- Pregnancy & Birth, Women's HealthGeneral Page Tier 3BlogIf you’re new to CenteringPregnancy®, you may have a lot of questions about your first visit, especially if you’re only familiar with one-on-one appointments with your OB/GYN or midwife. Don’t worry — having questions about this new experience is normal. Each CenteringPregnancy® visit includes self-led health assessments, a belly check with your healthcare provider and group discussion time. Meetings generally start at 16 weeks of pregnancy and continue through your due date month. The group will include eight to 12 expecting moms who are all due around the same time. It’s important to bring up any concerns with your prenatal care team prior to your first CenteringPregnancy® visit, as they will be able to provide more detailed information about the experience and what to expect. In the meantime, here are answers to some of the common questions around CenteringPregnancy® visits. What does the health assessment entail? For most women, each CenteringPregnancy® visit starts with a health assessment. During the health assessment, your care team will show you how to take your own blood pressure, weight and health data, which you will record in your medical chart. You will check this data each week and track your progress throughout your pregnancy. Some women may not be able to complete the health assessment before the group discussion starts. If that is the case, the health assessments may continue to take place during a break time halfway through the visit. Will I be able to meet with my provider privately? Every CenteringPregnancy® visit includes one-on-one time with your doctor or midwife for a private belly check. Your care team will use this time to take measurements and potentially do ultrasounds to assess your baby’s health and growth. Belly checks my take place at the beginning of the visit or during the break time. During your belly check you can bring up any personal questions or concerns that you may not feel comfortable bringing up with the group. We will ensure each woman gets the privacy she needs with her provider to ensure sensitive information is kept confidential. What will we talk about during group discussion? Most of your CenteringPregnancy® visit will be made up of group discussion time with the moms and members of your care team. During this time, your care team will lead discussions and interactive activities that aim to answer some of the major questions and concerns many expecting moms face. We will talk about topics including: Nutrition Stress management Pain management and common discomforts Labor and delivery Breastfeeding Infant care In addition to the planned topics, we will also be sure to leave time for the moms to ask questions and talk about any topics that may be on their mind. With these group discussions, we hope to help women feel more confident about motherhood and provide them with an environment where they can find support and friendship from other moms. How much am I required to share during the CenteringPregnancy® group discussion? While we encourage participation from everyone in the group, it’s important to remember that no one is required to share during the CenteringPregnancy® meetings. If you feel hesitant sharing your thoughts early on, don’t worry — many moms feel more comfortable as time goes on. Am I allowed to bring someone with me? Every participant is allowed to bring a spouse, partner or support person to the CenteringPregnancy® visits. This person can help you with your health assessments, sit with you during the belly check and participate in the group discussion. How long will the CenteringPregnancy® visit last? Each CenteringPregnancy® visit lasts between 90 minutes and two hours. This gives you 10 times the average time as a typical office visit with your healthcare provider. If you have more questions about CenteringPregnancy® please view our program website.
- Women's HealthGeneral Page Tier 3BlogFor most pregnant women, prenatal appointments are typically a one-on-one experience with an OB/GYN or midwife. But a growing trend in prenatal care called CenteringPregnancy® is shifting the way women receive care during pregnancy. CenteringPregnancy® combines the one-on-one provider experience with group prenatal care. Over the course of 10 prenatal visits, women receive routine prenatal care and spend time discussing pregnancy health topics with a group of 8 to 12 expecting moms who are all due at the same time. With this group-based program, moms not only receive personalized prenatal health care, they also have an opportunity to build friendships and community that can support them throughout pregnancy and motherhood. What does a CenteringPregnancy® visit include? CenteringPregnancy® visits include health assessments, a belly check with your provider and discussion time with the group of moms. Meetings start at 16 weeks of pregnancy and continue through the moms’ due date month. Unlike typical one-on-one visits, CenteringPregnancy® visits last between 90 minutes and two hours. This means moms get 10 times the average time spent with a provider during a prenatal check-up. Health assessment Every CenteringPregnancy® meeting starts with a health assessment, which is a time to check and record your basic health data. What’s unique about the CenteringPregnancy program is that you’ll learn how to take your own weight and blood pressure and document the information in your own chart. Belly check Each meeting also includes one-on-one time with your provider for a private belly check. You can also use this time to ask private questions that you may not feel comfortable sharing with the rest of the group. Group discussion In addition to the health check-ups, most of the CenteringPregnancy® visit includes ample group time with fellow moms and their partners or support people. During the group discussion, your care team will lead conversations and interactive activities that cover important topics like nutrition, stress management, common discomforts, labor and delivery, breastfeeding and infant care. The group discussion period always includes time for moms to discuss and ask questions about topics that are important to them. What are the benefits of CenteringPregnancy®? CenteringPregnancy® has been shown to improve the lives and outcomes of pregnant women. While the program may not be for everyone, it can bring many benefits for expecting moms and their families, including: Empowering moms to take charge of their own health Helping moms create friendships that can support them throughout pregnancy and motherhood Encouraging positive health behaviors and better health outcomes Helping ease anxiety and feelings of isolation that many new moms face Research has also shown that CenteringPregnancy can improve birth outcomes, such as: Lowering your risk of preterm births Reducing low birth weight Increasing breastfeeding rates In fact, a 2015 study done by the Yale School of Public Health found that group prenatal care can help the health of mother and baby. The study showed that women who participated in group prenatal care were 33 percent less likely to have babies with a low birth weight. The moms who had group care also had babies who spent less time in the neonatal intensive care unit. Is CenteringPregnancy® covered under my insurance? Group prenatal care like CenteringPregnancy® is usually billed to your insurance plan as a prenatal visit, so there shouldn’t be extra out-of-pocket costs for participating. Because CenteringPregnancy is your prenatal visit, it isn’t considered to be an added service, such as a childbirth education class. However, it’s important to talk with your insurance provider first to check your coverage. To learn more about CenteringPregnancy® and whether it’s right for you, talk to your provider or care team. Contributor: Ginny Bowers, Certified Nurse Midwife and International Board Certified Lactation Consultant (IBCLC).
- Behavioral Health, CommunityGeneral Page Tier 3BlogAbout four in ten adults (or 42 percent of Americans) report that there is a gun in their household. Recent data shows that more people died from firearm injuries in the United States last year than in any other year since 1968, according to the Centers for Disease Control and Prevention (CDC). Gun-related injury and death remains one of the most seriously, and largely unaddressed, challenges facing the country. As the number of firearm homicides and suicides rise, the medical community is taking notice and action to treat the issue as a public health concern. Well over 100 professional organizations, including the American Medical Association, the American College of Physicians, and the American Public Health Association, have identified gun violence as a threat to the health of the nation and have issued calls to action around gun safety. At Anne Arundel Medical Center (AAMC), leaders in ethics and medicine are working together to lay the groundwork for a policy on how clinicians can counsel patients on gun safety. “The perfect storm is brewing for us to no longer turn our back,” says David Moller, Ph.D., chief of clinical and organizational ethics at AAMC, in reference to gun safety. “It’s always about the people and, as medical professionals, we have a moral obligation to keep our communities healthy and safe.” READ MORE: Tips for talking to kids after traumatic events What does gun safety look like from a physician perspective? “My responsibility as a physician is to ensure the safety and wellbeing of patients,” says Vincent DeCicco, DO, family physician at Anne Arundel Medical Group (AAMG) Annapolis Primary Care. “To me, it’s like talking to patients about their risk for heart disease. My moral obligation is to ask patients about their behaviors and help them get on a healthier track. ” Dr. DeCicco says conversations about gun safety with patients start by encouraging healthy behaviors, which means owning a firearm in a responsible and safe manner. “Public health comes down to encouraging healthy behaviors,” adds Dr. DeCicco. “I won’t take your weapon away as a physician, but I do have a moral obligation to talk to you about the responsibility that comes with it.” Andrew McGlone, MD, physician at AAMG Annapolis Primary Care, concurs that gun safety is a public health issue. “The medical community is positioned to play a significant role in the reduction of injury and death from firearms,” he says. “We can start by promoting gun safety to decrease unauthorized access for children, adolescents, and patients at risk for suicide. Approximately 40 percent of gun deaths in Maryland are from suicide. Research estimates that 45 percent of suicide victims in the United States were in contact with a primary care provider within one month of suicide. Empowering health providers, patients and their families to have honest and stigma-free conversations about mental health, suicide risk and gun safety is imperative.” How can a public health approach help with gun safety? Like other major health threats, Moller says the medical community can help reduce avoidable gun-related injuries and deaths using a public health approach. Using domestic violence as an example, he says medical professionals needed to think bigger and broader about how to solve the problem to achieve substantive change. “As cases of domestic violence increased, medical professionals began to develop the idea that we needed a different approach, says Moller. “We began to reframe the problem of domestic violence away from the individual encounter and began looking at it as a community and public health problem.” As a result, health providers today often screen their patients for signs of abuse and many hospitals are providing coordinated services to domestic violence victims. Similarly, Moller says starting a conversation together about reasonable, sensible solutions and recommendations on gun safety, storage, accessibility, and health is pivotal. “This conversation is not aimed at taking away the legitimate right of people to own and use guns, but at minimizing the violence and the mortality that is associated with the role of guns in American society,” he adds. “It has to start with a conversation, and that conversation has to be reasonable, sensible and civil. For us in the medical profession, this transcends politics. Harm reduction is not the same as gun control. This is not political advocacy, it’s patient advocacy.” Originally published in What’s Up Magazine. Authors David Moller, Ph.D., is chief of clinical and organizational ethics at AAMC. Vincent DeCicco, DO, is a family physician at Anne Arundel Medical Group (AAMG) Annapolis Primary Care. To reach him, call 443-270-8600. Andrew McGlone, MD, is a physician at AAMG Annapolis Primary Care. To reach him, call 443-481-1150.
- Pediatrics, WellnessGeneral Page Tier 3BlogAs the summer comes to an end, parents and children are beginning to gear up for the coming school year, and that means gearing up for fall sports. For parents of children who play field sports, such as football or soccer, the question of what kind of cleats to buy can be a head scratcher. Should you go with metal cleats or plastic? High top or low top? Snug fit or loose with room to grow? Most likely, the student athlete is going to have a strong opinion, and it will have more to do with looks and what their favorite sports icon wears than actual comfort, fit, or performance. For children under 14, the best option is to forgo detachable cleats in favor of molded cleats or, even better, a rubber-soled, sneaker-style turf shoe. Children in elementary school through junior high are in their growth spurt years. Wearing certain types of cleats puts additional strain on tendons, especially the Achilles, and can cause inflammation and pain at the point where it attaches to the bone, which is still growing. By the time children are in their sophomore year of high school, bone growth is not as much of a concern and detachable cleats are okay. However, I advise young athletes to avoid styles with only two to four spikes clustered centrally on the heel. The narrower cleat arrangement provides less stability for the ankle and can cause strain to the Achilles tendon. Molded cleats that cover the entire perimeter of the heel are preferred because this improves stability and balance. For football players the choice to go with a high-top, mid-cut or low-cut cleat is usually guided by position played. High tops are more favorable for down linemen, mid cuts for some of the heavier backs and linebackers, and low cuts for the wide receivers and other speed positions. When buying any athletic shoe, keep these three things in mind: Focus on fit. When fitting any sports shoe, remember one foot is often just a bit larger than the other. Use the larger foot as your guide and then round up on size. This gives room for normal swelling during activity and for doubling up on socks to avoid blisters. For the younger athletes, consider replacing the factory inserts with a full-length cushioned insert available over the counter at any drugstore. They will provide better cushioning, which protects the feet and ankles. Athletic shoes can be expensive and many kids wear them for only a single season because they’re rapidly growing. Second-time-around shoes from a consignment store or older sibling are fine as long as they fit well, are in good condition, and you replace inserts. By David Keblish, MD, orthopedic surgeon at Anne Arundel Medical Center. Before joining AAMC Orthopedics, Dr. Keblish spent more than a decade as a varsity team physician and head of the Orthopedic Surgery and Sports Medicine Department at the U.S. Naval Academy. Dr. Keblish can be reached at 410-268-8862.[/su_box] Originally published Aug. 17, 2015. Last updated July 22, 2019.
- Men's Health, Women's Health, WellnessGeneral Page Tier 3BlogIf you play a sport or follow an exercise routine, injuries are possible. You may be tempted to keep playing through the pain. But that can lead to further problems down the road, especially if you don’t follow your doctor’s advice. A broken bone can take anywhere from two months to an entire year to fully heal, depending on the bone and the patient. It’s crucial to allow time for that healing process. Would you rather give yourself six weeks off to perform at 100 percent, or suffer for many months or the rest of your life because your injury didn’t heal properly? Your level of activity post-injury depends on its severity. Here’s a general guide to help. Sprains and strains Mild sprains and strains can be treated quickly, and exercise can continue. If your pain or symptoms associated with a sprain persist for more than a few weeks, seek medical attention. Warning signs of a more severe injury include significant bruising, swelling or significant dysfunction of a joint or body part. Broken toes Broken toes, too, can vary in terms of treatment. An injured big toe often needs treatment, while just taping the fourth or fifth toe provides support, protection and helps realign joints. If you have a deformity, such as a toe pointing the wrong way, seek medical attention. Any potential broken bone, even a small one, needs medical attention. Back injuries If you have back pain and/or a back injury, start by focusing on core stability exercises and flexibility. You should work with a physical therapist for a while before returning to unsupervised exercise. Once you start exercising again, start with low-impact activities, such as the elliptical or cycling. A return to higher-impact or contact sports should happen slowly over time. Get your doctor’s clearance first. Modifications when you have pain An injury doesn’t necessarily mean an end to all activity. You may be able to make modifications to your routine. For example, if you break your leg and you can’t walk, you might still be able to swim laps with a pull buoy without pushing off the wall during turns to get a cardiovascular and upper body workout. Or, if you have a severe injury to the upper body, you might still be able to do moderate exercise using a stationary bike. Author By Benjamin Petre, MD, an orthopedic surgeon with AAMC Orthopedics. To reach his practice, call 410-268-8862. Originally published June 26, 2017. Last updated July 22, 2019.
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