Frequently Asked Women's Health Questions1. How long has Associates in Women's Health been around?
Associates in Women's Health was founded in 1984.2. How long has Dr. Jones been practicing?
Dr. Jones finished his residency in 1994 and has enjoyed 25 years of private practice. He joined Associates in Women’s Heath in 2008.3. What services does Associates in Women’s Health offer?
We offer a full range of obstetric and gynecologic services including:
- Management of low and high-risk pregnancies
- Gynecologic surgery
- Pap Smears
- Contraception and Infertility
For a complete list, check out our Women’s Health Services page4. What insurances does Associates in Women’s Health accept?
We accept virtually all insurance plans offered in our service area. Please call our office at (307) 682-4664 if you have any specific questions regarding insurance coverage.
We accept all BCBS plans, United Healthcare, UMR, Cigna, Aetna, any plans with First Choice of the Midwest, any plans whose PPO is Multiplan, Medicare, Medicaid, and Tricare.
There are very, very few insurances that we don’t accept. As an added courtesy, even if we do not accept your insurance, we will still send in the claims for you!5. What does OB/GYN stand for? What is the difference between Obstetrics & Gynecology?
Obstetrics (OB) is care for a woman and her unborn baby while she is pregnant and in the immediate time following delivery. This is referred to as the postpartum period.
Gynecology (GYN) is the practice of caring for the female reproductive tract, which has historically also included breast health. We provide both clinical gynecology services as well as gynecological surgery services, if needed.6. What makes a pregnancy high risk?
There are many things that can make a pregnancy high risk:
- Medical conditions that a woman brings into the pregnancy such as diabetes, heart disease, hypertension, or lupus.
- A history of serious events like a blood clot or stroke.
- Prior surgery on the uterus from Cesarean delivery, removal of fibroids or correction of an abnormally shaped uterus.
- Many times, the risk comes from something that happens during the pregnancy itself. For example, twins, abnormal attachment of the placenta, preterm labor, birth defects, or the development of gestational diabetes or pre-eclampsia.
It is the role of obstetricians to identify these risk factors and to take steps to reduce the possibility that they will cause harm to either the mother or her unborn baby.7. What is an example of an outpatient service?
Outpatient is defined as, “A patient who receives medical treatment without being admitted to a hospital.”
We offer a full range of gynecologic surgeries. Most of these, including hysterectomy, can be done on an outpatient basis.8. What are some common signs of early pregnancy?
The most common signs of early pregnancy are nausea with or without vomiting, fatigue, and breast tenderness along with a missed period.
Less common signs of early pregnancy are increased or decreased appetite, an increase in acne, constipation or bloating, improved sense of smell, aversions to some types of food, food cravings (including cravings for non-food substances like dirt or paint), hearing your pulse in your ears, and increased color in the cheeks.9. How do I track ovulation?
There are several ways to track ovulation. The old-fashioned way is to check your temperature first thing in the morning, before getting up. Track this on a temperature chart and look for a sustained rise around mid-cycle.
Another way is to use ovulation predictor kits which test for a certain hormone in the urine which spikes as ovulation is about to occur.
Rather than trying to identify a specific day, however, Dr Jones recommends identifying a fertile window. This can be done by calculating your average cycle length over 3–6 cycles (day 1 to day 1 of menses) and using that to determine when you are midcycle. He then considers the fertile window to extend from 5 days prior to midcycle to 2 days after.
For example, if your average cycle length is 28 days, day 14 you are midcycle. Your fertile window extends from day 9 to day 16. During these 7 days, you should have intercourse as frequently as possible if you are trying to get pregnant.10. What kind of contraception (birth control) do you offer?
Associates in Women’s Health offers every kind of birth control currently approved for use in the United States. This includes:
- The pill
- The patch
- The contraceptive ring
- Depo-ProveraTM (the shot)
- The NexplanonTM arm insert
With all types of prescription contraceptives available in the U.S., you can begin attempting pregnancy as soon as you stop using birth control.
With the pill, patch, ring, and arm insert fertility rates are a little lower in the first cycle but return to normal within a month.
With IUD's, the return to full fertility is immediate.
With the 3-month contraceptive shot, return to fertility is less predictable but could take up to 3–6 months.12. When do I need to start seeing a gynecologist?
Barring any problems during adolescence, it is strongly recommended that women start to see a gynecologist by age 21; or earlier if she is or is planning to be sexually active. This is so that birth control options can be discussed and appropriate screening for sexually transmitted diseases (STD's) can be initiated. STD screening can be done using a urine sample.
The age at which Pap smear testing for cervical cancer begins is now 21, so most women younger than 21 do not even need to undergo a pelvic exam in order to initiate birth control and get checked for STD's.13. How do I know I’m in labor? When do I need to go to the hospital?
This seems like a very straightforward question but knowing when you are in labor can be more difficult to figure out than you might think.
There are two ways that labor can start:
- The most common (85–90%) is with contractions
- Less common (10-15%) is with the bag of water breaking first
As a general rule, we tell people to go to the hospital once their contractions are coming regularly 5 minutes apart or less and have been doing so for more than 1–2 hours. This is to help avoid a lot of unnecessary trips to the hospital only to get sent home for false labor. Likewise, patients are instructed to go to the hospital for evaluation if they think their bag of water has broken or is leaking regardless of whether they are having contractions or not.
These guidelines may not apply equally in all circumstances. Someone having their third baby and who was only in labor for 2 hours with the last one may want to head to the hospital at the first sign of "hard" labor to avoid delivering prior to arriving (delivering in a car does not do wonders for the upholstery!). Likewise, someone who has risk factors like a previous Cesarean delivery, twins, advanced cervical dilatation, or a history of preterm birth may need to take a more conservative approach to when she should be evaluated for labor. Conversely, a woman having her first baby and who has already been sent home a few times over the preceding few weeks may want to wait a little longer to make sure her contractions aren't going to dissipate and disappear like they have previously done. If there are any questions about when you should go to the hospital, this should ideally be discussed at a prenatal visit.
So, why all the confusion about what constitutes "real" labor? There are actually many things that can make it unclear at first whether what a woman is experiencing is really the onset of labor:
- For one thing, labor frequently likes to start late in the evening or at night, at a time when the woman is more focused on trying to get a decent night's sleep than paying attention to what her uterus is doing.
- In addition, many women have been having contractions off and on for days or weeks (frequently called Braxton-Hicks contractions or just false labor pains) prior to the time that her true labor commences, making it difficult to recognize which is which.
- Another consideration is that everyone's labor is different, and some people have a higher pain tolerance than others. With respect to the bag of water breaking, typically it starts with a big gush of fluid followed by persistent leakage thereafter. Nevertheless, sometimes the leak is small and the amount of fluid coming out is not enough to clearly say that it is amniotic fluid.
Here are some pearls that may help with the decision making:
- A strong contraction is a contraction that is painful enough that it causes you to have to stop whatever you are doing in order to focus on the pain or breathe through it
- The earlier the pregnancy is, the more subtle the onset of labor may be. Meaning, labor at 6 or 7 months may not feel as intense as labor at 9 months, particularly when it is first starting
- True labor typically builds as the labor progresses, with the contractions gradually getting stronger, longer, and closer together
- The bag of water breaking is frequently described as feeling like urine leaking, which makes sense considering the fluid is warm, clear, and watery (just like urine)
- Once the bag of water starts leaking, fluid will continue to escape from the hole in the membranes, meaning that the leakage will continue to occur and will typically NOT be a one-time event
- Loss of the mucous plug does not mean labor has started; conversely, bloody show (blood-tinged or bloody mucous being passed vaginally) is usually only seen once cervical dilatation has started to occur