Prescriptions - September 2016

Am I too old to have a baby?
Although there’s not really an age at which we tell people to not have children, there are a few factors one must consider. As we age, our chromosomes are more likely to have anomalies within them. Thus an aging mother is at higher risk for Down Syndrome and other chromosome abnormalities.  Miscarriage rates are much higher in older women, thus the emotional burden of miscarriages plays a larger role as we age. This is thought to occur because of the chromosome issues.
Many people have heard the term advanced maternal age, which refers to a 35 year old mother.  At this age, a woman’s risk of Down Syndrome is approximately one in 230 pregnancies. This age was chosen as advanced maternal age originally because the risk of causing a miscarriage with amniocentesis was 1:230, thus people over that age were offered amnio and those under 35 were not. Now we have less invasive testing methods whereby we can look at a baby’s chromosomes with blood taken from the mother’s arm. Although this eliminates the invasive nature of the test, the risk of chromosome abnormalities remains the same. Also as we age, other health related problems such as diabetes, high blood pressure and thyroid disease can become more of an issue and must be taken into consideration.  Now for those sleepless nights, that’s another topic all together.                        
  -Dr. Randall Royal

What is the likelihood of having twins?
Finding out that you are pregnant can be both exciting and scary—finding out you are pregnant with twins can be doubly so!  Having twins can be fun, but does have its risks and increased discomforts—just ask my twin moms, who are carrying around two babies in this heat.
According to CDC data, approximately 1/30 babies born today are a twin. This has almost doubled since 1980. This is due in part to women waiting until later in life to have children, but is mostly due to the increase in infertility treatments. Medications like Clomid and treatments like In Vitro Fertilization significantly increase the chance of having twins or other multiples. Another factor that increases the rate of twins is maternal family history. You should talk to your provider about your specific chances for twins and the risks of a twin pregnancy.      
-Dr. Meredith Mitchell

I have three boys.
How can I have a girl?
The only certain way is to go through in vitro fertilization (IVF).  When doing this, the eggs are mixed with the sperm and scientists can determine if the developing embryo is male or female after a few days of development and implant only that gender into the mother.  Assuming you want to try the old fashioned way, however, there have been some studies to show that male sperm swim faster, but die sooner than female sperm.  With this theory, the closer to the time of ovulation that you have intercourse, the more likely it will be a boy.  In general, sperm can live in the woman’s body for about three days.  So if you want a girl, you should have intercourse 2-3 days prior to ovulation and not have sex again until about a day afterward, when pregnancy is no longer probable.  I can’t say this is very exact science, but it is worth a try.  I always like to remind patients that a healthy baby is the most important outcome, not the gender.
- Dr. Katherine Coley

What can I do to improve my chances of a healthy pregnancy?
Start taking prenatal vitamins as soon as you decide to try to conceive—the folic acid is especially important during the first eight weeks of pregnancy to prevent neural tube defects like spina bifida.
Maintain a healthy weight to avoid
the risks associated with obesity in pregnancy (goal BMI of 19-25).
Healthy diet and exercise are important before and throughout your pregnancy.
Seek preconception counseling with your OB-GYN if you have medical problems or take medication.
Stop any bad habits, such as tobacco
or alcohol use, prior to pregnancy.
Prenatal care is important! Establish care with your OB-GYN early in the first trimester, and continue regular visits throughout your pregnancy.
- Marlena Mattingly, M.D. -

How long do I need to be off of birth control before I become pregnant?
Return to fertility occurs within just a few days of stopping most contraceptive methods, including pills, patches, rings, IUDs and implants. So don’t stop taking your pill until you are ready to conceive! The Depo Provera shot is the one exception to this rule and can stay in your system from 3-6 months after injection, which causes a delay in fertility.             
-Janna Jones Kersh, CNM

I have irregular periods. Does that mean it will be more difficult for me to get pregnant?
Irregular periods can be caused by a number of hormonal and health issues. Not having regular cycles can be a sign that you are not ovulating regularly, but not having cycles certainly doesn’t mean you can’t get pregnant. A normal cycle is anywhere from 21 to 35 days in length and isn’t necessarily the exact same length each month.  If your cycles are not regular or consistent, you should be evaluated for thyroid abnormalities, as well as other hormone alterations, which can decrease fertility.  There are treatments that can increase your chances of pregnancy sometimes not even requiring medication! It is ALWAYS a good idea to see your doctor if you are thinking about getting pregnant to talk about ways to increase your chances of a healthy pregnancy and baby. Many times the “fix” for irregular menses is simple, and it should not stop you from being able to get pregnant!         
-Tracey Leaver-Williams, M.D.

Meet the doctors:

Dr. Katherine Coley is a board certified OB/GYN at Advanced Women’s Care with 13 years of experience. She graduated residency from New York Presbyterian hospital/Weill-Cornell program. She has lived in Hilton Head since 2009 and is raising her three children here in the Lowcountry. For appointments, call 843-341-3996.

Janna Jones Kersh, CNM, is a certified nurse midwife at Beaufort Memorial Obstetrics & Gynecology Specialists. She received her B.S. from the University of Georgia and went on to earn her Master of Science degree in Nursing with a major in Nurse-Midwifery at Vanderbilt University. For appointments, call 843-522-7820.

Tracey Leaver-Williams, M.D., Board Certified in Obstetrics & Gynecology, Hilton Head Regional OB/GYN Partners offers care for women throughout their lives—from their adolescent years to post menopause. Our physicians perform a wide-range of obstetrical and gynecologic procedures and they are committed to provide compassionate, expert care for your wellness and maternal needs. For appointments, call 843-681-4977.

Marlena Mattingly, M.D. is an OB-GYN with Beaufort Memorial Obstetrics & Gynecology Specialists. A summa cum laude graduate of Belhaven University in Jackson, Miss., Dr. Mattingly went on to earn her medical degree with high distinction at the University of Kentucky College of Medicine in Lexington and completed her residency at the Indiana University School of Medicine.For appointments, call 843-522-7820.

Dr. Meredith Mitchell is a board certified OB/GYN with Riverside Women’s Care, which has locations in Bluffton and Beaufort. She delivers babies at the Women’s Pavilion at Coastal Carolina Hospital. For appointments, call 843-524-5455.

Dr. Randall Royal is a board certified OB/GYN with Riverside Women’s Care, which has locations in Bluffton and Beaufort. He delivers babies at the Women’s Pavilion at Coastal Carolina Hospital. For appointments, call 843-524-5455.