Obstetric Care
Specializing in Prenatal Care
Pregnancy Specialists in Hawaii
The following obstetrical care services provided by Ko’olau Women’s Healthcare focus specifically on the care and treatment of women before and during their pregnancy, at childbirth, and during the period of recovery following delivery.
Please, click on each service option to see the detailed information.
Prenatal Care in Honolulu and Kailua
Prenatal Care & Testing
At Ko’olau Women’s Healthcare, we are partners with you throughout your pregnancy.
Regular prenatal visits with Ko’olau Women’s Healthcare are important to monitor your well-being and your baby’s health. We can identify issues before they become serious problems for you and your unborn child. The frequency of prenatal visits depends on how far along you are in the pregnancy and any known health conditions.
About Prenatal Visits
Your first prenatal visit should be scheduled as soon as you think you are pregnant. As the pregnancy progresses, prenatal checkups will happen more regularly and may include special tests.
A typical schedule for prenatal checkups is as follows:
- Between Weeks 4-28. You'll have an appointment once a month.
- Between Weeks 28-36. You'll start having appointments twice a month.
- After week 36. You'll have weekly appointments.
If your pregnancy is high-risk, which depends on factors like the patient's age, weight, and other health problems or concerns, Ko'olau Women's Healthcare may recommend more frequent prenatal visits to closely monitor your pregnancy.
What to Expect During Your Prenatal Visit
The earlier you start prenatal care, the better! Ideally, your first prenatal visit occurs when you are around eight weeks pregnant or four weeks after your missed period. If you are already past this point in your pregnancy, please call one of our offices so we can start your prenatal care as soon as possible..
During a prenatal checkup, your OBGYN will:
- Get a urine sample.
- Review medical history.
- Check blood pressure, weight, and height.
- Check stress levels and lifestyle habits.
- Perform blood tests.
- Check the fetal heart rate.
- Feel and measure the patient’s abdomen.
- Take a fetal ultrasound.
- Answer any questions or concerns the patient has.
Other tests may be done to detect signs of possible health problems, including infection, congenital disabilities, gestational diabetes, or fetal distress.
Schedule Prenatal Care
Contact Ko’olau Women’s Healthcare to schedule a prenatal checkup or your first prenatal appointment if you think you are pregnant.
LABOR CARE IN KAILUA AND HONOLULU
Labor & Delivery Care
At the end of the third trimester of pregnancy, your body will begin to show signs that it is time for your baby to be born. The process that leads to the birth of your baby is called labor and delivery. Every labor and delivery includes certain stages, but each birth is unique.
Giving birth to a baby is hard work. It can also be scary, thrilling, and unpredictable. Learning all you can ahead of time will help you be ready when your time comes.
Birthing Options
An uncomplicated childbirth and a correctly executed birth are ideal. But we know that even the most carefully planned birth can take twists and turns. In those cases, it's important to be prepared for alternative delivery methods.
Vaginal Delivery
Vaginal delivery is the method of childbirth most health experts recommend for women whose babies have reached full term. There are three stages of labor:
- The first stage is from the onset of labor until the cervix is fully dilated.
- The second stage occurs from the time the cervix is fully dilated until the delivery of the baby.
- The third stage is from the baby's delivery until the delivery of the placenta and membranes.
Cesarean Section (C-Section)
A Cesarean section (C-section) is surgery to deliver a baby. The baby is taken out through the mother's abdomen. In the United States, almost one in three women has their babies this way. Some C-sections are planned, but many are done when unexpected problems happen during delivery.
Reasons to have a C-Section:
- You've had a previous cesarean with a "classical" vertical uterine incision (this is relatively rare) or more than one previous c-section.
- You've had some other kind of invasive uterine surgery, such as a myomectomy.
- You're carrying more than one baby.
- Your baby is expected to be very large.
- Your baby is in a breech or feet-first position.
- Your baby's heart rate gives your practitioner cause for concern.
- Your cervix stops dilating, or your baby stops moving down the birth canal, and attempts to stimulate contractions to get things moving again haven't worked.
Vaginal Birth After Cesarean
If you have had a cesarean delivery before, you may be able to deliver your next baby vaginally. This is called vaginal birth after cesarean, or VBAC. A woman who chooses VBAC is closely monitored. As with any labor, an emergency cesarean section is done if the mother or baby shows signs of distress. For many women, VBAC is an option. In fact, research on women who attempt a trial of labor after cesarean (TOLAC) shows that about 60 to 80 percent have a successful vaginal delivery.
Benefits of VBAC:
- A shorter length of hospital stay and postpartum recovery (in most cases).
- Fewer complications, such as postpartum fever, wound or uterine infection, thromboembolism (blood clots in the leg or lung), need for blood transfusion.
- Fewer neonatal breathing problems.
Risks of VBAC:
- A failed attempt at labor. Labor can result in a repeat C-section.
- Uterine rupture. Rarely, the uterus might tear open along the scar line from a prior C-section.
Vacuum Extraction
During vacuum extraction, a healthcare provider applies the vacuum — a soft or rigid cup with a handle and a vacuum pump — to the baby's head to help guide the baby out of the birth canal. This is typically done during a contraction while the mother pushes.
After a vacuum extractor delivery, there may be some bruising or swelling on the baby's scalp. This technique can only be used if the baby is born head first and is at full term; it can be dangerous for premature babies.
Obstetric Anesthesia
Anesthesia is routinely used to help relieve pain during a medical procedure, which often includes common occurrences like childbirth. Many individuals are familiar with epidurals and their primary use of reducing pain during the birthing process. Still, there are also a few other options available for expectant patients of Ko'olau Women's Healthcare.
Vaginal Birth After Cesarean (VBAC)
Many women prefer to have a vaginal birth in comparison to a cesarean for a wide variety of reasons. A majority of those who have already delivered by C-section can still opt for a vaginal delivery with a later pregnancy, which is known as a vaginal birth after cesarean, or VBAC. The highly trained OBGYNs at Ko’olau Women’s Healthcare have extensive experience providing guidance around VBAC.
Choose How You Want It To Be
There are many decisions to make about labor and delivery. Before your last weeks of pregnancy, be sure to talk to your Ko'olau Women's Healthcare doctor or nurse-midwife about your birthing options and what you prefer.
PERINATAL CARE IN KAILUA AND HONOLULU
Perinatal Care & Support
It covers three months before pregnancy and up to one year after birth.
With Ko’olau Women’s Healthcare, you can rest assured that your body and your baby are in expert hands from before the start of your pregnancy until well after birth. Experience the Ko’olau Women’s Healthcare difference; we will strive to ensure all your needs are met during one of life’s most beautiful moments.
Fetal Ultrasound
Ultrasound diagnostic imaging is used in a variety of medical settings, though many individuals are most familiar with this examination because of its consistent use throughout a woman's pregnancy. This particular type of ultrasound is referred to as a fetal ultrasound.
All ultrasounds are produced using sound waves that are delivered to a specified body area and then bounce back to a transmitting device that converts the length of the sound waves to create a detailed image of the patient's internal structures. This type of technology is extremely useful in the diagnosis of many medical conditions, or in this case, to routinely check in on the development of a fetus.
Preterm Birth
Preterm labor is labor that comes too early—between 20 and 37 weeks of pregnancy. In labor, the uterus contracts to open the cervix. This is the first stage of childbirth. In most pregnancies, this happens at 37 to 42 weeks. Preterm labor is also called premature labor.
Preterm labor doesn't always lead to preterm birth, but it may. A baby born too early may have serious problems, such as chronic lung disease. This is because many of the baby's organs, especially the heart and lungs, aren't fully grown yet. The earlier a baby is born, the higher the risk of problems.
Low Birth Weight
Ko'olau Women's Healthcare is dedicated to helping parents-to-be who might be facing the challenge of low birth weight. Through expert care, we help parents better understand their options and feel empowered to make the best possible decisions for their family by providing supportive resources, such as educational materials that discuss the causes and risks associated with low birth weight. With Ko’olau Women’s Healthcare by your side, you can navigate this difficult time with confidence, knowing that you have a team of trusted professionals in your corner.
Enjoy Your Pregnancy Journey
With Ko'olau Women's Healthcare, you can rest assured that your body and your baby are in expert hands from before the start of your pregnancy until well after birth. Come experience the Ko'olau Women's Healthcare difference; we will strive to make sure all your needs are met during one of life’s most beautiful moments.
Female Infertility Specialists in Honolulu
Infertility Testing & Treatment
Infertility is defined as the inability to become pregnant after a year or more of attempting to conceive. If a woman is over the age of 35, six months or more of trying to get pregnant may be an indicator of infertility. Women who are able to get pregnant, but can’t stay pregnant, could also be infertile.
At Ko’olau Women’s Healthcare, we will take the time to discuss all of the available infertility treatment options to help determine what is best for you and your growing family.
What Causes Infertility in Women?
The female reproductive system is so complex that a large number of factors could affect a woman’s fertility.
Disrupted Ovulation
If the ovaries are not releasing an egg, there is nothing for the sperm to fertilize. In many cases, issues with ovulation are the cause of infertility in women. The most common causes of disrupted ovulation include:
- Polycystic Ovarian Syndrome. PCOS occurs when a woman’s estrogen and progesterone levels are imbalanced. Over time, this causes small cysts to develop on the ovaries. This syndrome makes it difficult to get pregnant because it has the potential to stop menstruation.
- Hypothalamic Dysfunction. Hypothalamic dysfunction occurs when FSH and LH, the two hormones responsible for ovulation, become imbalanced. This can be caused by extremely high or low weight and severe stress.
- Premature Ovarian Insufficiency. This occurs when a woman under the age of 40 experiences a decline in ovarian function. The results are similar to early menopause.
- Menopause. Menopause is the natural decline in ovarian function that typically occurs around the age of 50.
Fallopian Tube Swelling or Blockage
The fallopian tubes are responsible for carrying the fertilized egg to the ovaries. When the egg cannot move through the fallopian tubes, it cannot attach to the wall of the uterus.
- Pelvic Inflammatory Disease. Typically caused by an untreated STI, pelvic inflammatory disease is an infection that affects the uterus and fallopian tubes.
- Previous Pelvic Surgery. If surgery was performed on or near the fallopian tubes, especially in the case of an ectopic pregnancy, this disruption may lead to an increased risk of infertility.
Uterine Dysfunction
The uterus nurtures the fertilized ovum as it develops into a fetus and continues to do so until the baby is ready for birth. The most common uterine causes of infertility include:
- Uterine Fibroids. Despite being mostly symptomless, these non-cancerous tumors can grow into the walls of the uterus and prevent a fertilized egg from attaching.
- Endometriosis. The tissue that lines the uterus may begin to grow in other areas of the reproductive system. This condition oftentimes results in ectopic pregnancies.
What Increases Risk of Female Infertility?
There are several contributing factors to a woman's reproductive function. While some causes cannot be prevented, reducing or eliminating certain behaviors can potentially improve the chances of becoming pregnant.
- Age. Women over the age of 35 tend to have more fertility issues than those 34 or younger.
- Smoking. The toxins in cigarettes can have a negative effect on reproductive health.
- Alcohol Consumption. Studies have shown a link between heavy alcohol consumption and decreased female fertility.
- Extreme Weight Gain or Loss. If a large amount of weight is gained or lost, especially in a short period of time, hormone levels can become imbalanced.
- High stress. Over a period of time, high stress can affect hormone levels.
How is Female Infertility Tested?
Generally, the first step will be to determine if the woman is ovulating each month. This could be accomplished by using a home ovulation test kit, a blood test, or even an ultrasound of the ovaries. If ovulation appears normal, the following tests are commonly performed:
- Hysterosalpingography. This test uses an x-ray to determine if the fallopian tubes are open and allow the egg to pass freely. In addition, your physician can detect any abnormalities inside the uterus.
- Laparoscopy. A tiny camera will be inserted into a small incision in the lower abdomen for the doctor to observe the ovaries, fallopian tubes, and uterus. Your physician will also be able to see any scarring or evidence of Endometriosis.
Infertility Treatment Options
The suggested treatment will depend on the problem type, age, and personal preferences. Each woman is unique, so not every treatment plan will be the same. The list below is far from comprehensive, but it introduces some of the most common forms of treatment.
Medication
Medications help treat ovulation issues. Typically, they will attempt to regulate hormone levels. Women who take fertility drugs have an increased risk of delivering multiple children (twins, triplets, etc.)
Infertility Surgery
While medication typically solves fertility issues, surgery is an option for women with physical abnormalities in their reproductive system. A surgeon may be able to correct an irregular uterine shape, remove fibroids, and clear blocked fallopian tubes.
Treatment for Female Infertility
Discovering the cause of female infertility can be a long and emotional process, but Ko’olau Women’s Healthcare can help. We will make it our goal to find the right solution for you and your growing family.
Postpartum Depression Treatment
Postpartum Depression
Postpartum depression (PPD) is a form of depression that occurs specifically during pregnancy or after childbirth. This mental illness is very common and affects more than 800,000 women in the United States alone.
Postpartum depression often makes it difficult for these women to perform daily activities for themselves or others. Postpartum depression is not to be confused with the baby blues, which tends to be much milder.
Common Causes
Postpartum depression is affected by several different physical and emotional factors rather than by a single source.
After childbirth, a woman experiences a dramatic change in her hormone levels, which leads to an alteration of chemicals in her brain. These chemical changes often result in powerful mood swings.
Sleep deprivation is another key contributor to postpartum depression. As the body undergoes an enormous amount of stress during childbirth, it is understandable that it requires an incredible amount of rest in order to fully recuperate. However, many new mothers find it difficult to attain such needed rest, which can heavily impact common symptoms of postpartum depression-like exhaustion.
Symptoms of Postpartum Depression
Postpartum depression typically creates feelings of extreme sadness, exhaustion, and anxiety in women for an extended period of time. Additional symptoms include:
- Crying more than usual or for no apparent reason.
- Feeling irritable, moody, or restless.
- Flashes of anger or rage.
- Physical pains such as headaches, muscle pains, or stomach issues.
- Changes in sleep habits – either too much or too little.
- Loss of interest in activities that were once very enjoyable.
- Isolation of self from friends and family.
- Difficulty in bonding with the baby.
- Significant changes in eating habits – eating too much or too little.
- Doubt in the ability to care for the baby.
- Inability to concentrate, remember specific details, or make decisions.
More concerning symptoms, such as thoughts of harming oneself or the baby, can be signs of a rarer mental illness called postpartum psychosis, which should be treated immediately.
Treatment Options at Ko’olau Women’s Healthcare
Treatment for postpartum depression is often handled using therapy, medication, or a combination of the two.
- Many patients experiencing symptoms of postpartum depression have found talk therapies to be very helpful. More specifically, patients often find success in Cognitive Behavioral Therapy (CBT) and Interpersonal Therapy (IPT).
- Medications such as antidepressants can help to regulate abnormal changes in chemicals in the brain, which lead to a more stable mood. Talking with your doctor about such medications is essential, as certain types may or may not be considered safe to take while breastfeeding.
Schedule a Postpartum Depression Consultation
To speak with a specialist about the diagnosis or treatment of your postpartum depression, please request an appointment today. You can also talk with one of our physicians immediately by calling the Ko'olau Women's Healthcare office location nearest you.