We’ve come a long way, baby

National Midwifery Week (Sept. 30–Oct. 6) highlights the evolution and modern importance of a time-honored vocation

National Midwifery Week highlights the role of the modern midwife

Anne Vaillant, CNM

In recent decades, expectant moms across the nation have been making a slow but steady return to their historical roots in terms of pregnancy care and childbirth. An increasing number are choosing a delivery experience that was the norm in early America and, in many parts of the world, still is today. These women are embracing the traditional—yet evolving—practice of midwifery.

Sept. 30–Oct. 6 marks National Midwifery Week, when Women’s Health Associates joins the medical community and family-centered organizations everywhere in highlighting the work of America’s certified nurse-midwives (CNMs) and certified midwives (CMs). With passion and dedication, we collectively deliver more than 300,000 babies in the U.S. every year and provide primary gynecological care throughout countless women’s lives.

Midwifery: A Natural History

In times past, the primary attending caregiver during labor and delivery typically was a “lay” woman, informally trained to support the mother and provide initial care for the newborn. While these functions remain at the core of modern midwifery practice, today’s midwives are specially trained, licensed and certified, most in nursing as well. Certified nurse-midwives address women’s health needs from adolescence through menopause and beyond, in addition to our essential role as care provider during pregnancy, labor and childbirth.

With the establishment of obstetrics as an important medical field in the early 1900s, the vocation of midwifery faded from common practice for several decades. Its gradual resurgence came in the 1960s and 1970s, as a handful of hospitals began offering formal training programs.

According to a report from the American College of Nurse-Midwives (ACNM), the proportion of CNM/CM-attended births has risen nearly every year for at least the last 20 years.

Advantages of Midwife-Led Care

Women often choose midwifery care for its holistic, woman-centered approach, which actually may lead to better outcomes and lower health-care costs. Research shows that women receiving care from CMNs experience lower rates of cesarean births and labor induction, lower use of regional anesthesia and higher rates of breastfeeding than women strictly under physicians’ care.

While these facts speak volumes, it’s important to note that collaboration is critical in today’s Ob/Gyn practice. As CNMs, we work very closely with our physicians, ensuring that every woman has access to the best medical intervention if concerns should arise.

If you’re seeking a personalized, optimal care experience during pregnancy and childbirth, or at any stage of life, our CNMs are ready to partner with you. Contact us for an appointment today.

Learn the subtle signs of a dangerously silent disease

Teal signifies support for those affected by ovarian cancer. During National Ovarian Cancer Awareness Month, join us in promoting awareness of this potentially devastating disease.
Teal signifies support for those affected by ovarian cancer. During National Ovarian Cancer Awareness Month, join us in promoting awareness of this potentially devastating disease.

Dr. Robert Wool

September is National Ovarian Cancer Awareness Month

Though considered rare among all cancers, ovarian cancer is the deadliest of gynecological malignancies—due, in large part, to its notorious silence. During the month of September, we join the National Ovarian Cancer Coalition and others nationwide in promoting awareness around this potentially devastating disease.

Because early signs of ovarian cancer, if present at all, often go unnoticed or are attributed to less serious conditions, diagnosis typically occurs at advanced, less treatable stages. For this reason, staying attuned to your body and recognizing when something isn’t right is the key to earlier diagnosis and, ultimately, effective treatment.

Most cases of ovarian cancer are seen in women over age 55, but it can develop at any age. It sometimes presents with common gastrointestinal issues, such as indigestion, bloating, pain, bowel changes or feeling full quickly. Other possible symptoms include urinary urgency (feeling of having to go) or frequency, back pain, pain during sex, period changes and extreme fatigue. Although ovarian cancer is an unlikely cause, never dismiss these problems, especially if they are new or unusual for you, get worse or don’t go away. Make an appointment with your ob/gyn as soon as possible.

Just as important as paying attention to your body’s signals is having regular gynecological exams, or “well woman” checkups. These allow your provider to get an overall picture of your health, including new concerns or recent changes. Unlike some other abdominal or pelvic cancers, ovarian masses themselves are difficult or impossible to feel on regular examination until they are quite large. This makes good communication critical for determining whether certain tests, such as transvaginal ultrasound, may be warranted.

If you’re due for a regular checkup or have any concerns about your gynecological health, call us for an appointment today. You know your body best. Be sure to listen to it closely—this month and always.

Vaccines during pregnancy: what expectant moms need to know

Some vaccines can be an important part of protecting the health of both mom and baby.
Some vaccines can be an important part of protecting the health of both mom and baby.

Dr. Jacqueline Kates

August is National Immunization Awareness Month

When it comes to health and wellness in pregnancy, any choice an expectant mom makes is for two (or more!)—including whether to receive vaccines. During National Immunization Awareness Month, we’re taking the opportunity to educate our patients and all pregnant women on this critical area of their care.

As with any medical treatment, recommendations around vaccinations center on risk vs. benefit. In general, a vaccine that contains inactive viruses is safe in pregnancy, and its protective benefits almost always outweigh its risk.

The flu shot and the Tdap vaccine—which prevents against tetanus, diphtheria and pertussis (whooping cough)—are primary examples of vaccines that contain no live viruses.  Not only do these vaccines protect both mother and fetus from potentially serious infections, but the baby will then retain some of that immunity after birth. For these reasons, we routinely recommend that women receive the flu shot and the Tdap vaccine during pregnancy.

That having been said, it’s important to note that only the flu shot—not the nasal mist—is recommended in pregnancy, as the nasal mist is made from a live virus. Other common vaccines that contain live viruses include the chickenpox (varicella), measles-mumps-rubella (MMR) and shingles (varicella zoster) vaccines. Since it’s possible a live virus vaccine, while generally safe for children and infants, could pose a risk to the baby, pregnant women should avoid these vaccines.

Health care providers may recommend other vaccines during pregnancy in certain cases, such as upcoming travel outside of the U.S. If a mom is at higher risk for infection due to certain health factors, we may determine that hepatitis A and hepatitis B vaccines would be beneficial.

It’s the job of your obstetric provider to explain the risks and benefits of receiving any vaccine, and to make recommendations based on your particular situation. Call us with any questions or to make an appointment. We can help you make the best choices for your baby’s health and yours.

Practicing safe sex important for both lesbians and heterosexual women

2 woman hugging
It’s important for your health care providers to have a complete picture of your health and lifestyle.

June is Lesbian, Gay, Bisexual and Transgender Pride Month

Debra Ames, CNM

While all women face certain health risks just by being women, those who have same-sex partners may mistakenly believe they are at less risk than heterosexual women. In honor of June as Lesbian, Gay, Bisexual and Transgender Pride Month, we discuss these conditions and how you can reduce your risks.

Understanding your personal health risks is important. For example, depression is more prevalent in women than men, but women who are lesbians or bisexuals can be at a higher risk of depression and anxiety. That’s why it’s important for your health care providers to have a complete picture of your health and lifestyle.

Women who have sex with women are less likely to get vaginitis but are still at risk for certain sexually transmitted infections (STIs) such as human papillomavirus (HPV), herpes, HIV, bacterial vaginosis and trichomoniasis (a parasite infection).

Just like with heterosexual sex, if you are a woman who has sex with other women, you should practice safe sex and have regular checkups and screenings to reduce your risks, especially if you are not in a monogamous relationship in which both partners have been tested for STIs.

Some infections may not have symptoms, but can still be passed along, which underscores the need for regular testing. Having the appropriate vaccinations is also important, such as those for HPV, hepatitis A and hepatitis B.

It can be a challenge for lesbian and bi-sexual women to find a provider with whom they feel comfortable. But it’s key to find a provider with whom you can be honest about your health concerns so you can make routine health care a priority. Annual checkups paired with the appropriate testing, as well as seeking care at the onset of concerns or symptoms, will go a long way in terms of reducing your health risks.

If you are looking for a women’s health provider who takes the time to get to know patients and enjoys providing a personal level of care, call us for an appointment today.

Create a checkup checklist for your next appointment

 

Make a list of things you want to discuss during your appointment so you don’t forget anything.
Make a list of things you want to discuss during your appointment so you don’t forget anything.

Dr. Jacqueline Kates

May 15 is National Women’s Checkup Day, which serves as an important reminder for women who are often taking care of children, parents and/or partners, that they also need to make time to care for themselves. Annual checkups can play a significant role in your overall health, especially because health care has become more personalized over the past few years.

For example, recommendations about routine screenings have changed. New guidelines take into account women’s health and family histories when determining when screenings such as annual mammograms and PAP smears should start and how frequently they should be repeated.

However, even if annual Pap smears aren’t recommended for you, you will still benefit from an annual checkup. There are many sexual, reproductive and gynecological health issues that are important to address.

Bringing a list of questions and concerns to the appointment can help you ensure you are covering all your health bases. Matters you may want to add to your list include your:

  • Menstrual cycle, including how regular it is, symptoms and their severity, and any changes or issues you have noticed.
  • Risks for sexually transmitted infections (STIs) and need for screening. It’s possible to have an STI and not have symptoms. Testing is the best way to screen and diagnose.
  • Birth control and family planning questions. We can help you choose the most appropriate birth option based on your health and lifestyle, and can also provide guidance about becoming pregnant when you are ready.
  • Cancer risk factors and screening recommendations, as well as instructions for how to perform a breast self-exam.
  • Other gynecological issues, such as frequent yeast or urinary tract infections, painful sexual activity or symptoms like itching or burning.

We want you to feel comfortable discussing all of your health issues or questions with us. There’s nothing you can ask us that we haven’t been asked before. Our goal is to provide the best possible care, and to empower you to play an active role in your health.

Are you due for a checkup? Call us for an appointment today.