Our Office COVID-19 Information
We are updating our guest and Covid-19 policies.
- No guests are allowed except for one guest during your ultrasound visit.
- Children are not allowed in the office.
- We require masks for all patients, both vaccinated and unvaccinated.
Failure to follow these policies could result in rescheduling your appointment. Thank you for your cooperation.
Protecting your health, and the health of our staff and providers is a priority. We ask that if you are experiencing a fever of 100.4 plus or productive cough to call us at 512-425-3825, Option 3 so that we can determine the best way to meet your medical needs.
St. David' Healthcare Visitation Policy Changes & COVID-19 Vaccine Booster
It’s been a year and a half since the first COVID-19 case was confirmed in Texas. As the virus continues to evolve, and COVID-19 continues to bear down on our community, we have remained steadfast in our resolve to combat it. Below are updates on some important and timely issues related to COVID-19 that we wanted to share with you.
Visitation Policy Changes
Due to a recent legislative mandate (Texas House Bill 2211), we are making changes to our visitation policy to comply with the new law. As of September 1, all patients will be allowed one visitor per day during visiting hours.
• Visiting hours are 5am-8pm
• Visitors must be 18 years of age or older
• Visitors must pass the entrance screening
• Visitors must wear a mask at all times
• Any patient seeking emergency care may have one visitor
One visitor may remain overnight for the following services or circumstances:
• Pediatrics under 18 years old
• Laboring mothers
• Patient advocates for elderly, disabled or impaired patients
• Undergoing surgery or a procedure
• End-of-life care
We are committed to providing a safe environment for our patients, physicians, colleagues and visitors. Universal masking remains in effect and additional PPE may be required. All visitors are required to comply with these policies.
Visitation may be denied if an attending physician determines in-person visitation with the patient may lead to the transmission of an infectious agent that poses a serious community health risk.
COVID-19 Vaccination Booster
After careful consideration of the latest medical data, the FDA recently authorized mRNA COVID-19 booster shots for immunocompromised people. A recommendation for the general population is expected soon. This measure is designed to further protect you from COVID-19 as immunity wanes with time and this virus continues to spread.
As a result, we are actively planning for hospital-based third dose vaccination clinics in late September or early October. These vaccinations will only be available to colleagues who have already received both prior doses of either the Moderna or Pfizer vaccine. Please remember to verify your vaccination status prior to September 15 through the HCA Healthcare COVID-19 immunization link.
A third shot is now available and recommended for those who are immunocompromised and, therefore, at greater risk of serious, prolonged illness. Immunocompromised colleagues are encouraged to speak with their physician about whether getting an additional dose is appropriate. This helpful link can identify the closest and most convenient location to receive the vaccine.
For now, booster shots are being advised for the mRNA vaccines only, which does not currently include the Johnson & Johnson shot. It is also recommended to receive the same vaccine administered during the prior two dose series.
For the thousands of St. David’s HealthCare colleagues who have received the COVID-19 vaccine, thank you for choosing to protect yourself and the people around you.
Moment of Silence
The Texas Hospital Association is encouraging hospitals throughout the state to observe “five minutes of silence” at noon on Friday, September 3, to honor those impacted by COVID-19. The observance hopes to shine light on the number of people who have died from COVID-19, on healthcare heroes – like you – who have bravely fought the pandemic, and on the importance of taking action to prevent further illness. We encourage you to participate in this time of reflection, honor and remembrance.
Our physicians are among the most trusted in Central Texas. The community has trusted us to care for them for decades, and now we’re asking them to trust us about the COVID-19 vaccine. We encourage you to watch the below video that features several of our physicians talking about the COVID-19 vaccine, and join us in sharing it with friends and family.
Thank you for your tireless work to beat COVID-19. Together, we can move forward and end the pandemic.
Individualized care at
every stage & every age
New Patients Welcome!
located near Mopac & Parmer
Individualized care at
every stage & every age
New Patients Welcome!
located near Mopac & Parmer
gynecologic consultant to the
UT Women’s Athletic Program
Natural Beginning Birth Center
Induction of Labor
Our Induction of Labor Practices
At OB/GYN North we limit the process of labor induction to true medical indications only. We appreciate that this deviation from spontaneous labor is often not the ‘first choice’ of our clients, but we hope that you will be receptive to our recommendations.
These decisions are made carefully based upon our collective experiences, training, and standards of care researched and developed by a variety of sources including, the American College of Obstetrics and Gynecology (ACOG) & the American College of Certified Nurse Midwives (ACNM).
As a practice, we believe that induction should be reserved for medical indications but we also understand that induction is essential under certain conditions and circumstances to ensure a healthy birth process for mom and baby. We see each labor process as individualized, and rely on well-studied, trusted mechanisms to ensure a safe birth. We encourage open communication and promote sharing of information. Remember, our goals always have safety for both you & your baby in mind.
Most induction methods will require monitoring of your uterine and fetal activity, as well as consideration of your oral intake and activity. We make every effort to support the least amount of interference as your body makes itself ready for your baby’s birth; individual circumstances will dictate some of these considerations.
There are a variety of ways in which induction can be accomplished and it is essential that your plan is customized to your specific circumstances, which we will share with you throughout the process.
If your cervix is firm, long, or closed, cervical ripening may be recommended before initiating labor. These options may vary and can range from natural approaches to more traditional methods (see ‘Natural Ways to Induce Labor’).
Induction sometimes necessitates a cervical ripening phase, which is advisable if your cervix is not ready for active labor as a “ripe” cervix (2-3 cm open, 80+% effaced, soft, anterior) increases the likelihood for a successful induction and vaginal delivery.
An obstetrician or CNM can sweep or strip your membranes (pressing your bag of water off the cervix without breaking it) in the office at your regular OB appointments. If your GBS swab is negative, you are beyond 38 weeks, and your cervix is open enough to permit it. This can stimulate the release of oxytocin from the pituitary gland helping to initiate contractions.
This only work 50% of the time, and generally is effective within 48 hours. It should be noted, that minimal data has been published on membrane stripping, so we advise that you explore this technique and empower yourself so that you are able to ask questions and make decisions that you are comfortable with.
Cervidil or Cytotec
Cervidil is a hormone-infused string (like a thin tampon) that the OB, CNM or labor RN can place in the vagina. The Cervidil remains in the vagina approximately 12 hours and then is removed.
Cytotec is a tablet that is placed in the vagina and can be repeated every four hours until your cervix is ready for more active labor.
These ripening agents have been shown to ready the body for labor and can ‘prime the pump’ to encourage your body to respond to other measures such as Artificial Rupture of Membranes (AROM, or breaking the water) or Pitocin given intravenously. Ripening agents are often used the night before your induction.
We will encourage you to sleep as much as possible during this preparatory phase. Your baby and your uterus will be monitored to ensure that these ripening agents are well-tolerated. On occasion, some women will begin active labor without further intervention.
Intracervical Foley Bulb/ Cervical Ripening Balloon
Foley catheter balloons can be used to mechanically dilate the cervix and have been helpful to ready the cervix for induction. With this method, small rubber tubing is placed through the cervix and a balloon inside the tubing is inflated just inside the inner edge of the cervix. The balloon, given time and sometimes in conjunction with small amounts of Pitocin, gently opens the cervix. The balloon may come out on its own, or be removed with gentle traction.
This process can take anywhere from a few hours to 12 hours, depending upon your body’s response, as well as your initial cervical dilation and effacement. Some women will be candidates for having the balloon placed in the office, and then go home overnight and proceed to the Labor & Delivery Unit at North Austin Medical Center to continue their induction the following morning. Rest is advisable during this time.
Artificial Rupture of Membranes (arom)/
Breaking the Water/ Amniotomy
Breaking the bag of water may be used on its own to initiate labor or in conjunction with other mechanisms of ripening and induction. This is usually dependent upon your cervical exam, the firmness of the baby’s head on the cervix, and whether or not this is your first baby.
While AROM can be used at any time after the cervix has dilated, it is often reserved for when the ripening phase has been completed. After the water bag has been broken, we do fewer cervical exams in an effort to minimize the likelihood of infection.
There are no strict time limits that are associated with AROM and length of labor, but assessment of you and your baby are important to identify and treat an infection, in the unlikely chance that it should occur.
The process of amniotomy is similar to a slightly longer cervical exam wherein a small hook is used to painlessly put a hole in the water bag which has no nerve endings. During the remainder of your labor, amniotic fluid will leak out intermittently.
Some women’s bodies respond quickly to this technique while others require additional measures to encourage their bodies into labor. If active labor (regular contractions that cause cervical change) does not ensue within 6 hours of AROM for induction, then pitocin will be necessary to initiate contractions.
Pitocin, a synthetic bioidentical hormone of oxytocin, has been used effectively for labor induction for many years and there is a vast amount of data that supports its safety in obstetric and midwifery practice. This hormone is infused, in a diluted form, intravenously. It may be the first-line medication used for induction, or may be used after a cervical ripening agent has been introduced or following amniotomy.
Our intention is to mimic the natural pattern of labor; this is done by carefully managing the rate of the infusion. While typically small amounts have proven to be effective, more important is the evaluation of the fetal and uterine response to the Pitocin. We use as little as possible to create the desired effect of regular contractions that bring cervical change.
Many are fearful that a pitocin labor will be much more painful, but this is false; when pitocin is initiated slowly and minimally, it allows the body to cope with the increasing intensity of contractions as in spontaneous labor. We work closely with the Labor & Delivery nursing staff to ensure that this process is both safe and effective.