Obstetrics is the branch of medicine related to the care of women during pregnancy, childbirth and the recovery period after delivery. Our practice is small so we can provide you with safe, personalized care that meets your individual needs. Becoming a mother is a profound experience filled with joy and excitement. But it can also be a time of uncertainty. We expect you to have plenty of questions. Is it okay to exercise? Can I still eat my favorite dessert? What about a cappuccino? Was that the baby kicking? Is that normal? We’re here to answer all of your questions and to support you every step of the way. We love it when you educate yourself and take an active role in your maternity care. As your partner, we’ll help you start this exciting new phase of your life—and your baby’s new life—empowered with the information and care you need.
Together, we’ll review all of your options so you can make choices based on your body, your personal philosophy, your family situation, and your unique vision for your birth. Whether you prefer an all-natural birth, medical assistance throughout, deluxe pampering, or expertise for a complicated pregnancy, our doctors will respect your wishes. The birth of your child will be one of the most memorable experiences of your life and you deserve a safe, deeply fulfilling experience.
While a majority of women are blessed with uncomplicated pregnancies, some women face difficulty because of existing medical conditions, multiple births, advanced age, or a variety of other reasons. At Centura Health Physician Group–Women’s Health at Littleton, we specialize in high-risk pregnancies for your added peace of mind. Dr. McCollough completed her residency training at the University of Texas–Southwestern program at Parkland Hospital in Dallas, Texas, a high-volume program delivering more than 15,000 babies annually. As the largest OB/GYN residency program in the nation, it trains physicians to confidently handle a wide variety of medical conditions and emergencies, with a strong emphasis in high risk obstetrics.
Dr. McCullough and Dr. Khan are affiliated with the BirthPlace at Littleton Adventist Hospital, an acclaimed mom-friendly center with patient satisfaction scores ranking consistently above 95%. The BirthPlace features the only designated Level III B NICU (neonatal intensive care unit) in the south metro area and the highest-level NICU within Centura Health. Littleton Adventist Hospital's NICU team provides individualized care for each newborn and includes experienced neonatal nurses, perinatologists (doctors specializing in fetal-maternal care), neonatologists (doctors specializing in the care of sick newborns), pediatricians, 24-hour in-house neonatal nurse practitioners, developmental specialists, and respiratory therapists. Consultation with other neonatal specialists is also available 24-hours a day.
The fully secured Labor and Delivery center at The BirthPlace offers you private, individualized birthing suites where your labor, delivery and recovery all take place. To tailor the birthing experience to your needs, you’ll find a wide range of amenities, including hydrotherapy tubs, aromatherapy, sleeping accommodations for your spouse or birth partner, and dedicated surgical suites for cesarean births. You’ll also have access to 24-hour obstetrical anesthesia with alternative anesthesia/analgesia options. In addition, the BirthPlace provides extensive support, including breastfeeding support, birth classes and education, the popular Birth-Day Wishes program to customize your birthing experience, the Baby & You Parenting program, and more.
Centura Health Physician Group–Women’s Health at Littleton offers:
- Complete obstetric care
- Expertise in high risk pregnancy management
- Maternal fetal medicine
- Management of post-partum depression
- Preventive care
- Whole person care and alternative medicine
- Affiliation with The BirthPlace at Littleton Adventist Hospital
- Nutrition guidance for pregnancy
- Childbirth and parent education classes, including breastfeeding services through Littleton Adventist Hospital
- Prenatal diagnosis and screening
Gynecology is the branch of medicine that focuses on diseases of the female genital tract, including the uterus (womb), fallopian tubes, ovaries, cervix (opening of the womb), vagina, and vulva (external genital organs). Our physicians care for adolescent girls, women in their reproductive years, and post-menopausal women. They treat a wide range of conditions, including menstrual problems, sexual problems, menopause, and infertility. They also offer help with family planning and contraception with a focus on preventive approaches for avoiding sexually transmitted diseases and unwanted pregnancies. Our physicians have a special interest in minimally invasive surgery to diagnose and/or treat gynecologic conditions, such as endometriosis, ovarian cysts, pelvic floor disorders, fibroids, polyps, ovarian cancer, and more.
Gynecologic procedures offered by our physicians include:
- Endometrial ablation
- Endometrial biopsy
- Pelvic laparoscopy
- Procedures to treat precancerous changes of the cervix (LEEP, cone biopsy)
- Procedures to treat urinary incontinence
- Tubal ligation and reversal of tubal sterilization
- Uterine artery embolization
- Treatment for interstitial cystitis
- Procedures to treat pelvic floor disorders
Preventive care for women includes the following services:
- Regular gynecological checkups, including a pelvic exam and breast exam
- Pap smear
- Bone density testing
- Breast cancer screening
- Discussions about colon cancer screening
- Age-appropriate immunizations
- Healthy lifestyle risk assessment
- Hormonal testing for menopause
- Alternative care for optimal wellness
Adolescents often have many questions about puberty and how it affects their bodies and their health. Puberty is the process of becoming sexually mature, usually between the ages of 10 and 14 for girls. The American College of Obstetricians and Gynecologists (ACOG) recommends that girls first visit a gynecologist between the ages of 13 and 15.
While most girls won't require a pelvic exam at that first visit, many gynecologists will conduct a regular health exam and discuss development and general health. Because adolescents are at risk for unintended pregnancy and sexually transmitted diseases (STDs), including HIV, forging a strong bond with a gynecologist can help her make informed decisions.
A girl's first appointment with a gynecologist can bring up feelings of embarrassment, fear, and confusion. She may wonder why she needs to see a doctor if she's not sick. Explaining the three following primary purposes for a visit may reduce her fears:
- Information: The doctor will share accurate information and offer confidential answers to questions about sex, sexuality, body changes, and menstruation.
- Prevention: The doctor will explain in simple language how to prevent pregnancy, sexually transmitted diseases, and other health conditions related to lifestyle choices.
- Treatment: The doctor will diagnose and treat any existing disorders, such as menstrual difficulties (not having a period, or having irregular, painful or heavy periods), pelvic pain, ovarian cysts, or other gynecologic conditions.
At Centura Health Physician Group-Women's Health at Littleton, we specialize in adolescent health and create a warm, supportive atmosphere where girls can feel comfortable asking questions about their bodies and their health.
Our physicians can also explain how healthy habits, including eating a healthy diet and being physically active, can help them feel and look their best, and even prevent diseases such as diabetes, high blood pressure, heart disease, osteoporosis, stroke, and some cancers when they are older.
Here are some possible conditions/topics the gynecologist is trained to treat/discuss with an adolescent patient:
- Questions about puberty
- Pregnancy and contraception
- Delayed/early onset of menses
- Ovarian cysts
- Pelvic masses
- Pelvic pain
- Polycystic ovary syndrome
- Hormonal problems
- Breast discharge
- Breast masses
- Sexually transmitted diseases
- HPV vaccine
The HPV Vaccine
The Center for Disease Control (CDC) recommends all 11 or 12 year old girls get three doses (shots) of either the Cervarix or Gardasil vaccine to protect against cervical cancer. Ideally, the vaccine should be given before the girl becomes sexually active. Gardasil also protects against most genital warts, as well as some cancers of the vulva, vagina and anus. Girls and young women ages 13 through 26 should get the HPV vaccine if they have not received any or all doses when they were younger. Our doctors would be happy to discuss the risks and benefits of the HPV vaccine with you.
As you seek help for infertility, we want you to know you are not alone. According to the Center for Disease Control (CDC), approximately 11 percent of women ages 15 to 44 experience trouble becoming pregnant or bringing a baby to term. We also want you to know we’re here for you with the expertise, information, and support you need.
Infertility is the inability to get pregnant and may be due to problems in the woman, man, or both. A wide range of health issues can affect a woman's ability to get pregnant, including hormonal (endocrine) disorders, injuries from infections, older age, birth defects, and lifestyle factors, such as eating disorders, excessive alcohol consumption, and smoking. (See list below.)
Infertility is grouped into two categories: couples are considered to have a primary infertility when they cannot get pregnant after at least one year of unprotected intercourse. Couples are considered to have secondary infertility if they have already been pregnant at least once, but cannot get pregnant now.
Healthy couples under age 30 who have unprotected sex regularly have about a 25 to 30% chance of getting pregnant each month. Peak fertility occurs in a woman in her early 20s. The age in which fertility declines varies from woman to woman.
A number of tests and procedures are available to diagnose the underlying causes of infertility, including blood tests to check hormone levels, body temperature monitoring to see if ovaries are releasing eggs, a pelvic ultrasound or a laparoscopic procedure to view your abdomen.
The primary symptom of infertility is the inability of a woman to get pregnant or the inability of a man to get a woman pregnant after trying for at least one year. If an underlying disease is the cause, symptoms of that condition may also be present.
Female infertility may result from:
- Growths (such as fibroids or polyps) in the uterus and cervix
- Eating disorders or poor nutrition
- Drinking too much alcohol
- Cancer or tumor
- Endocrine disorders, such as too little or too much of certain hormones
- Ovarian cysts and polycystic ovary syndrome (PCOS)
- Clotting disorders
- Birth defects that affect the reproductive tract
- Excessive exercising
- Smaller number of eggs left or unhealthy eggs
- Ovaries have difficulty releasing eggs
- Excessive physical or emotional stress
- Use of certain medications, including chemotherapy drugs
- Older age
- Scarring from sexually transmitted infection, previous abdominal surgery,or endometriosis
- And more
Treatment depends on the reason for your infertility and may range from education and counseling to surgery to medications. Infertility services may include:
- Testing to discover the underlying cause of your infertility
- Blood/imaging tests to monitor ovulation
- Fertility treatments, including:
- Medications to stimulate ovulation
- Intrauterine insemination
- In vitro fertilization (IVF)–joining sperm and egg in a laboratory dish
- Intracytoplasmic sperm injection (ICSI)–inject a single sperm into an egg
- Egg donation
- Sperm banking
- Embryo cryopreservation–freezing embryos for later use
- Counseling for couples who are dealing with infertility or loss of a baby
Our physicians embrace whole person care and alternative medicine, also called complementary and alternative medicines (CAMs). CAMs are a group of treatments that are not part of conventional western medical practice, but may be used by patients to achieve overall wellbeing. Patients may use CAMs to address a condition itself, to control treatment symptoms, or to improve their quality of life.
For example, meditation may help reduce the stress associated with a difficult pregnancy, massage may decrease the soreness that can come from prolonged bed rest, specific yoga postures may help increase flexibility and reduce back pain, and acupuncture may reduce nausea and lessen pain. Our physicians will discuss these therapies as they apply to your overall sense of overall wellbeing as well as to pregnancy and certain gynecologic conditions.
It's important to keep in mind that these treatments may not have undergone the same rigorous scientific testing as more conventional treatments, although the field of CAM research is constantly changing, and some therapies are becoming widely accepted.
Complementary treatments are those treatments used in conjunction with (or along side) more conventional therapies recommended by health care professionals. On the other hand, alternative therapies are often used in lieu of treatments recommended by a health care professional. Before using CAMs to take the place of western medicine, it's safest to discuss the details with your doctor.
As CAMs become more popular among the American population, many modern health care facilities are beginning to offer patients what is called integrated therapy. With integrated therapy, a patient's health care provider treats the patient with a combination of conventional and less-conventional therapies that form one holistic treatment plan. For example, Dr. Khan brings a broad range of unique skills to her practice as a certified yoga instructor with additional training in acupuncture.
Acupuncture has been practiced in Asia for thousands of years and is among the oldest healing practices in the world. The acupuncture technique that has been most studied involves inserting tiny needles through the skin to influence specific body functions.
Research indicates that acupuncture reduces nausea and vomiting after surgery and chemotherapy and can relieve pain. It's not fully understood how acupuncture works, but many believe it increases endorphins, your body's natural pain-killing chemicals. It may also change how your body releases chemicals that regulate blood pressure and flow.
Yoga is an ancient mind-body tradition with roots in India. There are various styles of yoga that generally combine physical poses, breathing exercises, meditation and relaxation. Yoga is often used to boost overall health and to help with conditions such as arthritis, high blood pressure, heart disease, asthma and epilepsy. Studies show yoga may also help to improve mood, alleviate insomnia and anxiety, lower heart rate and blood pressure, improve overall fitness and increase lung capacity.
Vitamins, herbs and other dietary supplements
A dietary supplement is a product that is intended to supplement the diet and may contain vitamins, minerals, herbs or other botanicals. Many people use dietary supplements to maintain overall health. If you are pregnant or thinking of getting pregnant it's extremely important to discuss supplements with your doctor. Some are needed for the health of the baby and others may harm the baby.
If your diet isn't well rounded, supplements can help you ensure that you're getting adequate amounts of certain vitamins and minerals. And scientific evidence shows that some supplements can help patients manage certain health conditions. For example, folic acid decreases the risk of birth defects, while calcium and vitamin D are essential for healthy bones. (Note: The National Institutes of Health says there are no good studies on the safety of herbs during pregnancy.)
While the FDA does not determine if dietary supplements are effective before they go on the market, scientific research continues to explore how supplements can complement traditional therapies in the prevention and treatment of certain health conditions.
When starting or changing a dietary supplement regimen, there are a few important factors to keep in mind:
- Keep your doctor informed of the supplements you're taking or considering
- Natural does not always mean safe
- Dietary supplements can interfere with over-the-counter and prescription drugs
- Certain supplements and herbs could be harmful to a fetus
Homeopathy was developed in Germany over 200 years ago, and functions on the principle of "like cures like," meaning that a disease can be cured by a substance that creates similar symptoms in healthy people. Generally, homeopathic remedies are created from natural substances (plants, minerals or animals) and are often placed under the tongue. Some of the main theories behind homeopathy clash with proven ideas in the fields of chemistry and physics, making scientific discovery on the efficacy of homeopathy challenging.
Chiropractic care and massage therapy
Chiropractic care and massage therapy both seek to improve a patient's health by working with the structures and systems of the body, including bones, joints, soft tissues, lymphatic and circulatory systems.
Chiropractic therapy involves manipulation of the spine and joints beyond their normal range of passive motion. Chiropractic therapy can help to make movement more comfortable and can help to alleviate back and neck pain.
Massage therapy is a broad group of therapies that involve manipulation of the body's muscles and soft tissues. Massage can help to reduce pain, rehabilitate past injuries,
Meditation is an ancient mind-body practice that began as a spiritual or religious practice. During meditation, patients sit with focused attention free of control or judgment. The goal of meditation is to induce a feeling of calm and relaxation while improving mental balance and enhancing overall health.
Urogynecology involves the diagnosis and treatment of female pelvic floor disorders (PFDs). The three main types of PFDs include urinary incontinence, fecal incontinence and pelvic organ prolapse. According to the National Institutes of Health, approximately one in four women suffer from a PFD. The female pelvic floor consists of muscles, ligaments, connective tissue and nerves that support the vagina, uterus and rectum. Depending on the severity of your condition, treatment for a PFD ranges from exercises and lifestyle changes to medication and surgery, such as vaginal reconstruction, sacrocolpopexy, and hysterectomy.
A condition in which you’re unable to control your bladder. The three main types of urinary incontinence include stress incontinence, overactive bladder/urge incontinence and mixed incontinence featuring symptoms of both stress and urge incontinence. The condition is more common in women than men and may be caused by a number of factors, including pregnancy, childbirth, menopause, nerve damage, overactive bladder muscles, or weak bladder muscles.
To diagnose urinary incontinence, your doctor will ask about your medical history and perform a physical exam focusing on your abdomen, genitals, pelvis, rectum, and nervous system. Your doctor may also order one or more of the following tests: a cystoscopy to view the inside of your bladder, a post void residual (PVR) to measure the amount of urine left after urination, a urine culture to look for infection, urodynamic studies to measure pressure and flow, and/or a uroflow to measure the pattern of urine.
Urinary incontinence can often be treated at home with bladder retraining and kegel exercises to strengthen the pelvic floor. Many forms of surgery are also available if home care isn’t successful. A common minimally invasive surgery for stress incontinence is the placement of a “sling” under the urethra.
A condition in which you’re unable to control your bowels. Fecal incontinence includes the inability to hold a bowel movement until reaching a toilet. Fecal incontinence can result from a difficult childbirth that injures the pelvic floor, a disease or injury that damages the nervous system, hemorrhoids, rectal prolapse, loss of stretch in the rectum, and poor overall health.
To diagnose fecal incontinence, your doctor will ask about your medical history and perform a physical exam focusing on your abdomen, genitals, pelvis, rectum, and nervous system. Your physician may also order one or more of the following tests: a colonoscopy to view the rectum and entire colon, an anal ultrasound to look at the structure of the anus and rectum, an anal EMG to check the health of the pelvic floor muscles, a defecography, an X-ray that shows how well you can hold and evacuate a stool, and anal manometry to check the function of the rectum.
Fecal incontinence may be treated with diet and nutrition, medications, bowel training, pelvic floor exercises, biofeedback, electrical stimulation and surgery designed to repair or replace sphincter muscles.
Pelvic organ prolapse (POP)
A condition in which the pelvic muscles and supporting tissues weaken, allowing the organs in the pelvis to fall out of place. (Prolapse means a slipping forward or down.) The pelvic organs include the vagina, cervix, uterus, bladder, urethra, and rectum. More than one organ can prolapse at the same time. Prolapse may occur as a result of labor and childbirth or surgery if the supporting muscles and tissue stretch or weaken. It can also occur over time with age. Other conditions can also lead to POP, such as obesity, chronic constipation and chronic coughing that strain the pelvic floor muscles. In some cases, the condition is hereditary.
To diagnose POP, your doctor will ask about your medical history and perform a pelvic exam. Your doctor may also recommend a series of tests, including one or more of the following: a pelvic floor MRI to asses how the pelvic floor functions, a defecography to assess symptoms related to bowel function, multi-channel urodynamics to assess difficulty urinating, or a CT scan to rule out other medical conditions.
For many patients at-home exercise and therapy can be successful. The goal of exercise therapy is to help you learn to control and relax your pelvic floor muscles. Other non-surgical treatments include biofeedback, electrical stimulation, and cold laser, a method that applies low-intensity laser light to the tissue to help reduce pain and inflammation. If you experience significant pain, your doctor may recommend surgery through either the abdomen or vagina. In some women the condition can get better over time.
The physicians at Centura Health Physician Group–Women’s Health Littleton have a special interest in minimally invasive gynecologic surgery and robotics. We offer surgery for a wide range of conditions, including uterine fibroids, endometriosis, pelvic organ prolapse, urinary and fecal incontinence, and more (see partial list below or call to discuss the full list of procedures we offer). We also offer office-based procedures for the treatment of abnormal uterine bleeding and contraception.
Our physicians offer a wide range of surgical procedures, including:
- Advanced laparoscopic and hysteroscopic surgery
- Robotic surgery
- Laparoscopic and vaginal hysterectomy
- Urinary incontinence surgery
- Vaginal hysterectomy
- Incision-less tubal ligation
- Endometrial ablation
- Minimally Invasive hysterectomy, myomectomy and sacrocolpopexy
- Loop Electrosurgical Excision Procedure (LEEP)
- Pelvic organ prolapse surgery
If you’re considering surgery for a gynecologic condition, you can take comfort in knowing our physicians will spend the time to listen to all of your concerns and translate complex medical terminology into clear, straightforward English. They want you to feel comfortable in your decision based on an understanding of the latest medical information. Our physicians offer you a wide range of surgical options to choose from, including advanced robotic surgery using the da Vinci® Surgical System.
Dr. McCollough has a special interest in gynecologic surgery with a focus on infertility and adolescent gynecology. Dr. Khan has a special interest in minimally invasive surgery and reconstructive pelvic surgery with advanced training in the da Vinci® Surgical System for robotic gynecologic procedures.
Unlike traditional laparoscopy, the da Vinci® System allows Dr. Khan to operate through a few small incisions instead of a large open incision. The da Vinci® Surgical System features a magnified 3D high-definition system and special wristed instruments, enhancing vision, precision, dexterity and control.
Robotic surgery for pelvic problems, such as uterine fibroids, endometriosis and vaginal prolapse, offers you the potential for less postoperative pain, less blood loss, a faster recovery, shorter hospital stay, smaller incisions with less scarring, and better outcomes.