AdventHealth Medical Group OB/GYN at Littleton

Starting around age 20, women begin to establish routines that are important to their reproductive and sexual health that they will continue throughout most of their life. During our routine gynecological appointments, we will discuss any health issue of concern. Routine gynecology care includes discussion and treatment of:

• Menstruation, including missed or irregular periods, painful periods and heavy bleeding
• Pre-pregnancy health
• Sexually transmitted diseases
• Pelvic exam and routine Pap smears

We also treat women for conditions and diseases of the breasts and reproductive systems, including:

• Abnormal uterine bleeding
• Uterine fibroids and cysts
• Labial adhesions
• Pelvic pain
• Polycystic ovarian syndrome (PCOS)
• Sexually transmitted infections
• Vulvar ulcers or lesions
• Vulvovaginitis and vulvitis
• Urinary incontinence

Gynecologists are often considered a woman’s primary care provider, especially through menopause when they see us annually for their well-woman visits. Because of this, we will talk with you about all recommended health screenings beyond those for your reproductive health system. We can perform most of these screenings at your routine annual gynecology appointment or make a referral for the test.

Routine health screenings for women include:

• Height, weight and body mass index (BMI): If your weight or BMI is above normal, we may recommend testing for diabetes. We offer nutrition and weight-loss care, including injectables, within our practice.
• Cervical cancer screening: Pap tests screen for abnormal cells in a woman’s cervix that could be cancerous or become cancerous. We recommend Pap smears every three years between ages 21 and 65 (or every five years when combined with an HPV test).
• Breast screening: Regular self-breast exams are no longer recommended; however, you should be aware of what your breasts feel like normally and alert us of any changes. We recommend annual mammograms to screen for breast cancer and other breast conditions starting at age 40 if you have no risk factors. Schedule a breast screening.
• Blood pressure and cholesterol tests: We will check your blood pressure at every visit, and we will recommend blood testing, including cholesterol screening, beginning with a baseline test by age 21 and then every three to five years.
• Skin check: We will examine you from head to toe to check for any worrisome signs of skin cancer. Our altitude and near year-round sun make this check very important.
• Lifestyle assessment: Good health habits — including exercise, a healthy diet, avoiding or quitting smoking and limiting or avoiding alcohol and marijuana — are the foundation of good health at every age. We’ll talk about these practices with you, not to make you feel guilty but to help encourage your journey.
• Mental and spiritual health: Because we believe in whole-person health, we will ask you about your mental and spiritual health at every visit. These are not religious questions but rather questions about joy and fulfillment. If you are struggling, we offer a behavioral health therapist on staff and can help you access spiritual health counseling through AdventHealth Littleton.

Reproductive health is an important and major part of every woman’s life. Whether you are wanting to avoid pregnancy or you are considering becoming pregnant, our Littleton OB/GYN team can help you understand your options and achieve your goals. We provide:

• Contraception options: We provide all types of contraceptive methods to help you avoid unwanted pregnancy, including birth control medications, IUDs and contraception implants (also known as long-acting reversible contraception, or LARC).
• Pre-pregnancy planning: If you are considering pregnancy, seeing an obstetrician first will get you off to the healthiest start possible. We’ll assess your overall health and address any health conditions or medications that may impact either your chances of getting pregnant or your pregnancy. Almost all health conditions can be managed before, during and after pregnancy.
• Fertility treatment: If you’ve been trying to get pregnant without success, we will assess you and your partner’s overall health and reproductive system to diagnose and treat issues, such as low sperm count in your partner or obstructed fallopian tubes or uterus in you. We’ll address common health or lifestyle issues, such as smoking, being over- or underweight, drinking too much caffeine and taking certain medicines that can make it harder for you to get pregnant. We also will help you create an ovulation calendar and give you tips on the most effective times to get pregnant. If you or your partner’s fertility problems require a specialist, we can help you find one to meet your needs.

If you are thinking about becoming pregnant or you are pregnant, our Littleton obstetric team is here for you. Once you choose an obstetrician or midwife within our practice, you will see your provider for most visits throughout your pregnancy journey. Our patients love this aspect of our practice because of the consistency. Of course, however, our providers do take vacations or otherwise need to be out of the office, so we can’t guarantee that you’ll have your provider at every visit.

Our Littleton obstetricians and midwives will care for you before, during and after your delivery. We offer:

Prenatal Care

As soon as you know you are pregnant, you should schedule your first prenatal visit. Early and regular prenatal care will help you stay your healthiest throughout your pregnancy, which, in turn, helps your baby be the healthiest possible. Regular prenatal care helps detect any issues in you or your baby early when they are most effectively treated.

We recommend having your first prenatal visit about eight weeks after your last period. With a healthy pregnancy, you can expect to follow this prenatal visit schedule:

• Weeks zero to 28, every four weeks
• Weeks 28 to 36, every two to three weeks
• Weeks 36 to birth, once a week

During these visits, your obstetric provider will check your health and make sure your baby is developing according to schedule. We’ll also recommend several tests throughout your pregnancy, including:

• Routine health tests: We’ll check your weight and blood pressure at every visit along with your baby’s heartbeat.
• Urine test: Using a simple urine sample, we can check for urinary tract infections and gestational diabetes. A urine test also detects protein in your urine, which is a sign of preeclampsia.
• Ultrasound exam: We use this imaging test, which uses high-frequency sound waves, to look at your baby’s growth and development. We also can use it to determine your baby’s gender (if you want to know that before birth).
• Glucose tolerance test: Helps us diagnose gestational diabetes.
• Group B streptococcus culture: Tests for bacteria that can cause newborn health problems.
• Maternal serum screening: Detects pregnancies at high risk for chromosomal disorders or neural tube defects.
• First-trimester screening: Detects pregnancies at high risk for chromosomal disorders and other issues such as heart defects.
• Optional testing, including:
  • Amniocentesis: Testing of the fluid around your baby to diagnose certain birth defects such as Down syndrome, cystic fibrosis or spina bifida.
  • Chorionic villus sampling: A sample of tissue from the placenta can diagnose certain birth defects, including chromosomal and genetic disorders.

Labor and Delivery Care

When the big moment arrives, we will be right there with you. But we will have worked with you long before to make your labor and delivery go as smoothly as possible. During your prenatal visits, your maternity doctor or midwife will talk with you about what to expect during labor and delivery. We’ll also discuss your options and preferences to create a birth plan, such as:

• Do you want to use pain-relief medications during your delivery?
• Do you want to be able to move around or use labor props such as an exercise ball, peanut ball or birthing stool?
• If you've previously had a C-section, do you want to have a C-section for this delivery or do you want to have a VBAC?

We deliver all of our babies at the AdventHealth Littleton BirthPlace, which features private birthing suites and a Level III neonatal intensive care unit. We recommend you take a tour of the labor and delivery unit during your pregnancy, preregister and take some of the many birth classes they provide. View upcoming classes here.

Postpartum Care

Our care doesn’t stop when your baby is born. We will see you after your birth experience to check that your body is healing. During these visits, we’ll also discuss lifestyle issues, such as stress and sleep, and assess your mental health. If you develop postpartum depression, our on-staff behavioral health therapist will be here to help you manage this condition, which affects about 15% of new moms.

Every woman’s journey through midlife and menopause is different. Some women will begin experiencing symptoms such as hot flashes, disturbed sleep, mood swings or weight gain several years before going through menopause, a time that is called perimenopause. Other women will hardly know they are going through this time of transition.

Our Littleton gynecologists have specialized expertise in treating perimenopause and menopause with lifestyle changes, over-the-counter aids and hormone replacement therapy. We also will discuss how menopause and the reduction in estrogen affects your overall health. For example, after menopause, you will be at increased risk for heart disease and certain types of cancers, so knowing how to prevent these from developing and when to get the appropriate screenings is important.

We perform in-office procedures as well as minimally invasive gynecological procedures for a number of health issues. Some of the procedures we perform include:

• Colposcopy: This is an in-office procedure used if you have an abnormal Pap smear to check your cervix and the wall of your vagina for abnormal tissue.
• Minimally invasive gynecological surgery: We perform most gynecological surgery laparoscopically through small incisions using tiny tools inserted via tubes. We perform laparoscopic gynecological surgery to treat many conditions, including endometriosis, fibroids, ovarian cysts, ectopic pregnancy, urinary incontinence and uterine prolapse. We also perform minimally invasive hysterectomies.

As girls grow into young adults, it can be an overwhelming time. But it doesn’t need to be. We can help your daughter understand and embrace the changes in her body as she grows.

At your daughter’s first pediatric gynecology exam, our primary goal is to establish a positive and trusting relationship. Her first appointment is educational. During this appointment, we will:

• Talk about what to expect during puberty, including menstruation
• Discuss age-appropriate topics around sexual health and safety, including online safety (please know that we will talk with parents first to understand what you feel is appropriate and you want us to discuss)
• Dispel myths, which is especially important with today’s online access
• Perform a visual exam of breasts and external genitals (we usually won’t perform an internal exam unless there is a specific reason)