Dr. Laura H. Downing

Dr. Laura H. Downing From a first visit to the ob/gyn, to pregnancy, to menopause, and everything in between, women’s health is unique, and caring for women is my privilege.

Dr. Downing graduated from Texas A&M University, earned her MD at Baylor College of Medicine, and completed residency specializing in obstetrics and gynecology at UT Houston Health Science Center.

“The breadth of issues an obstetrician/gynecologist cares for, as well as the depth of trust between a patient and her ob/gyn make my specialty unique."

Let’s be real- I’m bursting with Thanksgiving for this little nugget everyday. When she walks to me as fast as she can, ...
11/27/2019

Let’s be real- I’m bursting with Thanksgiving for this little nugget everyday. When she walks to me as fast as she can, curls bouncing, little lips going “oooo”, plowing into me, picking up those little legs and wrapping around me so I have to pick her up. I absolutely melt.
Happy Thanksgiving to you, friends!
Savor the season you’re in.
Savor the time with loved ones.
Savor the hug and laughter.
Savor the warm food over a shared table

Excited to be featured on  today as part of their   campaign! Follow for evidence based healthcare for women straight fr...
11/26/2019

Excited to be featured on today as part of their campaign! Follow for evidence based healthcare for women straight from doctors! ❤️👌🏼

Ready for a couple baby birthdays today! I have two inductions today- it’s always busy around the holidays! ❤️PSA from y...
11/21/2019

Ready for a couple baby birthdays today! I have two inductions today- it’s always busy around the holidays! ❤️
PSA from your friendly OB:
Y’all. Don’t comment on a pregnant woman’s belly. Just don’t. She’s either going to stress about too much weight gain or stress about the baby not growing well. Everyone carries different! Just tell her she’s beautiful and her body is amazing.
I have this conversation daily with my sweet patients! And like any parent would tell their child to respond to a comment, I tell them to say “My DOCTOR says I’m PERFECT!”

Feeling good after a truly patient centered LEEP today! From preoperative counseling to anesthesia in the OR to postop r...
11/19/2019

Feeling good after a truly patient centered LEEP today!

From preoperative counseling to anesthesia in the OR to postop recovery plan. I love it when a smart woman asks questions in order to understand her plan of care!

While these questions may at times arise from fear:
“Is this really necessary?”
“What are the risks of my diagnosis?”
“What are the risks of my treatment?”

When you ask all your questions. When your provider answers them. When you trust her and the plan. When you receive the EVIDENCE BASED treatment you need. That is POWER.

You are not a bystander in your HEALTH care. The only thing more satisfying to me than treating patients, is them UNDERSTANDING every step of the way.

Delivered one baby at the hospital this morning and met three new ones in the office! Lots of congratulating today.     ...
11/12/2019

Delivered one baby at the hospital this morning and met three new ones in the office! Lots of congratulating today.

How much should my baby move?Last of the four biggest questions your OB will always ask, and what to call us for: fetal ...
11/09/2019

How much should my baby move?

Last of the four biggest questions your OB will always ask, and what to call us for: fetal movement!

In general fetal movement can be variable in its frequency- every baby is different. Their position, size, and placental location can all contribute to how much movement you may feel! One study tracked fetal movement vs mom’s PERCEPTION of movement and found that some moms only felt about 30% of their baby’s movement!

So when mamas call I’m worried about decreased movement, thankfully it’s usually normal in there. BUT at the heart of this question is every family’s worst fear, so we take it VERY seriously.

A good first step when you’re over at least about 28 weeks is to do a “fetal kick count”. This is when you drink a big glass of something cold or sweet, lay down, and just pay attention to baby’s movement. You should feel 10 movements in an hour. I don’t tell patients to do this daily, it’s a tool in your pocket if you’re worried and want to stimulate some movement.

If you’re unsure whether the baby is moving enough at any point, you can ALWAYS call for this. If we can’t be reassured with a kick count, evaluation in office or L&D is the next step!

An ultrasound can be done to assess fetal movement, muscle tone, and the amount of amniotic fluid. We also monitor baby’s heart rate, as pictured in my last post. Together these are called a Biophysical Profile- a normal score reassures us that baby is well right now.

Other baby movement tips:
👶🏻 Movement is usually most noticeable after meals and in the evening or at bedtime (thanks, baby)
👶🏻 There’s no such thing as too much movement!
👶🏻 It’s pretty common to feel less while you’re active. Most likely you’re focused on other things like while at work.
👶🏻 Biophysical profiles aren’t PREDICTIVE of fetal well being. Continued decreased movement may need to be evaluated more than once, and may even be an indication for delivery at term.

How active have your babies been??

Will I know if I’m having contractions?I like to explain contractions like a volume k**b, not a light switch. Labor is d...
11/08/2019

Will I know if I’m having contractions?

I like to explain contractions like a volume k**b, not a light switch. Labor is definitely not like on TV when a woman exclaims suddenly, “I’m gonna have the baby! It’s time” and everyone panics.

Typically at some point in the third trimester a woman may start to have occasional, isolated, mild and painless contractions. These are commonly referred to as Braxton Hicks contractions. These are quite normal, and very common.

Labor in contrast is defined as regular (close and rhythmic) uterine contractions AND changing cervical dilation. These are typically painful- okay, active labor is virtually always painful. But like a said it’s a scale of grey between the two, not black and white.

Regular or painful contractions in a PRETERM pregnancy are NOT normal. Contractions earlier in pregnancy may also mimic low back pain, sharp pelvic pain, menstrual like cramps, va**nal pain, or re**al pain. When in doubt, CALL US. Preterm labor can be halted, but earlier intervention is best.

Once at term, you can wait till contractions are very close and strong- unless you also have decreased fetal movement (See next post!), va**nal bleeding, leakage of fluid, GBS, a prior C-section, or other complication.

If you just don’t know what’s going, let’s err on the side of evaluation! One routine way to do this is external fetal monitoring. With two monitors on your tummy, we can trace fetal heart rate and any contractions, over time. See the humps in the lower half of the paper I’m holding? Those are contractions! And guess what- that patient couldn’t feel them!

Long story short, if you can’t tell they’re there, they’re not doing anything! If they are there and you’re unsure what you should do, call your OB!

Ok ladies- did you feel contractions?? Braxton Hicks?? Labor??

Will I know if my water broke?It’s not like the movies!The next question you’ll get asked at every   visit is “Are you h...
11/05/2019

Will I know if my water broke?
It’s not like the movies!

The next question you’ll get asked at every visit is “Are you having any leakage of fluid?”

Determining whether the amniotic sac or “bag”, “water”, “waters” has spontaneously ruptured or “broken” is surprisingly not straightforward for every woman. A normal increase in va**nal discharge, abnormal discharge like yeast, and urine can all masquerade like the water breaking!

Regardless of gestational age or whether you have any contractions, you should notify your OB of persistent gush or trickle. She be checked out by your doctor in the office or on labor and delivery. A sterile speculum exam can be used to evaluate any fluid present in the va**na, and an ultrasound can be used to measure how much fluid is still present. Pictured is nitrazine paper which turns blue when amniotic fluid is applied- amniotic fluid has a basic PH. There is another commercial product available that can detect proteins that are present specifically in amniotic fluid as well with a pretty high sensitivity! Doctors need all these tools to help us determine whether your water has broken, so you can see how it’s not always obvious!

This also means you can reassure your boss that it most likely won’t be a tidal wave at work 😘

Was it obvious when your water broke?? 🙊🤗

The four big reasons to call your doctor when you’re pregnant!This is something we go over in the office on a daily basi...
11/05/2019

The four big reasons to call your doctor when you’re pregnant!

This is something we go over in the office on a daily basis, and such a normal question for parents to be to ask. I’ll go over the four cardinal questions every OB asks this week!

Starting today with va**nal bleeding. Honestly, this is usually an easy one- we don’t typically have to convince patients to call when they’re bleeding! Seeing any amount of blood when you’re pregnant is scary! Around 24 weeks with Ella I had some bleeding. It makes your breath catch in your throat. Thankfully all was well, and while no one likes a pelvic exam- that was one I was glad to have!

Believe it or not some bleeding in pregnancy may be normal. In the first trimester the process of implantation can cause bleeding, but it could also signal ectopic pregnancy, impending miscarriage, or problems with your uterus/cervix like subchorionic hematoma, polyps, or infection.

In the second trimester bleeding can signal preterm labor, cervical insufficiency (painless dilation), or placental problems.

Any new bleeding in pregnancy warrants a call to your doctor. You may be instructed to observe, or may be asked to come in. Frequently we find the cervix is friable due to hormonal changes, and can reassure a patient that all is well. If bleeding is heavier or associated with pain, evaluation in the ER or labor and delivery may be the best option.

It’s so important to rule anything serious out. And it’s so nice when we can all take a deep breath and relax once we know everything is ok.

Address

2911 Medical Arts Street, Bldg 2
Austin, TX
78705

Opening Hours

Monday 8am - 4pm
Tuesday 8am - 4pm
Wednesday 8am - 4pm
Thursday 8am - 4pm

Telephone

+15123910175

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