Frequently Asked Questions (FAQs)
Birth Control
Q. When should I first start birth control pills and what are the general instructions?
A. In general, you should either start taking birth control pills on the first day of your period or the first Sunday after the start of your period (not the end), whichever your doctor recommended. This ensures that you are not pregnant, and helps maintain your period on the pill close to the time it would normally occur. It is very important to take your pill at the same time every day, and take every pill. If you ever forget, take it as soon as you remember. If you miss more than one pill, take two pills a day until you catch up, but expect to get some irregular bleeding and expect that you will need to use back-up contraception with a condom. As you finish each pack of pills, make sure you have already received your next pack so you can go straight from one to the next.
Q. Is it normal to have irregular bleeding or no bleeding while on birth control pills?
A. While most women expect to have a decrease in their periods when they are on birth control pills, it is not unusual for the period to get so light that there is no obvious bleeding, even on the sugar pills. This is perfectly normal and not a cause for concern. There is no need to “take a break” from the pill to have a period. Your period should go back to how it was before when you stop taking the pill. Sometimes you may have light bleeding or spotting randomly on birth control, which is also perfectly normal. This can be due to irregular pill taking, sickness, stress, other medications, or can happen for no obvious reason. Most of the time, you will go back to normal in one or two cycles. There is no established amount of time that it is “safe” to take the pill, and depends entirely on your history and particular circumstances. Your doctor will discuss this with you when you come in for your annual exam.
Q. If I am taking progesterone to start my period, when should I start bleeding?
A. If you have not had a period for a long time (not on hormonal birth control) or your uterine lining has built up, your doctor may give you a prescription for progesterone to help your period start. It is important that you take all the pills, even if your period starts while you are taking them. It may take up to two weeks past the time that you finish the last pill for your period to start. Every woman’s body may react a little differently.
Q. Is it normal to have unexpected bleeding (called breakthrough bleeding) on birth control pills?
A. Because hormonal birth control (including pills, the patch and the ring) affects the lining of the uterus, it is not unusual to have occasional breakthrough bleeding (BTB). This is most common in the first three months of starting, if you have recently made a change in your medication, and if there have been any other health-related issues, even those not directly related to your period. Finally, although we recommend that you always strive to take your pill on time every day, we understand that almost everyone has been late or missed a pill at one time or another. Of course, you will get your best results by being very consistent. For this reason, many women may prefer a non-daily birth control option.
Pregnancy
Q. What over-the-counter (OTC) medications can I use while I am pregnant?
A. In general, most Tylenol (acetaminophen) products are okay at the dose recommended on the bottle for everyday aches and pains. Most stomach remedies are also okay, such as for upset stomach, gas, and diarrhea. For a more comprehensive list, please see your pregnancy packet provided at the first visit, or our Web site (under Obstetrical Care Guidelines).
3D Ultrasound
Q. What is ultrasound?
A. Ultrasound is the technique utilizing high frequency sound waves to produce an image which can be recorded on CD.
Q. What is 3D ultrasound?
A. 3D ultrasound utilizes advanced technology to produce 3D images thus creating more "life-like" images of your baby.
Q. Is ultrasound safe?
A. Yes, ultrasound has been utilized by physicians for over 25 years on millions of pregnant women and no adverse effects have been established.
Q. Is this a diagnostic test?
A. No. A 3D ultrasound is for your enjoyment and to provide you with precious keepsake memories in the form of photographs and CD. We will not provide measurements or determine due dates.
Q. Can the sex of my baby be determined?
A. Most of the time, yes. However, sometimes under certain conditions it may not be possible to determine the baby's gender.
Q. How far along should I be?
A. The best time to photograph the fetus utilizing 3D ultrasound is between 26 and 30 weeks gestation.
Q. Who may accompany me?
A. It’s up to you who you want to include. Just remember they may have to take turns as the space around the machine is limited.
Q. Are there any special requirements from me?
A. You must provide proof of a diagnostic ultrasound and sign a release. (A note from your OB on letterhead or prescription form will be required if you are not a patient of KCWC.)
Q. Do I need a full bladder?
A. No. It’s not necessary. It’s more important that you are comfortable.
Q. I’ve heard that 4D Ultrasound is better than 3D ultrasound. Is this true?
A. There is a lot of confusion surrounding this terminology. Some companies use the term “4D Ultrasound”, whereas other companies make ultrasound machines with similar capabilities marketed under the terms “3D Ultrasound”, or “Live 3D”. There is essentially no difference.
Post Partum Care
Q. What do I need to know after delivery?
A. The way you care for yourself after you leave the hospital is an important part of your total health care. Follow these instructions to maintain your good post partum health.
Q. What should I do when I am ready to wean my baby from breast milk?
A. Regardless of how long you decide to breast feed (nurse or pump) your baby, at some point you will be ready to stop. There are several ways to accomplish this. While it is possible to stop “cold turkey,” we don’t routinely recommend that since it tends to be very uncomfortable/painful for you. Some babies may gradually wean themselves as they take formula or solids or both. Once you make the decision, we recommend that over the course of one to two weeks, you begin eliminating one session of nursing/pumping every two to four days depending on how much milk you have. Try to pick different times of the day. For example, if you first eliminate one in the morning, the next one should be at night. That way, you allow your body to slowly reduce production of milk. It is not necessary to take a medication to stop (“dry up”) your milk. Finally, it is normal that there may be a tiny amount of leakage for up to one year after you stop. There is no need to “check” by squeezing on your nipple after you have quit, as that may cause you to make more milk.
Gynecology
Q. Do I need a Pap smear and/or exam every year?
A. When there is constantly new information about screening guidelines, it can be hard to know what is right for you. In general, women who have not had any significant Pap smear abnormalities in the past or have not required treatment for significant abnormalities (laser, LEEP, or cone) may not need a pap every year. We continue to recommend that you receive a gynecologic exam every year including a breast and pelvic exam as there is more to women’s health than having a Pap smear. It is also an opportunity for your doctor to review any other concerns you may have.
Q. What are the symptoms of vaginal infection?
A. Many women will be diagnosed with a vaginal infection at some point, and some women have these frequently. The most common ones are either a yeast infection or bacterial vaginosis (BV). There are quite a few similarities. Both can cause itching, burning, rawness, or discomfort. Both are usually associated with increased vaginal discharge. While all women have some vaginal discharge, the amount can vary between different women as well as for the same woman at different stages of her life. You may be more susceptible if you have recently taken antibiotics or if you have a new sexual partner. There are over-the-counter medications that can be used to treat yeast infections or to help relieve the symptoms. While it is okay to use these once in awhile, if you don’t get better, or if you get frequent episodes, it is better to come in and have a test to make sure you are getting the correct treatment.
Surgery
Q. What do I need to know after surgery?
A. Naturally, you should expect your life to improve now that you have had surgery, but first, your body needs to heal. How long your recovery will take is an individual matter. Follow these general instructions to guide your recovery.
Mammography
Q. Do I need a physician’s order for a routine mammogram (MMG)?
A. If you are 40 or over, you do NOT need an order for your regular screening MMG. You may call the center where you typically go and make an appointment. Please make sure they have the correct physician’s name when you have your mammogram performed so your doctor receives your report. However, if you are having a problem with one or both breasts, such as pain, a lump, or something else, please call your doctor first. In some cases, we may need to order a different/additional test, or we may need to see you first.