Though delivering babies and conducting pap smears are important parts of obstetricians’ and gynecologists’ jobs, the scope for an OB-GYN is vast. Treating and managing cancers, working with patients to bring them a sense of calm and understanding during a high-risk pregnancy, and treating conditions in the urinary tract are just a few more pieces of an OB-GYN’s day. HealthScene Ohio spoke with Dr. Elizabeth Kennard, director of the Division of Reproductive Endocrinology and Infertility and associate professor in the Department of Obstetrics and Gynecology at The Ohio State University Wexner Medical Center, to bring more awareness to the field and to debunk myths associated with reproductive health.
HealthScene Ohio: What types of things do obstetricians and gynecologists do that you find many people don’t know about?
Dr. Elizabeth Kennard: We provide care to women of all ages and treat all kinds of conditions. Sometimes we are just thought of as delivering babies and doing pap smears, but we manage urinary incontinence, cancers in the pelvis and high-risk conditions that complicate pregnancies, among many other things.
HSO: What are some of the biggest misconceptions you see surrounding the contraceptive pill?
EK: That it is dangerous to take for too long. In fact, long-term use of the oral contraceptive pill reduces the risk of both ovarian and uterine cancers.
HSO: What are the benefits and drawbacks of the contraceptive pill versus the IUD and the contraceptive implant?
EK: They are all effective if used correctly. The main difference is the “place and forget” aspects of the IUD and the implant. You don’t have to remember to use it daily. On the other hand, it’s easy to stop taking the pill when you want to get pregnant, and you have to see a caregiver to get the IUD or implant removed. Additionally, the LARCs (long-acting reversible contraceptives) can be more expensive at first, though when you average it out over the length of time they are used, they can be economical.
HSO: What do you recommend to women who desire a natural contraceptive method?
EK: This method can work, but it is not as effective as the others. It also doesn’t work well if a woman doesn’t have regular cycles.
HSO: Who should get the HPV vaccine?
EK: The vaccine is recommended for children around age 12, but can be given up to age 26 for females and age 21 for males. The earlier it is given, the less likelihood that the child will have already been exposed to HPV.
HSO: What is the most common cause of infertility in women?
EK: It is pretty evenly divided between male factors, tubal disease and lack of regular ovulation.
HSO: What can women do, if anything, to reduce their risk of infertility?
EK: Maintain a normal weight, don’t ever smoke and use protection to avoid sexually transmitted diseases.
HSO: It can be traumatic for a woman to discover she is infertile. What do you recommend or advise to women who are diagnosed as infertile?
EK: Take a deep breath. Most people with this can find a way to solve it. A specialist can help you find the best pathway.
HSO: At what age are most women considered most fertile?
EK: Until the age of about 35, fertility is the same. Then a decline in chances begins, which steepens after age 38. After age 42, most women cannot conceive unless they use donor oocytes.
HSO: In what instances should a woman pursue a cesarean section rather than a vaginal birth?
EK: This is a decision made with a caregiver and usually has to be individualized. In some cases, a cesarean section is always recommended: a breech baby, a prior “classical” cesarean section (which refers to the type of scar on the uterus), a condition in which the placenta is lying over the cervix, called placenta previa, and a few others. Most of the time, though, a cesarean section is a collaborative decision between the caregiver and the woman and her family, and it’s made close to delivery.
HSO: In your opinion, what are the best ways for a woman to track her ovulation if she is avoiding or trying for a pregnancy?
EK: With an ovulation predictor kit.
Amanda DePerro is a contributing writer. Feedback welcome at feedback@cityscenemediagroup.com.
About the Expert
Dr. Beth Kennard is the director of the Division of Reproductive Endocrinology and Infertility and associate professor in the Department of Obstetrics and Gynecology at The Ohio State University Wexner Medical Center. Dr. Kennard earned her medical degree from Case Western Reserve University School of Medicine.
Tracking Your Fertility
Although all women are different, most women’s ovulation cycles last between 28 and 32 days. Ovulation cycles can be measured by counting the days from the first day of a menstrual cycle until the day before the following one. Patients should visit their OB-GYN or purchase an ovulation predictor kit from a trusted manufacturer to get the most accurate prediction, especially women who have irregular cycles. However, for women who have regular cycles, estimate-based tracking can be done at home. This method is not 100 percent accurate.
WebMD
www.webmd.com/baby/healthtool-ovulation-calculator
WebMD’s ovulation calculator tracks ovulation based on the start dates of the user’s previous three menstrual cycles. For women on a 28-day ovulation cycle, WebMD assumes that days 13 through 17 will hold the highest chance of pregnancy.
AmericanPregnancy.org
www.americanpregnancy.org/ovulation-calendar
American Pregnancy uses two pieces of information: the first day of the user’s last menstrual cycle and the average length of cycles. For women who are unsure of how long their ovulation cycle is, the organization uses 28 days. American Pregnancy estimates that ovulation will happen between days 11 and 21 for women on a 28-day cycle.
