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Gynecology
“Great news!!!
“I’ve been practicing medicine for over 10 years and can’t stress enough how important pelvic ultrasounds are in keeping patients safe. It’s important to remind patients that having a routine pap smear may not be enough – an ultrasound may be indicated if you’re experiencing any abnormal pain or bleeding. Fibroids, polyps and cysts are becoming increasingly more common and without the use of ultrasound, these would be missed.” -Samantha Kesten, WHNP-BC
Call our office today to schedule your sonogram and same day consultation regarding your results.
The abortion pill now Has been shown to be safe and effective for pregnancy up through 10 weeks
“Great news!!!
The abortion pill now Has been shown to be safe and effective for pregnancy up through 10 weeks!!!”
it is a two-step process that allows the patient to pass the pregnancy in the privacy of their own home. Appointments are easy to schedule and patients find this method to be less invasive, as no surgery is required. If you’re looking to take the abortion pill, call our office today for same day appointments. We’re here to help.
The Use of Standard Ultrasound and 3-Dimensional Ultrasound in Gynecology
The use of Ultrasound in gynecology has become a very valuable tool in the diagnosis of many abnormalities or disease processes in the female patient. It is a diagnostic tool that is safe and convenient. It can be done in a very short period on the exam table without any discomfort or inconvenience to the patient.
3-Dimentinal Ultrasound is a more advanced technique than 2-Dimentional Ultrasonography and can give better and more specific results in certain areas of gynecological investigation:
1-Benign lesions-fibroids and intra-uterine adhesions which can a interfere with fertility; polyps; endometrial hyperplasia (pre-cancerous); adenomyosis; malposition of IUD (intra uterine device); Adding 3D USG to their gynecological workup will aid clinicians in diagnosing and managing their patients with benign gynecological conditions.
2-Oncology- Ultrasound is the initial imaging tool for evaluation of patients with an adnexal mass or abnormal uterine bleeding. Ultimately, a number of these are diagnosed with gynecological cancer. 3D USG is mainly used for the initial evaluation of patients with potential malignancy.
3-Urogynecology- A very effective tool in the diagnosis of incontinence and other uro-gynecological conditions. The introduction of trans-labial 3D USG (3D TL) has changed the approach to imaging technologies in urogynecology. Three-D TL can also be used for locating tension-free sub-ureteral slings that are used in the treatment of stress urinary incontinence. Likewise, synthetic meshes, such as vaginal wall meshes, are easily seen using 3D TL. Determining the location of the sling or the mesh and observing it in real time help the surgeon to assess the efficacy of his treatment.
4-Congenital Anomalies-3D USG is a highly sensitive and specific tool for accurately diagnosing congenital uterine anomalies.
Defining Abortion
Before you decide what is life and what is not, you must study embryology. Life does not occur with an explosion and a magic wand. It is continuously present in the form of an egg and a sperm. These entities are alive and anything you do to prevent their survival is abortion.
If nature were left to its own devices, when puberty came about, males and females would have intercourse and the sperm would join the egg and the embryo would develop. As ontogoney recapitulates philogony, the embryo will take many forms until it develops into a baby able to survive in the outside world (viability.)
Anything you do to disrupt this process is abortive by definition.
If you spill the sperm on the ground, wear a condom, use a spermacide, use a diaphram, do a tubal ligation, or frankly just abstain from sexual intercourse because you are lazy or frightful or even think it is wrong without a marriage contract in your hands, you are creating a barrier so that the sperm can’t reach the egg. Sperm is required for the egg to survive as the egg is required for the sperm to survive. Therefore you are killing the very entities that are essential for the human being to develop. That is abortive by definition.
With an IUD, you allow the sperm to reach the egg but you alter the uterine lining, effectively poisoning the soil of implantation so that the egg -sperm combination can’t nidate into the unterine wall and survive. That is abortive by definition.
Surgical abortion occurs after allowing the egg-sperm combination to imbed into the uterine wall. Essentially al orf these actions effect the same result, destruction of the egg, sperm or their combination. In fact, selectively trying to inject sperm into the female at a time when you know that the egg can’t accept the sperm is a backhanded stab at abortion. That’s called rhythm.
So is abstinence after you reach puberty.
The marriage contract was truly and attempt to determine when and if one could have children.
Basically, it said, prior to signing a contract of obligation creating an intact family unit, make sure that you do everything possible to prevent the egg and sperm from surviving.
The truth is that random pregnancies do not serve an advanced civilization well. Time and place of birth must have some degree of predictability. If not, there is chaos. Can you imagine, with all the trouble and rebellion that we have in the United States today, what would have happened in the last 45 years if the nation was burdened by 60-70 million unwanted children, most of which would be dysfunctional, un-educated, hostile and resentful. I don’t even want to think about it.
Now you may argue that human life begins at conception. What is conception?
When the sperm physically nears the egg, each carrying their haploid number of chromosomes, is this conception? Or does the sperm have to abut against the egg for this to occur even though it still maintains it’s integrity as does the egg. Or does it have to penetrate the Zona pellucida and enter the cytoplasm of the egg? Or does it have to migrate toward the nucleus of the egg or does it have to penetrate the nuclear wall? Or does conception occur as the DNA of the sperm begins to line up next to the DNA of the egg? Or is it when half of the DNA is lined up?
How about three quarters or all but one of the nucleatides that make up the DNA that makes up your genes and your chromosomes? Or is it only when every single one of them is lined up to create a diploid number of chromosomes which is necessary for futher embryological development?
Or is it when the egg-sperm combination makes two cells or four or the morula etc. etc. etc.? The point is that there is no POOF!!!!, one second it is nothing and the next second it is a human being. Development of a viable human being is a gradual and continuous process and anyplace that you disrupt the process is abortive by definition. Abstinence, rhythm, barriers etc. all are methods used to disrupt the process of developing human beings and many of these methods are advocated and supported by the so-called anti-abortionists. In summary, at best, the entire anti abortion movement is just self deception of the uneducated and the ignorant. At worst, it is a veiled plan.
Compare medical abortion to surgical abortion
Aspiration (Surgical) Abortion |
Medication Abortion with Mifegymiso |
| How does it work? A doctor uses gentle suction to remove the pregnancy and blood from inside the uterus. | How does it work? The first pill, mifepristone, disrupts the pregnancy. Misoprostol, the second medicine, is used at home 24-48 hours later to make the uterus contract and push out the pregnancy and blood. |
| How effective is it? More than 99% success rate. | How effective is it? A 98% success rate at one week follow-up. |
| When can it be done? An aspiration abortion can be done as early as five weeks from the first day of the last period. | When can it be done? a medical abortion can be done as soon as there is a positive pregnancy test and up to 9 weeks from the first day of the last period. |
| How many appointments are required? Most only need one appointment that takes 2-3 hours. This includes counselling, the procedure, and recovery time. | How many appointments are required? Usually it means two appointments including a one-week follow-up. A few will need a third appointment. |
| How long does it take for the abortion to be complete? The procedure itself usually takes about seven to eight minutes. | How long does it take for the abortion to be complete? About 95% will be completed by the one-week follow up. Most will pass the pregnancy tissue within four hours of using misoprostol. |
| How painful is it? There may be strong cramping for a few minutes during the procedure and for a short time after. Medications, including local anesthetic, painkillers and/or conscious sedation, are used to help manage pain. Milder cramps may continue for several days to several weeks. | How painful is it? It varies from mild to very strong cramping, with the worst when passing the pregnancy tissue. There are medications to take at home to help manage pain. Milder cramps may or may not continue for several days to several weeks. |
| Will I be able to get pregnant again in the future and when? The chance of an early aspiration abortion affecting future fertility is extremely rare: one in 10,000 or more rare than that. In fact, fertility returns very quickly and it is possible to be pregnant again right away.The doctor will discuss birth control options at your post op visit | Will I be able to get pregnant again in the future and when? A medication abortion has no effect on future fertility unless there is an extremely rare complication. In fact, fertility returns immediately;Birth control methods like the pill should be started the day after using the misoprostol pills. An IUD insertion can be arranged once the followup confirms the pregnancy is gone. |
| How much will I bleed? Bleeding afterward varies, but is often less than a period. Bleeding may start a few days after and can continue for up to several weeks. Some won’t bleed at all afterward. | How much will I bleed? Heavy bleeding and clots are common during the abortion process. Afterwards, there may be some spotting and/or bleeding up to the next period. |
| Can the abortion fail? There is about a one in 300 chance of needing the procedure repeated because of blood clots forming or tissue remaining in the uterus. A pregnancy continuing is very rare. | Can the abortion fail? There is about a one in 100 chance that the pregnancy will continue and an aspiration procedure may be necessary. About 4 in 100 will require the misoprostol a second time, or will choose to have an aspiration procedure to complete the process. |
| What are the possible complications? Surgical abortion has been formally studied for over 25 years and is very safe. Injury to the uterus is very rare in the first trimester. Excessive bleeding is very rare. Infection or needing a repeat procedure happens in less than one percent of cases. Abortion does not affect future pregnancies unless there is an extremely rare, serious complication. Serious complication are extremely remote. | What are the possible complications? Medical abortion has been formally studied for over 20 years and is very safe. The risk of excessive bleeding or serious infection is very low. Allergies to the medications are very rare. About 5 percent will need or choose to have a aspiration procedure to complete the abortion. Abortion does not affect future pregnancies unless there is an extremely rare, serious complication. |
| What are common side effects? Often there are no side effects. Some have dizziness, nausea or vomiting for a short time after the procedure. | What are common side effects? Some have few or no side effects, but it’s normal to have some flu-like symptoms when using the misoprostol. These include mild to strong nausea, vomiting, diarrhea, headache, dizziness, fever or chills. |
| Are there emotional issues specific to this method? Some people feel anxious in a medical setting or getting ready to have a medical procedure. | Are there emotional issues specific to this method? Some are anxious waiting for the abortion process to complete. Viewing the pregnancy tissue can also be difficult for some, especially when the pregnancy is over 7 weeks as there may be a visible embryo or fetus. |
Aspiration (Surgical) Abortion
How does it work? A doctor uses gentle suction to remove the pregnancy and blood from inside the uterus.
How effective is it? More than 99% success rate.
When can it be done? An aspiration abortion can be done as early as five weeks from the first day of the last period.
How many appointments are required? Most only need one appointment that takes 2-3 hours. This includes counselling, the procedure, and recovery time.
How long does it take for the abortion to be complete? The procedure itself usually takes about seven to eight minutes.
How painful is it? There may be strong cramping for a few minutes during the procedure and for a short time after. Medications, including local anesthetic, painkillers and/or conscious sedation, are used to help manage pain. Milder cramps may continue for several days to several weeks.
Will I be able to get pregnant again in the future and when? The chance of an early aspiration abortion affecting future fertility is extremely rare: one in 10,000 or more rare than that. In fact, fertility returns very quickly and it is possible to be pregnant again right away.The doctor will discuss birth control options at your post op visit
How much will I bleed? Bleeding afterward varies, but is often less than a period. Bleeding may start a few days after and can continue for up to several weeks. Some won’t bleed at all afterward.
Can the abortion fail? There is about a one in 300 chance of needing the procedure repeated because of blood clots forming or tissue remaining in the uterus. A pregnancy continuing is very rare.
What are the possible complications? Surgical abortion has been formally studied for over 25 years and is very safe. Injury to the uterus is very rare in the first trimester. Excessive bleeding is very rare. Infection or needing a repeat procedure happens in less than one percent of cases. Abortion does not affect future pregnancies unless there is an extremely rare, serious complication. Serious complication are extremely remote.
What are common side effects? Often there are no side effects. Some have dizziness, nausea or vomiting for a short time after the procedure.
Are there emotional issues specific to this method? Some people feel anxious in a medical setting or getting ready to have a medical procedure.
Medication Abortion with Mifegymiso
How does it work? The first pill, mifepristone, disrupts the pregnancy. Misoprostol, the second medicine, is used at home 24-48 hours later to make the uterus contract and push out the pregnancy and blood.
How effective is it? A 98% success rate at one week follow-up.
When can it be done? a medical abortion can be done as soon as there is a positive pregnancy test and up to 9 weeks from the first day of the last period.
How many appointments are required? Usually it means two appointments including a one-week follow-up. A few will need a third appointment.
How long does it take for the abortion to be complete? About 95% will be completed by the one-week follow up. Most will pass the pregnancy tissue within four hours of using misoprostol.
How painful is it? It varies from mild to very strong cramping, with the worst when passing the pregnancy tissue. There are medications to take at home to help manage pain. Milder cramps may or may not continue for several days to several weeks.
Will I be able to get pregnant again in the future and when? A medication abortion has no effect on future fertility unless there is an extremely rare complication. In fact, fertility returns immediately;Birth control methods like the pill should be started the day after using the misoprostol pills. An IUD insertion can be arranged once the followup confirms the pregnancy is gone.
How much will I bleed? Heavy bleeding and clots are common during the abortion process. Afterwards, there may be some spotting and/or bleeding up to the next period.
What are the possible complications? Medical abortion has been formally studied for over 20 years and is very safe. The risk of excessive bleeding or serious infection is very low. Allergies to the medications are very rare. About 5 percent will need or choose to have a aspiration procedure to complete the abortion. Abortion does not affect future pregnancies unless there is an extremely rare, serious complication.
What are common side effects? Some have few or no side effects, but it’s normal to have some flu-like symptoms when using the misoprostol. These include mild to strong nausea, vomiting, diarrhea, headache, dizziness, fever or chills.
Are there emotional issues specific to this method? Some are anxious waiting for the abortion process to complete. Viewing the pregnancy tissue can also be difficult for some, especially when the pregnancy is over 7 weeks as there may be a visible embryo or fetus.
Advantages of an Aspiration (Surgical) Abortion
- It can be done very early in a pregnancy (as soon as something can be seen in an ultrasound) as well as further along – up to 20 weeks 6 days at our facility.
- It is over more quickly – only one appointment is usually necessary, and it often requires less time off work than a medication abortion. The post-operative visit is essential to ensure that the pregnancy is terminated and that things are progressing normally.
- Although it is sometimes known as a “surgical” abortion, it is a very simple, safe procedure that involves gentle suction (there are no incisions/cuts, stitches or scarring).
- Recovery for most people is very fast, with most people returning to most of their normal activities within a day or two.
- It is a more effective method with a lower failure rate than medication abortion.
- There is typically less bleeding with an aspiration abortion than with a medication abortion – with aspiration, bleeding tends to be less than a period; with a medication abortion bleeding tends to be heavier than a period.
- There is typically less pain for less time than with a medication abortion.
- If you have anemia (low iron), this is the recommended procedure as a medication abortion includes more bleeding.
- It can be easier to keep an aspiration abortion private as there is minimal bleeding and cramping at home.
- During the abortion you have on site support from medical staff and counselors.
Disadvantages of an Aspiration (Surgical) Aspiration
- Some people feel anxious in a medical setting or having a medical procedure where a doctor inserts instruments into the uterus.
- Anesthetics and drugs to manage pain during the procedure may cause some short-term side effects such as dizziness or nausea (serious problems are extremely rare).
- You will need a ride, a companion on transit, or a taxi to get home from the clinic.
Advantages of a Medication (Medical) Abortion
- It usually avoids a medical procedure where a doctor inserts instruments into the uterus.
- You can be at home instead of in a clinic during the actual abortion, which may feel more comfortable or provide a sense of more privacy and control – in particular, for some survivors of sexual abuse/assault.
- It does not require a ride, a companion on transit, or a taxi to get home from the clinic – you can take transit on your own or drive to and from appointments.
- It seems like a miscarriage, which for some can feel more natural.
- Some people prefer to consciously experience the process of ending the pregnancy at home rather than being sedated as during an aspiration (although sedation with an aspiration is optional).
Disadvantages of a Medication (Medical) Abortion
- It can only be done up to 7-10 weeks after the first day of your last period.
- The process takes longer than an aspiration abortion and more appointments are necessary (at least two appointments 1-2 weeks apart) and it often requires more time to rest.
- Failure rates are higher than with an aspiration abortion (although still very low).
- There is typically more pain with a medication abortion. Cramping can be strong and usually lasts longer than with an aspiration abortion.
- Bleeding is typically heavier with a medication abortion – it may be very heavy at times and usually lasts longer than with an aspiration.
- Misoprostol, one of the medications used, can cause flu-like symptoms such as nausea, vomiting, diarrhea, fever, and body aches.
- During the abortion itself, you will not have on site support from medical staff and counselors.
- It may be harder to keep a medication abortion private, especially from people you live with (because of significant bleeding, cramping and other side effects) and because the medications involved can show up on Pharmanet which can be seen by doctors, nurse practitioners and pharmacists.
- Viewing the pregnancy tissue can be difficult for some, especially when the pregnancy is over 7 weeks and you may see an embryo or fetus.
- Those with anemia (very low iron) and/or severe vomiting are not good candidates for a medication abortion.
What will happen if you do an abortion with pillls after the first 10 weeks?
Patients often ask about mailing the abortion pill (Mifiprex) to them for use at home. This can be dangerous. Before taking the pill the physician must first determine:
1-that you are pregnant
2-that the length of your pregnancy is within the limits of safety for the use of the abortion pill.
If you take the abortion pill and you are too far along in your pregnancy, you subject yourself to the danger of severe hemorrhage.
That can be life threatening. See the article below from a study done by the Royal College of Obstetricians and gynecologists.
Medical abortion has been shown to be effective through the first trimester (12 weeks) and has been successfully used during the second trimester. (13)
In 2004, “The Royal College of Obstetricians and Gynaecologists evidence-based clinical guidelines stated that the medical regimen using Mifepristone in combination with Misoprostol would be a safe and effective alternative to surgery for women undergoing abortion at 9-13 weeks’ gestation. (20)
If you have been pregnant for longer than 12 weeks and do a medical abortion anyway, the medicines still work and cause an abortion. However, the risk of complications increases and it is more likely that you will need to receive treatment from a doctor afterwards (See the table below on complications to determine the exact amounts of increased risk). Therefore, it is strongly advised that the pills are taken in the waiting room of a hospital or in a cafe very close to a hospital. In that case, should you need urgent medical attention, you will be nearby. The symptoms are exactly the same as a miscarriage. If you need emergency care in a hospital, it is important to tell the doctors you had a miscarriage, as women can be prosecuted for having an abortion. The symptoms and treatment are the same.
Realize also that you will lose a lot of tissue and blood, but also a foetus (the size depends on the duration of the pregnancy), which can be recognized as such. It can be quite distressing to see. If you have no other means, doing the medical abortion is still much safer than dangerous methods for causing an abortion, such as inserting sharp objects into the vagina, ingesting toxic chemicals such as bleach, or punching the abdomen. You should never use these dangerous methods!
In summation. your life and safety and comfort count more than anything else in this world.
If you think that you are pregnant and you wish to terminate your pregnancy, schedule an appointment in order to be evaluated at our facility by one of our expert gynecologists, who, with you , will determine the best and safest method that should be employed in order to terminate your pregnancy.
Irregular vaginal bleeding
Below is a list of most of the major causes of irregular vaginal bleeding. If you experience even one episode of irregular vaginal bleeding, you must make an appointment to be fully evaluated in order to rule out the most serious causes of irregular bleeding and, more importantly, to catch and treat any serious aliment that may be discovered before it becomes untreatable.
Our staff of gynecologists and nurse practitioners is fully skilled and equipped to diagnose any of the causes of irregular bleeding and to take the appropriate steps necessary to make sure that you receive the best care and treatment for the problem. Please call and make an appointment as soon as possible.
1-Endocrine system factors-peri-menaupause, vaginal atrophy, Stein Leventhal syndrome, hyperthyroidism or hypothyroidism, endometriosis etc
2-Pregnancy-miscarriage, placental abruption, placenta previa, irritation in the vaginal canal, placenta accrete and increta, ectopic pregnancy
3-Medical- bleeding dyscrasia(for example thrombocytopenia or VonWillebrand disease), that is an abnormal clotting process; kidney or liver disease; celiac disease
4-Physical trauma-lesions on the vulva or in the vagina or the cervix or uterous from sexual intercourse, foreign objects etc.
5 Hiatrogenic-physician caused trauma; IUD; Post surgery; medications with anti coagulative properties; changing or stopping Birth control pills.
6-Cancers and precancerous lesions of the uterous, cervix, ovary, vagina, Vulva, fallopian tube.
7-Non cancerous growths-For example uterine polyps or fibroids or adenomyosis.
8-Infections of the reproductive tract-for example Pelvic Inflammatory disease, clamydiatrachomatis, gonorrhea, cervicitis, endometritus, vagnitis, urea plasma vaginitis, vaginosis.
The important message to recognize is that if irregular vaginal bleeding occurs, you need to make an appointment in order to be fully evaluated so that any serious condition can be dealt with before it becomes untreatable.
Free abortion!!!!
In the state of New York, most abortions are virtually free. If you have Medicaid you are covered. If you have insurance, you are basically covered by most providers. If you do not have either of those options, there are sources that will pay for the service if you qualify for financial need. Please call for more information Manhattan 877-894-1841, Queens, NY 866-340-1943, White Plains, NY 888-644-0999
Late-Term Abortion Clinics
While it’s not ideal to wait until late in your pregnancy to seek an abortion, it is sometimes necessary.
Second and third-trimester abortions involve invasive procedures and they’re hard to access. There aren’t many doctors who will perform late-term abortions and there are laws that could influence whether or not there is a clinic that offers one.
We provide late term procedures in all our NY facilities and in our Jacksonville, Orlando (Altamonte Springs) and Tampa Bay facilities in Florida.Our physicians that do these procedures are time tested. They have been doing them for may years and their safety and comfort records are unmatched.
If, for some reason, these locations are not convenient for you, check out Abortion.com to see lists of late-term abortion providers.
Post-Operative Exam, Birth control and a Preventative Medical Program.
It is extremely important that you make sure that you show up for your post-operative exam.
You must be examined to make sure that there isn’t any unwanted tissue remaining in your uterus and that you discuss and consider a method of birth control that will prevent future unwanted pregnancies. Furthermore, it is important that you consider participation in our preventative medicine program.
The best way to maintain optimum health is to try to prevent major problems before they occur.
In order to accomplish this goal, you will need a full physical exam, including Pap smear, breast exam and laboratory studies. A clean bill of health is what you hope for, but the discovery of a small abnormality simply fixed can prevent a major medical problem down the road.
Furthermore, improving the quality of your life includes a healthy diet and an exercise program and we can help you with both.
“An ounce of protection is worth a pound of cure”
CARING
The most important element of our abortion service is that we truly care!
We understand all your concerns from the psychological aspect of terminating a pregnancy to the actual procedure itself.
We are here to answer all your questions and help make you comfortable with your choice.
In sum, we are here for you!!
with patient safety being it’s sole mission.
All our staff clinicians are proud to be active and contributory members of the National Abortion Federation (NAF,) and The National Coalition for Abortion Providers (NCAP.)