The things real estate experts want you to know before moving
As the family grows, so do needs at home. Whilst the idea of moving to an urban condo, or a bigger house in the suburbs sounds very tempting, there are some factors you need to consider in making the move as smooth as possible. Surprises are lovely on birthdays, not so much when they come in the form of a scary unexpected bill.
Dreaming of Baby has sought advice from real estate experts. Here’s what they want you to know:
Acreage can be a big plus
Buzz Tatom, at Venture West Ranches, observes a trend in families opting for houses with some acreage for their kids. ‘If your locale allows it, purchase a home with a small amount of acreage. It allows your kids to be forced to get off their computer and get outside. They can be taught the responsibility of taking care of animals and improving the land. The lessons are numerous, from caring to learning how to fix things, to seeing what hard work can accomplish. A few acres can change a kids life in a very positive way!”
Analyze the costs
Before deciding on a property, it’s imperative to analyze all costs involved. ‘When comparing the alternatives, you can distill down to a financial analysis’, says Gary Lucindo from Lucid Realty. “There are multiple costs to consider and you can actually put a dollar value on all of them: commuting costs, including the value of your time; housing cost; property tax cost; and school cost, if you are considering private school. Unfortunately, most people don’t do this’, he concludes.
This is also what Nimrod Sheinberg, VP of Sales at Oz Moving & Storage had to say on moving to a bigger house: “There are many costs that you don’t even think about, mainly in everything around the living space; the roof, the yard, taking care of the driveway, heating, cooling, water heater, etc.”
Budget for Home-Related Taxes
When looking for a new bigger home, many parents-to-be forget to take into consideration home-related taxes. Jacob Dayan, CEO and co-founder of Community Tax asserts that being aware of real estate taxes – and tax breaks – is imperative: “Everyone sees the cost of the taxes during the purchase, but after the sale, families do not always budget for all of the home-related taxes on a yearly basis”. Added to this, he notes that “families often forget about home-related tax breaks. Many states offer first-time (the name is confusing as it is not always just for a first home) homebuyer tax breaks for those that haven’t purchased a new home in a while. In addition, homes with new additions and upgrades are usually eligible for some sort of tax break and these are often forgotten during the tax season as well.”
Get the timing right
Jeff Miller, co-founder of AE Home Group, had an interesting observation to make: “We find that many parent homeowners in Baltimore rush to the suburbs as their children become school age to take advantage of the better education system. This typically happens at the end of summer break and these buyers find themselves paying a premium for homes and they compete with other families.” Miller points out that in such cases, parents should be investigating private schools before rushing to the suburbs: “In these rushed situations, we recommend that our clients consider private schools in the short-term so they have the ability to purchase a home during the school year when prices are less competitive. Often times,
these savings far outweigh the cost of private school.”
Urban Living
In Washington, DC, many parents-to-be are choosing urban living over the suburbs. Kerry Adams, from TTR Sotheby’s International Realty, notes that “this requires flexible thinking when it comes to space since city living costs more”. As for options, she believes that “Centrally located, amenity-rich condos are a great option – if a two bedroom isn’t in your budget, look for a one bedroom with a den that can double as a nursery.” As Adams notes, this also has its perks: “with an onsite fitness center, you’ll have no excuse for avoiding post-baby workouts. Take advantage of the building’s common areas. You and your partner can take turns escaping to the library or community center for a little quiet time. An elevator is a must – pushing a stroller several flights of stairs while carrying groceries will get old real fast, and might even send you fleeing to the suburbs.”
Get to know the neighborhood
After moving ten times in eleven years, Ali Wenzke learned more than a few things along the way when it comes to moving with kids. She blogs at The Art of Happy Moving on finding ways to be happier throughout the moving process and these are some tips that she wanted to share:
“Consider the Neighborhood First and the House Second: Before you fall in love with a house, get to know the neighborhood. Do you see other young families around? How are the schools in the area? Even if you are a new parent, the schools are important – both for your own child and for the resale value of your home.
Look for Sidewalks: Sidewalks are a glorious thing. Whether you’re a city dweller or a suburbanite, there’s nothing better than a good old-fashioned stroll around the neighborhood with your baby. Fresh air does wonders for both the parent and the child. It’s how I kept my sanity during those early months.
Factor in the Commute Required to Get Your Bigger Space: A bigger house will not make you happier. However, a long commute does decrease the happiness of both the commuter and the commuter’s family. So, weigh the pros and cons of moving away to get a bigger space and try to shave off as much commute time as possible.”
Are you worried that you are not eating well enough and finding it difficult to make head or tail of all the information available out there?
We do know what it’s like, so we sought the details for you! Dreaming of Baby has asked nutritionists to share insight on the best foods for pregnancy. Here’s what you need to know about pregnancy nutrition, straight from the experts.
What should I be eating in pregnancy, and why?
“If you are eating a healthy diet before pregnancy, you won’t have to change the diet drastically once you are pregnant.” This is what Karen Wright, Certified Nutrition Specialist and practitioner at Metro Integrative Pharmacy in New York City had to share on food choices and the rationale behind the choice:
Food
Benefit
Wild salmon
· Good source of protein
· High omega-3 fatty acids
· Contains DHA and EPA
· Farmed salmon has lower concentrations of vital nutrients
· Contains Vitamin A and D, iodine
Dark leafy greens
· Source of calcium, magnesium, folate, iron, potassium, vitamins C, K and A
· Rich in fiber
Bone or fish broth
· Rich in minerals, especially calcium, magnesium, and phosphorus
· High in protein
· Essential fatty acids
Legumes
· Source of iron, especially black and navy beans
· Source of protein, folate and calcium
· Rich in fiber
Eggs
· Source of protein, good fat, vitamin, minerals, and amino acids
· Rich in choline which is required for brain development
Quinoa
· Complete protein with all essential amino acids
· Source of iron and magnesium
· Dietary fiber
· Whole grain
Rainbow mix of fruits and vegetables
· High vitamins, minerals and antioxidants
· High dietary fiber
· Source of vitamin A, especially yellow and orange vegetables.
· Variety of phytonutrients
Nuts and seeds
· Source of protein, omega-3 fatty acids, zinc, vitamin E
· Source of calcium, especially sesame seeds, chia seeds and almonds
· Source of iron, especially pumpkin seeds, cashews and sunflower seeds
Lean sources grass-fed animal protein
· Good source of protein
· Contain iron, vitamin A
Resources: Brown, J. (2014). Nutrition through the life cycle, 5th ed. Table compiled by Karen Wright, CNS.
Karen Wright is a Certified Nutrition Specialist and practitioner at Metro Integrative Pharmacy in New York City.
The top 5 foods in pregnancy
Mallory Franklin, PhD, RDN, LD from Nutrimedy has also shared with us the top five foods that you should be getting into your diet during pregnancy:
Salmon
Mallory Franklin, PhD, RDN, LD: “Fish is a rich source of essential Omega-3 fatty acids called DHA and EPA. These fats are important for the development of your baby’s brain and nervous system. Salmon is full of these powerful Omega-3 fatty acids. In fact, eating 3 ounces of salmon provides all the Omega-3s you need for the day. You can also try arctic char, trout, mackerel, anchovies, or sardines for your Omega-3 needs during pregnancy.”
Spinach
Mallory Franklin, PhD, RDN, LD: “This nutrient-packed green leaf provides many essential micronutrients imperative to a healthy pregnancy including calcium, iron, folate, magnesium, and copper. Not a spinach fan? No problem! Try kale, swiss chard, collard greens, or broccoli for the similar nutritional benefits for you and your baby.
Beans
Mallory Franklin, PhD, RDN, LD: “Protein needs during pregnancy increase to help support the development of your growing baby. By adding more beans to your diet you are more likely to meet those protein needs not to mention get some fiber, calcium, and iron as an added bonus. Try adding garbanzo beans, lentils, or soybeans to salads, stir-fries, and other dishes for an added chew and a more nutritious meal.”
Oatmeal
Mallory Franklin, PhD, RDN, LD: “Whole grains are an excellent source of carbohydrates, fiber, and B-vitamins. Oatmeal is a great substitution for common breakfast cereals that are high in sugar and simple carbohydrates. Serve oatmeal with scrambled eggs, diced tomato, and avocado for a new savory variation of this classic breakfast food. Incorporating other whole grains in your diet, such as farro, quinoa, whole wheat bread, and sweet potatoes is a great way to get healthy satisfying carbohydrates that are packed with additional nutrients.”
Water
Mallory Franklin, PhD, RDN, LD: “Staying hydrated during pregnancy is very important. Water helps cushion your baby, develop the placenta, and control your body temperature. Pregnant women should get between 8-10 glasses of water per day, which is 64-80 ounces.”
Mallory Franklin is a Registered Dietitian Nutritionist at Nutrimedy and holds a Doctorate of Philosophy in Nutrition.
Your nutritional intake during pregnancy has a great impact on your overall health and that of your baby. Whilst a balanced diet is the best way through which to obtain these nutritional requirements, vitamin supplements can also help.
If it’s normal for you to follow a healthy diet, then no drastic changes are required once you’re pregnant. This is what Karen Wright, Certified Nutrition Specialist and practitioner at Metro Integrative Pharmacy in New York City had to share on the importance of adequate vitamin and mineral intake.
Protein during pregnancy
Karen Wright, CNS: “An additional 25 grams of protein are needed during pregnancy for the baby’s growth. Protein is used as a source of energy and for repair of important body parts like the brain and muscles. Studies have shown that babies whose mothers did not get adequate amounts of protein had a lower birth weight. Low birth weight is associated with a range of issues.”
Omega-3 fatty acids
Karen Wright, CNS: “Essential fatty acids are the main source of energy needed for fetal growth and development. Omega-3 fatty acids are good for the heart and for lowering the risk of preeclampsia. There are some studies showing that mothers with omega-3 deficiency had a higher risk of postpartum depression. DHA and EPA are critical for the development of cell membranes for the brain, retina and other neural tissue.”
Vitamin A
Karen Wright, CNS: “Vitamin A deficiency can cause malformation of the lungs, urinary tract, and heart. A mother with low vitamin A levels is at risk for anemia. After birth, vitamin A helps with postpartum tissue repair. Vitamin A is best gotten from food because too much can lead to toxicity. Deficiency is more likely to occur in the third trimester when nutrient needs are greater.”
Iodine and thyroid health
Karen Wright, CNS: “Iodine is needed for thyroid health. Deficiency while pregnant can cause hypothyroidism for the mother and impaired motor and mental development for the baby.”
The importance of vitamin D in pregnancy
Karen Wright, CNS: “Vitamin D is needed along with calcium to help the baby’s bones and teeth develop. It also reduces the risk of rickets. Vitamin D is important for the skin, eyesight, immune system and for reduction of inflammation. Low vitamin D levels have been linked to preeclampsia and gestational diabetes. The risk of osteoporosis later on in life may increase if there is a deficiency of vitamin D during pregnancy.”
Calcium in pregnancy
Karen Wright, CNS: “Calcium is needed throughout the pregnancy to protect bones and maintain healthy blood pressure. During the third trimester, the fetus requires more calcium since this is the time when the bones are forming at a higher rate. A calcium deficiency during pregnancy increases the risk of hypertension and osteoporosis for the mom. The baby can be born with skeletal and teeth issues as well as rickets when calcium levels are low. Dairy is one source of calcium but many people are allergic to dairy.”
The importance of folate during pregnancy
Karen Wright, CNS: “Getting enough folate in the diet is important for neural tube and brain development, and organ and tissue growth. Though the synthetic form of folate, folic acid is often found in prenatal supplements, eating foods that contain folic acid on a regular basis will give added protection to the developing fetus. Anemia during pregnancy is also associated with low levels of folate.”
Magnesium
Karen Wright, CNS: “Lack of magnesium, especially in the second trimester, can cause the mother to have fatigue, muscle cramps and increased risk of hypertension. Premature birth is a problem associated with magnesium deficiency.”
Iron needs during pregnancy
Karen Wright, CNS: “Iron needs increase during pregnancy and because these needs are extremely important, a woman’s ability to absorb iron from food increases. If a woman is low in iron they are at a higher risk for low birth weight and preterm babies. Iron deficiency can cause anemia.”
Other dietary considerations during pregnancy
Karen Wright, CNS: “Vitamins, minerals and, antioxidants protect the fetus from damage. For example, low levels of zinc have been linked to birth defects and low birth weight. Vitamin E deficiency has been associated with birth defects and miscarriage. Constipation is often an issue for pregnant women. Consuming dietary fiber and water in adequate amounts addresses this issue. Staying hydrated can prevent urinary infections which are common during pregnancy. Hydration needs increase while pregnant.”
Karen Wright is Certified Nutrition Specialist and practitioner at Metro Integrative Pharmacy in New York City.
Are you thinking about trying for a baby? There are some things to think of before jumping on the baby-making wagon. A few changes before trying to conceive helps set you up for a healthy pregnancy and a healthy baby.
Dr. Aumatma Shah, Naturopathic Doctor, and Founder of Holistic Fertility Center discusses what you need to do before trying to conceive.
Daniela: Good afternoon and welcome to Dreaming of Baby! We have with us today Dr. Shah, here to answer your question: ‘I want to get pregnant, what should I do first?’ It’s a pleasure to have you with us today, Dr. Shah – before we start with our discussion, it would be great if you could introduce yourself to our readers.
Dr. Aumatma Shah: Thank you for having me here! I am a Naturopathic Doctor, in practice for over 10 years and focused on fertility for over half of that time. I am also the author of the best-selling book: “Fertility Secrets: What your doctor didn’t tell you about baby-making”
Daniela: We’re in good hands for getting our question answered then, thank you Dr. Shah! Let’s go straight to the question of the day: Once I start thinking of pregnancy, what should I do first?
The importance of peri-conception care
Dr. Aumatma Shah: First and foremost, you want to PLAN. Which goes beyond the decision to have a baby and gets into the territory of detoxification and optimal nutritional levels because your health (and your partner’s health!) will determine the life-long health of the baby. So, my belief is that, as soon as you decide you are ready to have a child, you should seek support in doing peri-conception care so you and your partner are in optimal states of health well before conception.
“As soon as you decide you are ready to have a child, you should seek support in doing peri-conception care so you and your partner are in optimal states of health well before conception.” Dr. Aumatma
Daniela: You refer to peri-conception care; what would this entail? Does this go beyond nutrition?
Dr. Aumatma Shah: Yes, eating healthy is a good first step, and of course following the general guidelines of avoiding alcohol, limiting caffeine intake, and eating a wholesome diet. Also, your OBGYN will probably suggest taking a prenatal. However, peri-conception care relates to eliminating toxins from the body (food, heavy metals, hormones, etc) and then working on nutritional levels that go beyond eating “healthy.” Every person’s needs are different, so I like testing functional nutritional levels and figuring out deficiencies and where nutrients can be optimized. It may also mean testing digestion to confirm that what you eat, even if it’s super healthy, is getting absorbed and utilized in the body.
Daniela: Thank you for elaborating on this, Dr. Shah. What kind of tests should be pursued at this stage and will eliminating toxins have an effect on the time it takes to conceive?
Dr. Aumatma Shah: Great question! My favorite general test is functional nutrition testing through a company called Spectracell. However, testing is individualized. When I talk to a patient, I’m usually listening for what might be happening under the surface, for example, did they have high exposure to toxins throughout their life due to their work? Or is their digestion compromised, shown via symptoms of bloating, gas, or constipation/diarrhea? Do they have signs of inflammation in the body? Do they have difficulty losing weight and are they cold all the time? If the answer to any of these is yes, then we would do more focused testing related to each of the potential underlying factors. In this sense, even tests are individualized. Not every person needs $2000 worth of tests. Instead, a consultation can help them narrow in on the ones essential for them. And yes, once these areas are addressed, they will have faster paths to conception because their body is able to quickly optimize to optimal health. Fertility is almost a “bonus” to their efforts in getting healthy.
Daniela: In your experience working with couples wishing to conceive, what kind of nutritional deficiencies have you found to be most common?
Dr. Aumatma Shah: B-vitamins are often deficient. Because of our high-stress lifestyles, we deplete B-vitamins at a faster rate and B-vitamins are water-soluble so we are not going to hold on to them. They need to be replenished frequently. On the other hand, Vitamin D is deficient in so many people and is a fat-soluble vitamin. Yet, many are deficient, and it is an essential precursor to many sex hormones. Lastly, Vitamin E is essential for egg and sperm health. So, even though less often found to be deficient, a deficiency can create many problems in conception.
Know your body
Daniela: This is very interesting and imperative knowledge for those on the journey to pregnancy. On a slightly different angle, you have spoken widely about empowering women through intimate knowledge of their bodies. Can you elaborate on this a little – how important is knowing your body when trying to conceive?
Dr. Aumatma Shah: YES! Thank you, this is one of my favorite topics. What I hear most frequently from patients is… “wow, why aren’t we taught this in school? Thank god for my fertility issues that brought me in to your office so I can learn these things.”
Dr. Aumatma Shah: The main thing that I think every woman ought to know is what is happening at each part of her menstrual cycle and what that means for her energetically. The best way to start to learn and empower yourself is to start by taking your basal body temperature in the morning. Then, add to that, any symptoms you’re experiencing – cramps, low sex drive, lower energy, worsened sleep, etc. And, after a few months of doing this, you will likely see some patterns that can give deep insights about what’s happening in your body at each phase.
“The best way to start to learn and empower yourself is to start by taking your basal body temperature in the morning.” Dr. Aumatma
Dr. Aumatma Shah: What we should expect to see in temperatures is slightly lower temperatures in the first half of the cycle, with a steep spike (signifying ovulation) and then temperatures staying high in the latter half. When this doesn’t happen, we can guess an imbalance in hormones, and depending on the pattern, I can usually tell which hormones are out of balance.
Dr. Aumatma Shah: Additionally, what is really fascinating for me and what I love teaching about is the energies in our bodies in each phase of this cycle. Menses mark the beginning of the cycle, you can most easily connect to it as the winter season. It is the time to be internal and self-contained; take care of yourself and take time for you! It is also the time to gain deep insights into yourself and the world around you. After that, it is spring season… this is when we are getting more energy and starting to engage with the world around us. Summer is the peak – it also connects with ovulation. This is when we are easy to connect with, a great time to engage with our partner, have those tough conversations, and overall enjoy time with others. This is also the time to see the fruition of intentions we may have set during ‘winter’. Then lastly, post-ovulation is fall season where we take stock of what we have left, what we need to hold on to and what must be let go. This is the time for beginning to conserve our energy for the winter to come. When we fall in sync with these rhythms on a monthly basis, it is easy for hormones to get more balanced and to have less “menstrual symptoms” that so many women consider to be completely normal.
“When we fall in sync with these rhythms on a monthly basis, it is easy for hormones to get more balanced and to have less “menstrual symptoms” that so many women consider to be completely normal.” Dr. AUmatma
Daniela: Wow! The way you describe the cycle is impressive and makes so much sense. In a way then, ideally, preparing for pregnancy is a time when to really get to know yourself and your body. Based on your own experience working with expectant moms, when a mom-to-be is fully aware of her body, does this usually have an effect on the pregnancy and birth itself?
Dr. Aumatma Shah: Yes, exactly! When a mom-to-be is fully aware and in tune with these rhythms, she has made space to invite in a baby. And, being in tune with herself makes it easier for her to be in tune with the baby. I often find that if she has lived in rhythm (as opposed to the go, go, go lifestyle so many women have), she will have fewer symptoms that we consider “normal” in pregnancy such as nausea/ vomiting, fatigue, pain, headaches, etc. A lot of these can be avoided now because she knows and is able to listen to what her body needs while pregnant. It makes it easy for her to say, “oh, today, I am feeling more exhausted. Maybe baby is growing a lot. I need to clear my schedule and take a nap instead.”
Dr. Aumatma Shah: This training will also benefit her in birth because again, she will have learned to listen to what her body and the baby needs. She is more likely to move if needed or dance if her body wants, instead of feeling confined to the birthing bed. And lastly, this shall help her restore her balance post-partum.
Daniela: Thank you, Dr. Shah. It’s been a pleasure discussing this subject with you today! On a final note, what would be that one piece of advice that you’d always share with a couple preparing for pregnancy – is there anything that maybe we have missed in our conversation today?
Dr. Aumatma Shah: Thank you, Daniela. I would say this to couples preparing for pregnancy: Trust in your body, it knows exactly what to do; but also, get help. Don’t wait for months and months if pregnancy is not happening. Instead, get tested sooner so you don’t frustrate yourself unnecessarily. Wishing and hoping that ‘it will happen next cycle’ can be tiring and depressing for both partners. Instead, take action sooner. If your doctor isn’t willing to help you, find someone who will!
Daniela: Thank you, and thank you for your time today Dr. Shah!
Whether you want to get the timing just right, or are looking for ways to assist your body to conceive, home insemination is a reachable alternative to many on the journey to parenthood. Home insemination offers privacy, affordability, and added comfort – identifying the right tools towards a positive pregnancy test helps you reach your dream faster.
Dreaming of Baby speaks with Carol Lomas, COO of Conceivex, the people behind the Conception Kit® at home-system. In this interview, we ask the questions you want answers to in determining whether or not this is the right tool for you.
CJ: Good afternoon, today we have with us Carol Lomas from Conceivex, a company dedicated to helping those trying to conceive. The interview is sponsored by Cryos International and we will also cover how Conceivex’s Conception Kit can be used with donor sperm for home insemination to increase the chances of pregnancy! Thank you for joining us Carol, would you be so kind as to introduce yourself to our readers and tell them a little about what you do and your solution for couples trying to conceive.
Carol Lomas: Thank you. I am the COO of Conceivex, makers of the Conception Kit® at-home system. The Conception Kit® at-home system gives patients the opportunity to take control of their own fertility in the privacy of home. Privacy is often one of the most important factors for many patients. At less than $405 at most pharmacies and a simple co-pay if covered by insurance, the Conception Kit® at-home system has all the tools and medical devices to help couples enhance the opportunity to conceive.
Conception Kit® at-home system
CJ: Let’s start by covering what one may find in the kit, and also how you help ensure that the user of the Conception Kit does, in fact, use the kit and donor sperm during ovulation.
Carol Lomas: Yes, inside the Conception Kit at-home system you will find 4 cervical caps (one to practice with prior to using donor sperm or ejaculate obtained from regular sex) and 3 cervical caps for insemination, 3 semen collectors (for patients not using donor sperm but who will have intercourse to collect the ejaculate), 3 intimate moisturizers that are sperm friendly and 3 pregnancy tests. Plus, a detailed Instruction for Use Manual, a Conception Journal (to track the patient’s cycle) and a Conception Wheel (that helps a patient time a pregnancy).There are also 24 ovulation predictors inside the Conception Kit at-home system. This gives the patient 8 per month so that the users using the donor sperm or ejaculate through intercourse will place the sperm inside the Conception Cap during Ovulation which is the key time to get pregnant.
The Conception Kit at-home system is a three-month medical device.
Monthly Box – the kit contains three in total.
CJ: Excellent, and how does the ovulation predictor work? Is this a standard urine test predictor?
Carol Lomas: Yes, it is.
Home Insemination – A how-to guide
CJ: So prior to using the sperm, the individual would first test to ensure they are ovulating. Is this correct?
Carol Lomas: Yes, and they would also read the Instruction For Use Manual on the Conception Kit, track their fertility cycle in the Journal and use the practice Conception Cap to make sure they have placed the cervical cap on the cervix correctly prior to the day when they will use the donor sperm or ejaculate from sex.
Daniela: Thank you; and how is the cervical cap used? If you could walk us through the test cap procedure…
Carol Lomas: First, let me walk you through the cervical cap and why it is important. The cervical cap (Conception Cap) is designed to hold, protect and concentrate sperm near the cervical opening(os) for 4-6 hours. By placing sperm at the cervical opening, the sperm have the best chance of entering the uterine cavity to fertilize the egg. This is very important when you consider that nearly 90% of sperm die in the acidic vagina within the first ten minutes. The Conception Kit at-home system extends the life of the sperm by preventing any sperm from backtracking onto the acidic vaginal walls and protects them from this environment. The practice cap is used to help the patient get comfortable with placement on the cervix prior to ovulation occurring when they would use the cervical cap for insemination.
“The Conception Kit at-home system extends the life of the sperm by preventing any sperm from backtracking onto the acidic vaginal walls and protects them from this environment.” Carol Lomas, COO, Conceivex
Daniela: Some women may be hesitant about the insertion part – how will they know if it has been inserted properly and is in the right place?
Carol Lomas: The cervix is the only thing at the back of the vagina, and it feels like the tip of a nose. It can be felt with the fingers. Patients can lie with their back on the floor with their feet on the wall and their knees bent at a 90-degree angle. Then do a partial sit up. The abdominal muscles will compress and move the uterus which will move the cervix into a position that will be more easily reached with fingers. The walls of the vagina are soft/flexible but the cervix is harder and, as already noted, feels like the tip of your nose. When the cap is in place, the patient should be able to feel through the base of the cap and feel the cervix inside the cap. The Conception Kit at-home system comes with very detailed instructions to help them with this process.
Daniela: To clarify, would insertion be similar to having a contraceptive cervical cap?
Carol Lomas: Yes, however, you will place the cervical cap over the cervix like you would a knit cap on your head. You do not need to place the entire cap over to the base of the cervix, just make sure it is around the cervix as a knit cap would sit on your head. When placing the cap, relaxing is important. If the vaginal area is to tight, try relaxing and stretching it. This can be done with your fingers. Starting with one finger, insert it and sweep it around the walls of your vagina in a circular motion, expanding the opening as you go. Now add one finger at a time, each time continuing the circular motion. Do this for about 10 minutes and really focus on relaxing your whole body while you do it. When you are ready to use the cap for insemination, your vaginal cavity will be expanded. Patients that will be having intercourse prior to inserting the cap will see that the action of intercourse will have helped expand the vaginal cavity. So remember to relax and stretch.
Daniela: Thank you for clarifying. You note that the cap has to be in place for 4 – 6 hours; does this mean that the woman has to rest during this time or she can continue with her day?
Carol Lomas: Yes, she can continue with her day, just no jogging or swimming.
The Cervical Cap
Home Insemination with Donor Sperm
CJ: When using the device with donor sperm, how does the process differ? Can you cover for us both uses? At Dreaming of Baby, we are dedicated to helping all those on the journey to parenthood. In the case of a couple using the product, would regular intercourse happen and then the cap be slipped into place? With donor sperm, would one place the sperm inside the cap and then put it in place, or first use the applicator to place the sperm inside and then place the cap?
Carol Lomas: To answer the donor question first: The patient would thaw the donor sperm (Cryos suggests two straws for each insemination) and would place the donor sperm inside the Conception Cap and then place on the cervix. In the case of using donor sperm, the patient needs a delivery system for the sperm to be placed at the cervix and protected from draining back out or sperm being killed by the vaginal environment. That is where the Conception Cap comes in. If the couple is not going to use donor sperm, they would have sex using the semen collector and then squeeze the ejaculate into the Conception Cap. There is also a sperm-friendly intimate moisturizer that can be used in both cases to help the vagina become more lubricated.
Daniela: Thanks for elaborating; so, with regards to the semen collector, how does this work, and are there any precautions to be taken to ensure optimal sperm health?
Carol Lomas: The semen collector is like a condom; however it is specifically made to not kill sperm like a condom would.
It is non-latex and non-spermicidal.
CJ: If I understand correctly, once the semen is collected, the process is the same for donor sperm & natural conception?
Carol Lomas: Yes, placement is the same.
Is home insemination effective?
CJ: So now that we have the how covered, I would like to ask a little about results and how much of an increase in the likelihood of pregnancy there is when using the Conception Kit?
Carol Lomas: Cervical cap insemination has a class effect between 18-44%, depending on the two patients involved.
CJ: Can you elaborate on what class effect means, am I understanding correctly that the increase in likelihood of pregnancy is 18 to 44%?
Carol Lomas: Yes, that is correct.
Daniela: The cervical cap method is a long-established solution, however, this method is no longer as common in hospitals. Can you explain a little why that is and how the Conception Kit counters this?
Carol Lomas: Good question. This was the way people were able to enhance fertility in the 1950’s 1960’s and 1970’s, however, cervical cap insemination was not a treatment that could be used at home at that time. Once the physician placed the semen fill cap on the cervix, the patients had to lay in the physician’s office for up to 4 hours. It was too time-consuming for the patient and very much so for the physician’s office, thus faster methods were designed in the 1970s like IUI which takes 15 to 30 minutes.
This does not mean that the method was not successful, just that the time was not practical for a physician office that turns the room every 15 minutes during a medical appointment.
Daniela: So, in effect, in terms of home insemination, the process is still very much applicable even with other different scientific advancements?
Carol Lomas: Yes, of course, the science behind cervical cap insemination is very sound to the point that cervical cap insemination is in the FDA Code of Federal Regulations.
Daniela: To ease the minds of our readers, how safe is the device on cervical health?
Carol Lomas: Very safe, the cervical cap is worn for up to 6 hours and is made of medical grade silicone, the same material that heart valves are made of.
When should I try home insemination?
Daniela: Thank you for explaining this; at which point of trying for pregnancy does Conceivex recommend that a couple utilizes the Conception Kit?
Carol Lomas: If a patient has been trying to conceive for 3 months with no success, or if a patient wants to self-inseminate at home rather than at a medical facility, or if a patient is trying to time a pregnancy (military family on a short timeframe together), we suggest using the Conception Kit at home system. Also, for patients on fertility medication, it is the perfect addition to the treatment plan. By combining the Conception Kit® at-home system with the fertility medications, you are ensuring that all available sperm are at the cervical opening and protected, while at the same time you are maximizing your egg production during each medication cycle. Since fertility drugs can only be used for a limited time, it is important to take full advantage of every cycle by adding the Conception Kit at-home system to the drug routine.
“By combining the Conception Kit® at-home system with the fertility medications, you are ensuring that all available sperm are at the cervical opening and protected, while at the same time you are maximizing your egg production during each medication cycle.” Carol Lomas, COO Conceivex
Daniela: Is it suggested that the patient schedules an OB-GYN appointment prior to using the device?
Carol Lomas: Yes, an OB-GYN, a Family Practice Physician, or a Urologist can prescribe this.
Daniela: And is the kit covered by insurance? What is the average co-pay in this regard?
Carol Lomas: As has already been noted, a prescription is a must. When the kit is covered by insurance as a pharmacy benefit (Express Scripts is now covering the Conception Kit at-home system depending on your plan), it is a simple co-pay of between $25-$75 at the pharmacy. Patients should check with their pharmacy benefit manager to see if it is covered. To do this, flip the insurance card over to the back and there should be a number for the pharmacy benefit manager. A patient can also have their pharmacist check for them. Patients should give the pharmacist the NDC number to help the pharmacist locate the Conception Kit in their system. The number is: 08597.1111.13. If not covered, the cost is around $405 at the pharmacy with a prescription.
CJ: Is the conception kit available at most pharmacies?
Carol Lomas: The Conception Kit at-home system is a drop ship item that the pharmacist will order. Once you give them the prescription, you can obtain the kit from Walgreens, Walmart, CVS Healthwarehouse.com (which is a mail-order pharmacy) and Village Pharmacy to name a few…
Conception Kit® at-home system vs IUI – cost and effectiveness
CJ: How does the cost of the Conception Kit compare with IUI treatment?
Carol Lomas: The Conception Kit costs 403 dollars and is a three- month treatment. On the other hand, one IUI can cost between $800 to $1500 depending on the clinic.
CJ: So, without insurance, the cost of IUI for 3 months would be upwards of $2400 when compared to $403 for the conception kit? What is the difference in known effectiveness of the treatments?
Carol Lomas: Yes, that is correct. They have a similar range for obtaining pregnancy. It all depends on the patients and the issues they may have.
Daniela: Thank you Carol, it’s been a very insightful conversation and it’s very positive to know of the options that those wishing to conceive can avail of in the comfort of their own home. On a final note, is there anything else you wish to add on the subject and which maybe we did not cover today?
Carol Lomas: The Conception Kit® at-home system gives patients the opportunity to take control of their own fertility in the privacy of home. Privacy is often one of the most important factors for many patients. For patients using donor sperm, I would like them to know that cervical cap insemination is better than just using a syringe. The Conception Cap® (cervical caps inside the Conception Kit at-home system) places the sperm in the correct position (at the cervical opening), at the correct time (during ovulation) and protects them from the vaginal environment while at the same time does not allow the sperm to drain back into the vagina like a syringe would. They are held at the opening of the cervix for 4-6 hours unlike the 30 minutes with a syringe. Simply put, the Conception Kit® at-home system extends the life of the sperm by preventing any sperm from backtracking onto the acidic vaginal walls and protects them from this environment. When the sperm is protected and placed right on the cervix, the chances of pregnancy increase. When you think of the cost of the straw of donor sperm this is important.
CJ: It has been wonderful having you with us today! I would also like to thank you for the step-by-step guide for home insemination users which we will include at the bottom of this interview. Thank you so much for your time and as always, we hope that this interview proves useful to those dreaming of baby!
Guide for Home Insemination with Donor Sperm
Conception Kit® at-home system with donor sperm from Cryos USA
It is important that patients know when they are ovulating to be able to order the sperm.
Steps include:
1. Reading and following the instruction inside the kit.
2. Start using the Conception Kit ovulation predictors to detect ovulation.
3. Patient would use the Practice Conception Cap to learn proper placement on the cervix
4. Depending when your ovulation occurs purchase your straws from Cryos, USA. It is very important that you purchase within a five-day window prior to ovulation. It is suggested that you use the seven-day Nitro availability straws with a two-day delivery service for the transporting of the straws to your home from Cryos, USA (thus three days of the seven-day viability are used in ordering and transport leaving you four days of viable sperm).
5. If you are unsure as to when you ovulate, use the first month of the Conception Kit to track your ovulation with the ovulation predictors.
a. Then purchase the straws for self- insemination on the second month.
6. A Conception Journal is provided to chart your cycle including ovulation.
Being able to place the sperm during the ovulation window is key for conception to occur.
Order Day of Cycle
two days to deliver to home
Ovulation Detected
At-home insemination days
Day 14
Day 16
Day 17 and 18
Day 13
Day 15
Day 16 and Day 17
Day 12
Day 14
Day 15 and Day 16
Day 11
Day 13
Day 14 and Day 15
Day 10
Day 12
Day 13 and Day 14
Day 9
Day 11
Day 12 and Day 13
Day 7
Day 10
Day 11 and day 12
7. Prior to thawing two straws of sperm, patients would detect the ovulation window (luteinizing hormone surge) by using the ovulation predictors inside the Conception Kit.
8. Once the luteinizing hormone surge has been detected with the ovulation predictors the patient would thaw two straws of sperm via the instructions from Cryos International, USA.
9. Patients would then transfer the sperm from the straws into the soft and flexible Conception Cap® (cervical cap used for insemination) and place on their cervix. The Conception Cap® is designed to hold, protect and concentrate sperm near the cervical opening(os) for 4-6 hours.
10. Patients would use the pregnancy test to see if conception has occurred.
Trying to conceive? Learn more about at-home insemination and the Conception Kit® by clicking here.
Oncofertility involves study and practice, bridging oncology and reproductive medicine. Certain cancers may require treatments that have an effect on fertility. Fertility preservation options ensure that cancer survivors can still achieve their dreams of parenthood.
Fertility Specialist Dr. Sharon Moayeri, MD MPH, discusses with Dreaming of Baby oncofertility and what it entails.
CJ DeGuara: Hello and welcome to Dreaming of Baby! Today we have with us Sharon E. Moayeri, MD, MPH, a Fertility Specialist here to discuss a very important subject: Oncofertility. Dr., would you be so kind as to start by introducing yourself to our readers?
Sharon E. Moayeri, MD, MPH, Fertility Specialist: Yes, thank you. I’m Dr. Sharon Moayeri, a Board Certified Reproductive Endocrinologist in Private Practice in Newport Beach, Southern California. I take care of patients seeking fertility treatment including in-vitro fertilization and have a special interest in patients wanting to do fertility preservation procedures for medical reasons, such as a cancer diagnosis.
CJ DeGuara: So to better understand Oncofertility: I believe that there are different types of situations that impact fertility, the diagnosis of cancer itself as well as the treatment of it has an impact. Can you walk us through some of the most common situations today and what is normally done or recommended?
Cancer Treatments and Fertility
Sharon E. Moayeri, MD, MPH, Fertility Specialist: Sure, certain cancers that may affect women of reproductive age, such as breast cancer, may require treatments like chemotherapy that causes early menopause. Many cancer doctors will support a woman’s decision to undergo fertility treatment to harvest and freeze her eggs prior to this exposure to give her the chance to have children once she is in remission. In other instances, cancers may impact a woman’s ability to carry a pregnancy and the use of a gestational carrier surrogate may be needed.
CJ DeGuara: Excellent and for the male counterparts, I believe the radiation therapy and chemo can have an impact also?
Sharon E. Moayeri, MD, MPH, Fertility Specialist: Yes, for men the impact may be short term or long term. Collecting and freezing sperm prior to treatment is a great option to preserve his fertility.
CJ DeGuara: An important question, do all cancers that require chemotherapy impact fertility?
Sharon E. Moayeri, MD, MPH, Fertility Specialist: Not all chemotherapy or cancer treatments necessarily affect fertility or lead to early menopause -the type of medicine used and the age of the patient play a part in this risk.
Preserving Your Fertility Following a Cancer Diagnosis
CJ DeGuara: So it would be advised that an oncology patient asks the right questions if they are going to undergo treatment? Who should they ask and what should they be asking?
Sharon E. Moayeri, MD, MPH, Fertility Specialist: Yes, it is important for patients to discuss fertility concerns early on with their Oncologist and preferably before they receive any treatments. Though it is increasingly common for Oncologists to discuss fertility as part of a patient’s comprehensive treatment, this practice is still not universal. Fertility treatments can be performed in a short amount of time and most Oncologists support patients who choose to pursue their options.
“It is important for patients to discuss fertility concerns early on with their Oncologist and preferably before they receive any treatments.” Dr. Sharon Moayeri
Fertility preservation options for cancer patients
CJ DeGuara: On that note, in cases where the patient is aware that their condition may lead to sub-fertility or infertility, you mentioned egg vitrification as an option. What does this entail and why should it be done?
Sharon E. Moayeri, MD, MPH, Fertility Specialist: Egg vitrification (or freezing) is a modern technique to freeze eggs (and embryos) that has been shown to improve their survival upon thaw and use. Using vitrification, women can preserve their eggs and/or create embryos to bank. The process involves fertility medications over approximately two weeks leading to a minor procedure under anesthesia to extract a group of mature eggs. These eggs are stored for the future and remain the age they were when extracted. Importantly, the eggs are removed before exposure to the cancer treatments, since such exposure has a negative impact on the eggs. If the woman has a partner, she may opt to create and freeze embryos.
CJ DeGuara: Ok, so that is also an option?
Sharon E. Moayeri, MD, MPH, Fertility Specialist: Yes, absolutely. Some women choose to freeze both eggs and embryos; whereas other women elect to freeze eggs only. This is a personal option and depends on whether or not she has a partner or is willing to use an anonymous sperm donor.
CJ DeGuara: If the eggs have not been frozen, what options will a cancer survivor have?
Sharon E. Moayeri, MD, MPH, Fertility Specialist: If a woman doesn’t pursue egg retrieval and freezing of eggs or embryos prior to treatment, then she still has options later. Some women may not go into menopause and may resume their menses after their cancer treatment. If they are in remission and cleared by their Oncologist, then they may have the chance to conceive naturally or with the help of fertility treatments – such as in-vitro fertilization using her own eggs. Alternatively, women may opt for a donor egg and/or possibly gestational carrier surrogacy depending on if they are medically cleared to carry a pregnancy and the amount of time they are advised to remain in remission before carrying a pregnancy.
CJ DeGuara: And for men?
Sharon E. Moayeri, MD, MPH, Fertility Specialist: Men will often resume sperm production following their treatment. If not, and if they did not bank sperm beforehand, then they can opt to use donor sperm with their partner using either intra-uterine insemination or in-vitro fertilization.
CJ DeGuara: Is there any specific differences with oncofertility once the process (IVF) starts?
Sharon E. Moayeri, MD, MPH, Fertility Specialist: The timing is critical for oncofertility cases. Women start medicines immediately since we need about 2 weeks to reach the stage that their eggs are mature enough to be extracted and we don’t want to delay their cancer treatment. Also, we sometimes use concomitant medicines alongside the fertility medicines to reduce the risk of hormonal fluctuations that may be risky for some cancers. For example, concurrent medicines may include letrozole or lupron in patients who have breast cancer. However, most oncologists and fertility specialists agree that the short course of exposure to hormone fluctuations should not have much risk to women undergoing fertility treatments.
“Timing is critical for oncofertility cases” Dr. Sharon Moayeri
Sharon E. Moayeri, MD, MPH, Fertility Specialist: Another consideration for some types of cancer is that women may need more careful monitoring and management for the egg retrieval procedure if, for instance, the patient’s blood counts are affected.
CJ DeGuara: This has been very interesting. To summarize, for males and females diagnosed with cancer, banking eggs or sperm is highly advised prior to starting treatment?
Sharon E. Moayeri, MD, MPH, Fertility Specialist: It is definitely advised that men and women diagnosed with cancer consider banking eggs, sperm, and/or embryos PRIOR to their cancer treatment. This limits the exposure of the eggs and sperm to toxic medicines, radiation therapy and/or fertility-damaging surgery. There are some great options to do this and given the speed that we can accomplish this, there is rarely an instance where it should not be supported from an oncologist’s standpoint. Particularly, since cancer survival is increasing, and improving the quality of life after cancer includes consideration of family building goals. This is an area we are understanding better since regret is high among those who survive and may not have considered fertility-sparing treatments before their cancer interventions.
“It is definitely advised that men and women diagnosed with cancer consider banking eggs, sperm, and/or embryos PRIOR to their cancer treatment.” Dr. Sharon Moayeri
CJ DeGuara: Excellent, you have been a wonderful guest. If you had to give our readers some advice what would it be?
Sharon E. Moayeri, MD, MPH, Fertility Specialist: Talk to your oncologist early on to let him/her know your intent to preserve fertility and make sure that you don’t underestimate the options that are available for you to grow your family once you are cancer free!
CJ DeGuara: Thank you for your time today, Dr. Moayeri!
Dr. Sharon Moayeri is a Board Certified Reproductive Endocrinologist in Private Practice in Newport Beach, Southern California. Get in touch with Dr.Moayeri by clicking here.
Control of the pelvic floor is imperative in terms of a new mom’s overall health. Childbirth can lead to a weak pelvic floor with a common incidence of urinary incontinence, leaving many women more prone to depression.
The pelvic floor muscles also have an important role to play in female orgasmic response. Simply put, orgasms go beyond reproduction. Brent Reider, President of Relevium Labs discusses his research with Dreaming of Baby, highlighting the true role of the clitoris and orgasms in a woman’s overall well-being.
Daniela: Good morning, Brent! We’re very happy to have you with us again on Dreaming of Baby. We have discussed with you the treatment of incontinence following childbirth – a conversation which, whilst being absolutely enlightening, is also one which must be had. As you rightly noted in that interview, ‘40% of women who have had vaginal births and 25% of C-Section births will experience some form of urinary incontinence’. Added to this, ‘women with urinary incontinence have a higher incidence of depression (15%) than women without urinary incontinence (9%).” It is thus apparent that control of the pelvic floor is imperative for a woman’s overall health and well-being. Nonetheless, urinary incontinence after childbirth is not the only issue that merits attention and, as author of the article entitled, “Role of Pelvic Floor Muscles in Female Orgasmic Response”, we are looking forward to what you have to share with our readers on this all too important subject. Can you let us know more about your research in this field and what led to this study?
“Role of the Pelvic Floor Muscles in Female Orgasmic Response”
Brent Reider, President Relevium Labs, Inc.: Thank you for inviting me back again. It’s a pleasure. Postpartum health is one of the best investments we can make on a personal and public health level. I design FDA Cleared Class II medical equipment (7 devices personally, including the Yarlap) and I’m a colleague of the team that designs equipment used by the National Healthcare systems of France, Germany, Scandinavia and Great Britain for postpartum care. The European Healthcare Systems have been using NMES devices for postpartum perineal re-education (a rééducation périnéale) for decades to treat the urinary incontinence that sometimes follows pelvic floor muscle strain from birthing. Pelvic floor muscle re-education includes muscle massage – NMES is clinically proven to be the most effective way to tone after childbirth because the muscles are stimulated for the correct work-rest sequence for the correct amount of time. This what I do.
In addition, I am an author and referee for medical and scientific peer review journals. During the FDA usability study for our pelvic floor NMES device, the Yarlap, we noticed that what women reported regarding their overall pelvic floor health appeared to be in agreement with the research of Dr. Beverly Whipple and the position of the World Health Organization (WHO) on women’s wellbeing. It also seemed to answer the question posed in Dr. Lisa Lloyd’s book, The Case of the Female Orgasm: Bias in the Science of Evolution (2006). Simply put, the female orgasm is about wellbeing, not just reproduction.
“The female orgasm is about wellbeing, not just reproduction.” Brent Reider, President Relevium Labs, Inc.
The link between orgasm and your wellbeing
Daniela: That is a very interesting point to be made and it’s very positive to see that the subject of female orgasm is being addressed outside of a solely reproductive point of view. It would be great if you could elaborate further on this: what is the connection between female orgasm and wellbeing?
Brent Reider, President Relevium Labs, Inc.: The muscles of a woman’s pelvic floor are among the same muscles that contract during orgasm. Consequently, firmer tone of the pelvic floor muscles adds intensity to the muscle contractions during orgasm and enables a woman to identify, isolate, and command muscles of the pelvic floor. The tone of these muscles is integral to a woman’s continence, posture, and sexual response. Dr. Kegel observed that “sexual feeling within the vagina is closely related to muscle tone, and can be improved through muscle education and resistive exercise” (Kegel, A.H. 1952). As for posture, imagine a Gothic arch. The peak of the arch is at the base of the spine and the heels are where the arch meets the ground. All the weight of the body is carried to the ground by this musculoskeletal arch. As with any arch, there are strong forces pushing down to the base (the heels) and outward at the curve of the arch (the hips). A weak pelvic floor allows the strong forces to push outward at the hips and inward at the knees (see arch images). The muscles of the lower back try to compensate for this deflection causing lower back pain, and as the deflection becomes greater; hip, thigh and knee pain follow – and the pain may diminish mobility. As for continence, the muscles of the pelvic floor help hold organs in position and help direct the weight of the body in a musculoskeletal arch from the spine to the heels. If the muscles of the pelvic floor weaken; the organs shift, which places pressure on the bladder and results in what is commonly known as stress incontinence – leaking when you cough. Atrophied muscles can contract spasmodically causing urge incontinence or “overactive bladder.” Atrophied pelvic floor muscles may also lead to a loss of muscle control.
Musculoskeletal arch Copyright 2017 Yarlap® with AutoKegel®, RLI
A weak pelvic floor allows the strong forces to push outward at the hips and inward at the knees. Copyright 2017 Yarlap® with AutoKegel®, RLI
“Firmer tone of the pelvic floor muscles adds intensity to the muscle contractions during orgasm and enables a woman to identify, isolate, and command muscles of the pelvic floor. The tone of these muscles is integral to a woman’s continence, posture, and sexual response.” Brent Reider, President Relevium Labs, Inc.
Does a weak pelvic floor affect orgasm?
Daniela: Thank you for this very detailed explanation. It’s surprising how as women we are never – or rarely – given information on this. You’ve explained how the orgasm promotes pelvic floor muscle tone. Looking at this from another viewpoint – how would a weak pelvic floor affect orgasm?
Brent Reider, President Relevium Labs, Inc.: The better toned the muscle, the more intense the feeling (Kegel, A.H. 1952). Plus, what we know about muscle memory suggests that the more a muscle is trained from practice the more responsive it is – this suggests that the more you orgasm the better you are at it. Not only is the intensity affected by muscle tone, but the better the response time. Perhaps, since the tone of these muscles is integral to a woman’s continence, posture, and sexual response, this is why a woman’s ability to orgasm continues past menopause. What is truly exciting is when a woman in her 80’s calls to report that she has regained the ability to control her pelvic floor muscles using the Yarlap hold and release. Then she says, “Ah, to be orgasmic again.” By making wellbeing the issue, new mothers have vital information to share and help educate their own mother and grandmother: it’s never too late to try pelvic floor muscle re-education using NMES. And the tone of these muscles is integral to a woman’s continence, posture and sexual response.
The better toned the muscle, the more intense the feeling (Kegel, A.H. 1952).
Orgasm after childbirth
Daniela: That’s great to know – Many moms are concerned about childbirth, specifically how this could change their sexual lives. How does childbirth affect female orgasmic response?
Brent Reider, President Relevium Labs, Inc.: Childbirth will strain the muscles, but after recovery, what action she takes will have long-term effect. This is why the French, and other European Health Care systems give so much attention to postpartum re-education of the pelvic floor for muscle tone. With childbirth, the new mother becomes intimately aware of her pelvic floor muscles. She can use this new-found awareness to give care and attention to the muscles and this knowledge will empower her and improve her wellbeing, including her understanding and capabilities for achieving orgasm. Indeed, sexual intercourse is far from the exclusive pathway to female orgasm – the orgasm is not intromission specific. In this vein, numerous studies confirm stimulation of the clitoris, directly or indirectly, is the sole noncontroversial effective trigger of female orgasm.
“With childbirth, the new mother becomes intimately aware of her pelvic floor muscles. She can use this new-found awareness to give care and attention to the muscles and this knowledge will empower her and improve her wellbeing, including her understanding and capabilities for achieving orgasm.” Brent Reider, President Relevium Labs, Inc.
Re-educating your pelvic floor after childbirth
Charles: You stated above that “after recovery, what action she takes will have a long-term effect.” Is there a specific impact in delaying getting to work on repairing the pelvic floor muscles? How long can an individual wait before working on their pelvic floor muscles but still not allow permanent damage to set in; if that is the case… What are the common long-term effects?
Brent Reider, President Relevium Labs, Inc.: After childbirth, ask your doctor about when it’s safe to start exercising your pelvic floor muscles. A licensed healthcare professional will always be helpful in telling you about pelvic floor muscle re-education and when it’s safe. While it’s never too late to tone the pelvic floor muscles, a new mother – and partner – do not want to let the pelvic floor muscles of the mother atrophy (aka weaken). A healthcare professional will often recommend Kegel exercises to a new mother. Unfortunately, the majority of women of any age who try to tone their pelvic floor muscles with Kegel exercises find it difficult to perform the exercise correctly. This is why muscle stimulation (NMES) is effective for mothers of all ages. Naturally, during exercise, your brain sends an electrical signal to your muscles telling them when to contract and when to relax. A muscle stimulation (NMES) device sends a precise electrical signal to the pelvic floor muscles to strengthen and relax effectively – in as little as 20 minutes a day. Biofeedback devices are not NMES. Muscle re-education is clinically proven to be achieved most efficiently with NMES. This is particularly true if the woman seeking pelvic floor muscle re-education has difficulty knowing and voluntarily commanding her pelvic floor contractions. Indeed, with adequate pelvic floor muscle control, virtually all mothers have the tools to become Aphrodite’s mortal surrogate, with the skills of love powerful to incite to sublime distraction.
Female Visceral Organs in Natural Position Copyright 2017 Yarlap® with AutoKegel®, RLI
Female Visceral Organs Descended Copyright 2017 Yarlap® with AutoKegel®, RLI
The images above show how the bladder is normally and how weight or atrophy can push down on organs, pinching the bladder. This also presents a very good understanding of how, during pregnancy, the baby makes pressure on the bladder, further emphasizing the importance of Kegels.
Charles: So, if I’m understanding correctly there is a sweet spot time-wise; you have to wait a little to ensure you are healthy enough to exercise whilst not delaying too long?
Brent Reider, President Relevium Labs, Inc.: That is correct! But, even if you wait too long, you are still able to get it back. Never think it is too late.
Daniela: Thank you for clarifying, Brent. Is there any specific exercise that a woman can do during pregnancy to prepare her pelvic floor for childbirth – and thus limit the effects of the birth on her pelvic floor health?
Brent Reider, President Relevium Labs, Inc.: Absolutely. She should do Kegel exercises. For maximum efficiency, she should consider using an NMES device so the correct muscles work/rest for the correct amount of time.
Childbirth and your clitoris
Daniela: Thanks; so going back to the female orgasm, before our interview you spoke with us about the clitoris. Can you elaborate on this further – that is the anatomy of the clitoris and if this can be affected at all by childbirth?
Brent Reider, President Relevium Labs, Inc.: The clitoral gland is the only visible part of an extensive clitourethrovaginal complex that runs along the pelvic floor, near the pelvic floor muscles. The clitoris is much larger than most people think and this is critical to understanding where to stimulate (see image). As the clitoris runs along the pelvic floor it divides twice: first, it branches in the direction of the hips and, second, it branches to surround the vagina on three sides, close but perhaps not touching the wall of the vagina’s cervix – in proximity to the Gräfenberg spot as identified in 1981 by Dr. John Perry and Dr. Beverly Whipple. The G spot, as it became known, is not a distinct anatomical entity but is a functional unit in arousal of the clitourethrovaginal complex. The clitoris is so robust that even if there is an anatomical change to the female genitalia, it maintains its ability to respond to stimulation causing the muscles of the pelvic floor to contract and relax in orgasmic response. Normal childbirth will not hurt it. Understanding the structure and location of the clitourethrovaginal complex suggests orgasmic births may be possible.
Clitourethrovaginal Complex, Brent Reider Copyright 2017 Yarlap® with AutoKegel®, RLI
“The clitoris is so robust that even if there is an anatomical change to the female genitalia, it maintains its ability to respond to stimulation causing the muscles of the pelvic floor to contract and relax in orgasmic response. Normal childbirth will not hurt it.” Brent Reider, President Relevium Labs, Inc.
Daniela: Thank you for this very detailed answer, Brent. You note that ‘the G spot, as it became known, is not a distinct anatomical entity but is a functional unit in arousal as the clitourethrovaginal complex.’ Can you elaborate a little more on this?
Brent Reider, President Relevium Labs, Inc.: Research (Jannini) indicates the G-spot is part of and at the clitoral bulb which surrounds the vagina on three sides – close but perhaps not touching the wall of the vagina’s cervix – e.g. every woman is unique. Furthermore, women who experience multiple orgasms do so because their brains continue to receive signals from the genitals after orgasm and because the nerve pathways from the clitoris to the brain differ from those from the vagina to the brain perhaps resulting in different perceptions to stimulation. Whipple has repeatedly demonstrated that genital stimulation suppresses pain and the release of the pain-relieving oxytocin can remain in a healthy woman’s bloodstream five minutes after orgasm. Oxytocin is released in exercise and a neuropeptide involved in the encouragement of important processes in sport, encouraging exercise and may prolong it. Motivation to overcome remaining at rest is a principal factor in initiating exercise. Autonomous motivation for physical activity results in better behavioral pursuit, self-regulation, and sustainability. That is to say, “intrinsic” [autonomous] motivation, or being active for the inherent pleasure it brings, is the type of motivation most strongly associated with sustainability in exercise. Interesting note in this regard, the female orgasm can be so powerful that the woman rides on a series of contractions so pleasurable that she achieves a meditative-like state (Davidson). It has been described to me as, “like floating on a cloud.”
Daniela: Excellent, thank you for this very detailed look. To round up then, and if I understand well, the clitoris has a profound role to play in maintaining pelvic floor health as well as ensuring continence. Is this correct?
Brent Reider, President Relevium Labs, Inc.: Yes, the clitoris could be regarded as nature’s conveniently located maintenance switch for a woman’s well-being via muscle tone.
“The clitoris could be regarded as nature’s conveniently located maintenance switch for a woman’s well-being via muscle tone.” Brent Reider, President Relevium Labs, Inc.
Daniela: Great, thank you for the insight that you have so kindly shared with us today. On a final note, what’s that one factor moms-to-be should be keeping in mind with regards to overall pelvic floor health as well as retention of sexual feeling and well-being?
Brent Reider, President Relevium Labs, Inc.: Interesting point here, if the orgasm were for reproduction, would it not be located in a more intromission specific location. It’s not! It is well positioned for access for non-reproductive stimulation. Every indication suggests good pelvic floor muscle tone has many positive outcomes, including, continence, posture, and sexual response and that the female orgasm is part of this complex interplay of muscle tone and well-being. Enjoy your orgasm as part of that critical interrelationship.
Daniela: That is a great observation! Thank you for your time today, Brent, it’s been a very informative discussion.
Brent Reider, President Relevium Labs, Inc.: Thank you.
Would you like to regain control of your pelvic floor? Yarlap is an FDA-cleared device to tone and re-educate the muscles of a woman’s pelvic floor, by sending the signal directly to the muscle. Read more about Yarlap, here.
Brent Reider is President of Relevium Labs, Inc. manufacturers of Yarlap.
The onset of morning sickness can quickly dampen the excitement of pregnancy. As many as 90% of pregnant women experience a degree of pregnancy associated nausea and/or vomiting throughout their pregnancy. If the smell or sheer thought of food is sending you running to the bathroom, then do read on. This article will tell you all about morning sickness and ways and means to help in controlling it.
Why is it called morning sickness?
Many of us know that the term ‘morning sickness’ does a huge injustice to how most women feel in those first few weeks of pregnancy. For many, there is no such thing as ‘morning’ sickness. In reality, morning sickness can occur at any point during the day or night and affects all women and each pregnancy differently. It can come in bouts of minutes or hours, or last all day: the intensity of nausea and vomiting in pregnancy varies.
What brings about morning sickness?
There is no certainty as to what exactly triggers morning sickness. The most popular – and plausible – theory is that morning sickness is the body’s reaction to human chorionic gonadotropin (hCG), a pregnancy hormone produced at high levels during the first trimester. An increase in a woman’s sense of smell during pregnancy can also be a reason.
When does the morning sickness symptom start?
The onset of morning sickness is for many a first indication of pregnancy. The nausea usually starts at around 6 weeks but can start even earlier at 4 weeks of pregnancy.
When does morning sickness end?
Most women experience relief from nausea and vomiting by the onset of the second trimester (after the 12th week). For others, the symptoms may continue for a few more weeks, with a small percentage experiencing nausea all throughout pregnancy. Feeling nauseous is exhausting so make sure you get all the rest possible. Contact your doctor to identify relief options.
Will I miscarry if I have no morning sickness?
Whilst a number of studies have shown that women who have experienced miscarriages were less likely to have had nausea, the absence of morning sickness does not necessarily indicate an unsuccessful pregnancy. Consider yourself one of the lucky ones if you have no clue what morning sickness is!
When is a trip to the doctor a must?
Whilst mild morning sickness and occasional vomiting does not harm your baby, things can take a worrying turn if you are experiencing severe and prolonged vomiting. Hyperemesis Gravidarum involves severe nausea, vomiting, considerable weight loss and at times an electrolyte disturbance. Whilst mild cases are treated with dietary measures, rest and antacids, more severe cases might require a hospital stay to receive fluid and nutrition through an intravenous line. Contact your doctor if you are experiencing such symptoms or if your vomiting and nausea persist well into the second trimester.
What makes me more susceptible to morning sickness?
Various factors can make you more prone to morning sickness: a twin pregnancy or higher multiples; nausea and vomiting in a previous pregnancy; a genetic disposition in that female relatives also experienced morning sickness; prior motion sickness; a history of migraine headaches and the gender of your baby – mothers carrying girls are more likely to experience morning sickness in the first trimester.
Remedies for morning sickness
In identifying remedies for morning sickness, it must be recalled that each case is different. What works for one woman might not work for another, and what works in one pregnancy might not work in the next. Finding what personally helps you is the first step in taking control of morning sickness. Monitor your food intake and the scents you are exposed to and take mental notes of what sets you off and what calms you down. Preferences might also change throughout the weeks: what helped calm you down in week 8 might not assist in week 10. Nonetheless, many women find the following helpful:
Taking control of morning sickness
– Eating carbohydrates whilst still in bed. Leave a few crackers by your bedside and nibble on them when your stomach is still in tip top condition.
– Consume small meals at regular intervals – An empty stomach can increase nausea, whilst overeating can place serious strain.
– Opt for cold meals without strong scents.
– Ginger – many swear by ginger’s power. Grate ginger into hot tea (preferably decaf), or nibble on ginger cookies.
– Avoid cooking foods with strong smells.
– Vitamin B6 – This vitamin is known to help control nausea.
– Mango – Popular amongst women in India and the Philippines, mango is rich in antioxidants and Vitamin C.
– Stay hydrated – drink plenty of water. If this is not helping nausea levels, try adding lemon or lime for added flavor. Lemon and lime also help control nausea in their own right.
– Rest – Feeling tired has the potential of making nausea even worse.
– Avoid Triggers – know what sets you off and try to keep away. By tracking and knowing your body you may realise that your bouts of nausea are not so random. More often than not, nausea is set off by triggers that you can somewhat plan to avoid.
– Listen to your cravings – eat the foods that most appeal to you.
– Avoid warm and crowded places – feeling hot and flustered adds to your feelings of nausea.
– Exercise – pregnancy is no reason to stop exercising. Exercising during pregnancy is generally safe. If you were active before you were pregnant than it is likely safe to remain active during pregnancy. Consult your doctor in case of any concerns.
With morning sickness, as with other pregnancy effects, it remains imperative to call your doctor if your symptoms worsen or if they are having a serious effect on your quality of life.
A conversation with Leeann Rybakov, Founder of BuckWHAT Foods
Two and a half years ago, Leeann took her passion for healthy food to another level. Now a mom of two and founder of a thriving healthy food company, Leeann masters the balancing art of commitment and entrepreneurship with parenthood, and is energetically building a legacy for her little ones. She chats with Dreaming of Baby about the innate passion that keeps her going.
CJ DeGuara: Hello and welcome to Dreaming of Baby! We have with us today Leeann Rybakov from BuckWHAT for our Rise and Grind by Daymond John edition focused on Parentpreneurship. Leeann, would you be so kind as to tell our readers a little about yourself, what you do and when you started the business?
Leeann Rybakov: Hi everyone! Thank you for taking the time to chat. I started my food company BuckWHAT Foods about two and a half years ago. I had graduated from culinary school and realized that I did not want to be a restaurant chef but that I did want to combine my passions for health and cooking to create a healthy food company. I had grown up eating buckwheat, which has amazing health benefits and happens to be gluten-free! I decided to take my favorite ingredient and create a healthy snack with it. And that’s how the Nosh was born. After the Nosh, I created the Nosh Bar, and then granola. I decided to test out the products at farmers markets. And so, in the summer of 2015, when I was pregnant with my daughter, I sold the products successfully at Spring Farmers Market in East Hampton. I grew a following and people really loved it. My daughter was born and I decided I really wanted to take this company to retail. When she was 6 months old, a commercial kitchen for food start-ups was just opening up in Brooklyn NY – Brooklyn Food Works. I joined the community of food entrepreneurs in February 2016 and started to sell retail. I was in a few small gourmet stores to start, and in the summer of 2016, I was in my first Whole Foods. A few months later, I found out I was pregnant with my son. This is where things got very interesting. My daughter is now 2 years old, my son is 4 months, and I am in 45 retail locations, six of which are Whole Foods.
CJ DeGuara: In Daymond John’s book Rise and Grind the focus is a lot on how to OutPerform, OutWork, and OutHustle Your Way to a More Successful and Rewarding Life. Statistically, the food industry is one of the hardest to get into, what would you attribute your success to? What did you differently?
Leeann Rybakov: I cannot agree with you more on all accounts! I have to say that for me it’s definitely my support system. My husband has stood behind me through every hurdle and every victory. I’m not sure if that’s something different from the rest, but it definitely helps. I have something different, and I think people are truly taking a liking to it. We are seeing the industry changing in the direction of shorter shelf lives, and natural products. People want ingredients they can pronounce. On top of that, my products are ones that moms can share with their kids. There are only a few ingredients, they are all natural, and there is no added sugar. We are also seeing the rebirth of ancient grains. Buckwheat is a seed that has amazing health benefits. It’s also very sustainable. The hardest part is educating people on this ingredient that is often unfamiliar. But once people try it, they tend to come back for more.
Leeann Rybakov: Staying focused and positive is often hard. But that is my strategy. The hardest part is balancing your own food company (in a very competitive market) and having two kids. But at the end of the day, they are my motivation.
CJ DeGuara: I normally wouldn’t veer off subject, but buckwheat is interesting. What can you tell us about buckwheat and why should we be excited about it?
Leeann Rybakov: I am so happy you asked! Buckwheat is awesome! It is high in fiber, protein, low calorie, great for digestion, low glycemic, and it happens to be gluten-free. Most people are used to eating buckwheat in the roasted form, called kasha, but we take raw buckwheat and incorporate it into snacks and granola that get baked.
CJ DeGuara: Many parents take on entrepreneurship as a way to work from home, it is in a sense a modern way of teleworking or freelancing. Whilst that is admirable, I have a feeling you dream big, what are your goals with BuckWHAT?
Leeann Rybakov: I do have some flexibility with my scheduling. But I also find myself running around a ton. Evening hours when the household is a bit quiet can be some of my most productive. I hope to expand. I am currently working on adding 2 more flavors of the Nosh and 3 more flavors of the granola. I would like to see my products on grocery store shelves across the country. We will soon be on amazon fresh. I have a big vision on growing my BuckWHAT business into a buckwheat empire. Lots of exciting new additions to come!
CJ DeGuara: Would you say you can relate to Catherine Zeta-Jones’ mindset which she covers in her discussions with Daymond John in his new book Rise and Grind?
Leeann Rybakov: Absolutely! I was told that if you can envision your success, it will happen. I just try to keep positive and focus on the fact that I know I have something great here.
CJ DeGuara: Believing in your product and yourself is so important! Do you have any tips for parents-to-be, who are either already entrepreneurs and expecting a bundle of joy or are expecting a bundle of joy and planning to become parent-preneurs?
Leeann Rybakov: This question makes me laugh a bit because I am still trying to figure it out. But what I have learned along the way, and what I try to remind myself every day, is there has to be balance. Kids don’t need much, they just need to know you are there. So, I try to dedicate special time when I put my phone away (so hard) and just hang out. I also try to engage my daughter in what I am doing. If I am printing something, she has the task of taking it out of the printer. But I am still learning myself. That’s the fun part of being an entrepreneur. Learning every day!
CJ DeGuara: If you had to list five benefits your children get out of you being a parentpreneur instead of a traditional career, especially one as time intensive as that of a chef, what would they be?
Leeann Rybakov:
Flexibility in my schedule (I get to take my daughter to school every day)
Being a part of something from the start. They have been a part of this company from day one.
Perhaps not right now, since my eldest is 2, but I hope that one day they will know that they can pursue any dream they have. Creativity is an amazing outlet.
One day (since the eldest is only 2), they can walk into a store and be proud to see their mom’s products on the shelves (my nephew is 7 and he brags about it now, it’s awesome!)
Hopefully, one day, they can take over the empire!
CJ DeGuara: So, in a sense you are not just building your business for today but you have a legacy in mind! Tell us a little more about that and how it drives you to work harder!
Leeann Rybakov: Yes absolutely. My family is the ultimate drive. I am making many sacrifices along the way. In my mind, it has to be worth it.
CJ DeGuara: This has been awesome and we have covered a lot of ground. Is there anything you think that anyone moving into parentpreneurship really needs to know before they dip their toes in and take the plunge?
Leeann Rybakov: Don’t be afraid to make mistakes. And always set aside time to be with your kids. Otherwise, you just get so caught up in things, you lose sight of the big picture.
CJ DeGuara: Thank you so much for sharing your journey with us! If our readers want to reach you or learn more about what you do; what’s the best way to reach you?
Leeann Rybakov: Thank you!
Get in touch with Leeann Rybakov and learn more about BuckWHAT Foods by clicking here
In the run-up to and during pregnancy, the food you eat becomes all the more important. Your body needs more nutrients to provide the best nourishment, both for you and for your baby.
Dr. Anthony Shaya talks about what you should be eating more of, what you should be keeping away from, what’s healthy in terms of weight gain, and how diet and labor may be connected.
Daniela: Good morning and welcome to Dreaming of Baby! We have with us today Dr. Anthony Shaya of Partners in Women’s Health in Jupiter, Florida with whom we shall be discussing nutrition in pregnancy. It’s a pleasure to have you with us today, Dr. Shaya! Before we start with our discussion, it would be great if you could introduce yourself to our readers.
Anthony Shaya MD MPH FACOG: I am a board certified ob/gyn working in private practice in Jupiter Florida. I’m involved in prenatal care and ‘deliver’ over 100 babies/year.
Daniela: That’s impressive, thank you for this overview. To start addressing our subject today, how can a woman improve her diet once she finds out she’s pregnant? Are there any specific changes she should be making?
Anthony Shaya MD MPH FACOG: Several points. Generally, we recommend just eating healthy. Several small meals per day. In terms of specifics though, let’s talk about that. It is recommended about an extra 300 cal/day. However, in practice, most patients do not need to worry about that as just about everybody gets an adequate amount of calories in their diets. I tell patients you do not need to actively eat for two. I recommend healthy eating, meaning a balanced diet between protein, fat, and carbohydrates and ideally including a good amount of vegetables. One thing that is recommended to limit is seafood intake. This is because of the risk of mercury from any seafood. This basically means one serving of seafood per week. But patients must avoid fish that is high in mercury. This includes shark, king mackerel, swordfish and tilefish. Those fish should not be eaten by pregnant patients, or even breastfeeding patients or patients that are going to potentially going to conceive.
“You do not need to actively eat for two.” Dr. Anthony Shaya
Fish in pregnancy
Daniela: You mention limitations on specific fish. If a woman finds out she’s pregnant late in the day and has had these food items, what sort of effects could mercury potentially have?
Anthony Shaya MD MPH FACOG: Unfortunately, mercury can have some profound and adverse effects on developing babies. It can affect all organ systems and specifically can impact brain function, hearing and vision. When we say brain function, it can cause neurodevelopmental problems, in lay terms ‘brain damage’. However, I would counsel a patient to not stress about this and just change their eating habits going forward. We can also test for mercury levels. This said, there is also a very good benefit of seafood, it is high in omega 3 fatty acids, DHA. One study looked at this, and there is potential that the benefit from DHA counteracts some of the risk from mercury for patients that eat a lot of seafood.
Daniela: That is very good to know. In these first appointments, is blood work usually done with the aim of identifying any specific nutrition-related deficiencies?
Anthony Shaya MD MPH FACOG: At the first visit, a whole set of bloodwork is done. It is focused on checking for anemia. In terms of other general deficiencies, we do not check that. But we interview patients to further testing if needed.
Should I be taking supplements during pregnancy?
Daniela: Thank you for clarifying. A question which our readers have been asking: is supplementation a must during pregnancy or if a mom-to-be eats healthy, it’s enough?
Anthony Shaya MD MPH FACOG: Folic acid is very important for the development of babies and, specifically, their neurological system. Hence the idea of prenatal vitamins. We ideally want to have patients on prenatal vitamins with folic acid, prior to conception. However, we also want to continue that through the pregnancy. In today’s modern society, if someone is eating healthy, they probably get adequate amounts of folic acid and other vitamins. However, I still recommend supplementation with prenatal vitamins.
“In today’s modern society, if someone is eating healthy, they probably get adequate amounts of folic acid and other vitamins. However, I still recommend supplementation with prenatal vitamins.” Dr. Anthony Shaya
Morning sickness and nutrition
Daniela: Thank you. Unfortunately, many women experience morning sickness in early pregnancy – when does this become a concern, nutrition-wise?
Anthony Shaya MD MPH FACOG: We are always pressing patients to eat healthy and take their prenatal vitamins. In reality, some patients are unable to. In these situations, we ask patients to do their best, but I tell patients to do not force feed themselves. If for a month or two you cannot eat, and vomiting daily, it’s probably not going to affect your baby. Nausea and vomiting is generally a good predictor of pregnancy outcomes and most patients with severe morning sickness will go on to have a normal pregnancy. So basically, in that case, don’t worry.
Weight gain in pregnancy
Daniela: In terms of weight gain, what is healthy and what isn’t?
Anthony Shaya MD MPH FACOG: The recommended weight gain for a patient who is of normal weight starting pregnancy, is a total of 25-30 pounds. For underweight patients, 35 pounds for the whole pregnancy. For overweight patients, 15 pounds. Low weight gain can put patients at risk for placental problems and a low birth weight baby. Excessive weight gain can put patients at risk for gestational diabetes and large babies.
Weight gain in pregnancy
Patient starting pregnancy at normal weight: total of 25-30 pounds.
Underweight patients: total of 35 pounds.
Overweight patients: total of 15 pounds. Dr. Anthony Shaya
Gestational Diabetes, Preeclampsia and Food Choices
Daniela: You mention gestational diabetes; would you say then that gestational diabetes can be avoided through better food choices?
Anthony Shaya MD MPH FACOG: I would not say it can be avoided. But a pregnant patient can reduce the likelihood of getting gestational diabetes with better food choices.
Daniela: Thank you for clarifying. Would this also apply to preeclampsia?
Anthony Shaya MD MPH FACOG: Good question, there is no clear data on adjusting diet and reducing preeclampsia risk at this time.
Does nutrition in pregnancy affect labor?
Daniela: Thank you for this, Dr. Shaya. A penultimate question which some of our readers have been asking. Would you say there is a connection between nutrition during pregnancy and ease of delivery? Could they be, in some way, connected?
Anthony Shaya MD MPH FACOG: What we can say is that if there is excessive weight gain, and the patient develops or doesn’t develop gestational diabetes, there is increased risk of a larger baby and more likely birth trauma or cesarean section. So in that sense, yes, good nutrition and healthy eating through pregnancy will help at time of delivery.
Daniela: Thank you for clarifying this, Dr. Shaya. It’s been a pleasure discussing this important subject with you. On a final note, what would be that one piece of take-home advice that you always share with an expectant mom?
Anthony Shaya MD MPH FACOG: Eat healthy but don’t stress and freak out about everything that you eat. Two important points; probably people know this, but there is no known safe amount of alcohol in pregnancy. So, no alcohol in pregnancy. Caffeine in moderation/small amounts is considered fine.
Daniela: That is indeed imperative advice. Thank you for your time today, Dr. Shaya. The insight you have shared will be very helpful to our readers.
Dr. Anthony Shaya is a Board Certified Ob-Gyn assisting patients at Partners in Women’s Health in Jupiter, Florida. Click here to connect with Dr. Shaya.
