What is your Cesarean Section Rate?

The current Primary Cesarean Delivery rate for the practice is 19%. The NTSV (Normal Singleton Term Vertex) rate which represents the rate for uncomplicated, first pregnancies is 24% which meets the current national Leapfrog safety standards (2019 figures). The average for Broward County is 32%.

Do you perform routine Episiotomies?

Episiotomies are generally no longer performed routinely in modern obstetrical practice. The current philosophy is that a small tear causes less disruption of tissue and nerve fibre than an episiotomy. To that end, perineal massage is prefered while pushing as a way to reduce the risk of a large tear or the need for episiotomy. It's important to understand, however, that sometimes, an episiotomy is necessary in order to prevent a more destructive tear, or to be able to deliver the baby faster when necessary. 

Do you believe in Epidurals? What if I don't want one?

Epidural anesthesia is a safe and very effective form of pain relief during labor. In the United States, approximately 80% of women deliver with epidural anesthesia. Over the years, the science of epidurals has been fine tuned dramatically, so that women can now in many cases still move their lower body allowing them to push more effectively during delivery, while still having good pain relief. There is good data showing that once a woman is in active labor, the use of epidural anesthesia does not increase the risk of cesarean delivery. If a woman chooses not to have an epidural, she does not have to have one. However, the use of pain medication is limited near the timing of delivery so that it does not affect the baby at birth or any resuscitative measures that might be necessary. 

Do you believe in inducing labor?

There are certain situations where it may be necessary to deliver the baby for the health and well being of the mother or the baby before the due date. In these cases, medication may be given to help soften the cervix and prepare it for labor, followed by medication to make the uterus contract and start the labor process, which is called induction. Labor may also be induced when the pregnancy goes past the due date, in which case the function of the placenta, amount of amniotic fluid around the baby and the baby's size become a concern with regard to a safe delivery. Elective delivery for social or logistic reasons (eg. family or spouse traveling, work, moving homes) may be considered after 39 weeks. New guidelines discourage elective delivery before 39 weeks as the cervix may not be ready for labor, increasing the risk of cesarean delivery, or the baby's lungs may not be fully ready.