News & Events

Maternity Leave

It is a joy to care for you during your pregnancy.  We know that as you get closer to delivery, lots of questions often come up regarding maternity leave.  As your OBGYN provider, we are involved in completing paperwork for your employer about your leave.  It’s important to help you understand the process and expectations regarding leave because it is often confusing or there is mixed information.

How much medical leave will I be given when I have a baby?  Recovering from childbirth takes some time.  Medical leave paperwork asks your provider to determine how much time your need to be medically out of work.  The standard recovery time from a vaginal birth is 6 weeks and for a c-section, it’s 8 weeks.  We know that you want to spend more time with your little one than 6-8 weeks which is why many employers cover additional leave time through the Family Medical Leave Act (FMLA) or Paid Family Medical Leave (PFML).  However, from a disability perspective, we will complete medical forms with 6 weeks for a vaginal birth and 8 weeks for a c-section.

My employer offers up to 12 weeks of paid medical leave.  Can Bedford Commons OBGYN complete my form to allow for 12 weeks of paid medical leave?  Honestly, we want you to be home with your baby as long as possible.  However, when we are completing these forms, we need to actively answer the question of how long do you need to be “medically incapacitated”, meaning home to recuperate from having your baby.  Unless there are medical complications with your recovery after your baby is born, we need to be consistent in our medical leave requests, regardless of how much time an employer may offer.  It is not uncommon that new parents are told that if the doctor allows it, additional time will be given.  That is true if there is a medical indication for extended leave but that is quite uncommon.

How is bonding time different?  The State of Massachusetts offers 12 weeks to bond with a child, regardless of parents’ gender.  New Hampshire PFL allows for up to 8 weeks of bonding time in the first 12 months of having a child.  Unlike in Massachusetts where it is a state benefit, in New Hampshire PFL is optional so you may or may not have access to the benefits.  Employers can opt in for New Hampshire PFL or individual employees can opt in.  In both New Hampshire and Massachusetts, bonding time is different than the medical leave discussed above.  Bonding time is completed specifically by the employee (you) and does not require our office to complete any paperwork.  The paperwork must be filed after the medical leave portion is filed.  

Please know that we know adjusting to a new baby and sleepless nights are tricky.  We also know that precious time with your little one is priceless.  Talk to your employer about if you qualify for FMLA leave (up to 12 weeks total including the 6-8 weeks of medical leave) to allow for some extension of your leave.

Pregnancy

Early Pregnancy Loss – what happens to my baby after a D&C procedure

| Amanda Morneau, Perinatal Loss Coordinator, Elliot Hospital

To Patients and Families Experiencing an Early Pregnancy Loss:

We understand that this is a difficult time for you and your family and that you may have some questions regarding the handling of your babies’ remains. It is our desire to care for your baby with dignity and respect; therefore, we would like you to take some time to consider two options available to you for final disposition.

Private Arrangements: You may make private arrangements for cremation or burial – regardless of the gestational age at the time of pregnancy loss. Although the cost associated with burial will vary by cemetery, many funeral homes do not charge for cremation or burial preparations for early pregnancy loss. Please make any private arrangements within two weeks and notify the funeral home of your choice. You also need to notify our staff here at the Elliot. You can email AMorneau@elliot-hs.org or RBelt@elliot-hs.org and we can help to ensure that your babies’ remains are prepared for release. Please be aware that if you do not desire a private arrangement, all remains will be placed in the Elliot Hospital Memory Garden.

Elliot Hospital Memory Garden: The Memory Garden is located on the Elliot Hospital campus and is the final resting place of stillborn and early loss babies. Remains are cremated collectively and interred in the Memory Garden at a yearly memorial service. The Memory Garden is home to the Angel of Hope Statue and is a place where families can come to remember and honor their babies privately. If you elect this option, the cremation is completed at no cost to you.

If you choose the Memory Garden, please know that we have an annual Angel of Hope Candlelight Vigil on December 6th at 7PM in the garden. The Memory Garden Interment Ceremony and Memorial Service is on the Sunday before Memorial Day at 2PM. We would love to have you join us. For more information click here: Elliot Memory Garden information.  

If you have any questions about these options, please contact the bereavement line voicemail at (603)663-3396. Leave your name and number and we will return your call.

We are so sorry for your loss.

Sincerely,

Amanda Morneau, BSN, RNC-EFM, CCE
Perinatal Loss Coordinator
Elliot Hospital
AMorneau@elliot-hs.org

DaNae Belt, BSN RNC-OB, RNC-MNN, C-EFM
Clinical Nurse Manager
Labor and Delivery
Elliot Hospital
RBelt@elliot-hs.org

 

The following is a list of area funeral homes that provide free or low cost cremation for infants, stillborn babies and early pregnancy loss. This is not a comprehensive list. Please contact the funeral home of your choice directly to discuss options.

  • Phaneuf Funeral Homes & Cremation, Manchester NH (603) 625-5777
  • Lambert Funeral Home & Crematory, Manchester NH (603) 625-6951
  • Cremation Society of New Hampshire, Manchester NH (603) 622-1800
  • Advantage Funeral & Cremation Services, Nashua NH (603) 521-8424
  • Petit-Ronan Funeral Home, Pembroke NH (603) 485-9573
  • Still Oaks Funeral & Memorial Home, Epsom NH (603) 798-3050
  • Anctil-Rochette & Son Funeral Home, Nashua NH (603) 883-3041
News & Events

COVID19 Vaccine Considerations for Pregnant or Breastfeeding Women

| Bedford Commons OB-GYN

Many of our patients have been asking about the safety and effectiveness of the COVID19 vaccine in pregnancy and breastfeeding.  Vaccination is the best way to reduce the risks of COVID-19 infection and COVID-related complications for both you and your baby.  Now that the vaccine has been out since December 2020, we have a lot more information about the vaccine for pregnant and breastfeeding women.  We encourage all of our pregnant and breastfeeding patients to stay up to date on their COVID-19 vaccinations including the newly released omicron booster.

Both the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) recommend that pregnant and breastfeeding people be vaccinated against COVID19.

Although pregnant or lactating women were not included in the COVID19 vaccine clinical trials, hundreds of thousands of pregnant people have been vaccinated and no unexpected pregnancy or fetal problems have occurred.  There have been no reports of any increased risk of pregnancy loss, growth problems, or birth defects.

We know that about 1 to 3 in 1,000 pregnant women with COVID19 will develop severe illness.  Compared to those who aren’t pregnant, pregnant women infected by COVID19 with symptoms are 3 times more likely to need ICU care, 2 to 3 times more likely to need advanced life support, and have a 70% increased risk of death.  According to a September 29, 2021 urgent health advisory from the Centers for Disease Control (CDC), there have been more than 125,000 confirmed cases of COVID19 in pregnant people including more than 22,000 hospitalizations and 161 deaths.  To reduce these risk, the COVID19 vaccine is recommended.  See the full CDC health advisory here.  

The best way to prevent complications from COVID-19 is vaccination and continue to be up to date on your vaccination series.  We strongly recommend that our pregnant and breastfeeding patients get the COVID19 vaccination.  Pregnancy is not an indication for a COVID19 vaccine waiver.  

If you have questions about the vaccine, please talk to your provider at your next visit.

News & Events

I just tested positive for COVID-19 and I’m pregnant! Now WHAT?!?!

| Christina Haag, APRN

With rising COVID19 cases in New Hampshire, we are getting calls daily from our patients reporting a positive COVID-19 test.  We are here to support you with the latest information about pregnancy and COVID19.  We know that you are worried and have lot’s of questions.  We are updating this information as new guidance becomes available.

If you think you may have symptoms of COVID19, you should be tested.  Symptoms include: cough, fever, shortness of breath, headache, cold-like symptoms, sore throat, or loss or change to your sense of smell or taste.  There are many options for testing including at-home test kits (only should be done if you are symptomatic), state test sites, and pharmacies.  For a full list of testing sites, click here.  New Hampshire is also offering free COVID19 test kits.  To get your test kit, follow this link.

If you test positive for COVID-19, please call us during office hours at 603-668-8400 to let us know.  For the safety of our patients and team members, your next visit will be scheduled at least 10 days from the date of your positive test.  We are also happy to convert your scheduled visit to a telehealth visit to check-in with you.  You should isolate from others and stay at home for 10 days.  If you live with unvaccinated family members, try to isolate yourself from them.  If you are unable to isolate yourself, those family members also need to quarantine – they will need to quarantine for 20 days.  If you do need to leave your house for medical care, please be sure to wear a mask and call your healthcare provider before you arrive to notify them of your positive COVID-19 test result.

Most cases of COVID-19 are mild and can be managed at home with getting plenty of fluids and rest, as well as using medication to reduce a fever.  It is safe to treat a fever in pregnancy with Tylenol (Acetaminophen) 1000mg every eight hours.  In addition, make sure you’re staying hydrated by drinking a lot of water.  If you are fully vaccinated for COVID-19, your risk of severe illness is significantly less than those who are not vaccinated.

Primary care providers are well versed in the symptoms of COVID-19 and recommendations for treatment.  We would encourage you to reach out to your primary care provider for additional recommendations.  Because pregnancy is considered to be a high risk condition for COVID-19, your primary care provider may recommend that you receive monoclonal antibodies.  Monoclonal antibody treatments are recommended by the Centers for Disease Control (CDC) and the American College of Obstetricians and Gynecologists (ACOG) for treatment of pregnant people with mild to moderate COVID-19 who are at risk for complications from COVID-19.  There is a limited supply of monoclonal antibodies so we are relying on insight from your primary care provider as to whether you should receive monoclonal antibodies based on your symptoms.  Although monoclonal antibodies have not been specifically evaluated in pregnancy, preliminary data suggests that monoclonal antibody treatment is safe in pregnancy.  Orders for monoclonal antibodies need to come from your primary care provider.

If you feel like your symptoms are worsening, please reach out to your primary care provider for additional recommendations.  Watch for emergency warning signs for COVID-19 which may indicate more severe illness including difficulty breathing, confusion, persistent pain or pressure in the chest, or pale, gray, or blue-colored skin, lips or nail beds.  If you have any of these signs, seek emergency medical care immediately.

According to the data available from the CDC and ACOG, people with COVID-19 during pregnancy are more likely to experience preterm birth (delivering the baby earlier than 37 weeks) and stillbirth and might be more likely to have other pregnancy complications compared to people without COVID-19 during pregnancy.  Unfortunately, there are not any specific ways to prevent these risks once someone tests positive for COVID-19 other than monitoring for symptoms.  Due to a risk of pre-eclampsia (high blood pressures in pregnancy), if you are less than 28 weeks pregnant, you should begin taking low dose aspirin (81mg) daily starting at 12 weeks of pregnancy, if you have not already been instructed to take aspirin.  If you’re more than 28 weeks pregnant, you do not need to start aspirin.  If you’ve already been on it, continue taking your aspirin until you deliver.

If you were hospitalized with COVID-19, we will schedule non-stress tests to monitor your baby’s well-being twice weekly starting at 32 weeks (and at least 14 days after you were diagnosed with COVID-19) and an ultrasound to check your baby’s growth.  Please reach out to our office with any symptoms of preterm labor which include: Regular, frequent contractions or tightening of your belly, leaking fluid like your water might have broke, worsening lower back pain, and a sensation of significant lower pelvic pressure.

If you have not already received your COVID-19 vaccine or booster, once you are feeling better and it’s been at least 14 days since you were diagnosed with COVID-19, please get vaccinated.  Even if you have already had COVID-19, vaccination is still the best way to protect you and your baby.  

We hope you feel better soon.  Again, please be sure to seek emergency medical help if you are having any severe symptoms of COVID-19.

For more information, please visit: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnant-people.html

Gynecology

Special request from Bedford Commons OB-GYN – Please get vaccinated!

| Dr. Albushies, Dr. Bannister, Dr. Brandon, Dr. Hanlon, Dr. Henneberry, Dr. Leclair, Dr. Murphy, Dr. Rounds, Dr. Pawlowski, Dr. Viglianco, Dr. Weidner and Dr. Wilson

As you probably are aware, we are seeing a dramatic surge in COVID-19 cases.  After two years of providing healthcare in this new environment, many of us are exhausted; we are sure you are exhausted too.

This is our special request – please get vaccinated. 

With the rising COVID-19 cases in New Hampshire, we unfortunately have seen some of the sad outcomes that can occur with COVID-19.  We have witnessed firsthand the devastating effects of severe COVID-19 in pregnancy, seeing our patients hospitalized, some required ICU care, long term oxygen supplementation, and all of whom were in fear of harm to their baby.  Compared to those who aren’t pregnant, pregnant women infected by COVID-19 with symptoms are 3 times more likely to need ICU care, 2 to 3 times more likely to need advanced life support and have a 70% increased risk of death.  Severe COVID-19 can also cause issues for babies including a 60% increased risk of very premature birth, extended stays in the neonatal ICU, and risk of stillbirth.  All major medical organizations and we, your doctors, feel that COVID-19 vaccination in pregnancy is very safe and critically important because pregnancy is considered a high-risk condition for severe illness with COVID-19.

If you’re pregnant, get vaccinated as soon as possible.  We get calls daily from unvaccinated pregnant women who recently tested positive for COVID-19, asking us how they can prevent complications from COVID-19.  Unfortunately, there really isn’t anything that can be done once someone has COVID-19 other than monitor symptoms and treat a fever.  The only way to prevent complications from COVID-19 is vaccination.

If you’re not pregnant, make sure you get a COVID-19 vaccine and talk to friends and family members who are pregnant and encourage them to get vaccinated.  If you’re already vaccinated, thank you.  Be sure to also get your booster dose.

We know that everyone is really tired of this.  Please do your part and get vaccinated.

We care deeply about you so please, let’s work together to keep each other safe.

Gynecology

COVID Vaccine Boosters – Do I need one?

| Christina Haag, APRN

The short answer is YES.  As of November 29th, 2021, the U.S. Centers for Disease Control and Prevention (CDC) recommends that everyone ages 18 and older should get a booster dose.  

If you received Pfizer-BioNTech or Moderna vaccines: You should get a booster at least 6 months after completing your primary COVID-19 vaccination series.
If you received the Janssen (J&J) vaccine: You should get a booster 2 months after completing your primary COVID-19 vaccination.

Which booster should you get?
You may choose which COVID-19 vaccine you receive as a booster shot.  Some people may prefer the vaccine type that they originally received, and others may prefer to get a different booster.  CDC’s recommendations now allow for this type of mix and max dosing for booster shots.

For any adults 18 years old or older who completed their primary Pfizer-BioNTech or Moderna vaccine series at least 6 months ago OR received the Janssen (J&J) vaccine at least 2 months ago, a booster dose of the COVID-19 vaccine is recommened.

Where can I get a booster?  Although we are not giving COVID19 boosters at Bedford Commons OBGYN, if you are eligible for a booster dose, you can schedule an appointment at any retail pharmacy or can inquire about an additional dose through your primary care provider office.  Find a vaccine location by clicking here: https://www.vaccines.gov/.  If you haven’t gotten a flu shot this year, consider getting the flu vaccination along with your COVID19 booster.  Both can be given on the same day.

What about boosters in pregnancy?  We strongly recommend that our pregnant patients receive the COVID-19 vaccine and also strongly recommend the COVID-19 booster for our pregnant patients who qualify.  For more information about the COVID19 vaccine and pregnancy, click here.

Gynecology

What is a DO?

Throughout my training and career, this question has certainly come up more than once. Now, more than ever, with the topic of DO physicians making news and headlines (all press is good press, right? Not necessarily…) are we presented with the opportunity to educate and share exactly what “DOing” is.

DO stands for Doctor of Osteopathic Medicine whereas MD stands for Doctor of Medicine.  Like MDs, Doctors of Osteopathic Medicine are fully licensed physicians who can practice in all areas and specialties of medicine.  We practice evidence-based medicine, using the latest science and technology.  During our medical school training, like MD students, the first two years are centered around classroom learning, and the last two gaining clinical experience in various specialties during clinical rotations.

Many DOs sit for the same licensing exams as MDs (USMLE) during medical school in addition to their osteopathic licensing exams (COMLEX).  The field has grown 300% (wow!) in the last three decades, currently making up 11% of the physician population.  In addition, 42% of actively practicing DOs are female!

In many circumstances, patients may not even notice a difference between their DO or MD physicians.  Where DOs differ is the underlying philosophy that is incorporated in our medical school training.

The hallmark of Osteopathy emphasizes a “whole person” approach (a person is a unit of “body, mind and spirit”).  We are trained that the person and body is whole and interconnected, and each body system affects the other.  DOs have an additional 200 hours on top of general medical school curriculum that focuses on Osteopathic Manipulative Treatment (OMT).  OMT is a hands-on approach, where we learn in depth musculoskeletal exam and treatment of musculoskeletal dysfunction, which may be related to visceral (other body systems/organs) or somatic (musculoskeletal) causes.  While not every DO uses OMT in their day to day practice, this inherent philosophy of treating the person as a whole is how osteopaths are trained to approach each and every patient.  Many of my MD colleagues approach their patients with a similar view due to their compassionate personality, but this philosophy is not part a focus their medical school curriculum.

One of the best parts of being a DO, like all differences, is being able to bring a different perspective to the table.  I am proud of my training and where it has led me (here at BCOG!)!

Gynecology

Flu Vaccine – coming to Bedford Commons OBGYN October 1, 2020!

| Christina Haag, APRN

“Ouch, that hurt!  Why did you do that?!?” — that’s what my 5 year old daughter yelled at the nurse giving her the flu vaccine last year.

In the midst of the current COVID-19 pandemic, it’s easy to forget the flu season is just around the corner.  Or maybe you haven’t forgotten because you have seen signs advertising the flu vaccine at many national pharmacy chains.  I think I saw my first flu vaccine advertisement at the end of July, more than 2 months before the onset of the flu season!

The Center for Disease Control (CDC) recommends the flu vaccine every year for everyone 6 months of age and older.  It is especially important this year given the overlap of symptoms caused by COVID-19 and the flu.  Getting your flu vaccine is one of the best ways to protect against the flu.  Although the flu vaccine is currently available at many pharmacies, the CDC recommends waiting until late September to get vaccinated because getting the vaccine too early may cause reduced protection against the flu later in the flu season.

As we have been so focused on COVID-19, I think it is important to remember that last year, more than 410,000 Americans were hospitalized due to the flu and more than 24,000 people died from the flu.  Although wearing a mask can help prevent the flu, the best way to protect yourself is to get the vaccine.

At Bedford Commons OB-GYN, we will begin to offer the flu vaccine to our pregnant patients starting October 1, 2020.  We recommend the vaccine for all of our patients but due to a limited supply, we are only able to offer the vaccine in our office to our obstetric patients.  For our non-obstetric patients, we would recommend heading to your primary care or a local pharmacy to get vaccinated.

Click here for more information from the CDC about this year’s flu vaccine.