When Should My Daughter Have Her First Gynecologist Visit?


July 19, 2022 3:17 pm

For many young women, the thought of seeing a gynecologist for the first time can feel scary or even embarrassing, but this should be a time when your daughter feels comfortable and is able to ask questions about her developing body. We talked with Dr. Valary Gass of Women's Care to provide you with the information you need to help your daughter feel more positive and less stressed out about her first gynecologist visit.

What Age Should I Schedule My Daughter's First Gynecologist Visit?
"The American College of Obstetrics and Gynecology recommends that girls between the ages of 13-15 visit with a gynecologist," Dr. Gass explains.
For many parents, a reasonable time to talk with your daughter about scheduling her first appointment is after her first menstrual period. The real purpose of this appointment is to establish a relationship between your daughter and her gynecologist so she can feel comfortable asking questions and learn about what changes she can expect as she develops.

Preparing For Your Daughter's First Gynecologist Visit

The most important thing you can do to help ease your daughter's nerves is talk to her. Explain to her why this visit is important and help her understand what she can expect. Having an open dialogue with your daughter will encourage her to ask questions and feel more comfortable about the experience.
It is also a good idea to have your daughter create a list of questions she may have for her gynecologist before the visit. Sometimes being nervous can cause us to be forgetful, so writing these

questions down on a piece of paper will help her make sure she doesn't leave anything out. Common topics for questions include periods, hormones, birth control, sex, and sexually transmitted infections. These are all normal topics for your daughter to have questions about. Remind her that anything discussed with her gynecologist is protected by privacy laws, so she shouldn't feel embarrassed about asking these questions.


What Your Daughter Can Expect During Her Visit
"Most of the time, a girl's first gynecologist appointment does not involve a pelvic exam," Dr. Gass says, "but it should include taking a careful medical history, addressing any concerns like bad periods, and considering things like HPV vaccinations."
During your daughter's first gynecologist visit, she can expect to have a general physical exam where the nurse will record her height, weight, and blood pressure. Her gynecologist may then check for common health problems and talk with her about her medical history.
While her gynecologist will probably not conduct a pelvic exam during her first visit, it is likely that your daughter will have an external genital exam. During the external genital exam, your daughter's gynecologist will exam her vulva and may use a mirror to help her identify parts of her own body that she has yet to discover.
The most important thing to keep in mind is that this visit is an opportunity for your daughter to speak openly with her gynecologist and ask questions.

When Is a Pelvic Exam Necessary?
"The American College of Obstetrics and Gynecology suggests that most women begin regular Pap smear screening at age 21," Dr. Gass says. At that point, women should continue regular screening every three years until age 30 when they can switch to having a Pap smear with HPV co-testing every five years.
Your daughter most likely will not need a pelvic exam during her first gynecologist visit, unless she has expressed complaints of lumps, bumps, pelvic pain, or abnormal discharge. In these instances, her gynecologist may decide a pelvic exam is necessary.

When Should My Daughter Stop Seeing Her Pediatrician?
Once your daughter is seeing a gynecologist regularly, you may wonder if she needs to continue seeing her pediatrician. This is largely up to you and depends on the specific needs your daughter has as well as her gynecologist's preference for their practice. It is perfectly normal for your daughter to continue seeing her pediatrician well into college and it can be helpful if she has a complicated medical history. Just make sure your daughter continues her annual gynecologist visit as well.

Schedule An Appointment
If you would like to schedule an appointment with one of our providers at Women's Care, you can call or text us at 920.729.7105

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July 15, 2022 10:57 am

Dr. Gass talks about STIs

With the spread of STIs on the rise, we want to make sure every woman in our Circle of Care has the information she needs to live a safe and healthy life. That's why we're breaking down the most effective ways to prevent contracting an STI and what symptoms require a prompt visit to your OB/GYN.

What are STIs?
Sexually transmitted infections (STIs) are infections or viruses spread from person to person by intimate physical contact or through sexual intercourse. Common STIs include chlamydia, gonorrhea, HPV, genital herpes, and syphilis.

Aside from colds and the flu, STIs are the most common contagious (easily spread) infections in the United States. The American College of Obstetricians and Gynecologists reports that there are millions of new cases each year, so it's important to know the facts when it comes to protecting your body.

How Can I Protect Myself?
The good news is, that there are a lot of different ways you can protect yourself. You can reduce your risk of contracting an STI by:

  • Limiting your number of sexual partners. 
  • Using protection (such as condoms) every time you have vaginal, oral, or anal sex. 
  • Making sure you are up to date on all of your immunizations. Vaccinations are available for hepatitis B as well as some forms of HPV.

 Regular screening is also key to catching an STI early if you do contract an infection.
 "It's recommended that sexually active women between the ages of 15 and 25 have at least annual gonorrhea and chlamydia screening," Dr. Gass says.

There are some STIs that can be cured, but early detection is important.

"Additional screening can be offered for HIV, syphilis, hepatitis C, and other STIs," Dr. Gass says.


What are the Most Common Symptoms of an STI?
Some of the most common STI symptoms to look out for include:

  • A burning sensation when urinating
  • Sores, bumps, rashes, or blisters in the genital or anal area
  • Abnormal discharge 
  • Redness or swelling in the genital area
  • Pain in the pelvic or abdominal area
  • Pain, soreness, irritation, or other discomforts during intercourse
  • Bleeding after intercourse
  • Recurring yeast infections 

 If you believe you are at risk for contracting an STI, it is very important to schedule an appointment with your healthcare provider.

    "Sexually transmitted infections can have an impact on future fertility," Dr. Gass says.
    During pregnancy, STI's can also cause harm to the fetus. If you are pregnant and you or your partner have had -- or may have -- an STI, be sure to inform your doctor so you can work out a treatment plan that will decrease the chances of your child getting the infection.


Schedule An Appointment

"If you have concerns about STIs or believe you could need screening, please talk to your healthcare provider," Dr. Gass says. 

At Women's Care, our providers are devoted to you and your health. That means having the most advanced techniques, up-to-date educational information, and compassionate, caring staff.

To schedule an appointment with one of our providers to discuss STI screening or any other health related topic, please call us at 920-729-7105 or click here.

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Dr. Yarroch Talks About Endometriosis


Mar. 22, 2018 5:31 pm



Are you doubling over in pain during your period? Do you have cramps you just can't seem to shake throughout the month? For 1 in 10 women, these killer cramps are more than just your average visit from Aunt Flo, they're a symptom of endometriosis. Although endometriosis affects 176 million women worldwide, many go undiagnosed. Here's what you need to know about this painful disease and how to find out if endometriosis could be affecting you.

What is Endometriosis?
"Endometrial cells are what make up the lining of the uterine cavity," Dr. Yarroch explains. "In women with endometriosis, these cells are found in implants outside of the uterus where they cause inflammation."

This inflammation can result in pain and significant scarring to the surrounding tissue.

What Causes Endometriosis?

"There are various theories about what causes endometriosis, but the most accepted theory was first described in the 1920's and is referred to as retrograde menstruation," Dr. Yarroch says.

In this theory, it is proposed that there is a backflow of menstrual blood and tissue from the uterus through the fallopian tubes and into the pelvis.

"We do have evidence that there is an increased risk of endometriosis in women with heavy menstrual bleeding and longer or more frequent menstrual cycles," Dr. Yarroch says.

Doctors also know that estrogen plays a role and women who have a close female relative with endometriosis are 5-7 times more likely to have it themselves.


Spotting the Symptoms
Although it's a common misconception that endometriosis only occurs in women over the age of 20, the truth is that the disease can develop as soon as a girl gets her first period and can span the rest of a woman's reproductive years.

"The most common symptom of endometriosis is pelvic pain," Dr. Yarroch says. While this pain usually coincides with menstruation, some women can experience this symptom throughout their entire cycle.

Other symptoms to look out for include:
Pain during or after sex
Severe cramps that do not go away with NSAIDs or that impede the activities of your everyday life
A heavy menstrual flow
Periods that last longer than 7 days
Nausea or vomiting
Urinary and bowel disorders
Difficulty getting pregnant

Not every woman will experience all of these symptoms, but approximately 30%-40% of women who have endometriosis will experience issues with fertility.

Getting a Diagnosis
If you suspect that you may have endometriosis, we encourage you to speak with your doctor or make an appointment with one of the amazing providers at Women's Care. The only way to know for sure whether or not you have endometriosis is through a surgical procedure called laparoscopy.

Treating the Symptoms
There are a wide range of treatment options for endometriosis and your doctor may suggest a few less invasive methods before ordering a biopsy. At Women's Care, we work with you to choose a plan that fits your needs and your lifestyle. Some of the most common treatments include:

The use of NSAIDs, such as ibuprofen (advil, motrin) and naproxen sodium (aleve). NSAIDs can help relieve or lessen the pain caused by endometriosis by stopping the release of prostaglandins, one of the main chemicals responsible for painful periods. While NSAIDs can help manage the pain-related symptoms of endometriosis for some women, it's not effective in every case.

Birth control methods such as the pill, the patch and the ring are often helpful to treat the pain associated with endometriosis because they reduce heavy bleeding. This method works best for women who only have severe pain during their period and not during the rest of their cycle.

Progestins are recommended for women who do not get pain relief from or who cannot take hormonal birth control that contains estrogen (such as smokers). This synthetic form of the natural hormone progesterone is available by prescription as a pill or an injection.

GnRH therapy uses medicines that work by causing temporary menopause. The treatment actually causes the ovaries to stop producing estrogen, which causes the endometriosis implants to shrink.

For some women, surgery may be the best treatment method. While there isn't a cure for endometriosis yet, it is possible to remove some of the the scar tissue and lesions with surgery.
If you have endometriosis, surgery could be an option if you:
Have severe pain
Have tried medications, but still have pain
Have a growth or mass in the pelvic area that needs to be examined
Are having trouble getting pregnant and endometriosis might be the cause

"It is important to note that there are other conditions that can cause many of the same symptoms as endometriosis," Dr. Yarroch explains. "An OB/GYN can help determine if endometriosis is the appropriate diagnosis."

So What Now?

"Endometriosis can have a significant impact on a woman's life. Fortunately, there are treatment options available to manage pain and minimize recurrence," Dr. Yarroch says.

If you have endometriosis or believe you could have endometriosis, we strongly encourage you to speak with your doctor or one of our highly trained providers. We want you to know that at Women's Care, we're devoted to you and your health. We're here to meet both your physical and your emotional needs each step of the way, from diagnosis to treatment and recovery.

Join our Circle of Care and request an appointment with us today!

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The Facts Surrounding Cervical Cancer


Jan. 23, 2018 12:06 pm



According to the National Cervical Cancer Coalition, nearly 13,000 women in the United States are diagnosed with cervical cancer each year, even though the disease is almost always preventable with vaccination and regular screening. At Women's Care, we're devoted to keeping our patients healthy and we believe having access to the most up-to-date educational information is crucial to making important decisions about your well-being. That's why we sat down with Dr. Therese Yarroch to get the facts about cervical cancer prevention.




What Is Cervical Cancer? 

Generally speaking, cancer begins when cells in the body start to grow out of control. Cervical cancer occurs in the cells "in the bottom portion of the uterus that we can see on a speculum exam through the vagina," Dr. Yarroch explains.

Almost any part of the body can become cancerous and that cancer can continue to spread to other areas of the body.

Are Certain Women At A Higher Risk For Cervical Cancer?

Unlike many diseases, Dr. Yarroch notes that family history does not normally increase your likelihood of contracting cervical cancer.

"In most cases, cervical cancer is caused by HPV, which is a very common sexually transmitted virus that suppresses the immune system," Dr. Yarroch says.

Women who have a suppressed immune system, including those who smoke, are typically at a higher risk for cervical cancer, but it's important to remember that this disease is very preventable with vaccination and regular screening.

If Cervical Cancer Is Preventable, Why Is It So Common?

"Cervical cancer is one of the most common cancers in women worldwide, but it is less common than some other female cancers in the United States because we do have preventative measures in place," Dr. Yarroch explains.

Unfortunately, it still remains an issue because HPV is so prevalent.

"It's also important to keep in mind that not everyone is able or willing to follow all of the guidelines that are recommended to help prevent cervical cancer," Dr. Yarroch explains. That's why educating the public and providing access to affordable healthcare is so important.

Pap Smears And Pelvic Exams

"It used to be that women started getting Pap smears as teenagers and continued to get them every year," Dr. Yarroch says.

Now, screening guidelines recommend that women have their first Pap smear at age 21 and continue to have one every three years until age 30 when they can choose to get a Pap smear with HPV co-testing every 5 years instead.

Having regular Pap smears is crucial to preventing cervical cancer. During this portion of the exam, your gynecologist collects cells from the end of your cervix. Those cells are then looked at under a microscope to give your gynecologist a better indication of if cancer or pre-cancer is a concern.

"The important thing to remember is that even though you may not need a Pap smear every year, it is still strongly recommended that see your gynecologist and have an annual pelvic exam," Dr. Yarroch says.

"When we do a pelvic exam we are looking at the cervix and checking for any bumps or color changes on the cervix that would be concerning for cancer or pre-cancer," Dr. Yarroch explains.

HPV Vaccinations

"In the past, we didn't have any way to prevent the spread of HPV, which is the main cause of cervical cancer, but now we do." Dr. Yarroch says.

It is recommended that the HPV vaccination be given before a person even has the opportunity to become sexually active. While you can receive the vaccination later in life, it's important to note that most insurance companies do not cover the vaccination after age 27.

"We also find that the HPV vaccination is more effective in patients when it is given at a young age because the immune system is more robust and able to build up a stronger immunity against the virus," Dr. Yarroch explains.

"With this vaccination, the hope is that in the future we will be able to further reduce the incidents of cervical cancer," Dr. Yarroch says.

Schedule An Appointment

If you would like to schedule an appointment with one of our providers at Women's Care, you can call us at 920-729-7105 or click here.

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Changes To Pap Smear Screening Guidelines


Dec. 20, 2017 8:58 am


If you're like most women who dread having to get a Pap smear done at your yearly wellness check, you're in luck! Changes in the Pap smear screening guidelines now advise against annual Pap smears for the majority of women. We sat down with Dr. Valary Gass at Women's Care of Wisconsin to discuss what guidelines have changed so you know what to expect at your next gynecologist visit.

First, Let's Talk About What A Pap Smear Is


Even though Pap smears are no longer a yearly requirement, they're still important! Pap smears are
used to screen for cervical cancer in women. The test itself is used to collect cells from your cervix
and it helps your gynecologist screen for changes in your cervical cells that indicate cancer may
develop in the future. Cervical cancer is a particularly aggressive disease, so catching it early on
through Pap smear screening is crucial!

How Often Do You Actually Need To Have A Pap Smear Done?

All of the recent changes to the Pap smear screening guidelines have caused a lot of confusion
about when women should be screened, but the real answer is that it depends on the age, health,
and family history of each woman.

"The new guidelines state that women should start screening at the age of 21," Dr. Gass says,
but most women don't need to be screened every year.

"Women over the age of 21 should have a Pap smear done every 3 years," Dr. Gass explains.
"At age 30, women can continue getting a Pap smear every 3 years or they can choose to get a
Pap smear with HPV co-testing every 5 years."


For women who cringe at the thought of getting their next Pap smear done, these new guidelines
are great, but it's important to remember that your health and family history are also factors when
it comes to determining how often you should be screened.

If you have had an abnormal Pap smear in the past, have a history of cervical cancer, are HIV+,
have a weakened immune system, or if you were exposed to diethylstibestrol (a synthetic form of
estrogen) in utero, you may need to be screened more frequently.


Dr. Gass also points out that women should not stop screening unless advised by their doctor.


"If you have questions about when you should be screened, how often you should be screened or
when you should stop screening, please have a frank conversation with your doctor," Dr. Gass
advises.  


Keep Seeing Your Gynecologist Annually -- Even If You Don't Need A Pap Smear


Just because you get to skip your Pap smear this year doesn't mean you should skip your annual
wellness check too! For many women, their gynecologist is the only doctor they see each year.
Your annual wellness check is an opportunity to go over more than just your cervical cells -- plus,
it's covered by the Affordable Care Act! So do your body a favor and don't skip your annual
appointment completely.


Schedule An Appointment

If you would like to schedule an appointment with one of our providers at Women's Care, you can
call us at 920-729-7105 or click here.

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Breast Cancer Prevention


Nov. 28, 2017 6:39 pm


Did you know that 1 in 8 women will be affected by breast cancer during her lifetime? It might not be Breast Cancer Awareness Month anymore, but at Women's Care we believe it's important to keep the conversation going all year long. That's why we sat down with Dr. Valary Gass to talk about the preventative steps we can all take to stay healthy.

Knowing The Symptoms:

Breast cancer is the second most common cancer among American women, so it's important to know the signs that can help with early detection. Some of the symptoms include:
  • Skin changes, such as swelling, redness, or other visible differences
  • An increase in size or change in shape of one or both breasts
  • General pain in or on any part of the breast
  • Changes in appearance in one or both nipples
  • Nipple discharge
  • Lumps or nodes felt on or inside of the breast(s)

Most women who have breast cancer will notice only one or two of these symptoms at first. While the presence of these symptoms doesn't necessarily mean you have breast cancer, it should still be investigated by your healthcare provider.

When To Start Screening:

"Factors like your personal and family history can influence how early you start and how often you should be screened," Dr. Gass explains. The American Cancer Society suggests that women ages 40-44 should have the choice to start annual mammograms.
"Have a conversation with your doctor during this time about when you should start screening," Dr. Gass says.
Between the ages of 45-55, women should have annual mammograms. After the age of 55, women can choose to have a mammogram every other year or continue with annual mammograms.
"Have an open discussion with your physician about what screening strategy is right for you," Dr. Gass says.

If you would like to schedule an appointment with one of our providers at Women's Care, you can call us at 920-729-7105 or click here:

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So, What's The Real Benefit Of Having A Midwife?


Nov. 8, 2017 10:58 am



So, What's The Real Benefit Of Having A Midwife?

For many women, having the same care provider that they saw during their entire pregnancy with them throughout their labor and delivery is very comforting.

"Especially for a natural birth, where you need that bedside support!" Becky says.

Midwifery care is often described as having a "high touch, low tech" approach to medical care. Midwives are experts in supporting women in normal, healthy childbirth and focus heavily on building relationships with women and their families by listening and providing information, guidance, and counseling in a shared decision-making process.

"One of the reasons I became a midwife was because I really enjoyed the relationships and bonds I was able to form with my patients," says Kay. "To care for them throughout their pregnancy, to be there for the delivery, and then to see them for years to come and grow with them... it's really special!"

"I have patients that I saw as teenagers that are now having babies," Becky adds. "It's just incredible!"




Scheduling Your First Appointment

If you're interested in seeing one of our certified nurse midwives, you can schedule your first appointment by calling 920.729.7105 or by clicking here.

You can also learn more about each of our certified nurse midwives and healthcare providers here.

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Choosing The Right Health Insurance Plan


Oct. 24, 2017 3:13 pm



As the Health Insurance Marketplace transitions to plans with higher deductibles, patients are facing more financial responsibility than they ever have in the past. This makes understanding your plan options and benefits extremely important, so we sat down with Women's Care's Practice Administrator, Tasha Frahm, to learn more about what changes patients can expect and get her advice on how to choose the best plan.

Changes in the Health Insurance Marketplace

If you're getting your insurance from the Health Insurance Marketplace -- also known as Obamacare or the Insurance Exchange -- there are a few key changes to look out for this year.

"There are going to be a couple of really big players that are going to stop having programs on the Marketplace," Tasha explains. Two of the largest insurance companies who will be leaving the Marketplace are Anthem and Molina.

For those of you living in our service area, that leaves Network Health Plan and Common Ground Health Cooperative.

"Women's Care doesn't currently have a contract with Network Health Plan, but we are actively pursuing a contract with Common Ground Health Cooperative," Tasha says. "I feel very confident that we will be able to make that happen, so if patients see a Women's Care provider and they want to continue to see a Women's Care provider, Common Ground Health Cooperative is going to be their best bet."

Health Insurance Changes for State Employees

If you're a state employee, your plan options may be limited this year.

"State employees typically fall into the Employee Trust Fund," Tasha explains. "Historically, they have had upwards of seven different insurance options. This year, it looks like they are going to scale back quite a bit."

While statewide, Wisconsin employees may still have up to seven options, employees in our market will only have three insurance plans to choose from.

Those plans are Security Health Plan, WEA Trust, and Network Health Plan.

"If you're a state employee who sees a Women's Care provider or would like to see a Women's Care provider, it's important to remember that we don't have a contract with Network Health Plan," Tasha points out. "But we do have contracts with Security Health Plan and WEA Trust."

Why the Sudden Health Insurance Changes?

While this is a drastic change compared to previous years, it's not atypical to see a lot of change in the Marketplace within one year.

"Employers change year after year, and every year they change the health insurance plans they offer," Tasha says. "It just so happens that the state of Wisconsin employee population is so large that when the state makes a change, it affects a lot more people than when another company makes a change."

In other words, it may seem like state of Wisconsin employees are being affected the most by these changes because they are being affected on such a large scale.

What Should Women Consider When Choosing Their Plan?

  • Provider: If you are seeing a provider that you would like to continue seeing in the future, make sure that provider is covered by your new health insurance plan. If you are currently seeing a provider at Women's Care, we suggest looking into Common Ground Health Cooperative, Security Health Plan, or WEA Trust.

  • Benefits: Make sure you really understand the benefits of the plan you're considering, particularly preventative care benefits and the benefits that are important to you and your family. Pay attention to what you're paying out of pocket, if there's a limit to what you're paying out of pocket, and what you're responsible for.

  • Deductible: As we start seeing plans with higher deductibles, it's extremely important for patients to understand what happens after their deductible is met. Is there more money you still have to pay? If so, how much and until what amount?

  • Fertility Treatment / Pregnancy: If you're looking into fertility treatments or if you may become pregnant, we really encourage you to pay close attention to those specific benefits for each plan. Fertility is tricky because some insurance plans will cover a portion of it, while others won't cover any of it. Choose the plan that's right for you to avoid paying out of pocket later on.

  • Birth Control: If you have a preferred birth control method, figure out how it's going to be covered by your new health insurance plan and understand exactly what your benefits will be for the next year. Our government is changing and insurance companies will follow suit in the near future, so this is a very important area for women to consider!


Choose What's Right For You

With all of the health insurance changes taking place this year, it's crucial to research your options and take the time to understand everything that's available to you.

"Don't be afraid to reach out to different health insurance companies and ask questions before you select your plan, and also afterwards," Tasha encourages. "Understand what your coverage is so that you're not surprised when you get your next medical bill. I hate to see patients that are surprised because they thought something was covered and it wasn't. No one ever wants to be in that position."

For state employees, enrollment has already started and will close on October 27th, so be sure to get your research done so you can choose your plan soon!

As for everyone else, open enrollment is scheduled to begin November 1st and end on December 15th. It's important to note that this year's enrollment period is shorter than it has been in the past. Originally, open enrollment was scheduled to run through January 31st. However, the DHS' proposal to cut the duration of the enrollment period in half was approved, so be sure to enroll early!

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Myth #5: Midwives Only Work With Women Who Are Pregnant.


Sep. 29, 2017 1:04 pm



Even though midwifery has evolved alongside today's modern health care system, many myths surrounding this profession are based in common misunderstandings that are centuries old. At Women's Care, we believe education is a powerful tool, so we've teamed up with two of our certified nurse midwives to set the record straight!

Becky Kahler and Kay Weina have nearly 30 years of combined experience as certified nurse midwives and are passionate about the work they do.

Over the next few months, Becky and Kay will help us break down different myths, so stay tuned as we address some of the most common questions surrounding midwifery!



Myth #5: Midwives only work with women who are pregnant.

"We see patients from the early age of 12 all the way up to menopause," Becky says.

While many people think of midwifery as a practice solely focused on pregnancy and childbirth, midwifery actually encompasses a full range of primary health care services.

"Preventative care is also a part of what we do. We discuss birth control, abstinence, STD education. We do IUD insertions...." Becky continues.

The services midwives offer also include primary care, gynecologic and family planning services, preconception care and postpartum care.

Stay Tuned


Becky and Kay will be joining us for one last blog post, so stay tuned!

If you're interested in seeing one of our certified nurse midwives, you can schedule your first appointment by calling 920.729.7105 or by clicking here.

You can also learn more about each of our certified nurse midwives and healthcare providers here.

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Myth #4: If I Choose To Have A Midwife, I Am Putting My Baby At Risk If Something Goes Wrong.


Sep. 1, 2017 1:44 pm


Even though midwifery has evolved alongside today's modern health care system, many myths surrounding this profession are based in common misunderstandings that are centuries old. At Women's Care, we believe education is a powerful tool, so we've teamed up with two of our certified nurse midwives to set the record straight!

Becky Kahler and Kay Weina have nearly 30 years of combined experience as certified nurse midwives and are passionate about the work they do.


Over the next few months, Becky and Kay will help us break down different myths, so stay tuned as we address some of the most common questions surrounding midwifery!

Myth #4: If I Choose To Have A Midwife, I Am Putting My Baby At Risk If Something Goes Wrong.

If you're considering working with a midwife, but worried about what would happen to your baby if something goes wrong, you can relax!  Certified nurse midwives partner with other members of the health care team through collaboration and referral to provide the best possible care.

"We have a wonderful group of very supportive physicians that are on call and available to us 24/7, so if you're in the clinic and something comes up -- like high blood pressure or something out of the ordinary -- we have those physicians to consult with," Becky reassures.

While this doesn't necessarily mean your certified nurse midwife will transfer care, it could mean you will have a team of people working with you to ensure you have a healthy pregnancy rather than working with just one healthcare provider.

Certified nurse midwives are also available to assist physicians in the event of a c-section.

"Some of the patients that I see have had previous cesarean births and they want to have another cesarean. If they want to see me for their prenatal care, they can!" Becky says.

"However, there are some circumstances where your risk might be too great and we would transfer care -- like in the case of twin pregnancies," Becky explains. "I can care for a twin pregnancy, however I prefer not to. I feel like that's where the physician's expertise really comes in handy."

Stay Tuned

In our next blog post Becky and Kay will be answering questions about what midwives do and who their patients are, so be sure to check back soon!

If you're interested in seeing one of our certified nurse midwives, you can schedule your first appointment by calling 920.729.7105 or by clicking here.

You can also learn more about each of our certified nurse midwives and healthcare providers here.

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Why Are More Women Choosing To Use Nitrous Oxide?


Aug. 17, 2017 11:39 am



At Women's Care, we believe in providing our patients with options so we can develop a health plan that meets both their physical and emotional needs. That means having the most advanced techniques, which is why we're happy to offer patient-controlled nitrous oxide to assist with pain relief and anxiety during gynecological procedures.

"We have a lot of women who are now choosing to use nitrous just because of the ease and the availability," Tanya Henry, RN, explains. "Before when we didn't have it, just the simple procedure of an IUD placement or a biopsy for a patient who couldn't tolerate it meant we would have to use sedation of some sort."

When nitrous oxide is used for gynecologic procedures, the gas is inhaled through a mask for about 30 seconds before the procedure begins.

Unlike a sedative, the effects of nitrous oxide start to fade quickly as the gas is cleared from the body through the lungs.

"Nitrous oxide completely relaxes the patient enough without the complications that could arise in having to go to sleep," Tanya says. "It's much better than using a sedation option where the patient would be down and out for the rest of the day."

Within a few minutes after the nitrous oxide mask is pulled away, the gas leaves the patient's system, making it a great option for women who need to drive after their procedure.


If you would like more information about how to request nitrous oxide for your next procedure, please call our office at 920.729.7105.

You can also learn more about nitrous oxide on our website by clicking here.

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Myth #3: If I Choose To Have A Midwife, My Birth Has To Be All Natural


Aug. 3, 2017 7:51 pm


Even though midwifery has evolved alongside today's modern health care system, many myths surrounding this profession are based in common misunderstandings that are centuries old. At Women's Care, we believe education is a powerful tool, so we've teamed up with two of our certified nurse midwives to set the record straight!
Becky Kahler and Kay Weina have nearly 30 years of combined experience as certified nurse midwives and are passionate about the work they do.

Over the next few months, Becky and Kay will help us break down different myths, so stay tuned as we address some of the most common questions surrounding midwifery!


Myth #3: If I choose to have a midwife, my birth has to be all natural.


"I think a lot of people wonder, if you choose a midwife, do you have to have a natural birth? And I think a lot of women probably seek out midwifery because they're looking for a non-medicated or low-intervention birth, but we certainly can provide medications," Kay says.


While you can choose to have a natural birth with your midwife, certified nurse midwives are licensed, independent health care providers who can prescribe medications in all 50 states.


This includes IV medications and epidurals, which can be an option during labour even for women who originally wanted a natural birth but change their mind during the delivery.


"I think the biggest thing about midwifery care is that we want to listen to the women, we want to give them options, and we want your birth experience to be the most positive one because you're telling your birth stories forever!" Kay says.


"Another big thing is educating women and couples about the decisions they need to make -- the pros and cons, the risks and benefits -- and really supporting those decisions once they are made," Becky adds. "That's really important."


Stay Tuned


In our next blog post Becky and Kay will be answering questions about potential risks during pregnancy, so be sure to check back soon!


If you're interested in seeing one of our certified nurse midwives, you can schedule your first appointment by calling 920.729.7105 or by clicking here.

You can also learn more about each of our certified nurse midwives and healthcare providers here.

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Breastfeeding In Public: What You Need To Know


July 28, 2017 10:41 am


Our very own Dr. Vandenberg shares a few of her favorite breastfeeding facts and lessons.

By: Dr. Maria Vandenberg, MD
Obstetrican/Gynecologist

August is National Breastfeeding Awareness Month and there are hundreds of articles and blogs supporting breastfeeding moms circling about.  Here is another. 

First, I, of course, support breastfeeding moms, but I also support formula feeding moms as well. Breastfeeding is an amazing experience and great for babies when it works, but it saddens me when I see moms feel guilty or disappointed if they use formula. I mostly formula fed my first kiddos and they have turned into wonderful, intelligent, happy children. No guilt here. We all do what is best for each of our kids and we need to support and encourage each other.

How many of you are working moms who breastfeed? Well, I'm right there with you. It's hard, but so worth it if you are successful. Below you will find a list of my favorite pumping and breastfeeding facts and lessons I have learned along the way.

Facts
  • Did you know it is a federal law that companies with over 50 employees are required to provide a location (other than a restroom) and sufficient time for expressing milk for one year after the child's birth? Check this out: Department of Labor 
  • In Wisconsin, you can breastfeed (it is illegal for anyone to ask you to move or cover up) your child anywhere it is legal for you to be. So, don't break into a Taco Bell to breastfeed; however, if they are open, you can feed your child. Here is more info: State Breastfeeding Laws 
  • Most health insurances will supply a breast pump for breastfeeding moms!


Lessons
  • You can pump anywhere. The airport at empty terminals (although certainly, a strange man will sit next to you when every other seat is available). Bathroom stalls. The car. Even during oral exams through school/training. Pump through the awkwardness, my friends.
  • Like other articles have pointed out, your pump does talk; hopefully it just has nice things to say.
  • The milk you bring home each night really is liquid gold, and only other moms can understand how it feels to lose, spill, forget that precious milk. In fact, my entire supply of frozen milk was thawed because of a faulty circuit this summer. I was sobbing.
  • Your older children may become very interested in breasts and attempt to breastfeed your newest addition. This is endearing, but can be embarrassing in public.


While being a working mother who breastfeeds certainly has its struggles it is also a very rewarding experience for not only myself, but for my little one as well. Remember ladies: you are not alone when it comes to breastfeeding-the staff here at Women's Care of Wisconsin is here to help, support and encourage you through your breastfeeding journey! 

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What Is Nitrous Oxide and How Does It Work?


July 19, 2017 12:34 pm

Nitrous oxide, often called "laughing gas", has been a common practice to help cope with pain for many years. While it's mainly used in dental offices, Women's Care of Wisconsin is happy to offer you the option of patient-controlled nitrous oxide to assist with pain relief and anxiety during gynecological procedures.



Women's Care's Registered Nurse, Tanya Henry, explains that the nitrous oxide "helps relax you and helps you manage your pain" so that in-office procedures like getting a Pap smear or having an IUD placed are more comfortable.



When nitrous oxide is used for gynecologic procedures, it is a mixture of 50% nitrous gas and 50% oxygen. This gas is inhaled through a mask for about 30 seconds before the procedure begins and is self-administered by the patient, so you can breathe it in as you feel necessary.  


"Some people do find relief from the gas, however some people don't see that the pain goes away, but they're much more relaxed and allow us to do the procedure better because of it," Tanya explains.


Nitrous oxide is cleared from the body through the lungs, so as soon as you pull the mask away, the nitrous effect starts to fade. Within a few minutes, the nitrous oxide will have left your system, making it a great option for women who need to drive after their procedure.


"Essentially, what it's doing when we give you the nitrous is allowing you to relax so the doctor can do what they need to do and in the meantime you're not feeling as much pain or discomfort," Tanya says.


If you would like more information about how to request nitrous oxide for your next procedure, please call our office at 920.729.7105.

You can also learn more about nitrous oxide on our website by clicking here.

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Myth #2: Midwives Can Only Deliver Babies At Home


June 30, 2017 3:55 pm

Even though midwifery has evolved alongside today's modern health care system, many myths surrounding this profession are based in common misunderstandings that are centuries old. At Women's Care, we believe education is a powerful tool, so we've teamed up with two of our certified nurse midwives to set the record straight!

Becky Kahler and Kay Weina have nearly 30 years of combined experience as certified nurse midwives and are passionate about the work they do.

Over the next few months, Becky and Kay will help us break down different myths, so stay tuned as we address some of the most common questions surrounding midwifery!


Myth #2: Midwives can only deliver babies at home.

"Another question I get from patients is if I deliver at home," Becky says. "I do not deliver at home, but we can refer you to some of the community midwives that would provide you with that type of care."

According to the American Midwifery Certification Board, 94.9% of CNM-attended births occurred in hospitals in 2012. That same year, 2.6% occurred in freestanding birth centers and just 2.5% occurred in homes.

At Women's Care, our certified nurse midwives' practice is strictly hospital births only, with Becky primarily delivering at the Appleton Medical Center, Kay primarily delivering at the ThedaCare Neenah Center, and our newest midwife, Elise, going back and forth between the two locations.


Stay Tuned

In our next blog post Becky and Kay will be answering questions about all-natural births and medication, so be sure to check back soon!

If you're interested in seeing one of our certified nurse midwives, you can schedule your first appointment by calling 920.729.7105 or by clicking here.

You can also learn more about each of our certified nurse midwives and healthcare providers here.

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Myth #1: Midwives Are Just Untrained Labor Coaches


June 21, 2017 2:11 pm



Even though midwifery has evolved alongside today's modern health care system, many myths surrounding this profession are based in common misunderstandings that are centuries old. At Women's Care, we believe education is a powerful tool, so we've teamed up with two of our certified nurse midwives to set the record straight!

Becky Kahler and Kay Weina have nearly 30 years of combined experience as certified nurse midwives and are passionate about the work they do.

Over the next few months, Becky and Kay will help us break down different myths, so stay tuned as we address some of the most common questions surrounding midwifery!

Myth #1: Midwives are just untrained labor coaches.

Despite this myth's popularity, certified nurse midwives often have more training that many labor and delivery nurses. While labor and delivery nurses are required to hold a Bachelor in Nursing, certified nurse midwives go back to school to get their Master of Science degree in Nursing (MSN). They are also required to pass a national certification exam, which combined with their training and medical expertise qualifies them to deliver babies.

"I think a lot of nurse midwives were labor and delivery nurses to begin with, like us," Kay, who was a labor and delivery nurse for 10 years before going back to school, says.

"When you're a labor and delivery nurse, you get that patient to delivery, and when you get to that point, the doctor comes in to catch the baby," Kay continues. "I always thought -- well gosh! -- that's the best part! I could do that!"

Becky, who was a labor and delivery nurse for 14 years before she received her MSN, explains that being a certified nurse midwife is similar to being a nurse practitioner, but it's "more of an OB/GYN nurse practitioner role."

"I felt like I was missing a big part of each woman's journey as a labor and delivery nurse, but being a midwife allows me to see them in the beginning, throughout their pregnancy, and afterwards too!" Becky says.

Stay Tuned

We'll be updating this blog series with new posts soon, so be sure to check back! In our next blog post Becky and Kay will be answering questions about home delivery.

If you're interested in seeing one of our certified nurse midwives, you can schedule your first appointment by calling 920.729.7105 or by clicking here.

You can also learn more about each of our certified nurse midwives and healthcare providers here.

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3D Ultrasound: What's It All About?


May 18, 2017 9:14 am


Whether you're expecting your first child, adding a little brother or sister to the family, or just curious about advancements in medical technology, a lot of people have questions about 3D ultrasounds.

With the help of Women's Cares' ultrasound supervisor, Jackie, we're here to answer some of the most common questions patients have surrounding 3D ultrasounds and learn a little bit more about why this technology is so beneficial for patients and doctors alike.

One common misconception you may have heard is that 3D ultrasounds are replacing 2D ultrasounds. This simply isn't the case. Jackie explains that instead of replacing 2D technology, 3D technology works in adjunct with it.

"3D just gives us even more information than 2D. We build off of the 2D, so it doesn't go away, but 3D gives us more information for a better prenatal diagnosis." Jackie says.

In order to better understand how this technology builds off of each other, we asked Jackie what the biggest difference is between 2D and 3D.


"The biggest difference, really, is how the image is acquired," she explains.


While 2D uses just a single image or a single plane of information, 3D is multiplanar. This means 3D technology gives obstetricians a volume of information to work with, which makes it easier for them to identify potential health concerns.


One of the most common questions we get from patients about about ultrasounds is whether or not they are safe for the mother and the baby.


Jackie reassures patients that "ultrasound is very, very safe in the hands of skilled sonographers and skilled physicians" and that medical professionals have very specific guidelines as far as safety is concerned.


"With ultrasound, if we step back a little bit, many moms in the mid-to-late 70's, even the early 80's, didn't have ultrasounds," Jackie says.

While a lot of soon-to-be mothers are excited to see their baby in 3D for the beautiful pictures, this technology does more than just produce realistic images.

"On our end, 3D technology has been so beneficial in allowing us to have  improved visualization of the developing fetus," Jackie explains.

For example, in the case of a baby that might have a cleft lip or palate, 3D enhances the prenatal diagnosis. This information is beneficial for the surgeon who can now see the anomaly in-depth, for the pediatrician who is planning how best to care for the baby and for the parents who now have extra time to prepare.

"The number one thing parents want to know is, 'Is my baby okay?'" Jackie says. "3D ultrasound has revolutionized things for the obstetrician, so we can help answer that question."

The uses for 3D ultrasound technology expand beyond pregnancy as well.

"3D has allowed us to see uterine malformations, help with ovarian masses and tumors, and just provide us with more information for better diagnosis all around," Jackie explains.

3D ultrasound technology also provides a unique bonding tool for soon-to-be mothers, fathers and even siblings.

"Even the little squirts can see this picture! The 3D is so clear!" Jackie tells us. While the excitement of a mother and father seeing their baby for the first time is hard to beat, 3D ultrasounds are also emotionally beneficial for mothers who have previously miscarried and for infertility couples.

"It's just such a clear visual of the developing fetus that gives such relief to the family!" Jackie shares. The clarity of 3D ultrasounds allows them to see exactly what is going on with their baby, offering an extra level of comfort and security.

"I loved being pregnant and I just love to see, especially first time moms and dads, get so excited to see their baby," Jackie tells us. "It's so exciting and it never gets old for me."
If you're expecting and looking to schedule an appointment with one of our providers, you can call our office at 920.729.7105 or click here.

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What You Need To Know About Endometriosis


Mar. 21, 2017 2:21 pm



Are you doubling over in pain during your period? Do you have cramps you just can't seem to shake throughout the month? For 1 in 10 women, these killer cramps are more than just your average visit from Aunt Flo, they're a symptom of endometriosis. Although endometriosis affects 176 million women worldwide, many go undiagnosed. Here's what you need to know about this painful disease and how to find out if endometriosis could be affecting you.

What is Endometriosis?
Endometriosis occurs when tissue similar to the tissue that normally grows inside of the uterus also grows outside of the uterus on areas like your ovaries or inside the pelvic cavity. This tissue becomes inflamed as it grows, resulting in pain and significant scarring to the surrounding tissue.

While it's uncertain what the root cause of endometriosis is, doctors do know that estrogen plays a role. Research also shows that women who have a close female relative with endometriosis are 5-7 times more likely to have it themselves.


Spotting the Symptoms
Although it's a common misconception that endometriosis only occurs in women over the age of 20, the truth is that the disease can develop as soon as a girl gets her first period and can span the rest of a woman's reproductive years.


The most common symptom of endometriosis is pelvic pain. While this pain usually coincides with menstruation, some women can experience this symptom throughout their entire cycle. Other symptoms to look out for include:
  • Pain during or after sex
  • Severe cramps that do not go away with NSAIDs or that impede the activities of your everyday life
  • A heavy menstrual flow
  • Periods that last longer than 7 days
  • Nausea or vomiting
  • Urinary and bowel disorders
  • Difficulty getting pregnant

Not every woman will experience all of these symptoms, but approximately 30%-40% of women who have endometriosis will experience issues with fertility.


Getting a Diagnosis
If you suspect that you may have endometriosis, we encourage you to speak with your doctor or make an appointment with one of the amazing providers at Women's Care. The only way to know for sure whether or not you have endometriosis is to undergo surgery so your doctor can actually see and biopsy the abnormal tissue.


Treating the Symptoms
There are a wide range of treatment options for endometriosis and your doctor may suggest a few less invasive methods before ordering a biopsy. At Women's Care, we work with you to choose a plan that fits your needs and your lifestyle. Some of the most common treatments include:

The use of NSAIDs, such as ibuprofen (advil, motrin) and naproxen sodium (aleve). NSAIDs can help relieve or lessen the pain caused by endometriosis by stopping the release of prostaglandins, one of the main chemicals responsible for painful periods. While NSAIDs can help manage the pain-related symptoms of endometriosis for some women, it's not effective in every case.

Birth control methods such as the pill, the patch and the ring are often helpful to treat the pain associated with endometriosis because they reduce heavy bleeding. This method works best for women who only have severe pain during their period and not during the rest of their cycle.

Progestins are recommended for women who do not get pain relief from or who cannot take hormonal birth control that contains estrogen (such as smokers). This synthetic form of the natural hormone progesterone is available by prescription as a pill or an injection.

GnRH therapy uses medicines that work by causing temporary menopause. The treatment actually causes the ovaries to stop producing estrogen, which causes the endometriosis implants to shrink.

For some women, surgery may be the best treatment method. While there isn't a cure for endometriosis yet, it is possible to remove some of the the scar tissue and lesions with surgery.
If you have endometriosis, surgery could be an option if you:
  • Have severe pain
  • Have tried medications, but still have pain
  • Have a growth or mass in the pelvic area that needs to be examined
  • Are having trouble getting pregnant and endometriosis might be the cause


So What Now?
If you have endometriosis or believe you could have endometriosis, we strongly encourage you to speak with your doctor or one of our highly trained providers. We want you to know that at Women's Care, we're devoted to you and your health. We're here to meet both your physical and your emotional needs each step of the way, from diagnosis to treatment and recovery.

Join our Circle of Care and request an appointment with us today!


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The ART of Physical Therapy


Aug. 1, 2016 4:29 pm

For everything is connected, and just like dominoes, things can stand together and they can tumble down together.



Many times, my patients have questions about what I'm feeling or treating when I work with them. Most people know that physical therapists work with problems within the body, but in my line of practice, people are often befuddled about how and why they were sent to me in the first place. I am going to tell you a little bit about how we (physical therapists) view the patient, how we see and feel their problem and how we justify the treatments that we do.

The first thing physical therapists do is realize that we are treating a whole person, not just a hip, or a bladder, or a sciatic nerve, for example. We understand that the things going on inside your body - what is happening in all your organs and tissues - has influences on neighboring, regional and distant areas of your body (so please, do not be too put off if I'm intrigued by your big toe when you were referred to me for your low back pain). For everything is connected, and just like dominoes, things can stand together and they can tumble down together.

There is an ART to what physical therapists do, both literally and figuratively. Please let me explain: ART stands for Asymmetry, Range of motion and Tissue texture change.

Asymmetry means that your right and left sides don't match. So, when I'm evaluating a woman with any number of problems, I will check to see if her shoulders rest at the same height, if her arms are the same distance away from the body when she is standing up, if the hips are level, and/or if the feet are both pointing straight ahead. When there is a remarkable difference between left and right, I make a note of it and see if it may be part of a larger problem.

Range of motion refers to how much your joints move. When I evaluate someone with knee pain for example, I will measure how much her knee moves with an instrument called a goniometer. I will take that measurement and compare it the corresponding knee on the other side, and I will compare it to documented "normal" measurement for her age.

Tissue texture refers to the relative health of anything that I may be evaluating: muscle, nerve, fascia, ligament or tendons. Even bone has a particular texture or feel to it. In general, healthy tissue is soft and resilient (even bone has a softness to it). For example, if I am palpating (feeling with my hands) muscle tissue, I may be feeling something soft and then suddenly something hard. Depending on the anatomy, that particular finding could be completely normal, or it could be a problem.


Once I have evaluated the ART in my patient, I can put the pieces together, come up with a working diagnosis and explain to the patient what we are going to do to reduce pain, restore function, and get her on the path to living a happier, healthier life.


About PT Center for Women:
Michelle Landsverk is a licensed physical therapist at PT Center forWomen and has practiced the art of manipulative medicine for over 20 years. She specializes in a combination of modalities such as craniosacral techniques, myofascial release, joint manipulation, soft tissue and visceral mobilization, along with therapeutic exercise as an adjunct to manual medicine.

Michelle began her training at Marquette University where she received her Bachelor's Degree in Physical Therapy. She then completed the osteopathic manipulative medicine series of courses through Michigan State University and in 2008, she graduated from Concordia University with her Physical Therapy Doctorate. Recently, she finished the Barral Institute curriculum for visceral mobilization and continues to attend conferences to sharpen her skills at osteopathic manipulative treatment.

Michelle's interest in women's health came from her own experience as a patient during pregnancy. From her labor and delivery, to her postpartum stages, she found a passion for attending to the special needs of females. She recognizes the importance of understanding her patients' concerns and listens closely before evaluating and designing an appropriate treatment plan.

To learn more about Michelle's physical therapy services, visit www.ptcenterforwomen.com or call 920-729-2982.

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Meet Preston and Kristy!


May 10, 2016 9:49 am


Watch their video and learn how the team of specialists at Women's Care of Wisconsin worked together to bring their baby safely into the world.



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