Dr. Natalie Hage grew up near Columbus Ohio and went to the Ohio State University for her undergraduate degree where she majored in biology and minored in Arabic. Dr. Hage graduated with research distinction and honors. Next, Dr. Hage attended medical school at the University of Toledo in Ohio followed by her residency at Beaumont Health System near Detroit, MI.
“I have had many teaching experiences in the past, with subjects ranging from chemistry to piano, to OBGYN. I enjoy spending time with my patients to ensure that they truly understand any condition they may have whether normal or abnormal. I have traveled to Buffalo many times growing up as I have family in the area. In my spare time I like to travel, visit with friends and family, play piano, and cook.”
For our current patients, we hope that you’ll help us welcome Dr. Natalie Hage to our practice! And if you are looking for a new OB-GYN, Dr. Hage is accepting new patients. Please give our office a call to make an appointment!
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Whether the baby you’re carrying is your first or your fifth, you may be considering planning for an at home birth, a trend that is rapidly growing across the nation. While the comforts and privacy of home may sound appealing, before you arrange to give birth at home, you should familiarize yourself with the benefits and risks involved with this delivery strategy and then heavily consider what is truly best—and safest—for you and your growing family.
What Happens During an At Home Birth
During a planned home birth, a midwife will supervise your delivery. You may choose to have the attendance and support of anyone you’d like with you, from your baby’s dad to your entire extended family. Some women also elect to incorporate a warm water bath into their home delivery, which requires the temporary set up of a birthing pool. Women who choose an at home birth are typically not given prescription pain relief.
The Benefits of an At Home Birth
For centuries, at home births were the norm. (If you’ve ever watched Call of the Midwife, it’s amazing to see how mainstream at home births are!) At home births should only be considered for women with healthy, low-risk pregnancies. If you are considering an at home birth, here are a few benefits of this type of delivery plan:
- Most women are able to avoid an episiotomy, cesarean section, epidural and other similar interventions.
- You will be able to experience the birth of your new baby with family and friends.
- You are free to move around, change positions, take a shower, and eat or drink freely during labor.
- You are in the comfort of your own home.
- It costs less than a hospital birth.
What are the Risks of an At Home Birth?
Data shows that at home births increase a woman’s risk of a medical complication and ultimately the need for escalated medical intervention. More specifically, at home births pose a risk for:
- Necessitating a labor induction
- A cesarean section (C-section)
- A delivery that requires a vacuum extraction or the use of forceps
- Vaginal tears or lacerations
- Severe bleeding that requires a blood transfusion
- Infant seizures
- Infant nervous system disorders
- Infant death
The Potential for a Hospital Transfer
Your motivation to plan for an at home birth may surround the fact that you believe you will feel more comfortable at home, not surrounded by doctors, nurses, beeping machines, and a roommate who has dozens of visitors or likes to chat loudly on the phone. Understand, however, that at home births with complications may result in an emergency hospital transfer, which means you may ultimately end up in the hospital despite your desire to remain at home. A midwife may transfer you to a hospital if:
- Your labor is not progressing
- Your baby is not positioned head down
- Your baby is in distress
- You experience extreme pain or bleeding
- You have high blood pressure
Are There Cases When an At Home Birth is Not Recommended?
Yes. The American College of Obstetricians and Gynecologists cautions against an at home birth in cases of:
- Multiples
- A baby that is not positioned head-down
- You have had a previous C-section
- You are delivering earlier than 17 weeks or later than 41 weeks
- You have diabetes or high blood pressure or other high risk pregnancy conditions
If you have been hearing stories from women in your social circle or reading on social media about the perceived benefits of at home births, talk to your OBGYN. He or she can provide you with all of the information—including a thorough explanation of the benefits and risks—you need to know before you choose how you want to plan for your delivery. At our practice, we believe that a hospital birthing plan is best for mom and baby, but ultimately it is your decision.
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As women in today’s society, we often hold ourselves to high standards. Many women want it all: marriage, kids, a career, free time! The problem is that with impossible goals, the day-to-day things can get lost. It’s easy to push off being happy, living in the moment, and living the best life, when thinking about working for long-term happiness. Instead of waiting to be happy in the future, work to add in smaller goals and gratitude to make life happier now!
Practicing gratitude on a regular basis can help relieve stress and put you (and those around you) in a better mood. Small changes can go a long way toward a fresh outlook on life. As we celebrate Thanksgiving this week, we thought we’d share some ideas on how to practice gratitude:
- Establish a gratitude routine. Work in daily gratitude into your day in the morning or evening by taking 1 to 2 minutes to establish what you are thankful for on that particular day. Get in the habit of sitting quietly and either thinking or writing down these items each day.
- Make a list! Yes, that’ right, write down all the things you are grateful for: your spouse, your kids, your dog, your home…you get the idea. Try to come up with 50 or 75 items that make you thankful!
- Meditate. Even if you don’t see yourself as spiritual, consider trying yoga and setting an intention to be grateful. If public classes aren’t your thing, there are plenty of apps and videos online for guided meditations or yoga. The idea is to sit quietly and reflect on the positives aspects of your daily life.
- Strive to impress yourself, not others. It’s too easy to constantly be worrying about what other people think. Move away from worrying about what you can’t control and work on being your best self. This can include career, family, and friend relations, but also just an overall outlook on life.
- Embrace empathy. Being happy doesn’t mean you have to step on people to get there. Establishing appreciation for those around you will help you grow and develop empathy. Put yourself in someone else’s shoes. Don’t make assumptions about others.
- Support other females in your community. Many women struggle with stress on a daily basis. Instead of competing and judging other women, look for ways to bolster and encourage them! Help others and, ideally, others will help you.
- Avoid procrastination. There’s a sense of accomplishment that goes along with finishing tasks. Make a to-do list and cross things off as you finish. Keep goals modest and attainable for each day. Instead writing down a lofty goal to sew three Halloween customs or write an entire proposal, start with small goals. Divide the huge project up into tasks that can be completed each day.
- When all else fails, believe in yourself. Look inward to build confidence. You won’t succeed if you don’t even try, so trust in your own abilities to handle things. In order to be happy, you have to believe in yourself and trust your own decisions.
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Parents have been electing to have circumcisions performed on their newborn baby boys for centuries. It is a procedure that represents an important religious and cultural tradition for Jewish and Islamic families, as well as certain aboriginal tribes in Africa and Australia. Today, it’s estimated that approximately 55 to 65 percent of all newborn boys are circumcised in the United States for a wide variety of reasons that span religious beliefs, cultural and social reasons, and hygiene concerns. If you are expecting a baby boy, and are wondering if you should have him circumcised, review the information below to help put your mind at ease about the benefits and safety of this time-old tradition.
Overview
In a circumcision procedure, a doctor will surgically remove the skin covering the tip of an infant male’s penis. The procedure is typically performed in a hospital a day or so after birth and takes approximately ten minutes. During a circumcision, the doctor will position your baby on his back with arms and legs restrained. An anesthetic will be applied or injected to the area before the doctor removes the foreskin. After the procedure, a topical antibiotic will be applied, and the penis will be lightly wrapped in gauze. Healing takes about ten days. During this time, the penis will likely be sore and may look red, swollen, or bruised.
Benefits of Circumcision
In some cases, circumcision is medically recommended or necessary, as in cases where the foreskin develops too tightly to be retracted over the glans. For parents who worry that voluntary circumcision procedures put their newborn through unnecessary discomfort and may expose him to unnecessary risks, know that that there are certain benefits to the procedure, including:
- Easier hygiene – Throughout their lives, uncircumcised males must make more concerted efforts to regularly wash beneath the foreskin of their penis to ensure proper hygiene.
- Reduced risk of urinary tract infections – Uncircumcised males are at a higher risk of urinary tract infections (UTI). Severe infections, particularly at a younger age, can lead to kidney problems later in life.
- Decreased risk of sexually transmitted infections – Studies reveal that men who are circumcised may be at a lower risk of certain sexually transmitted infections, including HIV.
- Reduced risk of penile cancer – Though rare in general, penile cancer is more common in uncircumcised men. Women whose partners are circumcised also face a reduced risk of cervical cancer.
- Prevention of penile complications – In some cases, uncircumcised men experience phimosis, a condition in which the foreskin can be difficult or impossible to retract, which can lead to inflammation of the foreskin or head of the penis.
The American Academy of Pediatrics (AAP) advises that the benefits of circumcision outweigh the risks; however it does not recommend universal circumcision for all male newborns. Instead, the AAP recommends that parents make an informed decision about circumcising their son and ensure the procedure is performed safely with the use of anesthetics.
If you have questions about whether or not to circumcise your newborn, talk to your OBGYN. He or she will help you better understand the benefits and risks and help you make the decision that is best for your baby boy.
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All moms of young children can attest that there’s not enough time in the day. Between work, committees, shuttling kids to activities, and putting a meal on the table, there usually isn’t much time left. Here are some tips for saving time on busy weeknights.
Save Time Cooking
- Meal prep for the week. We’ve all heard the term and may have tried it to varying levels. Here’s the key, be sure you are cooking food you actually like and can get your family to eat. There’s nothing worse than making a week’s worth of meals that no one will eat when it comes down to it. Find a handful of easy recipes that you and your family enjoy and rotate through. Easy meals include slow-cooker roasted or shredded chicken with rice, beef stew, and pasta with red sauce. Load up on veggies in the recipe to keep it healthy.
- Prepare lunches on weekends. Dedicate a few hours to chopping veggies/fruit and packing lunches. Fruits like melons, berries, and citrus can be chopped in advance for a week’s worth of enjoyment. Prep healthy snacks in to-go reusable containers, including cheese and crackers, carrots and ranch, bell peppers and hummus, and string cheese and apple. This way, every time you pack lunches for school or work, you won’t be starting from scratch.
- Make large portions. If you know you have more time one night then the next, double up on dinner portions to give yourself a break the next night or have leftovers for lunch.
Get Through Housework Quicker
- Multitask. One of the best times to empty the dishwasher is when waiting for the oven to heat or water to boil. You are already in the kitchen, so put that proximity to work.
- Put the kids to work! If your kids are school age, they can handle household responsibilities. Make a weekly chore chart and have children choose the chores they’d like to help with.
- Organize. An easy way to have a less cluttered house is to invest in storage bins and baskets. It’s easier to train the kids to put stuff away, if there’s a clear and obvious place to put something…yes, the floor seems like a good option to them, but learning to store and care for their own things is a great life lesson.
- Hire out. It may seem like a waste of money, but remember, time is money. Time spend cleaning is time missed with your kiddos. One option: hiring your kids, hopefully at a discount rate, in the form of allowance, but if they are too young, consider a professional. Even just having someone in once per month to deep clean the bathrooms and kitchen will save you plenty of time and backpain!
- Tackle the laundry. While weekends should include time for family fun, see if you can work large laundry loads in, while meal prepping. If you can get a week’s worth of laundry done you’ll save time not only because it will be clean, but also because you can lay out five days of clothes for the kids in neat piles. You can also choose short cycles while doing laundry. Most people choose longer cycles, when in reality, their family’s clothes simply are not very dirty. Choosing a shorter cycle saves time and, even, natural resources, so you are also helping the environment.
Do you have any time savers for busy moms? Share them on our facebook page or comment below. We’d love to hear from you!
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For working moms, maternity leave hardly seems like enough time, given that with the birth of your first child, your entire world has been turned upside down.
As a new mom, you may be struggling with the decision to go back to work or to stay at home.
While not all moms have the luxury of making this choice (as some financial situations require moms to go back soon after) many moms are faced with the choice of when they should return to work after having a baby. Be assured, this is not an easy question for any new mom. Assuming you can make the decision, here a rundown of each side.
To Work?
The pros to going back to work include:
- Increased income
- Solidifying your position in career
- Performing engaging work that interests you
- Helping a segment of the population
- Interacting and socializing with adults
- Feeling accomplished when you meet your goals
Cons include:
- The cost of daycare
- Mommy guilt – having to emotionally cope with time away from your baby
- If breastfeeding, the inconvenience of having to pump at work
- Feeling spread thin, due to having to get everything done at work and at home
Not to Work?
The pros to staying home include:
- More time with your baby
- Not having to rely upon daycare or nannies
- More time to take care of the house
- Freedom to make your own schedule
- No pressure to meet deadlines or get to work on time
Cons include:
- Boredom
- Isolation
- A pause in your career path
Finding a Balance
Adjusting to the new addition of the family will take careful configuration. One in five moms will return to part-time work, while upward of 30% of moms choose to return full time. The ideal situation isn’t the same for everyone and finding what balance is comfortable for you, could take some trial and error.
If you stay home, consider other ways to keep active. Be proactive about making new mom friends through local classes and events in your hometown such as mommy and me yoga or music. Take some time to work on interests for yourself, perhaps you’ve always wanted a veggie garden or to learn how to swim. Use the time at home to engage in activities that also make you happy. Lastly, get involved in your community through volunteer work. Many local organizations need help and many will accept little ones at volunteer events. Focus on your own expertise (editing/writing, graphic design, photography, etc.) and offer it up to local groups.
If you go back to work, see if you can afford to start part time, considering how it will affect your career. You don’t want to lose your career trajectory because you eased back into work. Once back, find a groove that works for you, meaning a schedule and arrangement for child care that you are comfortable with. However, even with your limited free time, it’s great to find other mom friends to help ease the pressure and stress. You may even want to discuss a flexible schedule with your employer. Many companies are offering flexible work arrangements in order to keep their best and brightest employees on board.
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If you’ve ever wondered if you’re healthy down there, you’re not alone. Women’s bodies are complex entities, and it feels like they are continually giving us cues about our overall health. If you find yourself scrutinizing those cues, you’re wise to strive to understand your body and its physical signs better. An important indicator of your sexual health is your vaginal discharge. Whether you haven’t paid much attention to your discharge in your past, or you’ve always wondered if what you see is “normal,” it’s time to familiarize yourself with the signs of healthy and unhealthy vaginal discharge. Doing so will help you identify any possible symptoms of a potentially serious condition, and indicate that you may need to make an appointment with your gynecologist for a professional exam and possible treatment.
What is Vaginal Discharge?
Women first begin to produce vaginal discharge when they start to menstruate. Vaginal discharge is a way for the vagina to self-clean, and a means to expel cells and fluid. The production, consistency, and amount of discharge a woman’s body produces varies by individual and can change throughout her menstrual cycle—and her life. In addition to the menstrual cycle, factors that may impact a woman’s vaginal discharge include pregnancy, hormones, or the presence of an infection.
What Does Healthy Vaginal Discharge Look Like?
Healthy vaginal discharge is similar to the mucus that is produced and expelled by your nose. It may be light gray to white, thick, a little slippery, and stringy (think the consistency of some hair gels). Around the time that women ovulate, they experience an increase in vaginal discharge that becomes more slippery and stretchy (think the consistency of egg whites). Women typically experience less discharge during the days immediately following the end of their period.
What Does Unhealthy Vaginal Discharge Look Like?
Your vaginal discharge may be abnormal—a sign of a possible health issue—if it:
- Is accompanied by an unpleasant smell.
- Changes in color, particularly if it becomes grayish, greenish, or resembles pus.
- Develops a foamy texture or is the consistency or cottage cheese.
- Is accompanied by burning, swelling, redness, and extreme itching.
- Occurs with vaginal bleeding that is not due to your period.
What May Cause Unhealthy Vaginal Discharge?
You will want to make an appointment with your gynecologist for an official exam and diagnosis, but if you observe abnormal discharge, it may be due to:
What to Do if You Think Your Discharge is Unhealthy?
If you have any concerns about your vaginal discharge, especially if you are experiencing pain or discomfort in your vaginal area or your pelvis, make an appointment to see your gynecologist. He or she can diagnose your symptoms and provide you with a treatment plan if necessary.
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Extraperitoneal cesarean surgery is a procedure that dates before the antibiotics were available. At the time, its advantage was decreased morbidity and risk of infection by avoiding opening the peritoneal sac. Because this procedure is more difficult to perform; it was abandoned for the more traditional cesarean section technique. However, there are some instances where this technique is still useful today. Only a small number of OBGYNs across the nation are trained and qualified to safely perform the operation, among which is our very own Dr. Sayegh. Read on to find out if you might be a candidate for this procedure.
Common Forms of Cesarean Surgery: Classic and Low
In a classic cesarean surgery, a doctor makes an incision through the mother’s lower abdomen. A second incision is made in the uterus from which the baby is removed. Alternatively, a low cervical cesarean section is a procedure in which a baby is delivered through a transverse incision in the thin supracervical part of the lower uterine segment, an area located behind the bladder and the bladder flap. Compared to a classical cesarean section, the incision made in a low cervical cesarean section bleeds less during surgery and heals with a stronger scar.
What is Extraperitoneal Cesarean Surgery?
In an extraperitoneal cesarean surgery, an incision is made in the lower uterine segment that does not require entering the peritoneal cavity. With this method, the uterus is approached through the paravesical space and the baby, placenta, and membranes are all removed via the uterus incision.
What are the Benefits of Extraperitoneal Cesarean Surgery?
While cesarean surgery is often necessary for situations in which a natural birth is not possible, such as complications with the placenta, multiple births, or a chronic health condition such as high blood pressure, there are still risks involved for mothers and babies with any surgical approach. One of the most significant concerns is that of infection. Cesarean surgeries are by their nature, invasive which causes a risk of infection. The extraperitoneal cesarean surgery method helps to minimize the risk of an infection spreading from the uterus into the peritoneal cavity. Keeping the peritoneum intact prevents the spread of infection.
With this less invasive approach, other advantages include less pain and a faster recovery. Patients experience no nausea, and reduced post-surgical pain and discomfort, which allows for a more comfortable healing process for the new mother. Also, there is reduced possible trauma to the bladder with this procedure.
Who are the Best Candidates for this Procedure?
Not everyone is a candidate for this type of surgery. So who would benefit from an extraperitoneal cesarean? Typically, this procedure would be best for a patient with infection during labor, such as chorioamnionitis, a patient with previous bowel surgeries or bowel obstruction, and patients with known adhesions.
We are proud to provide our patients with the very best in treatment methods to help ensure a new generation of Western New York babies is brought into this world safely. For women who may require a cesarean section, your OBGYN will help you determine if an extraperitoneal cesarean is right for you.
If you have questions about Extraperitoneal Cesarean Surgery available from our practice, and whether it may be appropriate for you, contact us today.
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Normally, your body produces natural lubrication that keeps the vaginal area moist; however, a lack of moisture in the area can lead to vaginal dryness. At first, vaginal dryness may seem like a trivial annoyance, but it can lead to daily discomfort, while performing normal tasks (standing, sitting, exercising, and urinating), pain or discomfort during sexual intercourse, and emotional concerns.
Vaginal dryness typically arises when women encounter low estrogen levels, as estrogen keeps the vaginal tissue moist. While vaginal dryness can be encountered at any age, it’s more common in post-menopausal women. Besides age, other factors that may lead to low estrogen and vaginal dryness include: childbirth, breastfeeding, immune disorders, and cigarette smoking. Additionally, the use of certain cold/allergy, antidepressants, and anti-estrogen medication can also trigger this condition. Vaginal dryness is also common after ovary removal surgery and during cancer treatment.
Even though vaginal dryness affects roughly half of women after menopause, it’s infrequently discussed with doctors because it can be awkward or embarrassing. Symptoms can affect self-confidence and sexual confidence, leading to anxiety. Some women may misinterpret the symptom of vaginal dryness and mistake it for an STD, creating even more worry and anguish.
Do not use douche, lotions, and bubble baths. Even though they might be marketed for vaginal dryness, they can make the problem worse.
Best Treatment Options
A Vitamin E 400 mg capsule applied into the vagina daily. If you make a small prick in the capsule, it will absorb faster.- Cocoa butter wafers. You can also can insert one into the vagina each day while symptoms persist.
- Doctor prescribed solutions. Under doctor supervision, treatment may include application of local estrogen applied topically to your vaginal area. Typically, local estrogen will be in the form of small tablets or rings inserted into the area.
For discomfort during sexual intercourse, over-the-counter, water-based lubricant can help.
If vaginal dryness begins to affect your lifestyle or sex life, it’s time to speak with your doctor. Additionally, call your doctor if you begin experiencing any burning, itching, or additional discomfort. We are here to help.
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Lesbian and bisexual women are susceptible to contracting STDs or viruses from skin-to-skin and mouth-to-genital contact, as well as sharing sex toys and exchanging vaginal fluid or menstrual blood through manual stimulation. By not following safe sex practices, same-sex female couples are at risk of such STDs as chlamydia, syphilis, gonorrhea, and HIV. Women are also especially at risk of contracting human papilloma virus (HPV), a virus linked to the development of cervical cancer. To minimize your chances of contracting an illness, follow the same sex safe sex recommendations below.
- Follow Low-Risk Practices. Hugging, massaging, touching, and masturbation are intimate practices that offer the lowest risk of infection, second only to abstinence. They are also particularly valuable safe intimacy acts to practice if you are not in a monogamous relationship.
- Use Protection. Oral sex offers a lower risk for spreading and contracting STDs than anal and vaginal sex, but there are still risks. Same-sex female couples should protect themselves using a vulva dam or dental dam.
- Practice Good Hand and Nail Maintenance. For women who practice manual stimulation on one another, they could still put themselves at risk of injury or infection. Make sure your nails are trimmed and smooth to minimize the risk of cutting the delicate vaginal lining. Also, make sure you wash your hands before engaging in sexual behaviors to reduce the risk of spreading germs and bacteria from your hands to your partner or yourself.
- Take Time Off During Your Menstrual Cycles. STDs can be transmitted through a variety of bodily fluids, including menstrual blood, which could put women at a higher risk of contracting an STD if they engage in sexual activity during their periods. Take a few days off for safety to minimize risk.
- Do Not Share Sex Toys. Germs and bacteria that can cause disease can be transmitted using sex toys. Do not share vibrators or other sex toys. If you must share devices, clean devices thoroughly before use, or put a condom over them (yes, condoms work for sex toys too).
- Get Tested Annually. If you do contract an STD or virus, early diagnosis and treatment can help minimize the worsening of symptoms. Especially for women, some STD symptoms are not always externally visible, which means you could be spreading an infection to someone you care about without knowing it. It also means that you cannot wait until you notice a change in your body to talk to your doctor. As part of your annual OBGYN exam, talk to your doctor about your risks. He or she can guide you as to the frequency and type of tests you should receive.
- Limit Your Number of Sexual Partners. When you find the one, it will be easy to remain loyal in your sexual practices. Before embarking upon a monogamous relationship, however, limit your number of sexual partners to limit your risk of exposure to STDs.
- Be Open with Your Partners About Your Sexual History—and Learn About Their History Too. You may feel that having sex exclusively with women will lower your risk of contracting an STD, but keep in mind that most partners will have a sexual past, and for some, their previous interactions may include sex with men, which could put them and you at a higher risk. By being honest with your sexual history, and ensuring anyone you engage in intercourse with has been recently tested, you can make sure you are making informed, healthy decisions regarding your sexual health.
Women of all sexual orientations should be able to express their affections for their partners and explore their sexuality—but they must do it safely. With the risk of STDs ever present in our society, and the long-term (read: often permanent and possibly deadly) consequences too real to ignore, make sure you are protecting yourself and your partner. Anyone worth your affection will want to keep you—and herself—healthy, and will respect your desire to practice safe same-sex practices.
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