations in a supported environment. We encourage discussion and participation. Pacific Women’s Center holds childbirth education classes in Eugene on Monday nights from 6 to 8 pm. Please contact our office 541-342-8616 to schedule an appointment or schedule at the time of your next obstetrical visit. The $20 charge covers four hours of childbirth classes in Eugene at our location, and two participants. We’re excited to see you!

Male doctor sitting with female patient by window, side view

What to Know About Tubal Reversal in Eugene

If you had a tubal ligation, this means that your fallopian tubes were “tied” in some way, whether by blockage (being clamped closed with rings or clips), being tied, or being cut to close them. The idea behind this is that the closure of the tubes stops eggs from traveling from the ovaries into the fallopian tubes. The egg is normally fertilized by sperm in the fallopian tube.

Tubal ligation is considered to be a permanent form of birth control for women. But there is a procedure known as tubal reversal. Gynecology doctors such as those at Pacific Women’s Center can offer tubal reversal in Eugene.

What happens in a tubal reversal?

In a tubal reversal, the fallopian tubes will be re-opened. Depending on the method that was used to close them, they may be untied, reconnected or unblocked. A doctor’s willingness to do this tubal reversal procedure often depends on the reason why the procedure was done in the first place. Also, how old the woman was when it was done. Women who have the procedure thinking that they will never want children do change their minds as they get older. It is possible that this tubal reversal procedure will allow them the opportunity to become pregnant.

The doctor will want to ask you what type of surgery you had to have the tubal ligation. If you have ever been pregnant before and the outcome of that pregnancy is important for the doctor to know. Certain pelvic issues such as endometriosis or fibroids can cause scar tissue. This may be hard to overcome in a tubal reversal. The doctor will also want to review your previous hospital records.

If you have had a tubal ligation and want to become pregnant following a tubal reversal, it would be a good idea to have your partner examined. Ruling out an infertility issue in your partner could be the first step to making sure that you have the ability to get pregnant even if you do have the tubal reversal. Twenty to 40 percent of infertility issues in couples are caused by an issue with the man.

Recovery after a tubal reversal

Tubal reversal is generally a hospital or outpatient procedure. You’ll receive general anesthesia while your doctor uses a laparoscope to look into your pelvic area. If the doctor sees a promising situation for a reversal, he or she will then make a small incision. The incision allows them to access the area where the tubes are blocked and to make the reconnection. After the surgery, you may be allowed to go home, but you will be uncomfortable and will have a recovery period of up to four weeks before you can return to full activity.

The doctors at Pacific Women’s Center in Eugene, Oregon have experience in tubal reversal. Our doctors serve women through the full range of their life changes, from their teenage years to prenatal care, through pregnancy and birth and menopause and beyond. Talk to us, we’re here to help you!

Hands of doctor examining a pregnant woman

Obstetrics and Pregnancy Care in Eugene

You have some choices for what doctor to choose to help you during your obstetrics and pregnancy care in Eugene. Finding the right doctor to help you is an important part of helping the birth process to go as smoothly as possible.

Write down the qualities you want for your obstetrics and pregnancy care. You might start by asking yourself some basic questions such as whether you want a male or female doctor. Some gynecologists don’t practice obstetrics, so if you’re just choosing a gynecologist for the first time, you might ask yourself how important it is that you be able to go through the whole pregnancy and birth experience with the same care provider. All of the doctors at Pacific Women’s Center in Eugene have experience in obstetrics, gynecology and infertility. (Dr. Betterton is the only one of our doctors at this time who no longer delivers babies.)

At Pacific Women’s Center, our services encompass the whole range of needs of women throughout their lives. Our clinic can provide infertility care, prenatal care, surgical services, contraception, birthing services, classes and more!

Questions to ask yourself about your Eugene OBGYN care:

  • Do you prefer a male or female provider?
  • Should your care provider offer both obstetrics and gynecology?
  • Is your pregnancy and birth at risk for being high-risk? Some ob-gyns have special training in high-risk pregnancies and births.
  • Ask your doctor what his or her views are on pain management during labor. Is it important to you to have a doctor that is pro-natural birth? Are you OK with being offered epidurals and other pain management procedures during labor?
  • Who will deliver you if your doctor is not available?
  • Ask what the doctor’s Caesarean section rate is.
  • Does your doctor offer VBAC, a vaginal birth after caesarean, option?
  • The obstetrician you choose should have hospital rights at the hospital you want to go to when it is time for your birth.

All of these questions are designed to help you find a doctor that you feel comfortable with. Open, honest communication with a doctor that listens to you and respects your views are the hallmark of the care that we strive to provide at Pacific Women’s Center.

Rear View Of A Young Woman In Bikini And Sun Drawn On Back With Sun Protection Cream

How Much Vitamin D Do You Need During Pregnancy?

Vitamin D during pregnancy is important to the health of a woman and her unborn child. Expectant mothers should work with their doctors to get the recommended dosage of vitamin D to assure optimum health benefits from it.

What is vitamin D?

Vitamin D is a steroid vitamin from a group of fat-soluble pro-hormones. They contain the most significant compounds for human development, which are D2 and D3. Although prenatal vitamins have larger doses of vitamin D in them than normal vitamins, they don’t have the amount of vitamin D that a pregnant woman should take. Prenatal vitamins have around 400 IU (International Units).

How much vitamin D do you need during pregnancy?

No one knows the ideal dose of vitamin D in pregnancy but many experts suggest an additional 1,000 to 2,000 IU daily.

Why is vitamin D important during pregnancy?

Vitamin D plays an active role in supporting immune function, healthy cell division, and bone health. Additionally, vitamin D is a key ingredient in the absorption and metabolism of calcium and phosphorus. Studies are discovering a link between low serum vitamin D levels and an increased risk of various health issues. These include certain types of cancers, autoimmune disease, neurological disease, insulin resistance, and cardiovascular disease.

An expectant mother’s baby will benefit from vitamin D by having healthy bone development.

Vitamin D deficiency and its causes

A staggering number of people in the United States are deficient in vitamin D — 40 to 60 percent — and that includes pregnant women.

Several variables factor into why so many people are lacking vitamin D, but one major component has to do with only certain foods containing the vitamin.

Foods that have vitamin D are egg yolks, tuna, mackerel, salmon, beef liver, cheese, and cod liver oil. A significant amount of vitamin D is consumed through fortified foods like milk. For a large percentage of those who are lactose intolerant, this isn’t a viable source of vitamin D.

Other reasons have to do with the body’s unique ability to make and absorb vitamin D. Where a person lives, the time of year, how much time is spent outdoors, the use of sunscreen, skin pigmentation, age, obesity, pollution, and having healthy intestines with maximum absorption volume all have an impact on the amount of vitamin D a person can have. These are the determining factors in how much vitamin D a person needs.

Research has shown that a significant portion of the U.S. population falls into one of three categories that are related to vitamin D deficiency: obesity, use of sunscreen, and older citizens (ages 50 and over).

How to consume enough vitamin D

People can get enough vitamin D by making sure they eat foods containing vitamin D as well as getting a reasonable amount of sun exposure two or three times a week for up to just 5 to 10 minutes at a time. Ideally, exposing the hands, arms, legs, and face to the sun for these brief periods time will go a long ways in providing the body with vitamin D.

One of the most effective ways to increase vitamin D intake is through supplements.

There are two forms of vitamin D supplements: Ergocalciferol is a vegetarian form of vitamin D while cholecalciferol is the animal-sourced form that typically comes from fish liver oil or lanolin that’s derived from sheep.

The cholecalciferol form absorbs better than the vegan option. Ask you doctor how much vitamin D is best for you.

Pacific Women’s Center is here to assist pregnant women in sustaining their health as well as the health of their babies. Contact the center to learn more about figuring out how much vitamin D you need during pregnancy and getting the right amount just for you.

infertility treatments

Types of Testing and Treatment for Infertility

Many options are available to you and your partner when it comes to fertility treatment. Recent advances in medical technology have made these treatments more effective and accessible to everyone.

Underlying medical issues may be the cause of infertility. In all cases, testing and treatment are necessary to discover the issue and help you conceive whenever possible. Let’s take a look at some of the treatments that are available.

Hysteroscopy
The procedure allows your doctor look inside your uterus with a narrow tube-like instrument. Several factors can be determined with this infertility treatment, such as detecting the reason for irregular bleeding, heavy bleeding, or unexplained miscarriages. The health provider can also remove polyps, scar tissues, non-cancerous growths, or adhesions during this procedure.

Hysterosalpingogram
This is an x-ray procedure used to determine whether the fallopian tubes are open and if the inside of the uterus is normal. This is also an outpatient procedure and takes very little
time to perform.

Laparoscopy
This procedure is used to treat endometriosis, a known source for infertility. Endometrial tissue growth will be removed through laparoscopy surgery. It can also remove adhesions or scar tissue. It’s a minimally invasive procedure long done with a thin tube with a high-intensity light and a high-resolution camera.

Additional Treatments

If your doctor is unable to determine why you and your partner are unable to conceive, other infertility treatments will be discussed. They may include hormone injections, insemination, or additional surgery.

It’s important to you to have a baby and it’s important to us that we do everything possible to make that happen. Call us at Pacific Women’s Center so we can help you with your fertility needs. All of our doctors are experienced with infertility treatments and understand the struggles that go with this very sensitive issue.