Obstetrics & Gynecology
All Westchester Health obstetricians and gynecologists are board-certified, and have extensive experience in caring for women through the several stages of her life.
We revel in new pregnancy with our first-time moms. There is nothing more satisfying than handing a healthy baby to joyful parents. We offer comprehensive, personalized prenatal care as well as breast feeding education, and post-partum contraception.
We also work with our patients to decrease the incidence of gynecologic cancers. This is achieved through using the most up-to-date pap screening, HPV vaccine, expert breast and pelvic exams and a close working relationship with the radiologists who perform your annual mammograms. We are often the main healthcare provider to women in their reproductive age, and take the responsibility for preventive care seriously. As physicians we are always learning, by continuous medical education and by listening to our patients.
|Personalized prenatal care: Conception through delivery
|Long-term birth control
Minimally invasive gynecology
Alternatives to hysterectomy
|Menopause care, including
counseling and care
|Osteoporosis prevention and
Gynecology Frequently Asked Questions
Do you recommend the HPV vaccine, if so for whom and when?
Absolutely. HPV is the virus that causes cervical cancer, abnormal pap smears, and genital warts. The HPV vaccine, FDA-approved since June 2006, represents a breakthrough in our approach to cervical cancer: prevention instead of treatment. It is currently recommended for young women ages 9-26, and is dramatically more effective in young women who have not yet been exposed to the virus through sexual activity. The vaccine is a series of 3 shots at 0, 2 and 6 months.
Who pays for the HPV vaccine?
Most insurance companies routinely pay for the vaccine for young women up to age 18. In college-aged patients who are covered by their parent’s insurance, coverage is less consistent. Your individual policy may vary. This information can be obtained prior to your visit by calling your insurance company for specifics.
How old should my daughter be when she consults a gynecologist?
ACOG recommends that young women should meet with a physician experienced in adolescent gynecology at age 13-15. The counseling visit is meant to create another health home for your daughter and does not require a pelvic exam or pap smear. This meeting initially involves mother and daughter, followed by a confidential meeting with the young woman alone, to build trust and educate her about risk reduction and future health choices. It is best to meet prior to sexual activity, with the understanding that while information is empowering, it does not increase likelihood of sexual activity.
How often do I need a Pap test?
Beginning three years after onset of sexual intercourse, pap smears should be done annually until age 30. If Pap smears have been normal up to this age and you are in a stable, monogamous relationship, then every 2-3 years is reasonable. We still expect to see you for an annual exam at every age for routine preventive care.
I am over 30, my Pap smear was normal, but my HPV test was positive, what does this mean?
Like 80% of the U.S. population, you were exposed to the virus that is associated with cervical disease. Most patients will clear the virus within 2 years without treatment. Since persistent HPV can cause cervical disease, you will be watched carefully until the HPV test is negative.
When do I start getting mammograms, and how often?
Unless there is a palpable mass, mammograms start at age 40, and annually thereafter.
What do I do if I feel a breast lump?
Call the office, and we will see you the same day. While most breast lumps are not cancer, they deserve immediate attention to put your mind at ease.
Is breast MRI more sensitive than mammograms at diagnosing breast cancer?
Yes. Although MRI will detect more lesions, it will also increase biopsies for normal breast tissue, and costs 10X more than mammograms. MRI is currently recommended as an adjunct to mammograms and breast sonograms in patients with very high risk of breast cancer (positive BRCA I or II gene, personal history of breast cancer, and multiple family members with breast and/or ovarian cancer).
I have a family history of ovarian cancer, is there anything I can do in my twenties to reduce my risk of getting this cancer?
Yes. Long-term oral contraceptive use (the birth control pill) is associated with at least a 50% reduction in ovarian cancer.
Obstetrics Frequently Asked Questions
As a patient of Westchester Health, who will deliver my baby?
Your obstetrician or his or her partner will deliver your baby. Although we currently have 12 Ob/Gyn’s on staff, Westchester Health is comprised of 3 separate Obstetric divisions to provide the personalized attention of a small group. Each group is comprised of 2-4 obstetricians to ensure that your baby is delivered by a physician who knows you and has cared for you during your pregnancy.
Where will I deliver, and can I visit in advance?
Westchester Health obstetricians deliver at Northern Westchester Hospital in Mt Kisco.
NWH Labor and delivery has six beautifully decorated, state-of-the-art birthing rooms, with private bathrooms, that provide a warm, homelike environment, allowing the mother to remain in the same room throughout the birth experience. In addition to your obstetrician, NWH has 24-hour anesthesiologists and neonatologists on-site to ensure the best possible outcome.
The Center for Maternal/Child Health offers the community preparation classes in caring for newborns, one day and traditional childbirth classes, preparing for breastfeeding and unit tours. Also offered are classes for siblings and Totsaver (Infant CPR). For more information or to register for these classes, please call 914.666.1292, early in your pregnancy.
Web site nwhc.net
Are there any restrictions on what I should drink during my pregnancy?
Yes. There is no safe threshold for alcohol, so once you decide to try to conceive or think you may be pregnant, no wine, beer or other alcohol until the baby is delivered.
Are there any restrictions on what I should eat during my pregnancy?
Yes. Despite your hunger and all the rumors, you’re not actually eating “for two.” The fetus is very small, and only requires an additional 250 or so calories/day. These calories are best obtained through fresh fruits, vegetables and dairy, to ensure both you and the baby gain in a healthy manner.
Foods to avoid: cooked fish with known mercury risk (swordfish, tilefish, mackerel, shark, for more details, see web site: nrdc.org), raw fish: especially shellfish and sushi, hot dogs, deli meats, unpasteurized milk and cheeses: including brie and feta, refrigerated pates and meat spreads, herbal supplements and teas.
How much weight will I gain while pregnant?
If you eat healthy, and continue to exercise, you will likely gain 20-30 pounds for a single pregnancy (more for twins.) Your pre-pregnancy weight influences need for weight gain, underweight women should gain more, overweight women (by BMI) should aim to gain less for best outcome.
Are prenatal vitamins really necessary?
Yes. Prenatal vitamins contain Folic acid (a B vitamin) to help prevent major birth defects. Take a vitamin with 400 micrograms (mcg) of folic acid every day, before and during pregnancy.
What about caffeine – how much is ok in pregnancy?
The March of Dimes recommends that women who are pregnant or trying to become pregnant consume no more than the equivalent of one 12-ounce cup of coffee per day. A recent study (NEJM, 2008) has found that women who consume 200 mg of caffeine or more a day are twice as likely as women who consume no caffeine to have a miscarriage .
Smoking in pregnancy – what are the risks?
Smoking during pregnancy is the single most preventable cause of illness and death among mothers and infants. Women who smoke during pregnancy are about twice as likely to experience premature rupture of membranes, placental abruption, and placenta previa during pregnancy. Babies of smokers are 30% more likely to be preterm, to be low birthweight, and have a higher risk of SIDS (Sudden Infant Death Syndrome) than babies of nonsmokers.
Can I continue to exercise during while pregnant?
Absolutely. It is healthy for you and your baby to continue moderate exercise, if your pregnancy is uncomplicated. According to ACOG's guidelines, unless there are medical reasons to avoid it, pregnant women should try to exercise moderately for at least 30 minutes on most, if not all days.
Can I dye my hair while pregnant?
Yes. There is no evidence that dying your hair is not safe in pregnancy. To be cautious, you may want to wait until the second trimester. To minimize the amount of hair dye that may be absorbed through your skin, the Food and Drug Administration offers these recommendations:
- Don't leave dye on your hair any longer than needed.
- Rinse your scalp thoroughly with water after use of hair dye.
- Wear gloves when applying hair dye.
What will I be tested for over the next 9 months?
- Infections that could put the baby at risk (for example, HIV, hepatitis B, syphilis and other sexually transmitted infections).
- Antibodies that show whether or not you are immune to rubella (German measles) and chickenpox, both of which can cause birth defects if the mother is infected for the first time during pregnancy.
- Anemia (low red blood cell count), which could cause you to feel especially tired and possibly increase your risk of preterm delivery.
- Your blood type including whether you carry a protein called the Rh factor ; on your red blood cells. Women who lack the Rh factor are said to be Rh negative and need treatment to protect their babies from a potential blood problem.
- Bacteria in your urine. Up to 10 percent of pregnant women have bacteria in their urine, which indicates a urinary tract infection. Most have no symptoms, but even a symptomless urinary tract infection may spread upwards to the kidneys. Urinary tract infections are treated with antibiotics that are safe in pregnancy.
- Sugar in your urine This can be a sign of diabetes. Your health care provider may suggest additional tests if sugar shows up in your urine.
- Protein in your urine This can indicate a urinary tract infection or, later in pregnancy, a pregnancy-related condition that includes high blood pressure.
- Ultrasound uses sound waves to show a picture of the baby on a screen. Ultrasound may be done at different times in your pregnancy to assess your baby’s well-being, from your first visit to confirm pregnancy to 11-13 weeks to assess nuchal skinfold thickness (a marker for Down’s syndrome and other abnormalities.) Ultrasound is also usually done by a specialist at 16-20 weeks to confirm normal fetal anatomy.
- Carrier screening tests certain inherited disorders are more common in patients of Ashkenazi Jewish descent than other populations. A child who inherits an abnormal gene from each parent will have the disease. Some of these can be tested for early in pregnancy including: Tay-Sachs disease, Cystic Fibrosis, Fanconi’s anemia and others. These tests are performed in conjunction with genetic counseling by specialized prenatal counselors at NWH.
- First trimester screen noninvasive evaluation that combines a maternal blood screening test with an ultrasound evaluation of the fetus to identify risk for specific chromosomal abnormalities, including Down’s syndrome. A study published in the NEJM in November 2005 determined that first trimester screening was the most accurate non-invasive screening method available. The combined accuracy rate for the screen to detect the chromosomal abnormalities mentioned above is approximately 85% with a false positive rate of 5%.
- Amniocentesis and Chorionic Villous Sampling are options for every patient to definitively determine chromosomal abnormalities. The risk of miscarriage with procedure is generally considered to be less than 1/200; this number is usually weighed against likelihood of detecting abnormality to help guide choice.
Should I get tested for HIV?
Yes. Testing pregnant women is vital not only to maintain the health of the patient but also because interventions (i.e., antiretroviral and obstetrical) are available that can reduce perinatal transmission of HIV to the baby. Get tested for sexually transmitted diseases (STDs) and protect yourself from them.
What problems should I call my physician for?
If you are < 36 weeks, it is important to speak with your doctor if you are experiencing painful contractions, leaking fluid, or any vaginal bleeding. In the third trimester, if you notice that the baby is less active, after doing fetal kick counts and find <10/hour. Any time you are concerned.
Recommended reading during pregnancy?
Enjoy this gestation as a time to take care of yourself and to prepare for baby. Once the baby comes you’ll be too busy, tired and enthralled to read.
- What to Expect While You’re Expecting, 4th edition, 2008, Heidi Murkoff.
- Our Bodies, Ourselves: Pregnancy and Birth, 2008, by Boston Women's Health Book Collective.
- The Nursing Mother's Companion Fifth Revised Edition, 2005 by Kathleen Huggins.
- Your Baby's First Year, 2004 by American Academy of Pediatrics.
- Dr. Spock's Baby and Child Care: 8th Edition, 2004 by Benjamin Spock.
How do I choose a pediatrician?
Word of mouth and physician referral is the most reliable way to choose a pediatrician. Some patients find it helpful to meet with a potential pediatrician prior to delivery, to ask questions and determine compatibility. Westchester Health pediatricians are often chosen by our pregnant patients as this enables us the opportunity to continue to work closely together to give your family the best in personalized medical care. Our Pediatric Providers
All Physicians & Locations for Obstetrics & Gynecology