
Pre-conception counseling
If you have any questions about conception or pregnancy, or if you have any medical problems or take medications, it is valuable to have a pre-conception consult. During this visit, we will review your medical history and medications. We can safely discuss medications and recommend alternatives, if needed. It is ideal to optimize your health prior to becoming pregnant. There are often medications that are safe in pregnancy that we start on prior to conception. We can also review concerns within the family. For example, carrier screening can be done prior and can be most helpful during this stage. Carrier testing is done with a simple blood draw and gives us information about potential health issues you could pass down to your child. If you are positive, then your partner can be tested. If your partner is negative, in most cases, this will not affect your child. If your partner is positive, there is a chance you could have an affected child. If both are positive, genetic counseling can be very helpful. There are technologies offered by infertility specialists that can test embryos prior to implantation. A common misconception is that since there may not be health problems in the family, you would not be a carrier. This is not the case. Knowing your carrier status prior to conception contributes to a healthy pregnancy and child.
High risk pregnancy
There are many reasons a pregnancy can be considered high risk, both maternal and fetal. Maternal indications are frequently related to age or health complications. There is increased risk after the age of 35 in general, however, we take care of numerous women into their 40s that have no complications. For women over 35, the most common fetal risk is chromosomal abnormalities. This can be tested after 10 weeks. Both pre-existing and health problems that develop during pregnancy can affect both maternal and fetal health. Most commonly this includes gestational diabetes and high blood pressure. Both these conditions are manageable with successful outcomes.
We manage most high-risk pregnancies at Progressive Women’s Care. We always have maternal-fetal medicine specialists available, if needed. They are both in an outpatient and inpatient capacity. If indicated, you may have a consult with them, but we would still manage your care. Currently, we do not have MFMs that deliver at our hospitals, but are always available for assistance.
Related Services
Vaginal Birth After Cesarean Section (VBAC)
VBAC deliveries carry risk, but can be successful in the correct patient population.
Disability In Pregnancy
Vaginal & Sexual Rejuvenation
Many women suffer from symptoms that have become accepted as a normal part of life without options for improvement.
Meet The Team
Dr. Bertles is licensed by the Texas State Board of Medical Examiners and is board-certified by the American Board of Obstetrics and Gynecology. Amanda Smith, PA-C, spent the first 15 years of her career in primary care and is excited to join Progressive Women's Care and Dr. Bertles as she brings her primary care knowledge to women's health.


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