When a woman’s cervix begins to dilate and contractions are regular, she is then admitted to the hospital for baby delivery. Frequent pelvic exams follow to determine how much the cervix is dilated. The doctor gives the patient the direction to push after the cervix completely opens. Pushing and contractions help the baby move through the birth canal and into the world. The OBGYN doctor or the patient’s partner cuts the umbilical cord, followed by the delivery of the placenta, which concludes the baby delivery process.
In summary, baby delivery happens in three stages:
- Dilation and effacement of the cervix
- Pushing and birth
- Delivery of the placenta
If you are pregnant and live in the Youngstown, Ohio area, schedule an appointment with Dr. Hill today!
Endometrial ablation is the removal or destruction of the endometrium (lining of the uterus). This procedure does not require hospitalization and most women return to normal activities in a day or two. Ablation is an alternative to a hysterectomy for many women with heavy uterine bleeding who wish to avoid major surgery. After a successful endometrial ablation, most women have little or no menstrual bleeding. Patient selection and physician experience is essential to a good outcome.
Endometrial ablation is traditionally done using a hysteroscope, and most women are able to go home within an hour after the procedure. There may be mild cramping—which can usually be relieved by ibuprofen—however, stronger medicine may be needed on occasion. It is normal to be tired for a few days.
Intercourse and very strenuous activity are usually restricted for 2 weeks after endometrial ablation. It is normal to have an increase in discharge for 2 to 4 weeks afterward, as the lining of the uterus is shedding. The OBGYN doctor normally does the first check-up 4 weeks after the ablation.
A hysterectomy is the removal of the uterus (womb).
- If the entire uterus, including the cervix (the opening to the womb) is removed, the procedure is referred to as a total hysterectomy.
- If the cervix is left in place, it is referred to as a supracervical hysterectomy.
- And, when the OBGYN doctor removes the whole uterus, tissue on the sides of the uterus, the cervix, and the top part of the vagina, this is called a radical hysterectomy. In most cases, a radical hysterectomy is only done when cancer is present.
A hysterectomy may be recommended to a woman for many reasons, including:
Many times, a woman's uterus can be removed through minimally invasive surgical techniques, such as vaginally or with the standard laparoscope. However, women who have other conditions that make the hysterectomy more complex may benefit from the assistance of robotic surgery.
Myomas, also commonly referred to as fibroids, are benign tumors that arise from the muscular wall of the uterus (womb). Myomas are very common in women, however, when large, they may lead to pelvic pain, heavy vaginal bleeding or infertility.
A myomectomy removes these benign tumors, while leaving the uterus intact. The procedure is generally done for women who desire to have their fibroids removed and retain their uterus, largely for childbearing reasons.
Robotic surgery has advanced the management of these tumors so that larger myomas, which were once only removed through large abdominal incisions, can be safely and efficiently removed through minimally invasive surgical techniques.
Resection of Endometriosis
Endometriosis is a condition in which endometrial tissue—the tissue lining the inside of the uterus (womb)—is found in other locations of the body. This misplaced endometrial tissue can lead to extensive scarring in the pelvis, the most common location for endometriosis. This scarring can cause infertility and severe pelvic pain. Medical maneuvers such as birth control pills and other types of hormonal interventions are available for some women. However, surgical removal of the endometriosis implants—with or without removal of the ovaries and uterus—may be recommended.
This surgery can be quite complex as endometriosis can involve the colon, rectum, bladder and ureters. In the past, many of these operations required a large abdominal incision. Nowadays, a laparoscopic procedure performed with the heightened visualization and instrumentation of robotic assistance is a less invasive option.
Surgery of Cervical Cancer
- Surrounding tissues
- Lymph nodes in the pelvis
For some women who desire to preserve fertility, a radical trachelectomy is performed. This is the removal of the:
- Surrounding tissues
The uterus is left in place for future child bearing. These procedures are greatly aided with the development of robotic surgery, which allow well-selected candidates to undergo the surgery with this minimally invasive approach.
Surgery of Ovarian Cancer
Standard staging of ovarian cancer once required a large abdominal incision. While the majority of women with ovarian cancer are still recommended to undergo this standard approach, some may be offered a minimally invasive approach: small incisions through the heightened visualization and instrumentation of a robot.
Women who are amenable to this type of surgery typically have smaller tumors or may have isolated areas of disease recurrence.
Surgery of Uterine Cancer
Surgery for cancer of the uterus (womb) typically involves the removal of the:
- Fallopian tubes
The surgery may also entail removal of lymph nodes in the pelvis and in the upper abdomen—also referred to as a staging procedure. Although many times this procedure can be accomplished through the standard laparoscope, robotic assistance can help the surgeon perform this procedure.
Vaginal Birth After Cesarean (VBAC)
VBAC stands for Vaginal Birth After Cesarean. This is when a woman may choose to have a baby delivered vaginally after a previous delivery by Cesarean (also known as C-section). Benefits of a VBAC versus a repeat C-section include:
- Fewer complications
- Shorter recovery time
- Holding & breastfeeding your baby sooner
The success rate for VBAC is 75%, while 25% end up repeating a C-section.
VBAC is not recommended for women who have had a uterine rupture during a previous pregnancy. Also, VBAC isn't recommended for women who have had a vertical incision in the upper part the uterus (classical incision) due to the risk of uterine rupture.
Consult with OB/GYN Dr. Hill or Nurse Practitioner Cynthia Daniels to see if you are a good candidate for a Vaginal Birth After Cesarean.