Dr. Nathalie Ann Fleming

Dr. Nathalie Fleming provides care for a wide spectrum of women's health issues, including:

Menstrual and Hormonal Disorders

• Dysmenorrhea (Painful Periods): Cramping and pelvic pain associated with menstruation, which can range from mild to severe and impact daily activities.
• Abnormal Uterine Bleeding (Heavy, Irregular, Prolonged Periods): Menstrual bleeding that is different in frequency, duration, or amount than what is typical for an individual, requiring investigation.
• Thyroid Disorders affecting Gynecologic Health: Conditions like hypothyroidism or hyperthyroidism that can impact menstrual cycles, fertility, and pregnancy outcomes.

Screening and Preventative Care

• Bone Density Health (Osteoporosis Screening Referrals): Assessing risk factors for osteoporosis and referring for bone density screening (DEXA scan) when appropriate, especially around menopause.
• Cervical Cancer Screening (Pap Tests & HPV Testing): Regular screening to detect precancerous changes or cancer of the cervix, primarily through Pap tests and HPV DNA testing.
• HPV Vaccination Counseling: Discussing the benefits and recommendations for the Human Papillomavirus (HPV) vaccine to prevent HPV-related cancers.

Pelvic Floor and Urinary Disorders

• Fecal Incontinence (Accidental Bowel Leakage): The inability to control bowel movements, leading to unexpected leakage of stool from the rectum.
• Recurrent Urinary Tract Infections (UTIs): Frequent infections of the urinary system, requiring investigation for underlying causes and preventative strategies.
• Interstitial Cystitis / Painful Bladder Syndrome (IC/PBS): A chronic condition causing bladder pressure, bladder pain, and sometimes pelvic pain, ranging from mild discomfort to severe pain.

This list highlights some common conditions managed within Obstetrics and Gynecology and is not exhaustive. For personalized advice regarding your specific health concerns, please schedule a consultation with Dr. Nathalie Fleming or your primary care physician for a comprehensive evaluation and appropriate referral if needed.

• Annual Gynecological Exams & Well-Woman Care: Routine check-ups including pelvic exams, clinical breast exams, preventative health screenings, and discussion of overall gynecological health.
• Diagnostic & Operative Hysteroscopy: Procedure using a thin, lighted scope to examine the inside of the uterus and perform minor surgical treatments such as polyp removal, fibroid resection, or septum correction.
• Tubal Ligation / Salpingectomy for Sterilization: Surgical methods for permanent female contraception, including removal of fallopian tubes (salpingectomy) which may also reduce ovarian cancer risk.
• External Cephalic Version (ECV) for Breech Presentation: Procedure to attempt to turn a breech baby to a head-down position before labor, if appropriate.
• Dilation and Curettage (D&C) / Dilation and Evacuation (D&E): Procedures to dilate the cervix and remove tissue from the inside of the uterus, for diagnosis or treatment of various uterine conditions or after miscarriage.
• Oophorectomy / Salpingo-oophorectomy (Laparoscopic or Open): Surgical removal of one or both ovaries, and potentially fallopian tubes, often for cysts, tumors, endometriosis, or cancer risk reduction.
• Management of Common Pregnancy Complications: Diagnosis and treatment of conditions such as nausea and vomiting of pregnancy (hyperemesis gravidarum), gestational diabetes (in conjunction with specialists if needed), hypertensive disorders, and preterm labor risk assessment and prevention strategies.

Note: This list may provide an overview of common services in Obstetrics and Gynecology. Dr. Fleming provides a wide array of diagnostic, therapeutic, and surgical options tailored to individual patient needs within women's health, pregnancy, and childbirth. Specific services offered can be confirmed by contacting the clinic.

All medical and surgical services are provided in accordance with the standards of practice set by the College of Physicians and Surgeons of Ontario (CPSO). A referral may be required for insured services.

Dr. Fleming practices at The Ottawa Hospital, located in the Elmvale Acres, Hawthorne Meadows, and Billings Bridge neighborhoods of Ottawa. The hospital is conveniently situated near the Glebe Shopping District and is easily accessible via OC Transpo, including the O-Train LRT and bus services. The facility is wheelchair accessible, ensuring barrier-free access for all patients. Parking is available at the hospital for those arriving by car, providing convenient options for patients visiting for appointments or procedures.

Are services from Dr. Fleming, an Obstetrician and Gynecologist, covered by Ontario Health Insurance Plan (OHIP) in ON?

Medically necessary consultations, prenatal care, delivery, gynecological surgeries, and diagnostic procedures performed by a licensed Obstetrician and Gynecologist like Dr. Fleming are generally covered by Ontario Health Insurance Plan (OHIP) in ON when you have a valid referral from your family doctor or another referring physician. Some elective procedures, certain fertility treatments, or non-medically indicated services may not be covered. It's always recommended to confirm specific coverage details with Ontario Health Insurance Plan (OHIP) or the clinic.

Do I need a referral from my family doctor to see Dr. Fleming, an Obstetrician and Gynecologist?

Yes, for services to be covered by your provincial health plan (Ontario Health Insurance Plan (OHIP)), a referral from your family physician or another specialist is typically required to see an Obstetrician and Gynecologist like Dr. Fleming for most consultations and treatments. This ensures coordinated care. Some specific services or clinics (e.g., some sexual health or contraception clinics) might have different access pathways, but for ongoing obstetrical or gynecological care, a referral is standard. Please check with Dr. Fleming's office or your referring doctor.

What can I expect during my first prenatal visit?

Your first prenatal visit with Dr. Fleming is usually quite comprehensive, typically scheduled around 8-10 weeks of pregnancy. It will involve a detailed review of your medical history, your partner's medical history (if applicable), and any previous pregnancies. Dr. Fleming will likely perform a physical exam, which may include a pelvic exam, confirm your pregnancy (often with an ultrasound referral), estimate your due date, and discuss important aspects of a healthy pregnancy such as nutrition, lifestyle, prenatal vitamins, and options for genetic screening and prenatal testing. You'll also have the opportunity to ask any questions you may have.

What does an Obstetrician and Gynecologist (OBGYN) like Dr. Fleming do?

An Obstetrician and Gynecologist (OBGYN), like Dr. Fleming, is a medical doctor specializing in women's reproductive health, pregnancy, and childbirth. They provide care throughout a woman's life, including prenatal care, labor and delivery, postpartum support, diagnosis and treatment of gynecological conditions (e.g., infections, fibroids, endometriosis, menstrual disorders), family planning, contraceptive management, preventative screenings like Pap tests, and management of menopausal symptoms.

What are some common gynecological surgeries Dr. Fleming might perform?

Common gynecological surgeries include procedures like hysterectomy (removal of the uterus), oophorectomy (removal of ovaries), tubal ligation (female sterilization), D&C (dilation and curettage), endometrial ablation, and surgeries to treat conditions such as fibroids (myomectomy), endometriosis, ovarian cysts, or pelvic organ prolapse. Many of these can be performed using minimally invasive techniques like laparoscopy or hysteroscopy. Dr. Fleming will discuss if surgery is appropriate for your condition and explain the specific procedure, risks, and benefits.

How can Dr. Fleming help with menopause symptoms?

Dr. Fleming can help manage bothersome menopause symptoms such as hot flashes, night sweats, vaginal dryness, mood changes, sleep disturbances, and bone density concerns. Treatment options may include lifestyle modifications (diet, exercise, stress reduction), non-hormonal medications, vaginal estrogen for localized symptoms, or systemic hormone replacement therapy (HRT) after a thorough discussion of the benefits and risks based on your individual health profile and preferences.

The Ottawa Hospital
1967 Riverside Drive
Ottawa, ON K1H 7W9

Phone: (613) 738-8400 | Fax: (613) 738-8505

The facility is wheelchair accessible.

Dr. Fleming is a licensed Obstetrician and Gynecologist regulated by the College of Physicians and Surgeons of Ontario (CPSO) under the Regulated Health Professions Act, 1991 and Medicine Act, 1991 in ON. A referral from your family physician or another qualified healthcare provider is typically required for provincially insured consultations and treatments.

Verify registration with the College of Physicians and Surgeons of Ontario (CPSO): https://doctors.cpso.on.ca/DoctorDetails/Fleming-Nathalie-Ann/0057719-69307