Category: Patient Stories

With all the changes women experience during pregnancy, it can be difficult to know what is considered “normal” postpartum and what is concerning, especially when it comes to pelvic anatomy. At some point in your pregnancy, you likely heard your provider mention Kegels. Perhaps you diligently remembered to do them daily, or maybe it fell off your radar.

It’s important for women to perform Kegel exercises, also known as pelvic floor contractions, during pregnancy to prevent long-term pelvic floor issues such as incontinence. “The pelvic floor is stressed during both pregnancy and delivery, so the more a woman can strengthen the pelvic muscles before delivery, the better chance she has of avoiding the need for pelvic floor rehab postpartum,” explained Rafael Unda Rivera, MD, Western OB/GYN, A Division of Ridgeview Clinics.

What contributes to pelvic floor issues

Women who experienced a delivery that required the use of forceps―or who suffered pelvic trauma from delivering a larger baby or having a prolonged birth―are at a higher risk of pelvic floor issues. In addition, women with the following risk factors are more prone to pelvic floor concerns.

• History of incontinence
• Elevated body mass index (BMI)
• Tobacco use, which decreases blood supply in the tissue, affecting the healing process
• Three or more pregnancies
• Advanced maternal age while pregnant
• History of pelvic organ prolapse

When to consider postpartum rehab

Women who did not experience significant pelvic trauma during childbirth should be able to resume Kegel exercises in the weeks following delivery to help regain pelvic floor strength. However, women who experienced trauma—as with any injury—may need to wait several weeks to first allow for healing. It takes about three months for the muscles and ligaments to return to normal.

At the six-week postpartum appointment, your provider will discuss normal recovery and what is not considered typical. If you continue to experience any of the symptoms listed below three months postpartum, contact your provider for a referral to Ridgeview Rehab to learn if you are a candidate for pelvic floor rehab.

• Leaking urine with coughing, sneezing or with sudden movement
• Increased urinary frequency
• Difficulty emptying bladder
• Pain in the pelvis, abdomen, lower back or tailbone
• Pain during intercourse
• Bowel issues

Benefits of strengthening the pelvic floor

In addition to regaining bladder and/or bowel control, rehab helps with core (abdominal) support, a return to normal pelvic anatomy and helps to eliminate pain during intercourse.

Long-term, a healthy lifestyle is necessary for a healthy pelvic floor. “Rehab is not a permanent solution; women should continue with any prescribed exercises as instructed in physical therapy even after rehab has finished. In addition, a wholesome diet, regular exercise and avoiding unhealthy habits such as smoking are important to prevent pelvic floor issues from returning,” said Dr. Unda Rivera.

It is never too late to regain control and full function of your pelvic floor. If you feel you could benefit from pelvic floor rehab, schedule an appointment with your provider or one at Western OB/GYN, A Division of Ridgeview Clinics.

If you experience leakage every time you cough, laugh, sneeze or jump, you aren’t alone. Urinary incontinence is a common condition both men and women may experience, but most frequently affects women. The chance of developing incontinence increases with age, but is not an inevitable consequence of aging and is NEVER considered normal.

Michael Valley, MD, Urogynecologist, Western OB/GYN, A Division of Ridgeview Clinics, explains that many women find incontinence simply creeps up on them. “One day, they begin to experience a minor problem. A few years later, they find themselves crossing their legs every time they cough or laugh. They may have discontinued a favorite activity or exercise—such as running—because their leaky bladder became unmanageable. That’s the point when many women finally decide to seek advice from a medical provider,” Dr. Valley says. Those experiencing incontinence may find the condition isolating and embarrassing, but you are not alone.

On average, 1 in 4 women suffer with urinary incontinence.

According to the National Institute of Health, 24-45% of women over the age of 30 experience urinary incontinence at some point in their life. Women are more likely to develop problems following pregnancy, childbirth and menopause.

While common, this condition goes severely underreported as many women may feel uncomfortable discussing their symptoms with their primary care provider.

When it comes to severity, Dr. Valley shares, “Women may experience an extreme range in severity—from an occasional leak to a sudden and uncontrollable urge to urinate.” This range includes two common types of incontinence:

• Stress incontinence. This is most common in younger women. With stress incontinence, you may experience an occasional leak when you cough, laugh or sneeze.
• Urge incontinence. Often referred to as “overactive bladder,” you may feel a sudden urge to urinate that is so severe you can’t get to a toilet in time. This can happen when you don’t expect it, such as during sleep, when you arrive home in your car, or when you hear or touch running water.

Both types of incontinence can have a significant impact on your quality of life and make it unnerving to engage socially with friends and family when you don’t know when the problem might occur.

Treating incontinence doesn’t always mean surgery.

The good news is that for the majority of cases, treatments are available to cure or significantly improve symptoms. “We most often approach treatment with non-surgical options first, such as Kegel exercises to help strengthen your pelvic floor,” Dr. Valley says. A specialized pelvic floor/bladder physical therapist may assist you with this.

In addition, Dr. Valley suggests the following approaches before moving to a surgical option:

• Lifestyle changes. Exercise can help restrengthen your pelvic floor. Cutting down on caffeine, carbonated beverages and alcohol can also be helpful as these drinks may irritate your bladder.
• Behavioral techniques. In conjunction with Kegel exercises, you may also consider bladder retraining to learn to delay urination. Sometimes scheduling toilet trips rather than waiting for the need to go may decrease the times you leak. A pelvic floor/bladder physical therapist can help you with these techniques.
• Medications. There are several medications to treat incontinence in men and women. Most are useful for urge incontinence.

If your occasional problem has turned into a bigger issue that is impacting the quality of your life, the first step is to make an appointment with your Ridgeview provider to discuss further treatment options.

The COVID-19 pandemic has significantly changed how we receive health care. Early in the pandemic, wellness visits were canceled or postponed and many in-person appointments have since turned into telehealth visits.

Rebecca Baudoin, MD, Western OB/GYN, A Division of Ridgeview Clinics, encourages women to prioritize scheduling their recommended appointments. “No one will take care of you, except you! There will be no judgment about any delay; we just want to optimize your health and get screenings caught up,” Baudoin said.

When was the last time you had a wellness exam? Are there screenings you have missed due to the pandemic? Dr. Baudoin outlines nine important women’s health screenings.

1. Pelvic exam. Pelvic exams are recommended beginning at age 21 to assess your cervix, uterus and ovaries. A Pap test is also recommended at age 21 for cervical cancer screening. When a woman reaches age 30, a human papillomavirus (HPV) test is recommended, which can be performed from the same swab as the Pap. This swab collect cells from the cervix to check for any abnormalities that could lead to cervical cancer. Both are repeated every one to three years, based on recent health history.
2. Breast exam. Women should be familiar with their breasts in order to recognize any new lumps or changes. Your health care provider will perform a breast exam at your annual wellness appointment. If a lump or concerning tissue is found, they may order a non-routine mammogram or breast ultrasound as a precaution.
3. Mammogram. A mammogram takes radiographic photos of your breast tissue and identifies changes and abnormalities. Dr. Baudoin recommends an annual mammogram for women beginning at age 40 to check for signs of breast cancer. A 3D mammogram is currently the best available technology in mammographic breast cancer screening. If your insurance only covers 2D mammograms, Dr. Baudoin suggests paying out-of-pocket for the difference in cost to still have the 3D images done―an option you might consider doing every other year.
4. Skin cancer exam. Your health care provider will check your skin thoroughly for any new or suspicious moles or signs of skin cancer. You should pay close attention to the size, shape and texture of any mole you have and notify your provider of any changes.
5. Blood pressure screening. High blood pressure is a risk factor for heart disease. Your health care provider will check your blood pressure regularly at each wellness visit. Blood pressure numbers less than 120/80 are considered within the normal range.
6. Cholesterol screening. Women over the age of 40 should have a blood test to check their cholesterol levels every five years. High cholesterol increases your risk for heart disease and stroke, two leading causes of death in the United States according to the American Heart Association (AHA).
7. Diabetes screening. Women over the age of 40 should also have their blood screened for diabetes every three years. Dr. Baudoin advises that women who had gestational diabetes during pregnancy may need to be screened for diabetes and high cholesterol earlier than age 40.
8. Colonoscopy. A colonoscopy uses a scope to view the inside of the colon and rectum. Early detection is crucial for discovering polyps and treating colon cancer. Women with average risk—those without personal or family history—should begin colonoscopy screenings at age 45.
9. Osteoporosis screening. During and post-menopause, women’s bones may begin to weaken. A bone density test (DEXA) is suggested for women over 65 to check for osteoporosis. This test uses x-rays to measure the strength of the bones.

Regular wellness exams and health screenings are key to prevention. It’s important to talk with your health care provider about the role personal and family history may have on when and how often you should have these screenings. If you are due for your wellness visit, schedule an appointment at Western OB/GYN, A Division of Ridgeview Clinics.

After having an epidural with her first son in 2019, Shelby Hallblade, Carver, knew she wanted to try a more natural approach the second time around. “When I had an epidural with my first born, Silas, I didn’t know there was another way,” Shelby said. This time she wanted to be more educated about her options. A co-worker recommended Leah Schroeder, nurse midwife, Western OB/GYN, A Division of Ridgeview Clinics.

“Leah spent 30 minutes with me at my first appointment. Not only did she answer my questions, but she asked me questions and challenged me to think about things that I hadn’t even considered. I learned that I could do things naturally and that pain was not to be feared, but could be managed. Leah educated me and advocated for natural childbirth. She listened to me and respected my wishes,” Shelby said.

Choosing a natural childbirth in a hospital setting
Planning a birth at Ridgeview’s Birthing Center gave Shelby and her husband, Kyle, the option of the natural birth they had envisioned, while providing comfort in knowing they had full access to the resources and services Ridgeview offers including a Level II Neonatal Intensive Care Unit (NICU), if needed.

“In childbirth, things can sometimes go wrong. It is good to have someone there if you need it. I felt comfortable at Ridgeview, like being at a hotel or home. It was very nice without the hospital feeling,” Shelby said. The nurturing and inviting birthing suites feature large jetted tubs to allow for water births aided by certified nurse midwives. A water birth was appealing to Shelby to help her relax and manage pain during the birth process.

Blessed with a sign of good luck—rare en caul birth
After laboring at home for two hours, Shelby was eight centimeters dilated when she arrived at Ridgeview on March 19, 2021. Schroeder was waiting for her upon arrival.

Schroeder helped Shelby into the tub, guided her breathing between contractions and worked through various techniques to help Shelby manage her pain. “Leah was with me the whole time—from the time I arrived at the hospital until delivery and after—supporting me through each contraction.”

Baby Sawyer was born just 45 minutes after the Hallblades arrived at the hospital and was born en caul. An en caul birth is a rare occurrence where the baby is born inside an intact amniotic sac, occurring in one to two percent of vaginal births, which is less than 1 in 80,000 births. In many cultures, an en caul birth is seen as a sign of good luck. It was good luck sign to the Hallblades, as they were blessed with a healthy newborn following the natural birth they had envisioned.

Managing the pain of childbirth naturally

“Leah helped me feel more in tune with my body and helped me understand and allow things to happen naturally. I was able to feel everything, and I learned how to work through it.” Shelby said. Some of the techniques that helped Shelby manage the pain of childbirth naturally were:
+ Developing a calming music playlist that played on the speakers in the birthing suite
+ Diffusing essential oils
+ Hearing positive affirmations & bible verses that Shelby had on notecards
+ Creating a calming atmosphere

Shelby noticed immediately how much easier the recovery was for her second birth compared to her first, something she credits to the water birth.

Using a nurse midwife—pregnancy, birth, post-partum and beyond
Shelby was impressed with how everyone at Ridgeview respected her wishes for a natural birth, and that Schroeder was with her for the entire journey—pregnancy, birth, post-partum support and beyond. Shelby continues to see Schroeder as her primary care provider. She sees Schroeder and the team at Western OB/GYN for everything from annual physicals and screenings, to natural family planning and has already referred many friends as patients to the practice.

Take a virtual tour of Ridgeview’s Birthing Center and learn more about the providers at Western OB/GYN, A Division of Ridgeview Clinics.

“I wasn’t terribly worried about COVID-19 until Governor Walz issued the stay-at-home order at the end of March,” said Sarah Cowell from Arlington, Minn., who was nearly 8 months pregnant with her fourth child at the time. “I quickly became concerned and had a long list of questions for my provider.”

Sarah has delivered all four of her children at Ridgeview Medical Center in Waconia and all with a provider from Western OB/GYN, A Division of Ridgeview Clinics. Her last two children were delivered by Rebecca Baudoin, MD.

Having a baby during the pandemic

“Dr. Baudoin was amazing. During one particular prenatal visit, we just sat together and had a long conversation about COVID. Although there is still so much unknown, Dr. Baudoin was very knowledgeable about new findings about the disease and how it would affect my labor and delivery, and safety of me and my baby.”

I learned that:

1. Mother-to-child transmission of COVID-19 during pregnancy is unlikely.

2. Pregnant women who do become ill with COVID-19 may get sicker than non-pregnant individuals because of changes related to pregnancy and should follow closely with their health care team.*

3. If a pregnant woman is ill with COVID-19 at the time of delivery, Ridgeview has a process in place to still take care of mother and baby AND separation of a new mother and baby is never forced, but a shared decision that the mother makes after an informed discussion with the health care team.

“We talked about all of it and I left that appointment feeling at ease—that everything would be ok.

It was a bit different planning and having my baby during COVID. I had to be screened (answer a few questions) prior to entering the clinic for a prenatal visit and everyone stayed 6 feet apart when checking in. Wait times were minimal, if any, and masks were required by all staff and patients.

I had to self-quarantine 14 days prior to my scheduled C-section and I also received a COVID-19 test prior to surgery, which came back negative.

What didn’t change during my experience was the amazing care I received at Ridgeview. I appreciated all of these extra precautions and felt completely safe and comfortable the entire time.

Dr. Baudoin had assured me that having Evie during the pandemic would be every bit as special as my other birthing experiences—and she was right. The compassion and kindness shown by my entire care team was amazing and I am grateful for everything that was done for me and Evie. We were treated like royalty,” Sarah said.

“When Dr. Baudoin delivered Evie, she squealed with delight. It was evident she was just as excited to meet her as we were.”

*Modified from previous version to reflect the change in CDC designation of pregnant women as a high risk group.