OB Services

• Preconception Planning
• Prenatal Care
• Pregnancy Checklist
• Pregnancy and Weight
• Managing Labor Pain
• High Risk Pregnancy Care
• Labor & Delivery Tours
• OB Services
• Preconception Counseling

• Ectopic Pregnancy
• Recurrent Miscarriage
• Vaginal Birth
• C Section
• Follow-up Care After Delivery (post-partum)
• Diabetes in Pregnancy Care
• Multiple Birth Management
• Fetal Growth Management
• Preterm Labor Risk

• Cervical Incompetency
• RH Factor Disease
• Obesity and Pregnancy
• Placenta Previa
• Pre-Eclampsia
• Gestational Hypertension
• Pregnancy from IVF and ART
• Vaginal Delivery After Cesarean (VBAC)

Pregnancy

Pregnancy is an exciting time, and having regular prenatal care is the best way to avoid potential complications.

From preconception through pregnancy, delivery and aftercare, our physician and nurse practitioners’ team have the knowledge and compassion to guide you through every stage of motherhood. In addition to routine prenatal care, we specialize in high-risk pregnancy, so you can feel confident that you and your baby will receive the appropriate level of care.

At Leon W. Lewis MD P.C., we care for women throughout their journey of becoming a parent, from before conception to after childbirth. Our skilled team of medical professionals is here for you and your family’s needs throughout your entire pregnancy, childbirth, and postnatal care.
During your pregnancy, you will visit your doctor on a regular basis for physical examinations, blood tests and ultrasounds to monitor the growth and development of your baby. We will also discuss with you your options for the delivery process, and then work with you to ensure that labor and delivery is comfortable and stress-free.
Your obstetrician is also here for those patients experiencing pregnancy complications. Our obstetrician is well equipped to treat a variety of conditions such as pre-eclampsia, placental or uterine abruption, ectopic pregnancy, fetal distress, and many other conditions.

Our obstetrician is also available for other services you might need throughout your pregnancy and delivery such as episiotomy, circumcision, dilation and curettage, cervical cerclage, and various types of delivery methods.

Our comprehensive OB services are for all mothers and mothers-to-be, including women of all ages and those struggling to conceive. We collaborate with other providers to provide collaborative and interpersonal care to women facing medical challenges, reproductive trauma, grief, and loss.

Our affiliation with Huntsville Hospital and Crestwood Medical Center ensures that during your delivery, both you and your baby will receive the highest-quality care available. You’ll also gain peace of mind from knowing that a Level 3 NICU is available to provide intensive newborn care, should your baby need it.

In most cases, you'll need to have an office visit every month for the first 28 weeks, then every other week until week 36, and then every week until the baby is delivered. If you have a high-risk pregnancy, you'll need to be seen more often to ensure you and your baby stay healthy.

Prenatal Exam

Our first appointment together will be scheduled after we confirm your pregnancy and is typically 8 weeks after your last menstrual period. Most patients will have subsequent appointments for routine check-ups, screenings, and tests monthly throughout the pregnancy, with more frequent visits scheduled closer to the due date.

During your initial appointment, we will discuss your health history and treatment plan, as well as offer advice on how to have a healthy pregnancy. 

• You will be weighed, and your blood pressure will be measured.
• You will be asked about any symptoms you might be experiencing.
• You will be asked to provide a urine sample to check for infection and other issues that could pose a problem.
  Depending on how far along you are in your pregnancy, your belly may be measured to track the development of the baby.
• Your provider will listen to the baby's heartbeat.
• You will have blood testing performed.
• At certain points during your pregnancy, an ultrasound will be performed to check on your baby's development.

High-Risk Pregnancy

High-risk pregnancies are pregnancies that pose special risks to the health of the mother, the baby or both. Should your pregnancy be classified as high-risk, obstetrician has the expertise and training to effectively manage every potential complication, including:

• Advanced maternal age
• Multiples (twins, triplets or more)
• Incompetent cervix
• Gestational diabetes
• Preterm labor
• Hypertension
• Placenta previa

Some of the most common causes of high-risk pregnancies include:

• Smoking
• Older age
• Carrying more than one baby
• A history of more than one miscarriage
• High blood pressure or diabetes before pregnancy or developing during pregnancy.
• Obesity
• Chromosomal disorders

Genetic Screening

Genes transfer information from parents to their offspring. Some diseases are passed along this way. Women with a family history of cancers such as breast, ovarian, uterine, and colon cancer, need to consider genetic screening. It is better to be proactive instead of reactive. Speak with your family members and obtain a detailed history such as the type of cancer and age at which the cancer started. We can review these to see if you qualify for genetic screening. A saliva test is all that is needed.  Genetic screening seeks to identify those at risk so they can take steps to ensure that they will not develop the disease they are genetically predisposed to.

Past my due date

Carrying the baby beyond 41 or 42 weeks can be dangerous to both you and the baby. If you go beyond the normal delivery time of 37 to 41 weeks, we'll assess your health and your baby's health as well as your cervix to determine if you're ready to be induced.

Whether you are planning to try for a baby soon or already have a positive pregnancy test, our primary focus is you and your healthy baby. Our obstetrical services range from preconception care through pregnancy and birth and beyond.

• Family planning
• Preconception health counseling and genetic screening
• Pregnancy testing
• Prenatal care and monitoring
• Patient education and access to birthing classes
• Prenatal testing and screening
• Sonogram/ultrasound fetal imaging
• Nutrition counseling
• High-risk pregnancy care
• Natural labor and delivery
• Vaginal and cesarean delivery
• VBAC (vaginal birth after cesarean)
• After-birth care
• Postpartum depression treatment

Because prenatal care is so important to your health and that of your baby, we encourage you to schedule an appointment with our Obstetrician as soon as you become pregnant or plan to become pregnant.

Postpartum Care

Postpartum checkups with an ob-gyn are a key opportunity to make sure new moms stay healthy. This critical “fourth trimester”—the time of recovery after giving birth—is a chance to set the stage for a new mom’s best possible health, now and in the future.

The postpartum period—the 12 weeks following the birth of a child—is an important time for your health. As you recover from childbirth and learn to care for your baby, your postpartum check-ups will help make sure you are:

• healing physically, mentally, and emotionally
• feeling good about your health and your baby’s care
• feeling that you can ask for help if you need it.

In the weeks after birth, many moms struggle with anxiety, pain, fatigue, and other concerns. If you are having a hard time, you are not alone. Ob-gyns can help moms with these problems, don’t feel embarrassed asking for help. Care and treatment can make life better for you and your family.

Checkups can give you and your obstetrician a full picture of your physical, mental, and emotional health. Your obstetrician will do a physical exam, including a pelvic exam, to make sure you’re healing well from birth. Your obstetrician will also ask questions to find out if you’re having any of the problems new moms often struggle with. These include:

• depression, anxiety, or both
• problems with feeding or other newborn care
• poor sleep, fatigue, pain, or bleeding
• leaking urine or pain when you urinate.
• gas and constipation
• emotional support and help with childcare, chores, transportation, and meals.
• basic needs, such as food, diapers, and money for bills
• Your ob-gyn should ask about your sexual health too. Together you can talk about
• sex, including when it’s safe to have it and what you can do if you have pain or concerns about a lack of interest. •    birth control and choosing the best method for you.
• timing for future pregnancies

Contraception

Contraception is a highly personal choice, and one that can have a significant bearing on a woman's future. Today, women have several options when it comes to birth control. In addition to birth control pills, implantable IUDs, arm implants and diaphragms are all available, as well as tubal ligations for more permanent birth control. The best way to determine which option is the best one for your needs and your lifestyle is to schedule an office visit so you can learn about all your choices. All these options are designed solely to help prevent pregnancy, and not to prevent transmission of an STD.

For women who are sexually active but do not wish to become pregnant, there are several birth control options, or contraceptives, available that are safe and effective. We will work with you to find a form of birth control that is right for you and your lifestyle.

Many of the birth control options listed below have excellent rates with less than 1% of women becoming pregnant when using birth control correctly. Every contraceptive has its own risks and benefits. It is important that you make this decision together with your doctor so that you are aware of all your options and choose the one that is right for you.

Abstinence

Refraining from sexual intercourse, is the only means of birth control that is proven to prevent pregnancy 100%.

Barrier

These methods of birth control include male and female condoms as well as diaphragms, or cups, that work to prevent sperm from entering the uterus. Diaphragms fit over your cervix – the opening of your uterus – to prevent sperm from entering. Diaphragm fitting is completed like a pelvic exam, using a speculum to widen the vaginal canal so your cervix can be accessed. Different sizes of diaphragms are “tried on” your cervix to achieve the best possible fit. When using a diaphragm, it's also important to use a spermicide to provide extra protection.

Hormonal

Hormonal birth controls may come in the form of pills, patches, shots, or implants. These methods alter your hormone production to either prevent your body from releasing eggs or to thicken cervical mucus so that fertilization does not occur.

Procedural

These birth control methods involve undergoing minor procedures to prevent pregnancy. An IUD, or intrauterine contraception device, is a device placed within the uterus and works to decrease ovulation, thicken cervical mucus, or block sperm from entering the uterus. Another, form of procedural birth control is tubal ligation. This form is permanent as the Fallopian tubes are cut, clamped, or burned off. This prevents eggs from traveling to the uterus or sperm from reaching the eggs.

IUD placement procedure. IUDs are small T-shaped devices that can be implanted in a quick procedure performed right in the office. The procedure begins just like a pelvic exam: You'll lie on your back, and a speculum will be used to widen the vaginal canal gently. The IUD will be placed into your uterus through the cervical opening. A local anesthetic can be injected into the cervix to prevent possible discomfort if needed. The IUD features a long plastic tail that hangs down into the vaginal canal. Because there is a slight chance, an IUD could become displaced and fall out. You should feel for this tail to ensure the IUD is still in place before having intercourse.

Infertility

If you’ve been trying unsuccessfully to get pregnant, our Austin OB practice can provide answers, as well as referrals to fertility specialists if needed. The standard definition of infertility is the inability to conceive after 12 months of unprotected sexual intercourse. Today, this has been modified to take age into account, and now women over 35 may be considered infertile if they have failed to conceive after trying for six months. Infertility means that a couple is not sterile but for some reason has not been able to conceive a child.

Causes of Infertility. Infertility can be caused by a variety of issues affecting both men and women. Most male fertility problems are related to issues with the quality, quantity, or motility of sperm. For women, some of the most common causes of infertility include:

• Older age
• Problems that prevent the ovaries from releasing eggs normally, including polycystic ovary syndrome (PCOS)
• Uterine adhesions (scars), large fibroids or polyps
• Endometriosis, which causes uterine tissue to grow outside the uterus.
• Heavy mucus production in the cervix
• Abnormalities within the uterine structure or lining
• Chemotherapy or radiation treatments
• Some chronic health conditions and genetic issues may also cause infertility.

Once a couple is diagnosed as infertile, the doctor will perform tests to determine the cause or causes. Tests are used to determine the cause of infertility. There are many tests available for diagnosing the causes of infertility, including blood tests, semen analysis, ultrasound imaging and minimally invasive office-based exams to evaluate the structure of the cervix, uterus, and fallopian tubes.

Then treatment can begin. Today, there are more options than ever for treating infertility and facilitating conception, including infertility drugs, in vitro fertilization (IVF), intrauterine insemination (IUI, also called artificial insemination) and other techniques. Your treatment will be based on the results of your tests to ensure the best chances of conception.

Today’s technology often allows even truly infertile couples to conceive a child, sometimes with the assistance of a third-party donor or surrogate. People who consider undergoing IVF or other assisted reproductive techniques (ART) often do so after they have failed to conceive for 12 months. Others who have known risk factors for infertility or for having a child with a genetic disorder seek treatment sooner.

In Office Sonography

Ultrasound imaging is a versatile technique that the providers at Leon W. Lewis MD, PC, use to diagnose diseases and guide invasive procedures. An ultrasound imaging procedure produces a real-time image of your internal organs and tissues. It can even show blood as it flows through your arteries and veins.

To create this image, a hand-held device called a transducer emits soundwaves through your body. The sound waves bounce off your organs and tissues to create an image that your provider views on a nearby monitor during the procedure. Your provider explains these images and can use them to make or confirm a diagnosis.

Some ultrasound imaging procedures are invasive. In some, your provider must insert the transducer into your or vagina to get the needed images. In other cases, your provider moves the transducer over the outside of your body, like on your abdomen, after applying a smooth gel. The procedure takes about 30 minutes. Once it’s over, your provider goes over the images with you and what your next treatment steps should be.

There usually isn’t much you need to do to prepare for an in-office ultrasound. However, your provider will give you instructions if necessary. Depending on the examination area, the instructions might include:

• Avoiding eating or drinking beforehand
• Arriving with a full bladder
• Wearing loose clothing to your appointment
• Removing jewelry during the procedure or leaving it at home

After your in-office ultrasound, it’s safe to go home or continue your workday. You don’t have to spend any time in a recovery room, nor do you have to reserve time for rest later in the day.

GYN Ultrasound

Ultrasounds usually go together with your gynecological care. There are a wide variety of uses for gynecological ultrasounds, including:

• Looking at anatomical problems with your pelvic organs
• Checking for cancerous or non-cancerous growths
• Evaluating fertility problems
• Checking for causes of abnormal bleeding or pain
• Monitoring pregnancies
• Assessing ectopic pregnancies
• Checking an IUD (intrauterine device)

Preparation. You’ll need to follow some steps to make sure you’re prepared for your ultrasound. Based on whether your ultrasound will be internal or external, you’ll receive some instructions to follow. For example, if you’re having a transabdominal (external) ultrasound, your bladder should be full. This means you’ll need to drink lots of water before your appointment. If you’re having a transvaginal (internal) ultrasound, your bladder should be empty. You should make sure to show up for your appointment wearing loose, comfortable clothing that can be easily removed.

After we have your ultrasound results, you’ll discuss them with your gynecologist. These results can be helpful in determining your next steps in your treatment process or even to rule out certain factors in your diagnosis. There are some further testing options that can be used for a more in-depth look at any concerns you might have based on your ultrasound results, so your gynecologist will determine your next best steps.

The OB Ultrasound. Obstetrical ultrasounds are used to determine your appropriate due date and how your pregnancy is progressing. The obstetric ultrasounds that we typically perform include:

• 6-12 Weeks – Dating Ultrasound: Determine an accurate due date, the location of the pregnancy, and the number of babies.
• 10-13 Weeks – First Trimester Screening:  Some abnormalities can be visualized in the first trimester.

Ultrasound imaging is safer than other imaging procedures. It doesn’t expose you to radiation, which can sometimes be harmful to your health or the health of an unborn baby.

Obstetrical ultrasound is a safe, noninvasive procedure that uses sound waves to create images of the fetus, placenta, and amniotic fluid. These images can be viewed in real time on a computer monitor. This procedure can be performed with the abdominal probe, which involves moving a transducer across the skin of the lower abdomen, or with the vaginal probe, which involves inserting a transducer into the vagina and rotating it for a comprehensive view of the fetus and surrounding organs.

An obstetrical ultrasound may be performed several times throughout pregnancy to monitor the growth and development of the fetus. During the first trimester, ultrasound can determine the age of the fetus or detect any potential birth defects, such as Down syndrome. Later in the pregnancy, regular ultrasound exams measure the size and position of the fetus, placenta, and amniotic fluid to help ensure that delivery will not have any major complications.

The results of this procedure are visible immediately on a computer screen for the obstetrician and patient to view together. Normal results for a healthy fetus show a normal size, heart and breathing rate and no visible birth defects; though this is not an indication that the baby is perfectly healthy.

An abnormal ultrasound may indicate a fetus that is too small or underdeveloped for its age, in a breech position or has a birth defect such as absent kidneys or heart defects. It can also indicate serious problems such as an ectopic pregnancy or lack of a fetal heartbeat. If abnormal results occur, your doctor may perform additional testing.