General Questions
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How often should I see my OB/GYN?
You should see us once a year for your well-woman exam.
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How do I contact a physician when the office is closed?
You may call the main number 407-644-5371 and the answering service will take your call and direct it to the physician that is on-call.
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Where do I go if I need emergency care outside of normal business hours?
If you have a life-threatening emergency, please call 911 or go to the nearest emergency room. If your problem is urgent but not life-threatening, you may go directly to Winnie Palmer Hospital triage, and one of our physicians will be contacted.
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How do I ask a medical question?
Please enter the Patient Portal, and you will be instructed on how to privately ask your questions. We make every attempt to answer your question on the same day during business hours.
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Do you draw blood at the office?
Yes, we offer lab services, including blood draws at all 3 office locations.
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How do I get my prescription refilled?
Please request your refills at least 48 hours in advance, through the Patient Portal.
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When should I have my first pelvic or internal exam?
It is recommended that you have your first pelvic exam and pap smear at age 21 if you are otherwise healthy . If you require birth control , are in need of STD testing or have any menstrual issues, you should make an appointment to be seen earlier.
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What does a gynecologic exam consist of and what is a Pap Test?
The yearly exam consists of a general exam, breast and pelvic exams. A speculum is usually used to look at the cervix and vagina. Your doctor may not always need to do a pap test but will still need to do a pelvic exam every year to check the uterus and ovaries.
A pap test is a screen for cervical cancer. The latest guidelines recommend a pap test every 3-5 years for those who have not had any abnormal pap smears previously. Your doctor will discuss your individual case and how the new guidelines will affect you.
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How often should I get a mammogram?
Yearly mammograms are recommended starting at age 40, and continuing for as long as a woman is in good health. Some women will start their mammograms earlier based on medical and family history.
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What types of changes will I see in menopause?
Each woman’s menopause experience is different. Many women who begin menopause have no physical changes at all except for irregular menstrual periods that eventually stop when menopause is reached. In addition to irregular menstrual periods, some women experience symptoms of hot flashes, difficulty sleeping, difficulty concentrating, memory changes, and/or vaginal dryness. Every woman is different, and there are many measures available to lessen these symptoms. Our physicians and nurse practitioners are all very experienced in helping women navigate their way through the menopause years.
Insurance Questions
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What health insurance plans do you accept?
We accept most health insurance plans. Please call our office to inquire about a specific plan.
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Does Medicare cover an annual exam and mammogram?
Please refer to the Medicare website to stay updated on the latest guidelines and coverage of exams.
Pregnancy Questions
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When should I schedule an appointment for my first OB visit after learning that I am pregnant?
Ideally you should schedule your first OB visit at around 6-7 weeks from your last menstrual period. However, if you are bleeding or in pain before then you should schedule an appointment immediately.
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Do I have to call before I go to the hospital in labor?
If you are one of our patients, you DO NOT have to call us when you are in labor. A physician from this practice is immediately available at all times to see you at the hospital. If you are having regular contractions every 5 minutes, or if your water breaks, you should go to “triage “ at Winnie Palmer Hospital or Oviedo Medical Center. Other reasons to go to triage are a decrease in your baby’s movements or any heavy vaginal bleeding during pregnancy.
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How many ultrasounds will I have during my pregnancy?
You may have an ultrasound in the first trimester to assess how far along you are, and whether there may be more than one fetus. We offer an ultrasound for genetic testing around week 12. There is another ultrasound scheduled at 20 weeks to assess fetal anatomy. Some patients may require additional ultrasounds depending on fetal and or maternal conditions.
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What will happen at my first prenatal visit?
The first visit will usually include a general exam and pelvic exam, blood work, assessment for any high-risk pregnancy factors, and any other testing or referrals deemed necessary based on your medical history. We will discuss any questions or concerns that you may have. We also give you lots of helpful information so that you can have an enjoyable pregnancy.
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How often are my visits?
In a normal low risk pregnancy, the first several visits are usually every 4-6 weeks; by 28-32 weeks you will be seen every 2 weeks and by 36 weeks patients are seen weekly. In high risk pregnancies these intervals may change depending on fetal and or maternal conditions.
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What is a high risk pregnancy?
High risk pregnancies are complicated by a maternal, fetal or obstetric complication. Examples of fetal conditions include multiple gestation like twins and triplets, fetal growth problems or any medical complication the fetus may have that is detected during the pregnancy. Maternal high risk conditions include advanced age, high blood pressure, diabetes, and autoimmune diseases such as lupus. Obstetric complications include conditions such as placenta previa (where the placenta implants over the cervix) and preterm labor.
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What is your practice philosophy on episiotomies ?
An episiotomy is a cut to the perineum — the skin and muscles between the vaginal opening and anus. We do not routinely cut an episiotomy.If we think that there will be tearing of the vagina or surrounding tissue in the wrong direction, or if there is a shoulder dystocia (where the shoulders are impacted), then we would need an episiotomy to make more room to get the baby delivered safely.
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Which hospitals do you use to deliver your patients?
We deliver our patients at Winnie Palmer Hospital for Women and Babies , and Oviedo Medical Center.
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What if I have questions after the office has closed?
The physicians are available to all patients 24 hours a day, 7 days a week for emergency calls. They can be accessed by calling the answering service at 407-644-5371 after office hours. Non-emergency questions can be answered via our phone menu items.
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Should I rotate through the different providers during my pregnancy?
Ideally, meeting as many providers as possible is helpful for some patients who may be uneasy with the notion of meeting a physician for the first time at delivery. Many patients feel comfortable in seeing two or three providers regularly throughout the pregnancy. Your comfort is most important to us and so patients have the liberty to see as many providers they feel comfortable with.
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If I need an urgent visit, can that be arranged quickly?
Absolutely, if there is an urgent need to be seen you usually can be seen the same day.
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Who should receive the Tdap(tetanus-pertussis) vaccination?
All adults should receive the Tdap booster at least once during adulthood. It is recommended that every pregnant woman obtain the vaccine during the second or third trimester of pregnancy, even if they have received the vaccine previously. Any adults that will be around a newborn baby should have the vaccine as well.This vaccine is available at all of our offices for family members of our patients.
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Is there a guarantee that the doctor that I usually see in the office will deliver my baby?
There is no guarantee that the doctor that you regularly see in the office will deliver your baby. We have Hospitalists (doctors who just do deliveries) and Midwives in addition to the doctors that you see in the offices, that cover patients at both of the hospitals to ensure patient safety and overall exceptional care .
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Are mammograms and ultrasound services offered in your office?
Yes, our practice offers both of these services.
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Does the group offer TOLAC’s?
Yes , our group encourages a “trial of labor after c-section” (TOLAC) if you have had only one prior uncomplicated c-section, and you go into labor on your own. We are unable to “induce” you, and recommend delivery no later than 41 weeks by repeat c-section if labor has not begun.There is a small risk of uterine rupture in this situation, and we will need to discuss the risks and benefits regarding TOLAC at your pregnancy visits.
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Should I exercise when I am pregnant?
Being active and exercising for at least 30 minutes a day can be very beneficial and help to avoid some unwanted pregnancy side effects. Activity during pregnancy helps reduce backache, constipation, bloating and swelling; helps with sleep and mood; helps prepare for labor by strengthening your muscles and your endurance. Swimming, walking and stationary cycling are all excellent ways to exercise in pregnancy. Try to avoid any sports that are dangerous because of the potential for injury including skiing, contact sports and scuba diving.
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What is a 4-D ultrasound?
4-D fetal ultrasounds are similar to 3-D ultrasounds where they show width, height and depth , with the difference associated with time: 4-D ultrasound allows a 3-dimensional picture in real time. We offer these ultrasounds at our office purely for fun pictures of your baby. It is best to do this ultrasound between 28-32 weeks .
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What Should I Avoid Eating While Pregnant?
Women are strongly urged to avoid alcohol during pregnancy, and to limit caffeine to no more than 200mg per day. For perspective, an 8-ounce cup of brewed coffee contains about 95 milligrams of caffeine, an 8-ounce cup of brewed tea contains about 47 milligrams and a 12-ounce caffeinated cola soft drink contains about 29 milligrams. Women are also encouraged to avoid unpasteurized deli meats ,raw meats and fish , and soft and unpasteurized cheeses.
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What can I take if I have a cold?
If you are out of the first trimester, you may take Tylenol, Robitussin, Mucinex, Sudafed, and any lozenges or throat sprays over the counter Please avoid aspirin and ibuprofen products. Please consult your physician regarding any other medications.
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Is it Ok to travel while pregnant?
It is safe to travel, either by car or plane through 32 weeks. After that, please consult your doctor.
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Are Dental X-Rays Okay?
We discourage “routine” screening x-rays while pregnant. However, they are safe if needed to diagnose a potential problem. If this is the case, please make sure that they shield your abdomen with a lead apron while taking the x-ray.
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What are Fetal Kick Counts?
Start by finding a comfortable position during a time when your baby is usually most active. You may sit comfortably, or lay down on your left side. Lying on your left side also allows for the best circulation which could lead to a more active baby. Count the movements of your baby until you reach number “ten”. As long as you reach this number before two hours is up, then your baby is moving appropriately. You may eat something sweet, or drink a cold beverage to get your baby to wake up and move more. If you are unable to count 10 movements in 2 hours, please call the office for an immediate appointment if it is during business hours and you are less than 37 weeks pregnant. If you are over 37 weeks pregnant or the office is closed, please proceed directly to Winnie Palmer triage for evaluation.
Surgery Questions
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Do you offer Endometrial Ablation in your office?
Yes we offer many in office surgeries . We offer uterine ablations like the Novasure or Minerva for heavy, profuse menstrual cycles not corrected by medical treatments. Surgical treatments for abnormal pap smears are also performed in the office such as colposcopy and LEEP (Loop Electrosurgical Excision Procedure).
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Do you have doctors that are trained to perform daVinci robotic surgery ?
Yes, we have many doctors in our practice that are highly skilled in performing daVinci robotic assisted surgeries. These surgeries are performed at Winnie Palmer Hospital, and are mainly indicated for hysterectomy and myomectomy (remove fibroids).
Birth Control Questions
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Will the antibiotic that I am taking interfere with my birth control pills?
It is possible that an antibiotic may decrease the effectiveness of the birth control pills. It is recommended that you use “back-up” protection (condoms) for the remainder of the pack of pills.
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When do I start taking my birth control pills?
You may either start the first pill on the first day of your menstrual cycle, or do the “Sunday start” and start on the very next Sunday that falls on the calendar after your menses has started.
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What if I miss more than one birth control pill?
Use back-up protection for the remainder of that pill pack until your menstrual cycle begins.
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How can I get emergency contraception (morning-after) pill?
Plan-B is sold over the counter in most pharmacies in town.
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Can I get an IUD (Intrauterine device - Mirena or Paragard) even if I have not had a baby yet?
An IUD is a safe and highly effective birth control option for women of all ages, with and without a previous pregnancy. One concern about the IUD is that sometimes it can slip out of the uterus, a process known as expulsion. If this happens, the IUD is no longer effective and a woman can become pregnant. Expulsion is more likely in women who have never had a pregnancy — even women who have had a miscarriage or abortion are able to retain their IUD better compared to those who have never been pregnant. The possible risk of expulsion is not a contraindication for Mirena or Paragard in women who haven’t had a pregnancy, but it is something to keep in mind and discuss with your healthcare provider.