obgyn

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8 Exercises That Can Help Induce Labor, According to a Fitness Specialist and OB/GYN

At 2 years old, my nephew is nothing but adorable. But when he was ten days past his original mid-June due date, my sister had some other choice words to describe him. She loved being pregnant, but towards the end of her third trimester, she couldn’t wait to get things moving (and meet her firstborn son). Like many moms, her due date came and went without a contraction in sight. And though that extra time is totally normal, it can feel like your baby will never come. Luckily, there are safe and effective ways to help naturally induce labor—exercise being one of them.

Now, before we dive in, there’s something you should know. “There aren’t any exercises that have been shown to cause women to go into labor if your body wasn’t already starting the process,” explains Dr. Heather Irobunda, MD and board-certified OB/GYN based in New York City. It can, however, help prepare your body for what’s to come. “Usually, exercises help your body transition from the early labor process into more of an active labor process.” Basically, that means it can help encourage labor by properly adjusting the baby’s positioning as well as improving the mother’s alignment by “causing more weight to be placed on the cervix, which increases the cues to the body and, more specifically, the uterus.” Light cardio, like walking, is one way to help progress this process along. If you feel comfortable, she also suggests engaging in some low-impact movements like squats and lunges. You can also sit and roll around on an exercise ball to help open up your hips and “allow for the baby to sit lower in the pelvis, helping the body know that it’s time for labor.”

We know what you’re thinking…but is it safe? The answer is yes. In fact, it’s safe to do exercise in general while pregnant, “as long as [the movements] are not more strenuous than your level of fitness prior to the start of your pregnancy,” Dr. Irobunda says. Your second trimester is no time to start training for your first marathon, and the final trimester is no time to try a new Zumba class. Stick to the low-impact movements your body is used to and always make sure you’re in an environment where you can safely engage in these exercises. Having a workout buddy is a good idea, too. “Make sure you have someone nearby if you need help moving around,” she cautions. “If it’s not possible to have someone present while you’re exercising, make sure your phone is handy in case you need help.” And before you even purchase that big bouncy exercise ball, always discuss any labor and delivery plans with your doctor. Exercise might not be recommended for women with certain medical conditions or high-risk pregnancies.

If your doctor gives you the go-ahead, here are eight OB/GYN approved exercises to try now, all provided by Brooke Cates, a pre and post-natal exercise specialist as well as the founder of The

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health

Chesapeake OB-GYN admits backdating patient consent forms but denies unnecessary surgeries

Dr. Javaid Perwaiz knew that government-funded Medicaid insurance required that patients consent to sterilization surgeries at least 30 day before they were performed.

And yet he admitted during testimony Thursday in his criminal trial in U.S. District Court in Norfolk that he frequently backdated the forms to make it appear he’d complied with the rule, which prosecutors said was created decades ago to prevent low-income women from being pressured into getting sterilized.

“It was to help the patients,” Perwaiz said of his backdating practice.

Each had already expressed a desire to get sterilized more than 30 days before the procedure was done, he said, and he didn’t want to make them wait any longer. Even the ones who’d first come to him just a few days before getting procedures done had told another doctor they wanted it, he said.

Also, some were close to having their Medicaid insurance run out and he wanted to ensure they got the surgery while still covered. Perwaiz said he always informed them the procedure was permanent, but also told them it could be reversed later.

The 70-year-old doctor’s testimony came during the 11th day of his trial on 61 counts of fraud.

The trial began Oct. 14 and is expected to last several more days. Prosecutors have alleged Perwaiz performed numerous unnecessary surgeries and procedures on his patients for years in order to fund a lavish lifestyle.

The doctor first took the witness stand in his own defense Wednesday, testified all of Thursday, and is set to return Monday when the trial resumes.

During testimony Thursday, Perwaiz also conceded he never used scopes with cameras that could project what he was seeing inside the patient onto a monitor in the operating room — a common practice used by all the other OB-GYNs doing surgery at Chesapeake Regional Medical Center.

Perwaiz said the equipment wasn’t available when he was training in the 1970s, nor was it something he was comfortable using, or was required to use.

But the longtime physician strongly denied ever doing surgeries that weren’t medically necessary, or inducing pregnant patients to deliver their babies earlier than was medically safe. Prosecutors have alleged he regularly induced pregnant women early in order to make sure he was the one to deliver the baby and get paid for it.

Assistant U.S. District Attorney Elizabeth Yusi asked Perwaiz to explain why most of his pregnant patients in 2019 had their labors induced early, and almost always on Saturdays when he was at the hospital performing surgeries.

Perwaiz said that there were risks with letting a patient go beyond 39 weeks of pregnancy and he was trying to prevent that.

While prosecutors contend that the inductions were routinely scheduled at 38 weeks of pregnancy — which the American College of Obstetricians and Gynecologists says is unsafe for the mother and baby — the doctor said he always did them in the 39th week.

He also said he was proud that his rate of cesarean section

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health

Javaid Perwaiz, ob/gyn accused of unnecessary procedures, testifies

“Yes, I knew the 30-day requirement. I just couldn’t say no,” he said from the witness stand Thursday. “I’m an advocate for my patients.”

He said he performed the sterilizations in contradiction to the requirement to benefit his patients. Often, they had discussed sterilization with doctors who referred them. They told him, he testified, that their insurance would run out if he waited or that they could not get a ride or a babysitter on other dates. Asked during cross examination if he could name which of the patients in the indictments told him that their insurance was running out, Perwaiz could not.

Backdating forms is part of three broad categories of charges against Perwaiz. Prosecutors say he altered medical records to justify unnecessary surgery, often scaring women by mentioning the threat of cancer. They allege he changed due dates so he could induce women into labor on the Saturdays he was operating on other patients at Chesapeake Regional Medical Center. And they contend he billed insurers for office medical procedures done with broken equipment.

He is also charged with falsifying his application to health-care providers by omitting a felony conviction for tax fraud in 1996, which resulted in a brief suspension of his license, and failing to admit his loss of privileges at Maryview Hospital in 1983. Perwaiz, 70, has been jailed since his November arrest.

In a full day of testimony, Perwaiz, led by defense lawyer Emily Munn, defended the care he gave to the two dozen patients named in the 61 counts against him. In case after case, she broadcast his medical charts and the form he filed with Chesapeake Regional Medical Center before surgery. The charts were identified by the initials of the women prosecutors charge he operated on unnecessarily — D.B., D.P., A.G., T.D.C., A.F., A.N. S.N., D.B.D — and by their age and the complaints they wrote down, which several women who testified previously said were false.

In case after case, Perwaiz explained that the complaints by the women — often pelvic pain, bleeding and cramping — justified his procedures. Often, he said, women asked him to be sterilized. In none of the cases of women named in the indictments, Perwaiz said, did he refer them to other doctors after finding evidence of cancer.

During cross examination by Elizabeth Yusi, an assistant U.S. attorney, Perwaiz said due dates for patients were changed not for his convenience so he would be paid for the deliveries, but because he relied on a “range” of possible dates from several ultrasound examinations. The American College of Obstetricians and Gynecologists and Chesapeake hospital guidelines advise against inducing labor before 39 weeks without a medical reason, saying it leads to health problems for the baby. Chesapeake Regional Medical Center prohibited inducing labor before 39 weeks without a medical reason.

Perwaiz said his own research indicated no reason for that policy. “There is no difference in immediate morbidity and mortality” he told Yusi. “I find it not understandable that we enforce

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