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Margaret L. Montgomery, MS, CNM is a nurse in Washington, DC specializing in obstetrics & gynecology and midwifery. Margaret L. Montgomery, MS, CNM is affiliated with MedStar Georgetown University Hospital, MedStar Washington Hospital Center and MedStar Health.
Cesarean Section (C-Section)
A Cesarean section (more often known as "C-Section") is a surgery performed during labor and delivery. A C-Section is a procedure that delivers a baby through an incision in the lower abdomen and uterus. In the United States, about a third of all births are performed by Cesarean section. Most often, a C-section is done by an obstetrician/gynecologist (OB-GYN), or in certain regions, a general surgeon or family physician.
C-section incisions can be up-and-down (vertical), from belly button to lower abdomen or side-to-side (horizontal), across the lower abdomen. Side-to-side incisions are more frequently used. After the exterior incisions are made, the doctor then cuts into the uterus and amniotic sac and delivers the infant and cuts the baby's umbilical cord. The mother receives medicine to expel the placenta and the doctor helps to safely remove it. Finally, the doctor uses sutures to seal the uterus and tissue incisions. The initial C-section skin incision is also closed with sutures or staples.
C-sections are typically performed with regional anesthesia, which inhibits pain in the lower half of the body, but allows mothers to be awake. However, some mothers may receive general anesthesia, where they are put to sleep during the surgical procedure.
C-sections may be planned or unplanned, depending on the circumstances of the birth.
Pre-existing conditions like heart disease, high blood pressure, herpes, and HIV may prompt a doctor to prescribe a C-section. Other situations for C-section include:
Other mothers may require a C-section due to complications arising during delivery. These unplanned, emergency C-sections allow for a healthy birth even when complex complications are present. Problems during labor which may necessitate a C-section include:
Mothers should expect about a six-week recovery period following a C-section, including an initial hospital stay of two to three days. While in the hospital, mothers may spend time with their baby and begin breastfeeding. After returning home, mothers should limit strenuous activities such as lifting, reaching, and exercise, and should make sure to get plenty of rest.
Gastrointestinal Problems (Digestive Disorders)
The gastrointestinal system, or GI tract, is the name given to a collection of organs that work together to digest food. These organs fit together in a long tube, running from the mouth to the anus, and include the esophagus, stomach, and intestines, among others. With so many parts working together, complicated by today's busy lifestyles and diets, digestive problems are common. As many as 1 in 3 Americans have a digestive or GI disorder. There are a huge variety of digestive problems, but the most common are IBS, constipation, GERD, hemorrhoids, and ulcers.
IBS, or irritable bowel syndrome, happens when the muscles surrounding the colon contract too easily or frequently. The result is abdominal pain, cramps, diarrhea or constipation, gas and bloating. IBS attacks can often be brought on by specific triggers, so a key part of treatment is learning which foods trigger IBS attacks and avoiding them. Treatment also includes exercise, avoiding stress, and medications if needed.
Constipation, or large, hard, or infrequent stools, happens to everyone at some point. It can be caused by a disruption in routine or food, or by eating a diet without many fresh fruits and vegetables. Although it is uncomfortable, constipation is common and usually not serious, but it can sometimes become chronic. Adding fiber to the diet, exercising, and taking medications may help.
GERD, or gastroesophageal reflux disease, is a severe form of chronic heartburn where stomach acid spills back up into the esophagus. Left untreated, the acid may even eat away at the esophagus and cause serious damage. Treatment includes changing the diet to avoid trigger foods, losing weight if needed, medications, or even surgery.
Hemorrhoids are blood vessels around the rectum that become irritated, swollen or torn while straining during a bowel movement. They are most often caused by constipation, but can also be caused by pregnancy, diarrhea, or simply a genetic predisposition towards hemorrhoids. Treatment involves first treating any constipation issues, then keeping the area clean and soothed until it has healed. If these measures are ineffective, surgery is sometimes used.
Peptic ulcers are sores or spots of inflammation in the lining of the stomach or close to the stomach in the small intestine. Usually this area is coated with a protective lining that shields the tissue from the strong stomach acid, but a break in the lining can let acid in, causing the sores. It used to be thought that stress caused ulcers, but now it is known that is not the case. Most often, they are caused by an infection by H. pylori bacteria, but ulcers can also be caused by alcohol abuse or overuse of aspirin, ibuprofen, naproxen, or other NSAIDS. The symptoms of an ulcer are pain, hunger, nausea, and fatigue.
Gastrointestinal problems, perhaps more than any other area, are markedly affected by lifestyle. Many disorders can be prevented or treated at least in part by eating a healthy diet high in fiber, exercising regularly, drinking enough water, and limiting alcohol intake. Still, the frequency of digestive disorders means that even the healthiest person can be affected by them. Anyone who notices blood in their stool, experiences abdominal pain, unexplained weight loss, or any significant change in bowel movements should see a doctor.
Urinary Tract Infection (UTI)
A urinary tract infection, or UTI, happens when bacteria enter the body through the opening where urine is normally released. The bacteria infect the lining of the urethra and bladder, turning them red and inflamed. This causes pain in the abdomen or pelvic area, a burning sensation during urination, a sense of urgency about going to the bathroom, frequent urination, and urine that smells bad and looks cloudy, or even contains traces of blood. If the urinary tract infection is severe, it may travel all the way to the kidneys, a more serious kind of UTI called pyelonephritis. Patients with this kidney infection might have blood in their urine, feel back pain, and develop a fever.
Urinary tract infections are extremely common: 12% of all men and 40-50% of all women will have a urinary tract infection during their lifetime. They are more common in women because women have shorter urethras, so bacteria have a shorter distance to travel from the outside of the body to the bladder and cause an infection. Some people also have urethras that are an unusual shape or have an obstruction in the urethra that makes getting a UTI more likely. Also, certain chronic illnesses like diabetes weaken the immune system, so any bacteria in the body are more likely to cause an infection.
A urinary tract infection can be diagnosed very quickly by a doctor. A sample of urine can be examined under a microscope for the presence of bacteria or white blood cells. There are also diagnostic strips that can be used to test a urine sample without the need for a microscope. Once a diagnosis is made, treatment is a course of oral antibiotics, and most patients feel better within just a few days. There are some things that patients can do themselves to help reduce the risk of getting a urinary tract infection in the future. Stay well hydrated, wipe from front to back after going to the bathroom, wear breathable cotton undergarments, and don't hold it in when patients feel the urge to go.
She is certified by the Board Certification and has a state license in District of Columbia.
Board Certification: Board Certification
Licensed In: District of Columbia
Margaret L. Montgomery, MS, CNM is associated with these hospitals and organizations:
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Ms. Margaret Montgomery practices midwifery. Her clinical interests include gestational diabetes (diabetes during pregnancy), opioid addiction, and placental disorders. Ms. Montgomery (or staff) speaks the following languages: French and Haitian Creole. She is affiliated with MedStar Washington Hospital Center. She has an open panel in Washington, DC according to Doctor.com.
