Women’s Health Week #3 – Contraception & Birth Control

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By Dr. Hadass Fuerst & Dr. Marissa Jacobs

Women’s Health Week is May 8 -14 and this year NOAH is highlighting three health issues that women should be familiar with and discuss with their provider any time of year.

NOAH recommends that everyone have a primary care provider (PCP) and a medical home. If you don’t have one or both of these, contact NOAH and establish a PCP who is right for you!

Contraception & Birth Control

Nearly 65% of all women between age 15 and 49 in the U.S. use some form of birth control. But the reasons why are more than pregnancy prevention. Learn more about the types and uses for contraception from two of NOAH’s family medicine providers, Dr. Hadass Fuerst and Dr. Marissa Jacobs.

Why use birth control?

Birth control reduces the chances of an unintended pregnancy when used correctly. But beyond that, many individuals use hormonal birth control to help regulate menstrual cycles, prevent ovarian cysts, regulate hormones, and reduce menstrual pain, Acne, and excessive body hair growth.

What are different contraception options?

You have options but talk to your PCP or OBGYN about what method is right for you. Here are the different types of birth control available:

  • “The Pill” – A daily pill that combines two hormones: estrogen and progesterone. Failure rate: 7%.
  • Progestin-Only Pill – Like “The Pill” above but only the hormone progesterone. Failure rate: 7%.
  • Implant (Nexplanon) – This is a small rod placed in the arm by your doctor that gives a continuous dose of progestin slowly over 3 years. Low failure rate: 0.1%.
  • IUD (Intrauterine Devices) – These small T-shaped devices are placed in the uterus by your doctor. There are two options:
    • Hormonal: Releases a small hormone dose each day and can last 3 to 6 years. Low failure rate: 0.1% – 0.4%.
    • Copper: Can stay in your uterus for up to 10 years. Low failure rate: 0.8%.
  • Injection/Shot – This is a progestin shot every three months. The biggest side effect of the injection is weight gain. Failure rate: 4%.
  • Patch – The patch placed on a person’s skin releases hormones. A new patch is put on each week for three weeks, with no patch during the fourth week. These can be difficult in hot climates because it doesn’t stick as well. Failure rate: 7%.
  • Vaginal Ring – The ring releases estrogen and progesterone. You wear the ring for three weeks and then remove it on the fourth week. Failure rate: 7%.
  • Other methods:
    • Diaphragm – 16% failure rate
    • Male condom – 18% failure rate
    • Female condom – 21% failure rate
    • Cervical cap – 23% failure rate
    • Sponge – 24% failure rate
    • Fertility based methods (tracking cycle days, basal body temperature) – 26% failure rate
    • Spermicide – 28% failure rate

How to pick the right form of birth control?

Remember that not everyone will respond the same way to every form of birth control. And not everyone has the same reason for needing birth control. Be sure to discuss with your provider any types of current or previous forms of birth control used and any side effects so together you will find the right form of birth control for you!

The Benefits and Support for Breastfeeding Month

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By Dr. Roberta Matern, MD

I am a family physician who delights in caring for the couplet (newborn and new mother) because helping growing families is so rewarding, and I strongly encourage breastfeeding and support families however I can.

Trusted organizations like the American Academy of Family Physicians and the American Academy of Pediatrics recommend babies are breastfed until at least 6 months old. Studies show that exclusively breastfed babies are generally healthier, but any amount of breastmilk is wonderful and encouraged!

Benefits of Breastfeeding

In general – though individual babies may differ – babies fed only breastmilk for their first 6 months have many benefits; moms too!

  • Babies tend to be healthier with fewer colds and doctor visits.
  • Decreased likelihood of SIDS (sudden infant death syndrome).
  • Babies are less likely to have diabetes, obesity, leukemia, and high blood pressure later in life.
  • Helps moms lose weight.
  • Decrease mom’s chances for breast cancer, diabetes, heart disease, and high blood pressure.
  • Breastfeeding has the added bonuses of no waiting for formula to warm up, it is free, and it is easy on the environment.
  • And more!

It’s Not Always Easy

While natural and better for babies and moms, breastfeeding can have challenges, and helping the couplet through that is important.

Challenges include:

  • The time it takes to get it going, especially if it is your first baby
  • The time commitment, which can be stressful for some moms and families
  • Moms needing to watch what they eat and drink – too much caffeine and alcohol, dairy, spicy foods, etc.

The good news is, we have lactation consultants that love being able to help moms and families through these issues!

Plan for Breastfeeding

I start talking about breastfeeding during prenatal visits, exploring mom’s feelings and answering questions. If there are any issues with mom’s breasts or nipples, I try to coordinate with a lactation consultant before delivery.

Next is promoting skin-to-skin contact right after delivery. Putting the newborn directly on mom’s belly or chest right after birth improves chances of exclusive breastfeeding and increases the duration of breastfeeding! Skin-to-skin helps mom and baby bond by increasing their levels of oxytocin…the “love” hormone.

Helping families know what is normal and what to expect during the first few days is key. At first, mom’s breasts produce colostrum – a very important food for babies full of nutrients and antibodies that fight infection. There is only small amounts of colostrum produced and babies will eat frequently because their stomachs are only about the size of a cherry – so they fill up and empty quickly.

A few days after delivery, mom’s breast milk will come in and that’s about the time babies’ stomachs start to grow. Newborns eat a lot and it’s important (regardless of breastfeeding or not) to learn your baby’s ques to know when they are hungry. Moms should have babies close to them and continue skin-to-skin during those early days and weeks.

While breastfeeding is recommended through 6 months, it can continue for months (or even years) after that. The World Health Organization recommends breastfeeding until age 2, while most couplets in the US do not breastfeed for that long. But any amount of breastfeeding is super healthy for baby and mom!

If you have questions about breastfeeding, talk to your NOAH prenatal doctor or your baby’s pediatrician. 

Maternal Mental Health Awareness Month: More Than Postpartum Depression

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By: Alyssa Fagan-Clark, LMSW |Behavioral Health Counselor

During May, we celebrate Mother’s Day and Maternal Mental Health Awareness month! We often think of new motherhood as a time of excitement, care giving, happiness, and a deep sense of love. And while it is often all these things, conditions like postpartum depression can also be a period of intense struggle and uncertainty for many mothers and their loved ones.

According to Postpartum Support International, perinatal mental health disorders are the number one childbirth complication. One out of every seven mothers will face some form of postpartum mental health disorder, and the number is much higher for women of color with one of every three mothers impacted.

According to the CDC, the rate of maternal depression diagnoses at delivery is increasing. In 2015, the rate had increased seven times from where it was in 2000! This is more than the slight emotional changes most women – around 80% – experience in the 3-5 days after childbirth known as the “Baby Blues” period.

The “Baby Blues” happens after childbirth, when a woman’s body undergoes extreme hormonal and physical changes, in addition to the added emotional stress of caring for a newborn. This period typically lasts 2 weeks or less. Symptoms of the “Baby Blues” usually include moodiness, tearfulness, feeling overwhelmed, and general tiredness. While these emotional changes are normal and expected for most women, significant mood changes occurring for moms past this two-week period are a sign that she likely needs additional mental health support. While postpartum depression is a term many people may be familiar with, there are many other types of mental health disorders new mothers face.

Perinatal mental health disorders can include:

  • Anxiety
  • Depression
  • Obsessive compulsive disorder
  • Post-traumatic stress disorder
  • And in rare cases, psychosis

Mothers who experience symptoms of these disorders may find themselves scared, uncertain, or even ashamed. Most mothers don’t expect complications like this during a time they thought they would be their happiest.

There are some risk factors for perinatal mental health disorders, including:

  • Personal or family history of mental illness
  • Economic stress
  • Having a baby who experienced a NICU stay
  • Experiencing an especially stressful or traumatic birth
  • Certain health diagnoses such as a thyroid issue or diabetes

A new mother’s best and most immediate source of help may be close friends and family members, who can recognize if she is struggling emotionally and assist her to get connected with professional support.

Luckily, the NOAH behavioral health team has mental health practitioners who are specially trained to work with new mothers (and fathers) who are struggling with mental health needs in this special time. If you or a parent you know needs care, please contact NOAH today.

Understanding & Preventing Some Birth Defects

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By Dr. Lindy Truong

Birth defects are not uncommon. Every year, one out of every 33 babies is born with some kind of birth defect ranging from minor, to those with life-long challenges. Some are preventable, and many can be managed better with proper care and support from a medical team.

There are, however, some factors that increase the risk of having a baby with a birth defect. January is National Birth Defects Prevention Month, so here are ways to increase the chance of having a healthy baby. This year’s theme is “Best for you. Best for baby.”

Healthy Moms for Healthy Babies

One of the most important steps a patient can take to having a healthy baby is to make sure they are healthy themselves prior to getting pregnant and throughout pregnancy. One of the most important ways to do that is to maintain a healthy weight before becoming pregnant, since women will gain weight during pregnancy. Babies born to obese women have an increased risk of having birth defects, such as heart and spinal cord defects.

Folic Acid During Pregnancy

Folic acid plays a big role in a baby’s development during pregnancy. Women who are pregnant or might become pregnant should try to have 400 micrograms of folic acid every day. In early development, folic acid helps form the neural tube—a structure that begins forming in the first 3 to 4 weeks after conception. Later, the neural tube becomes the brain and spinal cord. Folic acid is important in preventing birth defects that affect the baby’s brain (anencephaly) and spine (spina bifida).

Prenatal Care

Starting prenatal care as early as possible during a pregnancy has shown to increase healthy, full-term deliveries. If someone is pregnant, they should start prenatal care as soon as they think they might be pregnant. It will be important to continue all prenatal appointments throughout the pregnancy. These appointments ensure that both baby and mom are healthy, monitor any medications because some can cause birth defects, and so much more.

Preventative Health

Being current on vaccinations is important to protecting both mother and baby. The two most important vaccines to have during pregnancy are the Flu and Tdap (tetanus, diphtheria, and pertussis a.k.a. whooping cough) vaccines. When mothers get these vaccines during pregnancy, it also protects them from the flu and whooping cough for a short period post-delivery as well!

What to Avoid

Last, but not least, it is very important to avoid substances like alcohol, smoking, and recreational drugs. These can seriously increase the risk for birth defects. Drinking any alcohol during pregnancy can increase the risk of fetal alcohol syndrome and defects. Smoking and recreational drugs similarly increases the risk that the baby will be born smaller and with birth defects.

Expecting a baby can leave the parents with many questions, which is why having a trusted medical home for you and your baby is so important. If you plan to get pregnant, take care of yourself and do what is best for you, because it is also what is best for the baby.

You can schedule a preconception visit with your healthcare provider before you even become pregnant, which is a good place to start. Being healthy before pregnancy sets a good foundation for a healthy pregnancy. Continue with regular prenatal visits for close monitoring along the way. These are simple yet important things one should do to prevent birth defects in their baby.

June is World Infertility Month by Katelyn Millinor, LPC

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Infertility is defined as the inability of a sexually active, non-contracepting couple to achieve pregnancy in one year.

World Health Organization

June is World Infertility Month. This topic can be difficulty for people to deal with but millions of women and men deal with infertility, and mostly in silence. The CDC reports that 12.7% of women 15-49 years of age have received some type of infertility service. It is important to stay educated on risk factors and strategies to help manage the emotions associated with infertility.

Many risk factors for both male and females are the same while others are gender specific. Infertility is not solely a women’s issue as about 30% of infertility cases involve male factors.

Risk factors for women include:

  • Chronic diseases such as diabetes, hypertension, asthma etc.
  • Hormonal imbalances.
  • Age.
  • Sexually transmitted diseases.
  • Fallopian tube disease.
  • Endometriosis.

Risk factors for men include:

  • Cigarette or marijuana use.
  • Hernia repair.
  • Certain prescription drugs for ulcers or psoriasis.
  • Undescended testicles.

Infertility can often create one of the most distressing issues for couples. Infertility brings to light deep emotions while dealing with the multitude of medical decisions and the uncertainty that follows. Feeling depressed, anxious, or isolated are only a few of the emotions in the process of pursuing infertility or infertility treatments. The journey can be very hard.

If you are struggling with infertility consider the following tips:

  • Give yourself permission to be angry.
  • Allow your partner to cope and feel differently than you.
  • Improve your communication about infertility.
  • Improve relaxation skills such as deep breathing.
  • Try a support group (consider Resolve.org).

Consider discussing this with a mental health professional to clarify thoughts and help with decision making. Counseling may be helpful for learning how to cope with physical and emotional changes, communication with your partner, and to strengthen coping skills to manage moving forward. NOAH is here to help. Our counselors and medical staff are here to support you through your journey of infertility.

Things to Pack for the Big Event

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Get a jump start on packing for the Big Event, giving you one less thing to worry about when #baby ready join the world! Our Care Team at NOAH will work with you and your #child to choose the best path for their overall #health and #wellness. To schedule an apt., please call 480-882-4545!


Newborn Care – Video

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Now that you have brought your #baby home from the #hospital, what do you do? Dr. Patty Avila, Pediatrician, shares some great bathing and socialization #tips to help you and your baby get off to a good start. Our Care Team at NOAH will work with you and your #child to choose the best path for their overall #health and #wellness. To schedule an apt., please call 480-882-4545!

National Birth Defects Month

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Birth defects affect one in every 33 babies born in the U.S. The goal of #NationalBirthDefectsPreventionMonth is to generate awareness noting birth defects are common, costly, and critical, and to offer steps that you can take to increase your chance of having a healthy baby.
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