Blog - West Des Moines OBGYN

Sep
05
2019
What to Know Before Having a Hysterectomy
When a woman’s uterus needs to be removed because of fibroid tumors, heavy bleeding, cancer or other uterine issues, a hysterectomy can be an option to treat the condition by removing the uterus. Because the uterus is removed surgically, the patient can expect to require 2-8 weeks to recover depending on the type of hysterectomy.

Indications for Hysterectomy
- Uterine fibroids are muscular tumors that develop in the wall of the uterus. They are typically benign. The fibroids can be tiny in size like an apple seed or grow larger like a grapefruit.
- Endometriosis occurs when endometrial tissue grows outside the uterus which can cause pain and make it difficult to become pregnant. Endometriosis is most commonly found in the ovaries, fallopian tubes, the tissues that construct the uterus or the outer area of the uterus.
- Cancer or precancer of the uterus, cervix or ovaries could lead to a hysterectomy to remove the cancerous cells from your body.
- Uterine prolapse is when the uterus falls down into the vagina which can lead to problems with urination and bowel movements and pelvic pressure. A uterine prolapse commonly affects women who have had an injury to the muscles of the pelvic floor. The main cause is childbearing. Other causes can be prior pelvic surgery, menopause, obesity and extreme physical activity.
- Abnormal vaginal bleeding can be secondary to fibroids, uterine polyps, cancer, an infection or a change in hormone levels.
Myths

There are common myths about having a hysterectomy, but it’s important to know all the facts before having surgery. Discuss any worries with your doctor before the procedure so your questions are answered from an educated, experienced source.
- Major Surgery There are different approaches to having a hysterectomy such as abdominal, vaginal, laparoscopic and robotic. Your gynecologist can decide the best course to take based on your situation. Minimally invasive surgery is preferred when it is feasible due to its fast recovery time.
- Activate Menopause In most cases, a hysterectomy will not result in menopause as long as the ovaries are not removed during the surgery. Discuss the possibility of removing ovaries with your gynecologist prior to your hysterectomy.
- Lengthy Recovery Time Depending on what approach is taken during the hysterectomy, your recovery time can vary, but in general, women are discharged from the hospital after 0-3 days and are feeling back to normal after 2 weeks of surgery.
- Only Way to Relieve Symptoms You should talk to your doctor about the severity of your situation and if there are other options such as medications if you are not ready for surgery.
Different Approaches for a Hysterectomy

Based on your medical history and doctor’s recommendation, there are a few options for how a hysterectomy is performed. Each has a different technique but may have different recovery times.
- Abdominal “Open” Used in cases where there are large tumors, severe scarring or if the cancer is widely spread, the abdominal hysterectomy will involve an incision in the stomach’s lower area where the uterus will be extracted from. Typically, the patient will stay in the hospital 1-2 days and need to take 4-6 weeks of time off work.
- Vaginal The entire surgery is performed through the vagina resulting in fewer external scars. This is most commonly done in cases of prolapse. Usually, a patient will be discharged the day after the surgery and will need to take 4-8 weeks off of work.
- Laparoscopic A video camera with long surgical instruments will be inserted to remove the uterus. Generally, the patient will stay one night in the hospital and need to have 2-6 weeks off from work.
- Robotic The surgeon will operate with remote hand controls laparoscopically to remove the uterus. The patient may stay the night in the hospital or may be discharged home after the surgery and need 2-6 weeks off work to recover from a robotic hysterectomy.
What to Expect

After your procedure, you will be prescribed medication to help alleviate any pain you feel. As soon as you are able, you can start to move around. It is recommended to not exercise heavily or lift anything over 10 pounds. and to not have vaginal intercourse until after cleared, usually six weeks of recovery time.

WDM OBGYN uses the enhanced recovery after surgery (ERAS) protocol with the minimally invasive technique with the robot, so our patients can go home the same day as their surgery. This protocol allows our team to track fluid intake prior to surgery and have specific preoperative medications that help with pain control so our patients have a faster recovery to return home. Schedule an appointment with us to experience the difference.
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Gynecology
Aug
16
2019
Preconception Care & Counseling

If you’re thinking about having a baby or have already started trying, you may benefit from preconception care and counseling to ensure your body is ready for pregnancy, identify possible risk factors, and learn the steps to having a healthy pregnancy.

When should you get preconception care?

You can get a preconception checkup any time—even up to a year before you want to get pregnant. Even if you’ve already had a baby, you can still benefit from a preconception checkup as your health may have changed since your previous pregnancy.

If you’ve been trying to have a baby and have been unsuccessful, preconception counseling provides education on healthy lifestyle habits and recommended supplements that can improve your chances of conceiving.

What happens at a preconception visit?

Your health care provider looks for health conditions that may affect your pregnancy and the health of your baby. A risk assessment will find any potential complications of pregnancy. Based on the results, your health care provider may suggest behavioral changes that can help reduce risk factors such as increasing folic acid intake, quitting smoking, reducing alcohol consumption, and improving diet.

Additionally, your provider may give you a physical exam including a pelvic exam, perform a Pap test, test your blood to check your blood type and Rh factor, and may recommend prenatal genetic screening or a consultation with a genetic counselor.

Key factors to address when trying to become pregnant:

Healthy Weight

A woman should control her diet and exercise. Starting pregnancy at a healthy weight can reduce the risk of diabetes and high blood pressure during pregnancy, fetal growth anomalies, preterm birth, stillbirth, cesarean section and hemorrhage after delivery.

Folic Acid

Taking folic acid, no less than three months before getting pregnant, has been shown to prevent neural tube defects such as Spina Bifida by up to 70%. Folic acid is essential for the development of the baby’s neural tube, part of the nervous system, which forms around the time a woman misses her first menstrual period. It is best to start a prenatal vitamin with folic acid prior to conception.

Quit Smoking

If a woman can quit smoking before she becomes pregnant, she will improve her likelihood of becoming pregnant. Additionally, she will reduce the risk of an ectopic pregnancy, miscarriage, birth defects, stillbirth, placental abruption, low birth weight, preterm birth, undernutrition, and anemia.

Alcohol and Drugs

Alcohol consumption during pregnancy can lead to fetal alcohol syndrome. Drug exposure, including prescription pain killers, in pregnancy, may cause neonatal abstinence syndrome and increase the risk of sudden infant death syndrome. Addiction to alcohol, cannabis, or opioids may lead to miscarriages, birth defects, intrauterine growth restriction, preterm birth, and lifelong learning disabilities.

Why Choose West Des Moines OBGYN for Preconception Care?

At West Des Moines OBGYN, our priority is you and your baby. We will always put your needs first and develop the appropriate care plan for you. Whether you’re trying to become pregnant for the first time or are expecting another child, we are here to help you along the way. Schedule a preconception visit with us and experience the difference.
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Obstetrics
Jun
11
2019
Menopause Management & Treatment
Menopause is a natural biological process for women. While most women believe menopause occurs in their early 50s, its symptoms can start at least 10 years earlier. Some women pass through the change of life with minimum disruption and discomfort. For others, symptoms can be severe and debilitating. Fortunately, there are many effective treatments available including lifestyle adjustments, medications (hormonal and non-hormonal), and Mona Lisa Touch with which West Des Moines OB/GYN can help.

What is menopause and its symptoms?

During the menopausal transition, women can experience many different physical and emotional changes. The most common symptoms are hot flashes, night sweats, difficulty sleeping, vaginal dryness, mood swings, and short-term memory loss. These troublesome symptoms are often related to the disrupted hormonal rhythm that starts in perimenopause. Often times, menopause occurs during other midlife stressors like relationship issues, caring for young children, struggling with adolescents, caring for aging parents, career changes and education issues.

Menopause Facts
- Eight out of 100 women cease menstruation before age 40 (premature ovarian failure).
- Five out of 100 women continue menstruating until almost age 60.
- The average age when menopause occurs is 51.
- Women who smoke tend to experience the change of life earlier than nonsmokers.
How to Relieve Symptoms

Lifestyle Changes

Simple lifestyle changes such as changing what you consume, your sleeping habits and how often you exercise can help relieve symptoms. For example, decreasing or avoiding caffeine and alcohol consumption completely can positively impact you; drinking water is the best alternative because it will keep your body hydrated. Also, be sure to eat a well-balanced diet and increase your intake of Vitamins B, C, D and E by taking a women’s multivitamin. In addition to what you eat, sleep for 7-8 hours per night so your body gets the rest it needs. Plus, if you get a good night’s rest, you will have enough energy to exercise regularly.

Hormone Replacement Therapy (HRT)

Hormone replacement therapy (HRT), also referred to as postmenopausal hormone therapy is a treatment doctors might recommend to help relieve common symptoms of menopause and to address long-term biological changes such as bone loss. Women who have not undergone a hysterectomy are generally prescribed estrogen along with progesterone for HRT. Women who have had a hysterectomy use only estrogen during their hormone therapy treatments.

When going through hormone therapy, systemic products circulate throughout the bloodstream and to all parts of the body. These products are available as an oral tablet, a patch, gel, emulsion, spray or an injection that can treat hot flashes, night sweats, vaginal symptoms, and osteoporosis. Local, or nonsystemic, products affect only a specific or localized area of the body can be used for vaginal symptoms and are available as a cream, ring or tablet.

Overall, the goal is for the patient to use hormone therapy at the lowest effective dose for five years or less. There are also a few non-hormonal therapies available to help with menopausal symptoms. Women should see their health care professional to discuss menopause and the specific symptoms they are having to understand all of their treatment options.

How West Des Moines OB/GYN Can Help

All of the providers at West Des Moines OB/GYN offer menopause management including hormone replacement therapy. One of our nurse practitioners, Maggie Livingston, ARNP, NCMP, has been certified by the North American Menopause Society (NAMS) since 2014.

Several of our physicians offer Mona Lisa Touch, a non-hormonal CO2 laser for symptoms of vaginal dryness, painful intercourse, and irritative vaginal symptoms unrelieved with other methods. This quick procedure (<5 minutes per treatment) is performed in the office for three treatments initially followed by one booster treatment in 12-24 months depending on when patient’s symptoms return.

During a consultation, we will discuss your menopausal symptoms and after reviewing your personal history and risk factors, we can determine the best treatment option for you.

Through all of life’s stages, our care team at West Des Moines OB/GYN is here to support you. We provide a variety of convenient services and individualized care for your specific needs. Learn more about our services or schedule an appointment and experience the difference.
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Gynecology
Feb
12
2019
Cervical Cancer Screenings & Prevention
In 2019, the American Cancer Society estimates that doctors will diagnose over 13,000 cases of invasive cervical cancer. The majority of cervical cancer cases are caused by a sexually transmitted virus called human papillomavirus (HPV), but other factors increase the risk of cervical cancer including HIV, history of smoking, chlamydia, being overweight, long-term use of birth control pills or IUDs, multiple full-term pregnancies and family history of cervical cancer. However, as many as 93 percent of cervical cancers could be prevented by screening and HPV vaccination. Cervical cancer screenings are completed at routine women’s health checkups and can help to find changes in the cells of the cervix that could lead to cancer.

Prevention Through Pap Tests

Regular screenings are key to preventing not only cervical cancer but many other types of cancer as well. Cervical cancer is especially treatable when detected in its earlier stages through a Pap smear.

What is a Pap test?

During a routine pelvic exam, a Pap test will be performed by your doctor, where a device called a speculum is inserted through the vaginal canal to see your cervix. Your doctor will then use a special brush or stick to collect cells from the cervix to be examined in a lab.

How do Pap tests prevent cervical cancer?

Doctors can detect precancerous cells in the cervix which can be treated before cancer has a chance to develop. Regular Pap testing is the most important step you can take to prevent cervical cancer. The most invasive cancers are commonly found in women who have had no regular Pap testing.

How often should I get a Pap test?

We recommend having a pelvic exam with an annual exam for the majority of women, but how often you have a cervical cancer screening depends on your age and health history. Pap guidelines are not synonymous with annual exams. For the best results, consult with your doctor about how often you should be screened.

It is generally recommended that women ages 21-29 get a Pap test every three years, but HPV testing is not routinely recommended. Women between the ages of 30 and 65 should have a Pap test and HPV test every 3-5 years, but it is acceptable for them to have a standalone Pap test every three years.

Are there exceptions?

Yes, there are exceptions. Some women need to be screened more frequently than others due to health conditions or previous abnormal pap results.

Women may need to be tested more often if they have:
- A weakened immune system caused by chemotherapy, organ transplant or steroid use
- Had a previous treatment for abnormal cervical cells or cervical cancer
- Tested positive for HIV or their mother was exposed to diethylstilbestrol (a synthetic hormone) while pregnant
Women that have had a hysterectomy with no residual cervix may no longer need regular Pap tests. If you are over the age of 65, you can stop cervical cancer screenings if you do not have a history of abnormal cervical cells or cervical cancer, or if you have had three negative Pap tests in a row or two negative co-testing for cervical cancer and HPV in the last 20 years. Doctors recommend not scheduling a Pap test if you are currently on your period.

How can I prevent cervical cancer?

To reduce your risk of cervical cancer, you should get vaccinated against HPV. The vaccination is recommended for women ages 9-26 but soon we will offer the vaccine up to age 45. The vaccine is most effective if given to girls and boys before they become sexually active. At our office, we offer Gardasil 9 to girls and adults ages 9-26. By practicing safe sex with a condom and having fewer sexual partners, your risk for cervical cancer may decrease.

Routine Pap tests can detect precancerous conditions of the cervix, so they can be monitored or treated. Most medical organizations suggest that women begin having routine Pap tests at age 21. Colposcopies and LEEP procedures may also be recommended if a pap smear is found to be abnormal.

Discontinuing smoking can also reduce your risk of developing cervical cancer, as smoking is associated with squamous cell cervical cancer.

Why choose West Des Moines OBGYN?

Pap tests and cervical cancer screenings are an important part of the women’s healthcare that you will receive at our office. We provide customized care for our patients and we will remind you when you are due for preventative screenings and routine exams based on your medical history and needs. We know what a warm, welcoming, and result-oriented patient experience feels like because it is what we seek ourselves.

Schedule your next appointment with us and experience the difference.
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Preventative Care
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Dec
13
2018
Reducing Your Breast Cancer Risk
Take your health into your own hands by following a healthy lifestyle to help prevent breast cancer from forming. Eating healthy, exercising, and not smoking are protective measures you can take to lower your risk of breast cancer. Unhealthy lifestyle choices can lead to risk factors that increase your likelihood of developing cancer. Not all risk factors are in your control, such as your family history, but in this blog, we’ll address several things you can do to help reduce your risk of developing breast cancer.

What is breast cancer?

Breast cancer is an uncontrolled growth of malignant cells that form in the tissues of the breasts. One in eight women will develop invasive breast cancer, and it is the second most common type of cancer in American women. This type of cancer is always caused by a genetic abnormality, but only 5-10 percent of the abnormalities are inherited from your parents. The remaining 85-90 percent are due to genetic abnormalities from the aging process and normal “wear and tear” of life in general.

What preventative measures I can take to lower my risk for breast cancer?
- Reduce alcohol intake
The more alcohol you consume, the greater your risk of developing breast cancer. Based on general research, it is recommended to limit your alcohol intake to less than one drink per day. Those who have two to three drinks per day have about a 20 percent higher risk of developing breast cancer compared to women who don’t drink alcohol.
- Control your weight
Prior to menopause, your estrogen is primarily made by your ovaries, but a small amount is made by your fat tissues. After menopause, most estrogen sources come from fat tissue. If your body has more fat tissue—you are overweight or obese—after menopause, your estrogen levels can spike and lead to a higher chance of getting breast cancer. Overweight women also tend to have higher blood insulin levels. Talk with your doctor about what a healthy weight is for your body.
- Get up and move
In addition to eating and drinking healthy, you also need to exercise. Studies show that moderate to vigorous physical activity is linked to lowering your risk for breast cancer. The American Cancer Society recommends adults get at least 150 minutes of moderate intensity activity or 75 minutes of vigorous intensity activity throughout the week. The increased activity affects the body’s weight, inflammation, hormones, and energy balance and can help lower the risk of breast cancer.
- Breastfeed children
Estrogen levels may remain low while a woman is still breastfeeding. Studies suggest that breastfeeding may slightly lower the risk of breast cancer, especially if it is continued for 1 ½ to 2 years after the child’s birth, but it is difficult to study in countries where breastfeeding for this long is uncommon. The possible explanation for this effect may be that breastfeeding reduces the total number of a woman’s lifetime menstrual cycles.
- Limit dose and duration of postmenopausal systemic hormone therapy
Combination hormone therapy for more than three to five years increases the risk of breast cancer, and it can also increase the likelihood that cancer may be found at a more advanced stage. If you’re taking hormone therapy for menopausal symptoms, ask your doctor about alternative options. If you decide the benefits of short-term hormone therapy outweigh the risks, use the lowest dose that works best for you. Make sure to have your doctor monitor the length of time you are taking hormones, so you can discuss possibilities for your health in the future.
- Give up smoking
New evidence suggests if you are a woman and smoke, this can increase your breast cancer risk. Smoking can cause harm to women of any age, but it causes a higher risk of breast cancer in younger, premenopausal women. For postmenopausal women, research has reflected a correlation between heavy second-hand smoke exposure and breast cancer risk. By choosing to stop smoking, it ensures better health and decreases the chance of breast cancer for yourself and for those around you.

What else can I do?
1. Be conscious of breast cancer detection.
2. If you notice any changes in your breast, like a new lump or skin changes, consult your doctor.
3. Also, ask your doctor when to begin mammograms and other screenings.
4. If you have a strong family history of breast cancer and/or ovarian cancer, discuss this with your physician. You may be a candidate for genetic testing for the BRCA1 and BRCA2 gene. This testing can be ordered by any of associates, and we are fortunate to have an Advanced Registered Nurse Practitioner, Shawna Freeman, on staff, who has obtained her American College of Obstetricians and Gynecologists Certificate of Women’s Health Genomics.
You are the expert about your own body and medical history, so if you feel something is wrong, consult a doctor. Being extra cautious has no consequences but not scheduling recommended screenings could. Our team of OB/GYN trained associates can provide screenings, testing, and if the results confirm cancer, we will set up treatment options. Contact our office if you have any questions about breast cancer detection or if you’d like to schedule a screening.
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Preventative Care
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Nov
08
2018
MonaLisa Touch Treatment & Benefits
What is MonaLisa Touch?

MonaLisa Touch (MLT) is a treatment for vaginal atrophy after menopause, cancer treatment, or oophorectomy (removal of ovaries), which involves the use of a fractional CO2 laser that is specifically designed to treat vaginal tissue. In the past, women who experienced vaginal atrophy were limited to hormonal treatment, lubricants, moisturizers, and creams. Commonly treated symptoms include vaginal itching, vaginal dryness, pain during intercourse, and vaginal laxity.

MLT is also being used to treat lichen sclerosus, which is a skin condition most common in postmenopausal women that creates patchy white skin that is thin. “Although the FDA has not approved MLT for this disorder, it is being widely used and is proving to be very effective. A study is being finished and will be submitted to the FDA in hopes that it will approve MLT for lichen sclerosis.“ (Retrieved from www.realself.com)

Who Can Benefit from MonaLisa Touch Treatment?

So, who needs MonaLisa Touch? Sometimes, with age, it’s easy to assume the changes women experience are normal; however, vaginal pain or discomfort of any kind is certainly something to be concerned about. Women that are experiencing symptoms of vaginal atrophy or lichen sclerosus should contact their doctor right away and discuss setting up an appointment for further examination.

Symptoms and conditions to be aware of:

Vaginal atrophy:
1. Thinning, drying, and inflammation of the vaginal walls due to lack of estrogen
2. Most commonly occurs in women experiencing menopause or premenopausal women undergoing cancer therapy
Lichen sclerosus:
1. Lichen sclerosus is a skin condition that creates patchy white skin that is thin. It primarily affects the vulva in females.
2. It is more common in postmenopausal women.
3. Symptoms of lichen sclerosus include itching, discomfort, ulceration, bleeding, and painful intercourse.
Women experiencing:
1. Dryness, burning, itching, and decreased vaginal lubrication during sexual activity leading to painful intercourse
How Does It Work?

Now that you know what symptoms and conditions to be aware of, you’re probably wondering, how exactly does MLT work? During a treatment session, a vaginal probe is inserted into the vagina. A laser energy is delivered to the vaginal wall which stimulates a healing process through collagen growth and increased vascularization, improving the overall condition of the vagina. So, what can a patient expect from the procedure?
1. It is done in-office and is a short non-surgical procedure.
2. For the diagnosis of vaginal atrophy, there are 3 5-minute treatments that happen at 6-week intervals.
3. For the diagnosis of lichen sclerosus, there may be up to 7 external treatments performed in a 12-month period.
4. Treatment requires no anesthesia or downtime, and it is a relatively painless procedure that allows patients to resume intercourse within 2 to 3 days.
5. The procedure is fast, simple, and safe, and causes minimal side effects. Possible side effects include spotting, watery vaginal discharge, redness, swelling, inflammation, tenderness, itching, irritation, changes in pigmentations and scarring.
Why Choose West Des Moines OB/GYN?

West Des Moines OB/GYN is the only OB/GYN group in the Des Moines area to offer MonaLisa Touch, and an all-female provider at that. Because we understand on a fundamental level the health challenges women sometimes face, we have an especially important duty to offer the best possible treatment options for our patients’ conditions. Each doctor at West Des Moines OB/GYN takes seriously the responsibility of ensuring our patients receive the highest quality of individualized care available.

If you have been experiencing any of the symptoms we addressed above and would like more information about MonaLisa Touch treatment, give us a call or schedule an appointment.
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Gynecology
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Aug
09
2018
Understanding High-Risk Obstetrical Care
The blessing of pregnancy may come with a whirlwind of emotions. You may be feeling excited, nervous, joyful, anxious, and a host of other emotions, all of which can be amplified by the news that it will be a high-risk pregnancy. At this point as a mommy-to-be, you are probably trying to learn as much as possible about what to expect over the next few months. Keep it up! Preparing for what comes next is important and even more so when it comes to high-risk pregnancies.

What does it mean to have a high-risk pregnancy?

A pregnancy is considered high risk if, at any point during the pregnancy, the life of the mother or baby are threatened. A high-risk pregnancy often requires more specialized care for the mother and the baby. There are various factors, for the baby and the mother, that can lead to a pregnancy being designated high-risk, such as:

For Baby
- The potential for premature birth, which increases the likelihood of health complications.
- Defects or conditions found during prenatal testing which may, or may not, endanger the baby’s life.
For Mother
- Some pregnancies develop into high-risk pregnancies due to symptoms and physical changes that occur as the mother progresses through her pregnancy.
- The existence of the mother’s pre-existing health conditions, which may increase potential risks during pregnancy.
- Serious health issues that can threaten the life of the mother, or her baby, or are known miscarriage risks such as advanced maternal age, obesity, high blood pressure, blood clotting disorders, thyroid disorders, diabetes, etc.
What exactly causes a high-risk pregnancy?

Complications during a previous pregnancy may increase your risk with subsequent pregnancies. These prior complications will cause your doctor to monitor your progress more closely. Pre-existing health conditions may also cause a pregnancy to be classified as high-risk from the very beginning. If the following conditions have affected you make sure you speak with your doctor, as they may negatively affect your pregnancy.
- Blood disorders like sickle cell disease or clotting disorders
- Chronic kidney disease
- High blood pressure or preeclampsia
- HIV or AIDS
- Lupus
- Maternal age over 35 years old
- Obesity
- Thyroid conditions-Hyperthyroid or Hypothyroid
- Type 1 or Type 2 diabetes
- History of preterm labor or birth
- History of uterine surgery such as multiple cesarean sections or myomectomy
Today, there is plenty of information warning against unhealthy lifestyle habits and highlighting the adverse effects they may have on your life. Smoking, alcohol consumption, and substance abuse are common lifestyle choices that can negatively affect a pregnancy. Smoking increases the likelihood of giving birth to a preterm baby and could result in a low birth weight. Fetal exposure to alcohol can cause serious harm or even death of the infant. Substance abuse may affect a developing baby in a variety of ways, causing preterm delivery, neonatal dependency, neonatal withdrawal, developmental delays and other birth defects.

Does my prenatal care differ because I’m high risk?

A high-risk pregnancy will surely necessitate more frequent prenatal visits and close monitoring, but the difference in prenatal care will be entirely dependent upon the circumstances. If a condition is serious enough it may be necessary to be referred to a Maternal-Fetal Medicine doctor for specialty care. West Des Moines OB/GYN refers these cases to Dr. Neil Mandsager and Dr. Jona Conklin at the Perinatal Center of Iowa.

Questions To Ask Your OB/GYN

What specific factors make my pregnancy high-risk? Should I be seen by a specialist?

Finding out what makes you at higher risk can help you understand what additional care and monitoring you may need throughout your pregnancy and delivery. The doctors at West Des Moines OB/GYN Associates are happy to explain what factors have led to a high-risk designation and whether you will need to be evaluated by a specialist.

How long has this office been open?

It may feel that there are several unknowns when it comes to a high-risk pregnancy. It may be comforting for you to know that an office is well established and that your doctors have plenty of high-risk obstetrics experience. West Des Moines OB/GYN Associates has been in practice for over 25 years.

How many doctors will I see?

At West Des Moines OB/GYN Associates your visits will alternate between all of the doctors in the group, so that you may become familiar with each doctor. Getting to know each doctor personally creates comfort and confidence when it is time to deliver your baby. All of the doctors cycle through a rotation of “on-call” duties and perform deliveries regularly. To ensure we provide the best care possible, there may be some high-risk cases in which we restrict care to 2 or 3 physicians.

Who is available for call-in questions?

You want to know that your questions will be answered when they arise. Ask what number you should call for questions and who you’ll be speaking with. West Des Moines OB/GYN offers dedicated OB call-in nurses at 515.223.5466 during the following daytime hours:
- 8:30 a.m. – 4:30 p.m. Monday – Thursday
- 8:30 – Noon Friday
- After-hours and weekend emergencies are directed to the “on call” doctor
Is there a number for off-hours problems and emergencies?

Sometimes you’ll have questions or concerns arise outside of normal business hours. Ensure that there is a number you can call after hours and how to notify your doctor in case of an emergency. At our office, if you have an emergency after hours, the on-call physician can be reached by calling 515.223.5466 and pressing “9”. If you are unable to reach a physician and you have a real emergency, please go to the emergency room. The physician will return your call as soon as possible.

What high-risk conditions do they treat?

If you’re a first-time mother or are looking for a new OB/GYN office, you may want to know that your new physician has experience with high-risk pregnancies. All of our practitioners are Board-Certified in Obstetrics and Gynecology which includes high-risk pregnancy care, often in coordination with a Maternal-Fetal Medicine specialist. Our high-risk obstetrical care includes but is not limited to:
1. Twin gestation
2. Hypertension/Preeclampsia/Eclampsia
3. Gestational Diabetes
4. Advanced maternal age
5. Preterm labor
6. History of incompetent cervix
7. Pre-existing maternal conditions
  
  Heart disease including essential hypertension
  
  Respiratory disease including asthma and pulmonary embolism
  
  GI disease including Crohn’s and Celiac disease
  
  Hematologic conditions including Sickle Cell disease and clotting disorders
  
  Pre-existing diabetes type 1 and type 2
With which hospitals are they affiliated?

Maybe you have a specific hospital at which you wish to deliver. Or you just want to know that the hospital is well-equipped for high-risk pregnancies. You should find out which hospitals your OB/GYN delivers at and whether that fits your birth plan. West Des Moines OB/GYN Associates performs all deliveries at the main campus of Mercy Medical Center, which is the safest and best-equipped facility to handle a high-risk delivery. Mercy Medical Center is a level 4 facility for Obstetrics with a dedicated Obstetrics Emergency Department.

This campus also has a level 4 Neo-natal Intensive Care Unit (NICU) to assist with any special treatment a baby may require after birth.

How often will I get to meet with the doctor face to face?

Each high-risk case requires individualized care. Typically, the frequency of appointments will increase as the patient reaches the third trimester, at which point visits might be weekly or twice weekly. If there is a problem or concern, we will always prioritize our patients’ needs.

Will my treatment be individualized or will set protocols be followed?

Your pregnancy is unique and you want to know that your care will be individualized to your specific needs. West Des Moines OBGYN will individualize your care plan every step of the way. All of our Board-Certified physicians follow the recommendations put in place by the American College of Obstetrics and Gynecology, and the Society for Maternal-Fetal Medicine. For high-risk pregnancies, we may coordinate your care with local Maternal-Fetal Medicine physicians.

What procedures are done at the clinic/office? Which procedures take place in a hospital or ambulatory center?

You’ll likely be meeting with your physician more often with a high-risk pregnancy, and you may want to know where you’ll be traveling for your appointments. Whether it’s for your commute or your comfort, find out where different procedures you may need will take place. We perform 3D/4D Fetal Ultrasound, Non-stress Tests, Biophysical Profiles, and optional genetic testing, including Cell-Free DNA Testing, in our office. A referral to Maternal-Fetal Medicine would be made for Chorionic Villus Sampling, Amniocentesis and further invasive testing and treatment.

Why Choose West Des Moines OB/GYN Associates?

At West Des Moines OB/GYN, we pride ourselves on providing individualized care plans for all our patients. From preconception to postpartum, we will care for your baby, your body and your mind. Whether you’ve had a previous high-risk pregnancy or are a first-time expecting mother, your pregnancy is unique and we want to be sure all your questions are answered and concerns heard. Our priority is you and your baby. Schedule an appointment today and experience the difference.
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