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
The Collaborative Model of Care
We combine the non-interventionist approach of midwifery with the safety net of western medicine. Our goal is to allow the onset of natural labor and have patience with labor’s progress given the wide variation in each woman’s labor course.
Our patients have the opportunity to meet all of our providers as they journey through their prenatal care. Patients choose a LEAD PROVIDER who they see for every other appointment, while the intervening appointments cycle through the other providers. This guarantees that each patient will get to know the provider that assists them with their labor as we share labor & delivery call.
As we all hold the same philosophy about non-interventionist care, our patients have the safety of knowing that the care provided will be consistent and respectful of their birth intentions. Exceptions can be made for those patients who feel strongly about seeing only one provider for all appointments.
Provider on Call
Our call schedule rotates every 24hrs with a primary provider covering the hospital for deliveries.
Monday – Rebecca Teng, MD
Tuesday – Allie Evans, MD
Wednesday – Mahta Rouhani, MD
Thursday – Maansi Piparia, MD
Friday – Aditi Arroway, MD
Saturday – Rotating MD
Sunday – Danielle Duquette, CNM
Natural Labor & Childbirth
Labor is truly a marathon that requires physical and mental preparation to endure the long journey to an exhilarating birth. We advocate for women to stay mobile in labor – walking, showering, squatting – to aid in the progress and tolerance of labor. We use intermittent fetal monitoring (low-risk patients) and heplocks (IV base only) to facilitate this movement. We encourage comprehensive childbirth education such as the Bradley method, hypnobirthing/babies, and conscious birthing, to ensure a strong preparation.
Pain Relief in Labor
Although strong advocates for natural birth, we are not the “anti-epidural” practice. We empower women to make their own choices about pain-relief in labor – understanding both the risks and benefits. We allow each woman to make that decision for herself whenever she reaches a threshold where she needs help. Austin Anesthesia Group provides 24/7 coverage for the North Austin Medical Center labor floor. Epidurals can be placed at any time in active labor – even at 10cm/full dilation. Other pain relief options include water-therapy (shower), aroma-therapy, acupuncture (needles must be placed prior to hospital admission), TENS (transcutaneous electric nerve stimulation), and intravenous narcotics (fentanyl or stadol).
Inductions of Labor
We minimize inductions of labor to only true medical indications that threaten maternal/fetal health in order to limit the risks of inductions, particularly cesarean section. When inductions are necessary, we often employ non-medication methods, such as mechanical balloon cervical dilation and artificial rupture of membranes. Cervical ripening agents (cervidil) and pitocin have their place, but are used judiciously to closely mimic the natural onset of labor. Our pitocin protocol is half the strength of the traditional induction protocol – beginning with only 1 milliunit and increasing by 1 milliunit every 15-30 minutes.
Vaginal Births After Cesarean Sections
We encourage VBACs for women with one prior cesarean section, which although not done by many practices in Austin, is clearly sanctioned by the American College of Obstetrics and Gynecology in hospitals with 24-hour anesthesia coverage. We also allow women to VBAC who have had two prior cesarean sections, but we review these cases individually to ensure that they are safe candidates for this. VBACs require a special commitment from both patient and provider due to the slight risk for uterine rupture, approximately 1%, of which the majority are NOT catastrophic. Each woman approaching VBAC must change the circumstances from her first birth to increase the likelihood for success, such as allowing spontaneous labor, delaying epidural use, limiting weight gain, and increasing exercise. Because of the increased risk with VBACs, we do require continuous monitoring which allows for early detection of any fetal compromise. Thankfully, with the advent of mobile telemonitors, this can be accomplished while still allowing complete mobility.
Our cesarean section rate of less than 20% is well below the Austin hospital average of 40-50%, and is artificially elevated by the large number of women attempting VBACs in our practice. Because of the number of women that we care for each month, we do about ten cesarean sections per month and are skilled at the surgical art of surgical delivery. Although a vaginal birth may be preferable, cesarean section is the safety net for the approximately 15% of women that the World Health Organization estimates require surgical birth for the safe passage of the newborn and mother through childbirth.
We care for many sets of twins each month, often in conjunction with a Maternal-Fetal Medicine specialist (David Berry MD and Austin Maternal Fetal Medicine). We advocate for vaginal birth assuming both babies are vertex (head-down), or the first baby is vertex and the second (regardless of position) is the same size or smaller than the first. All physicians in our practice are skilled at breech delivery of second-twins which when done appropriately is very safe and sanctioned by the American College of Obstetrics and Gynecology.
Many of our patients are high-risk with a history of high-blood pressure, diabetes, leg/brain clots, aneurysms, recurrent miscarriage, in-vitro fertilization, etc. These patients receive care from both physicians and midwives in the practice, often in conjunction with a Maternal-Fetal Medicine specialist (Austin Maternal Fetal Medicine and David Berry, MD). We are able to fully monitor the progress of the pregnancy and fetal well-being through regular ultrasound and fetal heart rate monitoring to ensure both maternal and fetal safety. When in labor, these patients often receive team care from both the midwife and physician on call, working together to provide the highest quality of care possible.
We are all supportive of a woman’s right to choose not only the nature of her birth experience, but the location as well. For low-risk patients, home-birth may be an appealing option. Transfers of care are accepted when patients develop high-risk conditions (such as pre-eclampsia, medication-requiring diabetes of pregnancy, etc.) that are outside of the scope of practice for homebirthing midwives. Thankfully, transports in labor are relatively rare and are accepted on a case-by-case basis when certain criteria for safety are clearly met. We do NOT accept transport patients that transferred out from our practice to a home-birthing midwife due to the legal implications of dismissal of our practice as the active care provider.
We are not accepting transfer patients at this time. This is only temporary and will resume in a couple of weeks. We need to evaluate our current patient volume and ensure we can see our current patients in a timely manner before accepting new patients. If you are still interested after the end of December 2021, and will be less than 20 gestational weeks, please give us a call.