When you come to any of the three clinics at The Group for Women during your pregnancy, we will provide quality ultrasounds that track your baby’s progress. We offer two distinct procedures for monitoring fetal health: Abdominal – During this common scan, we place a special gel on your stomach and apply the ultrasound transducer, which glides over your belly to reveal images of your baby on a monitor. This ultrasound is used to determine the sex of your child and to track growth. Transvaginal – A small transducer is inserted into your vagina to create the images of your baby. These are more commonly used in the first trimester. Ultrasounds are used for a variety of purposes throughout your pregnancy. Not only do we look for fetal anomalies, but the ultrasound may also be used to detect low levels of amniotic fluid, to determine multiple babies, to check fetal position and behavior, and to confirm your due date. Contact us today at 757-466-6350 to schedule your appointment.  

The birth of baby is an exciting and wonderful time. Despite the skill and dedication of physicians and hospitals, complications during birth sometimes occur. Although rare, among the more serious of these complications is one that results in severe damage to a newborn’s nervous system – called a “neurological injury.” This type of injury may have a catastrophic physical, emotional and financial impact on a child and family. In1987, the Virginia General assembly passed a law that offers an alternative to lengthy malpractice litigation when a qualifying neurological injury occurs at birth. The law created the Virginia Birth-Related Neurological Injury Compensation program. Exclusive Remedy The law provides that afterwards under the Program are exclusive. That means that if an injury is covered by the Program, the child and his or her family are not entitled to compensation from a malpractice lawsuit. Instead, the child is eligible for a lifetime of benefits from the Virginia Birth-Related Neurological Injury Compensation Program. Crtieria & Coverage A “birth related neurological injury” is defined by the Virginia law as an injury to the brain or spinal cord of an infant. The injury must be caused by oxygen deprivation or mechanical injury occurring in the course of labor, delivery or resuscitation necessitated by oxygen deprivation or mechanical injury that occurred in the course of labor or delivery in a hospital. The injury must render the infant permanently motorically disabled and (i) developmentally disabled or (ii) for infants sufficiently developed to be cognitively evaluated, cognitively disabled. The disability must cause the infant to be permanently in need of assistance in all activities of daily living. The law only applies to live births. It does not apply to disability or death caused by genetic or congenital abnormality, degenerative neurological disease, or substance abuse in the infant’s mother. The law only applies to the hospital at which you deliver or the physician/midwife delivering obstetrical services at the birth of your child participates in the Program at the time of birth. Benefits The Program’s benefits are established by Virginia law. The Program may provide actual medically necessary and reasonable expenses for: Medical care Hospital care Rehabilitative care Residential and custodial care and service Special equipment or facilities Related travel expenses Loss of earnings for age 18 to 65 Reasonable expenses for filing the claim, including attorney’s’ fees An award not exceeding $100,000 to the family of an infant dying within 180 days after birth Benefits Not Covered Expenses covered by the other government programs Expenses covered by prepaid health plans, HMOs or private insurance

Post-Partum Depression Most mothers take their child home and revel in the time they have. For some mothers, a bout of depression may set in. Postpartum depression describes a range of physical, emotional and behavioral changes that can range from mild to severe. In very rare cases, new mothers may experience postpartum psychosis – and the effects can be incapacitating. Symptoms The most common, and mildest, form of post partum depression sets in 2-3 days after childbirth. Women may feel depressed, anxious and upset. They may feel angry with their partners, their new baby and other children. They may cry suddenly, question their ability to care for their baby and have difficulty making choices. Mercifully, this form of post partum depression, often called the “baby blues,” disappears without treatment within 1-2 weeks. Severe post partum depression, where the mother experiences intense feelings of sadness and despair that are debilitating. This form of despression usually sets in 1-3 weeks after delivery but can appear up to one year, later. Post partum depression is caused by a number of factors, including: Fatigue: Many women feel completly exhausted after giving birth, and it can take weeks to regain normal strength.  For those who have had a cesarean section, it make take even longer. Changes in hormone levels: Estrogen and Progesterone decrease sharply in the hours after childbirth. These changes may trigger depression in the same way that smaller changes trigger mood swings and tension before menstrual periods. History of Depression: Women who have experienced depression, before, during or after pregnancy or are currently being treated for depression have an increased risk of developing post partum depression. Emotional Factors: Feelings of doubt about pregnancy are common. If the pregnancy is not planned or wanted, it can affect how a woman feels about her pregnancy and baby. Even when the pregnancy is planned, it can take a long time to adjust to the idea of having a baby. Parents of babies who are sick or need to stay in the hospital may experience feelings of anger, sadness or guilt. These emotions can affect a woman’s self-esteem. Lifestyle Factors: Lack of support from others and stressful life events such as death of a loved one, family illness, a move to a new city can increase the risk of post partum depression. If you believe you are suffering from post partum depression or family members are suggesting that you are, it’s important to reach out to your health care provider as soon as possible. Do not wait until your post partum check up. Postpartum depression is treated much like other types of depression. The most common treatments for depression are antidepressant medication, psychotherapy, and participation in a support group, or a combination of these treatments. Psychodynamic therapies, which are sometimes used to treat depressed persons, focus on resolving the patient’s conflicted feelings. These therapies are often reserved until the depressive symptoms are significantly improved. In general, severe depressive illnesses, particularly those that are recurrent, will require medication along with, or preceding, psychotherapy for the best outcome. Do you know the #1 Complication of pregnancy and childbirth? Anxiety and Depression Fact Sheet Call for your appointment today at 757-466-6350.  

Mothers-to-be respond to the pains associated with childbirth in different ways. Some may have a higher threshold of pain than others, but at The Group for Women we offer all patients various options. For more information, please call us at 757-466-6350. Anesthesia services: Pain Relief for Children Good pain relief during labor and delivery enables you to be more comfortable and to more effectively participate in the birth of your baby. The degree of discomfort experienced during labor and delivery varies from patient to patient and from one labor experience to the next. Some women do very well with techniques such as Lamaze, while most request further assistance and thereby use a combination of techniques. Depending upon your labor pattern, labor progress, medical history and your baby’s condition, additional pain management might include intravenous (I.V.) medications or epidural analgesia. The vast majority of women in labor prefer to have epidural analgesia because of the excellent pain relief a long history of safety for both mother and baby. Remember, the choice of analgesia is a decision determined by you and your health care team (anesthesiologist, obstetrician, nurse anesthetist, nurse). Epidural Analgesia The epidural space runs the length of your back and is located just outside the sac that contains the spinal cord, nerves, and spinal fluid. A tiny catheter placed in the epidural space in the small of your back (the lumbar region) allows the administration of pain control medications before, during and after your delivery. Epidural analgesia is often more effective than other forms of pain management following certain types of procedures, and your anesthesiologist will explain this method more thoroughly if it is indicated. Potential Risks of Epidural Analgesia/Anesthesia We are very proud of our excellent obstetrical anesthesia track record of safety and concern for mother and baby. Though serious side effects occur infrequently, we are fully prepared to handle any situation. It is important to note that in almost every situation, the advantages of pain relief during childbirth greatly outweigh the potential risks. A catheter bumping against a nerve can cause a brief “funny bone” sensation, but nerve injury related to an epidural is exceedingly rare. Most patients have a backache after childbirth whether or not they have had an epidural. Sometimes, patients will have “breakthrough pain” and will require an additional does of medications or occasionally, the epidural may need to be replaced. Communicating with your care provider is very important in obtaining the most responsive pain management. Other very uncommon events might involve some medication entering a blood vessel or the spinal fluid sac. If the epidural needle or catheter enters the spinal fluid sac, the patient may get a headache 24 to 48 hours later. We have effective treatments for this problem. Anesthesia For Cesarean Section There are two types of anesthesia used for Cesarean sections: regional or general anesthesia. A recommendation will be made by your anesthesiologist after a thorough review is conducted of you and your baby’s medical condition. Both methods of anesthesia have a long history in obstetrics, and although there are risks, they have been shown to be safe for you and your baby. Regional anesthesia is an attractive choice because you can be awake during your baby’s birth and your support person can join you in the operating room. Also, your baby’s exposure to medications is reduced and the potential risks of general anesthesia can be avoided. Regional anesthesia is administered using one of two techniques: epidural or spinal anesthesia. If you already have an epidural catheter in place from labor, stronger anesthetic medications will be given to establish anesthesia for your Cesarean section. Once the epidural or spinal anesthetic becomes effective, you will be numb from your mid-chest to your toes. Your legs may seem heavy and you will not be able to move them until after the anesthetic wears off. You also may feel some tugging, pulling or pressure as the bay is born, but you should not feel pain. An alternative to epidural anesthesia is spinal anesthesia, which involves injecting a local anesthetic into the spinal fluid sac. Receiving a spinal anesthetic is very similar to receiving an epidural anesthetic. You can discuss the relative risks and benefits of spinal or epidural anesthesia for Cesarean section with your anesthesia provider. Occasionally it is necessary to use general anesthesia. To minimize your baby’s exposure to anesthetic agents, your abdomen will be cleansed and draped before you go to sleep. Medication will be injected through your I.V. to induce general anesthesia. After you are asleep, a special breathing tube will be placed into your mouth to reduce the risk of aspiration of stomach contents. After the tube is in place, the surgery begins. After the surgery is completed, the breathing tube will be removed and you will be transformed to the recovery room for observation. A sore throat is an occasional complaint following surgery.

For more information on our Prenatal Services, please call 757-466-6350. Birthing class cancelled due to COVID-19??? We’re here to help. Please visit the following link for several videos you can view from the safety of your home. https://www.babycenter.com/childbirth-class What is an anesthesiologist? An anesthesiologist is a doctor of medicine who has completed four years of medical school after graduating from college. Following medical school, today’s anesthesiologist completes four or more years of specialized medical training in the field of anesthesiology which includes pain management and critical care medicine. Subspecialty fellowships can also be completed for subspecialty board certification. What is a CRNA? A CRNA, or Certified Registered Nurse Anesthetist (also referred to as a nurse anesthetist) is a Masters degree-prepared, advanced-practice nurse who has graduated from an accredited school of nurse anesthesia. CRNAs have the education and advanced skills to administer anesthetics under the supervision of Atlantic Anesthesia’s physician anesthesiologists. What type of anesthesia am I going to have? Each woman’s labor is unique to her. The amount of labor pain you may feel depends on a variety of factors such as your level of pain tolerance, the size and position of the baby, strength of uterine contractions, (anesthesiologists, obstetrician, nurse anesthetist, nurse) will review your medical conditions with you in order to determine the most appropriate anesthetic plan for your labor and delivery. How will my medications interact with the anesthesia? Few medications interact significantly with regional or general anesthesia. Your anesthesiologist will review your medications with you and advise you of any necessary changes to your anesthetic plan. Can I eat or drink anything while in labor? Any time anesthesia may be required, an empty stomach is preferred to decrease the risks associated with vomiting. Digestion of food slows significantly during labor. Oral intake should be limited to clear liquids while you are at home. Once you decide to come to the hospital or our obstetrician instructs you to come to the hospital, do not eat or drink anything until you have been admitted and evaluated on the labor/delivery unit. During labor, ice chips are available. What if I have significant medical problems or have had problems related to anesthesia in the past? Bring these problems to the attention of your obstetrician who will contact our group well in advance of your admission. Sometimes, a patient is asked to meet with anesthesiologist before her due date to coordinate any special tests or additional consultation between our obstetrician and one of our anesthesiologists is sufficient. At what point may I have epidural? The decision to provide analgesia will be made jointly by you and your obstetrical and anesthesia care teams. Our anesthesia group feels that no time is absolutely too early to too late to provide pain relief. However, before beginning an anesthetic, we will insist that you be examined by an obstetrician at least once following the onset of your labor. The above policy may be waived if we have knowledge that your obstetrician is on the way to examine you. How soon will the epidural block take effect? Most patients will notice a significant reduction in labor pain within 20 minutes of epidural catheter placement. Your anesthesia care team will ensure you are given relief from your epidural before completing the procedure. How long will the block last? Epidural catheters can safely remain in place for the duration of your labor delivery. The effects of the medicine may last several hours. Will an epidural alter the duration of labor? Occasionally, if epidural analgesia is started very early, labor might slow for a very short period of time, but more often, epidural analgesia shortens labor because the patient is more relaxed and the baby comes down easier. When is general anesthesia used? When regional anesthesia is unsafe, or when your or your baby’s medical conditions preclude the time and positioning necessary for an epidural or spinal, your anesthesiologist will administer general anesthesia for a Cesarean section. General anesthesia may also be used if your regional anesthetic is inadequate for a Cesarean section. General anesthesia is not used for vaginal deliveries. Can I contact an anesthesiologist directly? If you would like to speak directly to one of our anesthesiologists, call 757-388-4871 between 9:00 a.m. and 4:30 p.m. if you will be delivering at Sentara Norfolk General Hospital or Sentara Leigh Hospital. For Sentara Virginia Beach General Hospital, call 757-395-6769 between 8 a.m. and 3:30 p.m. Following this conversation, if you would like to meet personally with an anesthesiologist, we will schedule an appointment for you. Billing Most physicians, including your anesthesiologist, are in private practice; that is, they are not hospital employees. Therefore, you will receive a separate statement from your other physicians. The hospital bill will include charges for hospital supplies used in the administration of your anesthesia.

When the time comes to have your baby, you want an experienced team with you throughout the birthing process. The obstetricians at The Group for Women have helped bring many new bundles of joy into the world, and we are here to provide the care and support you need in the delivery room. Our affiliation with Sentara Leigh Hospital provides you with a safe, clean environment for you and your newborn. When you arrive at Sentara Leigh to give birth, please make sure to bring your completed pre-admission paperwork provided to you by our office during your initial OB care visit found inside your STOB folder. If you’ve misplaced the form or are unable to print it, no worries, a nurse will provide this form to you upon check in at the hospital. Submitting this form to the hospital in advance with also reduce your time in the admission office when you arrive for your delivery. (a copy of this form is provided below) We encourage you to see all of the obstetrical providers throughout your OB visits so that you will be acquainted with whoever is on call the day you deliver. Advanced Birthing Center tours and Birthing Classes for expectant parents are provided by Sentara Leigh Hospital. Please call the hospital at 800-736-8272 for more information. To schedule an appointment with any of the doctors at The Group for Women, call us today at 757-466-6350. More Info

Throughout your pregnancy, you may have a number of tests performed to ensure your health and that of your child. The team at The Group for Women is dedicated to providing optimal for our expectant patients, and use only the best medical equipment for screenings and prenatal testing. We have made the following tests available to you: Ultrasounds – We monitor fetal progress throughout your pregnancy. Blood Tests – We measure levels of PAPP-A and HCG to monitor placenta growth and health Alpha-Fetoprotein Screening (AFP) – This test checks the levels of AFP in your blood. Abnormal levels could warn of birth defects, Down’s Syndrome, or multiple births. Amniocentesis – The amniotic fluid is tested to diagnose for possible chromosomal disorders and spina bifida. Chorionic Villus Sampling (CVS) – Placental tissue is tested for anomalies and genetic disorders. Glucose Tolerance – Your glucose levels may be tested to check for gestational diabetes. Cystic Fibrosis Carrier Testing 1st Trimester Screening For more information on prenatal testing, call us today at 757-466-6350. The Group for Women is a leader in women’s healthcare providing OBGYN services, Urogynecology, Birth Control, Hormone Replacement Therapy, office procedures and minimally invasive and outpatient surgical procedures to patients in the cities of Virginia Beach, Chesapeake, Norfolk, Portsmouth, Suffolk, Newport News and Hampton throughout Hampton Roads and beyond. Call us today for your appointment 757-466-6350.

Cystic Fibrosis is a concern for many pregnant women. Here you will find the basic information on CF. Please call us at 757-466-6350 if you have further questions. What is Cystic Fibrosis? Cystic fibrosis (CF) is one of the most common inherited diseases in the Caucasian population. It is caused by a failure of a protein that maintains the chloride (salt) balance in the body. CF causes the body to produce thick, sticky mucus that can cause breathing problems and lung infections, digestive problems (difficulty absorbing some types of foods), and infertility. CF does not cause mental retardation or birth defects. The symptoms of CF may vary from person to person. Some health problems caused by CF can be treated, but the disease itself cannot be cured. Most people with CF have a shortened life span; some will not survive past early childhood, but others will live into their 40s or longer. 1 The average survival of people with CF is about 36.5 years. What causes Cystic Fibrosis? Cystic fibrois is caused by an altered gene that a person inherits from his or her parents. CF is inherited in a recessive manner, which means both parents must be carriers to have an affected child. A person who has no family history of CF and no children with CF can still be a CF carrier. A CF carrier will not have CF-related health problems but may have children with cystic fibrosis if his or her partner is also a CF carrier. When both parents are carriers of CF, there is a 25% chance with each pregnancy that the child will have the cystic fibrosis. Who is at risk for Cystic Fibrosis? Cystic fibrosis is found in all ethnic groups, but is most common in Caucasians. * About 1 in 2500 Caucasians is born with the disease. The carrier frequency of the several ethnic groups is shown below. The chance of being a carrier is greater for those who have a family history of CF. Cystic Fibrosis (CF) Carrier Frequency Racial or ethnic group Carrier rate Ashkenazi Jewish 1 in 25 Caucasian (non-Hispanic) 1 in 25 Hispanic American 1 in 46 African American 1 in 65 Asian American 1 in 90 How does the CF carrier test work? Carrier testing is a special test involving the cystic fibrosis gene. Genes are found in the body’s cells, and each gene contains a molecular code that determines how cells function. If there is a problem (called) a mutation) in a gene, it may not work properly. CF carrier testing is a blood test that looks for mutations in the CF gene. How accurate is the test? There are many possible CF genes mutations. Some are rare, and there may be some that have not been discovered yet. LabCorp tests for the most common CF mutations. A negative test significantly lowers the chance that a person is a CF carrier, but there is still a small chance that a rare mutation may be present. The following table shows the chance of being a CF carrier when the test is negative. Ethnicity Carrier detection rate for the 32 CF mutations CF carrier risk prior to testing4 CF carrier risk after a negative result for 32 mutations Ashkenazi Jewish 97% 1 in 25 1 in 800 Caucasian (non-Hispanic) 90% 1 in 25 1 in 240 Hispanic American 73% 1 in 46 1 in 168 African American 69% 1 in 65 1 in 207 Asian American 55% 1 in 90 1 in 198 This table applies only to people without a family history of CF. LabCorp also offers an expanded carrier test that looks for additional CF mutations that may be useful for individuals with a family history of CF or other special situations. What does it mean if the test is positive? If the CF test indicates a person is a carrier, the next step is to test his or her partner. Both parents must be carriers to have an affected child. If the partner has a negative test result, the chance of having a baby with CF is very low. 1 If the test is positive, the couple has a 25% chance with each pregnancy of having a child with CF. What can a couple do if there is a risk of having affected children? There are several options for couples who are at risk of having a child with cystic fibrosis. Many include personal choices that are best discussed with a health care provider. A genetic counselor is a special type of health care provider who has expertise in genetic disorders such as CF, genetic testing, and the choices available to a couple during pregnancy. Two available options that may be discussed with a genetic counselor are chorionic villus sampling (CVS), a test done between 10 – 14 weeks of  gestation, and amniocentesis, a test done between 15 and 20 weeks of gestation. Other options are available and can be discussed with your health care provider. Why is CF testing recommended? Cystic fibrosis is a common disorder in Caucasians. The American College of Obstetricians and Gynecologists (ACOG) and the American College of Medical Genetics (ACMG) have recommended that carrier screening be offered to all Caucasian couples who are pregnant or considering pregnancy and made available to all patients. CF testing is not required; it is an option. Couples might choose to have carrier screening if prenatal diagnosis for CF is important to them, or if they want early diagnosis and treatment for their children at risk for CF. Choosing CF carrier screening is a personal choice that should be discussed with a health care provider or genetic counselor. Where can I find more information? Cystic Fibrosis Foundation Telephone 800-FIGHT-CF (800-344-4823) Web site http://www.cff.org Genetic Alliance Telephone 202-966-5557 Web site http://www.geneticalliance.org National Society of Genetic Counselors Phone 312-321-6834 Web site http://www.nsgc.org Note: This material is provided for general information purposes only. It is not intended as a substitute for medical advice and/or consultation with a physician or technical

For more information on AFP Tetra and testing procedures, call The Group for Women at 757-466-6350. Down syndrome and trisomy 18 are conditions caused by chromosomal abnormalities. Chromosomes are present in every cell of the body and contain genetic information that helps determine how we look, how our bodies grow and develop, and our health. A developing baby normally receives 23 chromosomes in each cell. The chromosomes pairs are numbered 1 through 23. Sometimes a baby can be born with too many or too few chromosomes. Errors in the number of chromosomes may cause a variety of birth defects, ranging from mild to severe. In Down syndrome, also called trisomy 21, a baby has an extra copy of the #21 chromosome. All babies with Down syndrome have some degree of mental retardation and often have physical abnormalities such as heart defects. About 1 in 800 babies is born with Down syndrome. 1 AFP Tetra 75% to 80% Down syndrome pregnancies. Trisomy 18 is also known as Edwards syndrome. Babies with this condition have an extra copy of the #18 chromosome. Trisomy 18 causes severe mental retardation and physical abnormalities. Most babies with trisomy 18 die within the first year of life. Trisomy 18 is rare, occurring in 1 in every 7500 births.3 AFT Tetra detects 73% of trisomy 18 pregnancies. Open neural tube defects, such as open spina bifida, occur when the baby’s spinal cord does not close completely during development. About 1 in 1000 babies is born with open spina bifida. 1,5 The effects of open spina bifida range from bladder control problems to paralysis and hydrocephalus. AFT Tetra detects 80% of pregnancies with open spina bifida. What does it mean if my AFP Tetra screening is negative? A negative test result significantly reduces the likelihood that your baby has Down syndrome, trisomy 18, or an open neural tube defect; however, screening tests can not completely rule out the possibility of these problems. Additionally, screening tests do not detect other chromosomal abnormalities or birth defects. Does a positive AFP Tetra result mean my baby has a birth defect? No. Screening tests cannot diagnosis problems with your baby or pregnancy. A positive test result can only tell you that your baby is at increased risk for having Down syndrome, trisomy 18, or an open neural tube defect. Typically, a woman who has a positive screening result is offered additional test to determine if the baby has one of these conditions. If my test result is positive, what happens next? Follow-up options are discussed between you and your doctor. If your screening test is positive, your physician may recommend one or more of the following. Genetic counseling. Genetic counseling is designed to help you understand your test results and follow-up options and may include a discussion of your family and pregnancy history. Genetic counseling may be provided by a certified genetic counselor, perinatologist (high-risk pregnancy physician), or your own obstetrician. Ultrasound. This procedure uses high-frequency sound waves and a computer to create images of the developing baby. In the second trimester, a detailed ultrasound examination of the baby may be able to identify some birth defects such as open spina bifida. Babies with Down syndrome and trisomy 18 may have certain features that can be seen on ultrasound, but, in general, neither can be diagnosed by ultrasound alone. Ultrasound is also used to measure the baby and determine how far along you are in your pregnancy (gestational age). The levels of the proteins measured in the AFP Tetra test vary with each week of pregnancy, so knowing the exact gestational age is an essential part of the test. If ultrasound dating changes your gestational age by 10 days or more, your physician may ask the lab to recalculate your test results. Ultrasound may reveal the presence of twins, which can also affect your AFP Tetra result. Non-Invasive Prenatal Test (NIPT):  genetic testing using cell-free fetal DNA that circulates in maternal blood.  The test can be done as early as 10 weeks of pregnancy to detect Trisomy 21 (Down syndrome) and many more chromosomal abnormalities. This test is only indicated for high risk pregnancies such as: personal or family history of aneuploidy, advance maternal age, an abnormal serum screen and/or abnormal ultrasound. Amniocentesis. This procedure is usually performed after the 15th week of pregnancy. Ultrasound is used to guide a thin needle through the abdomen into the uterus, and a small amount of fluid (amniotic fluid) from around the baby is removed. The cells in the fluid are examined in the laboratory to determine whether a chromosome abnormality like Down syndrome or trisomy 18 is present. Amniocentesis can diagnose most chromosomal abnormalities but cannot diagnose or identify all birth defects. Alpha-fetoprotein (AFP) is also measured in the amniotic fluid, and if open spina bifida is suspected, a spinal protein called acetylcholinesterase (AChE) is measured as well. This combination of tests can diagnose most, but not all, babies with open spina bifida.6 What is Maternal Serum Screening? Maternal serum screening is a simple blood test offered in pregnancy to identify women who are at increased risk of having a baby with Down syndrome, trisomy 18, or an open neural tube defect such as open spina bifida. What is AFP Tetra? AFP Tetra is a maternal serum screening test that is offered between 15-21 weeks in pregnancy and measures the levels of four proteins in a women’s blood: AFP (alpha-fetoprotein), hCG (human chorionic gonadotropin), uE3 (unconjugated estriol), and dimeric inhibin A (DIA). Results of the blood test are combines with clinical information about you, such as your age and weight, to determine your baby’s risk for having Down syndrome, trisomy 18, or an open neural tube defect. If you are found to be at increased risk for having a baby with one of these conditions, follow-up testing will be offered. Note: This material is provided for general information purposes only. It is not intended as a substitute for medical advice and/or consultation with a physician or technical expert.

What is Tubal Ligation? Tubal Ligation (sterilization) is an outpatient surgical procedure to block a woman’s fallopian tubes. This is a permanent form of birth control. Once this procedure is done, your eggs cannot move from your ovaries through either of your 2 fallopian tubes and into your uterus. The procedure cuts the path for both your egg to reach your uterus and for the sperm to connect with the egg for fertilization. Many people refer to this procedure as having your “tubes tied.” How is the Procedure Done? This is done as an outpatient procedure in the hospital. That means you will get to go home after the procedure. Anesthesia is used, so you are asleep for the procedure while one or two small incisions are made on your abdomen near your belly button. A flexible tube with what that looks like a small telescope on it (laparoscope) is inserted into the incisions. Instruments are then inserted through the tube. Your doctor then coagulates (burns) and cauterizes your tubes and seals then shut. A small clip is then placed on each tube. Your doctor finishes the procedure by closing your incisions with a few stitches. After being in recovery, you should fell well enough to go home. A new alternative to outpatient tubal ligation is an in office hysteroscopic sterilization. The Group for Women offers this procedure. To learn more, call The Group for Women to make an appointment with your doctor 757-466-5751. More information is also available in this article by The Group for Women’s Jeffrey Wentworth, MD, In Office Hysteroscopic Sterilization. Dr. Jeffrey M. Wentworth joined The Group for Women in 2000. Dr. Wentworth is board certified and is a Fellow of the American College of Obstetrics and Gynecology. In his work at The Group for Women, Dr. Wentworth is regularly involved in the implementation of clinical trials with various pharmaceutical companies. Contact The Group for Women today at 757-466-5751 to schedule your appointment. The Group for Women is a leader in women’s healthcare providing OBGYN services, Urogynecology, Birth Control, Hormone Replacement Therapy, office procedures and minimally invasive and outpatient surgical procedures to patients in the cities of Virginia Beach, Chesapeake, Norfolk, Portsmouth, Suffolk, Newport News and Hampton throughout Hampton Roads and beyond. Call us today for your appointment 757-466-5751.