Vaccines during pregnancy: what expectant moms need to know

Some vaccines can be an important part of protecting the health of both mom and baby.
Some vaccines can be an important part of protecting the health of both mom and baby.

Dr. Jacqueline Kates

August is National Immunization Awareness Month

When it comes to health and wellness in pregnancy, any choice an expectant mom makes is for two (or more!)—including whether to receive vaccines. During National Immunization Awareness Month, we’re taking the opportunity to educate our patients and all pregnant women on this critical area of their care.

As with any medical treatment, recommendations around vaccinations center on risk vs. benefit. In general, a vaccine that contains inactive viruses is safe in pregnancy, and its protective benefits almost always outweigh its risk.

The flu shot and the Tdap vaccine—which prevents against tetanus, diphtheria and pertussis (whooping cough)—are primary examples of vaccines that contain no live viruses.  Not only do these vaccines protect both mother and fetus from potentially serious infections, but the baby will then retain some of that immunity after birth. For these reasons, we routinely recommend that women receive the flu shot and the Tdap vaccine during pregnancy.

That having been said, it’s important to note that only the flu shot—not the nasal mist—is recommended in pregnancy, as the nasal mist is made from a live virus. Other common vaccines that contain live viruses include the chickenpox (varicella), measles-mumps-rubella (MMR) and shingles (varicella zoster) vaccines. Since it’s possible a live virus vaccine, while generally safe for children and infants, could pose a risk to the baby, pregnant women should avoid these vaccines.

Health care providers may recommend other vaccines during pregnancy in certain cases, such as upcoming travel outside of the U.S. If a mom is at higher risk for infection due to certain health factors, we may determine that hepatitis A and hepatitis B vaccines would be beneficial.

It’s the job of your obstetric provider to explain the risks and benefits of receiving any vaccine, and to make recommendations based on your particular situation. Call us with any questions or to make an appointment. We can help you make the best choices for your baby’s health and yours.

A hot topic: menopause myths busted

The hype surrounding menopause often makes the anticipation worse than the actual experience
The hype surrounding menopause often makes the anticipation worse than the actual experience

Dr. Robert Wool

Women often look forward to menopause with a mix of anticipation and dread. On the one hand, not having their period anymore may be a welcome relief. However, the thought of hot flashes and other symptoms and changes that accompany this phase of life can seem daunting.

With many of our patients, we’ve found the hype surrounding menopause often makes the anticipation worse than the actual experience.

Menopause Takes Time

Many of the changes women experience as they enter menopause are gradual. You are clinically in menopause once you have not had a period for 12 months. But it’s not like flipping a switch; it can take anywhere from several years to a decade for that to occur. During that period, which we call perimenopause, your body is experiencing gradual changes.

For example, it’s important to know that missing a period or two does not mean you are in menopause. Even if your periods become irregular or if you don’t have one for a few months, you may still be fertile and able to conceive until you are truly in menopause.

Hot Flashes

People also have misperceptions about hot flashes, perhaps one of the most talked about symptoms of perimenopause. But not all women experience hot flashes as they enter menopause and those who do don’t all have the same experience. Hot flashes can range from mild to moderate or severe. Some women have a few episodes and others have them more frequently. Others may experience them only at night.

Hot flashes are not the only symptom of menopause. There is a wide range of changes and symptoms women may experience, including sleep disruption, irritability, mood swings, changes to skin and hair, weight gain, vaginal dryness and incontinence.

Easing the Transition

The majority of related symptoms are the result of decreased estrogen production during the perimenopausal and menopausal years. The good news is there are ways we can correct or minimize the severity of many of these symptoms.

Treatment options vary based on specific symptoms. Hormone replacement therapy may help alleviate several symptoms, but many women are reluctant to take them.

There are certainly women for whom hormone replacement is not recommended due to other health issues, such as high cholesterol or blood pressure, obesity, breast cancer and other conditions. For generally healthy women, however, hormone replacement can help ease the transition to menopause.

Talk to your healthcare provider about your specific symptoms. It’s often helpful to jot down notes about what you are experiencing, from trouble sleeping too hot flashes and other symptoms, to track frequency and severity. This can help us come up with strategies that will work best for your individual situation.

 If you are beginning to experience signs of menopause, or are struggling with some of the changes, schedule an appointment and we’ll work with you to address any concerns.

Practicing safe sex important for both lesbians and heterosexual women

2 woman hugging
It’s important for your health care providers to have a complete picture of your health and lifestyle.

June is Lesbian, Gay, Bisexual and Transgender Pride Month

Debra Ames, CNM

While all women face certain health risks just by being women, those who have same-sex partners may mistakenly believe they are at less risk than heterosexual women. In honor of June as Lesbian, Gay, Bisexual and Transgender Pride Month, we discuss these conditions and how you can reduce your risks.

Understanding your personal health risks is important. For example, depression is more prevalent in women than men, but women who are lesbians or bisexuals can be at a higher risk of depression and anxiety. That’s why it’s important for your health care providers to have a complete picture of your health and lifestyle.

Women who have sex with women are less likely to get vaginitis but are still at risk for certain sexually transmitted infections (STIs) such as human papillomavirus (HPV), herpes, HIV, bacterial vaginosis and trichomoniasis (a parasite infection).

Just like with heterosexual sex, if you are a woman who has sex with other women, you should practice safe sex and have regular checkups and screenings to reduce your risks, especially if you are not in a monogamous relationship in which both partners have been tested for STIs.

Some infections may not have symptoms, but can still be passed along, which underscores the need for regular testing. Having the appropriate vaccinations is also important, such as those for HPV, hepatitis A and hepatitis B.

It can be a challenge for lesbian and bi-sexual women to find a provider with whom they feel comfortable. But it’s key to find a provider with whom you can be honest about your health concerns so you can make routine health care a priority. Annual checkups paired with the appropriate testing, as well as seeking care at the onset of concerns or symptoms, will go a long way in terms of reducing your health risks.

If you are looking for a women’s health provider who takes the time to get to know patients and enjoys providing a personal level of care, call us for an appointment today.

Create a checkup checklist for your next appointment


Make a list of things you want to discuss during your appointment so you don’t forget anything.
Make a list of things you want to discuss during your appointment so you don’t forget anything.

Dr. Jacqueline Kates

May 15 is National Women’s Checkup Day, which serves as an important reminder for women who are often taking care of children, parents and/or partners, that they also need to make time to care for themselves. Annual checkups can play a significant role in your overall health, especially because health care has become more personalized over the past few years.

For example, recommendations about routine screenings have changed. New guidelines take into account women’s health and family histories when determining when screenings such as annual mammograms and PAP smears should start and how frequently they should be repeated.

However, even if annual Pap smears aren’t recommended for you, you will still benefit from an annual checkup. There are many sexual, reproductive and gynecological health issues that are important to address.

Bringing a list of questions and concerns to the appointment can help you ensure you are covering all your health bases. Matters you may want to add to your list include your:

  • Menstrual cycle, including how regular it is, symptoms and their severity, and any changes or issues you have noticed.
  • Risks for sexually transmitted infections (STIs) and need for screening. It’s possible to have an STI and not have symptoms. Testing is the best way to screen and diagnose.
  • Birth control and family planning questions. We can help you choose the most appropriate birth option based on your health and lifestyle, and can also provide guidance about becoming pregnant when you are ready.
  • Cancer risk factors and screening recommendations, as well as instructions for how to perform a breast self-exam.
  • Other gynecological issues, such as frequent yeast or urinary tract infections, painful sexual activity or symptoms like itching or burning.

We want you to feel comfortable discussing all of your health issues or questions with us. There’s nothing you can ask us that we haven’t been asked before. Our goal is to provide the best possible care, and to empower you to play an active role in your health.

Are you due for a checkup? Call us for an appointment today.


Sexually transmitted diseases on the rise; prevention and testing are essential

April is STD Awareness Month.
April is STD Awareness Month.

Dr. Robert Wool

More than 20 million new sexually transmitted infections occur every year, and more than 2 million cases of the three nationally reported STDs (chlamydia, gonorrhea and syphilis) were reported in the United States last year alone; the highest number ever, according to the Centers for Disease Control (CDC).

The good news is that STDs can be prevented and are easy to treat. However, routine testing and prompt treatment are essential.

Many people who have an STD don’t know it because they often don’t have signs or symptoms. If left untreated, STDs can lead to serious health problems. The only way to know for sure whether you have an STD is to get tested.

STD Prevention and Treatment

Effective prevention strategies include: abstaining from sex; practicing mutual monogamy with an uninfected partner, reducing the number of sexual partners; and consistently using condoms. Vaccines are available to help prevent hepatitis B and some of the most common forms of HPV (human papillomavirus).

Antibiotics can cure chlamydia, gonorrhea and syphilis; without treatment they put men, women and infants at risk for severe, lifelong health problems, chronic pelvic pain, infertility and other reproductive problems, HIV infection, and even death. Syphilis, which was nearly eradicated about a decade ago, is on the rise, and can be passed from mother to baby during pregnancy.

We urge all of our patients who are sexually active to make annual STD screening and timely treatment part of their routine health care. We encourage open dialogue so you are aware of your health risks and can take the steps necessary to reduce them. Some people may be embarrassed to talk to their health provider about STDs, but there is no shame in taking steps to ensure your health; our main goal is to provide the best possible health care.

If you have any questions about STDs or need testing, call us for an appointment.