Perfect age for pregnancy? - Soothe your PMS moods Put an end to endometriosis pain - CHI Health
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Perfect age for
pregnancy?
Soothe your
PMS moods
Put an end to
endometriosis
pain
May 2022
CHIhealth.com
Keep this What to expect with a well-woman exam
date:
Head-to-toe physical exam Speculum, to see what you can’t
Everything from Examination for cervical or vaginal
headaches to tissue abnormalities and signs of
Yearly well- cardiovascular risk to
bone health, plus
skin cancer on or near the vulva.
Hands-on pelvic exam
woman visit breast cancer and other
preventive screenings.
Checking for uterine and pelvic
masses or discomfort, which is
Once a year, put yourself Pap smear, but may important because no annual
first. Prioritize your health not be needed every year screening tests exist for uterine or
with a well-woman exam. It’s Testing for abnormal cervical ovarian cancers.
powerful medicine. cells recommended every 1 to 5 Time for your questions
“We can find precancerous cells years, depending on results. Testing From body changes to sexual health.
long before they become cervical for the human papillomavirus (HPV) “You should feel comfortable asking
cancer. That’s huge. It’s priceless,” at the same time as Pap smear, or as your provider anything,” Kennedy
said Chelsey Kennedy, WHNP, CHI needed. said.
Health Nurse Practitioner. Each visit is
unique to your needs and stage in life.
“The preventive care we offer and Looking for an Ob-Gyn? Your perfect match is just a few clicks
what we talk about depends on the away. Take the short quiz on MyProviderMatch.com to find a
patient,” Kennedy said. provider that fits your needs.
You’re not
Crying over spilled coffee? Yelling 5 or more symptoms with most
in traffic? “Hormones that regulate menstrual cycles during a year. The
horrible!
menstrual cycles can also trigger difference is often the intensity.
emotional symptoms beyond physical “If troubling symptoms affect your
symptoms like bloating and breast life or relationships, talk to your
tenderness,” said Kathryn Klayum,
It’s just hormones
provider,” said Dr. Klayum. PMS and
DO, CHI Health Ob-Gyn. PMDD can improve with lifestyle
Premenstrual syndrome (PMS) is changes. PMDD can also improve
when you have more than 1-2 mild with medication therapy like oral
symptoms. Premenstrual dysphoric contraceptives and selective serotonin
disorder (PMDD) is when you have reuptake inhibitors.
PMS vs. PMDD
Mood changes Intense mood swings, including anger
Feeling down/depressed Extreme sadness/hopelessness
Feeling anxious Extreme anxiety
Fatigue/difficulty sleeping Sleepiness/insomnia
No suicidal thoughts Suicidal thoughts
Affects usual routine Affects relationships, work, hobbies
CHIhealth.com/PMS
2 Better You • 2022
Put an end to endometriosis pain
Pain is not normal. John Cote, MD, there is evidence that it’s a type of
CHI Health Ob-Gyn says if you autoimmune disorder, and genetics
experience painful periods, non- have been found to play a role.”
menstrual pelvic pain, and pain during While endometriosis can impact
intercourse, talk to your provider – fertility, there is no way to know the
it could be endometriosis. extent until you’re trying to conceive.
Endometriosis is an estrogen- “We don’t need a surgical diagnosis to
dependent disease. It occurs when start treating your symptoms, so it’s
endometrial cells and tissue from important not to wait to seek help,”
inside the uterus get out and attach Dr. Cote said. “There is no magic
to other areas of the body. cure, yet, but we do have medications,
response – leading to inflammation,
“We’ve found them everywhere, from hypersensitivity, and ultimately: pain. hormone suppressants and physical
fallopian tubes to ovaries and bladders, therapies that can help. Even
“The exact cause of endometriosis
even bowels,” Dr. Cote said. something as simple as changing your
is hard to pin down. The backward
These rogue cells are stimulated by diet can help with inflammation, but
flow of menstrual blood can lead
estrogen, which triggers an immune you have to start somewhere.”
to endometrial cells spilling into the
pelvic cavity,” Dr. Cote said. “But CHIhealth.com/Endometriosis
Pregnancy: A test in patience and persistence
Not everyone’s journey to mother- Dr. Schultz said. “We can get a lot
hood looks the same. On average: of answers from lab work, hormone
analysis, ultrasounds and other
57% of couples trying will non-invasive methods.”
achieve pregnancy within
three months
“Your ability to conceive
72% within six months is not a reflection of you
85% within a year or your worth.”
For the 15 percent who don’t conceive
within a year, Sarah Schultz, MD, Once identified, many specific
CHI Health Ob-Gyn, says it’s time to abnormalities can be fixed with life-
talk to your provider about fertility. style changes, medications or surgeries.
For women with a known endometri-
For the unexplained issues, the next
osis diagnosis, or those over the age
step is a referral to a specialist.
of 35, she suggests coming in after six
months. “There are many ways to grow a family
that we can explore together,” Dr.
“A third of the time, fertility issues
Schultz said. “We will walk this road
stem from the woman, and about a
with you and do everything we can
third of the time it’s the man. The
to support you on this journey.”
other 40 percent of the time it’s a
combination, or it’s unexplained,” CHIhealth.com/Infertility
CHIhealth.com • Better You 3
28 Deliver baby
35
your way!
CHI Health Birth Centers and Maternity
Centers both offer comfortable suites
and nitrous oxide to relax moms-to-be,
with some key differences:
Birth Center:
• For healthy, low risk moms
and babies
• Midwife-centered approach
• Holistic delivery emphasizes
25
natural pain relief
Maternity Center:
• Located within full service
hospitals
Perfect pregnancy age: • Round-the-clock access
to specialty care
• Pain relief options include
Behind the numbers epidurals
Looking for the perfect place to have
Is age just a number when it comes women over age 40 can have issues
your baby? Check out the back cover
to pregnancy? It’s true – your fertility getting pregnant.
for more! CHIhealth.com/Maternity
declines as you age. But CDC statistics “We know that fertility really starts
show more women are waiting longer to decline in a woman’s late 30s, but
to have children. that decline can happen earlier,” Mothers’ average
The current national average age Dr. Kuhlmann said. “Most women
at first delivery is 27. in their 20s and early 30s don’t age at first birth
In 2020, 30- to 34-year-old women have much trouble, but there are
had a higher birth rate than 25- to exceptions.”
29-year-old women for the fifth Factors include low ovarian reserve,
straight year. chronic medical conditions like
So, why the wait? “Often women in diabetes or hypertension, and male
their late 30s are more established in infertility.
their careers,” said Maggie Kuhlmann, “There’s no perfect time,” she said.
MD, CHI Health Maternal Fetal “You have to make a decision that 1970: 21.4
Medicine and High Risk Pregnancy balances your goals for starting a
Specialist. “They feel more prepared family with the other things going on 2000: 24.9
to deal with the complexities of in your life.”
parenthood.” 2010: 25.4
Most women assume they will be 2020: 27.1
able to have babies as soon as they’re Having a baby can be
ready. It’s not always that simple. It’s expensive, scan the QR
a common misconception that only code for ways to save!
National Vital Statistics Reports
4 Better You • 2022
Is it hot in here, or is it baby fever?
So, you want to have a baby… Next up, you‘ll want to schedule and Dr. Boyer recommends and
now what? attend regular prenatal visits. It’s encourages everyone to get the
First, congratulations! important to keep track of your health, COVID-19 vaccine, whether you’re
and your baby’s. pregnant, or looking to conceive.
Now, it’s time to find a provider.
A preconception appointment can Pregnant women are at a higher risk
help rule out any potential health for COVID-19 complications, and
or fertility issues, establish medical getting the vaccine before or during
history and ensure any medications pregnancy gives antibodies to your
you’re on are safe for baby.
pregnancy. Providers also The best advice for becoming a
encourage women to start first-time parent? It’s okay to not
taking prenatal vitamins be perfect.
6-12 months before getting “Perfect parents don’t
pregnant. exist, and children don’t
“Focusing on being the best need perfect parents,” Dr. Boyer
and most healthy version of said. “All they need is committed,
yourself is the most important loving parents who are doing their
thing,” said Samantha Boyer, DO, best. It’s okay to mess up, because
CHI Health Family Medicine provider. every parent does.”
“Deciding to have a baby can feel like For information on childbirth classes
this huge leap into the unknown and and support offered by CHI Health,
it’s likely you’ll experience joy, but a go to CHIhealth.com/ChildbirthEducation.
little planning will help anxiety and
nervousness.”
Breastfeeding,
good for you and baby!
Breast milk keeps your baby healthy. “We’re sitting face to face, giving
But for new moms, it can be stressful that hands-on help and support,”
to learn. Whether it’s through one- said Cheryl Hruska, RN, BSN, IBCLC,
on-one meetings or support groups, Certified Lactation Consultant with
CHI Health has lactation teams to CHI Health. “It’s a lot more beneficial
help you, and your baby, navigate than what somebody can get from
the process. a computer screen or a comment
CHI Health offers free, in-person section online.”
support groups for moms and For more information on lactation
babies up to a year old. consulting visits or support groups
near you, go to: CHIhealth.com/
Breastfeeding
CHIhealth.com • Better You 5
Pay attention to
preeclampsia Should I…call
A new baby can make your heart go
pitter patter – too much.
the midwife?!?
Preeclampsia is a serious blood
pressure condition that can
develop during pregnancy but can
also begin after women take their
babies home. It can take weeks,
even months after delivery, for
preeclampsia to completely resolve,
according to Amanda Stuelpnagel,
MD, CHI Health Ob-Gyn.
“If identified early, complications
such as stroke, heart attack and
seizures are largely preventable,” The CHI Health Birth Center offers a homelike setting for moms-to-be.
she said.
Who should deliver your baby? Family Many families appreciate midwives’
doctor, Ob-Gyn…or maybe a midwife low-tech, high-touch approach that
is right for you. emphasizes hands-on care and options
“I encourage all soon-to-be families like water births over induction of labor
to explore what’s available knowing and epidurals. Like their physician
Danger Signs of Preeclampsia counterparts, midwives can provide
certified nurse midwives are a safe and
Before or after delivery, seek trusted option for low-risk, vaginal pain relief and a higher level of care is
emergency medical care for: pregnancies,” said Karen McGivney- always at the ready as back-up.
• Blood pressure of 160/110 Liechti, MSN, APRN-CNM, Certified “Midwives are part of the Birth Center
or higher Nurse Midwife at CHI Health. care team at CHI Health. We can
seamlessly transition from a natural
• Seeing spots or sparkles “We walk the journey to cesarean birth. And our patients
• Severe headache have access to some of the best
• Stomach pain, nausea
with our moms, neonatologists in the state staffing our
or vomiting listening to their NICUs,” she said.
“Your birth plan and who you trust
• Trouble breathing or
shortness of breath
preferences, sharing to make it happen is a very personal
• Swelling in hands or face options and what decision. We want our families to have
the birth experience they dreamed
works well.” about.”
“Many women make the mistake of It’s a misconception midwives are Midwives are currently available at
thinking they are ‘back to normal’ untrained labor coaches. CHI Health facilities in Omaha and
after delivery,” she said. “Just like Certified nurse midwives (CNM) are Lincoln, and coming soon to
pregnancy, the postpartum period master’s and/or doctorate degree nurses CHI Health St. Francis.
is a critical time and new moms with additional focused training on CHIhealth.com/DoctorMidwife
need to remember to take time for prenatal and postnatal care including
themselves and their health.” breastfeeding, labor and delivery, and
well-woman services.
6 Better You • 2022Ask your baby expert
It’s impossible for new parents to To find the right provider for
know everything. From daily your newborn, ask yourself:
parenting questions to big health care
decisions, providers are available to • Did the provider give me a
help. chance to ask questions?
“Partner with a provider you trust to • Was the provider really listening
help you navigate parenthood, as well to me?
as someone with the experience and • Did the provider explain things
expertise you can rely on to keep your in a way I could understand?
baby healthy and safe,” said Terry
Becker, MD, Family Medicine and • Did I feel comfortable sharing
Obstetrics physician with CHI Health. my thoughts and concerns?
If you choose the right provider, the • Did the provider seem to know
How often should relationship can last a lifetime. about the latest medical
advances?
I feed my baby? “Growing with and advocating for our
patients–newborns through adult- The third trimester is when Dr.
Is that poop color hood–we build lasting relationships
in family medicine. Even more, we
Becker recommends parents start
looking for their baby’s provider.
normal? know you and your medical history Don’t know where to start?
inside and out. I have many families MyProviderMatch.com takes the
What about that I see five different generations of guesswork out of finding the right
patients. This helps me to know that provider for your family.
co-sleeping? family thoroughly,” he added.
CHIhealth.com/BabyPoops
Happiest time of your life…or is it?
Most new moms (80 percent*), “You are not alone. Talking to a trusted family member, friend, therapist,
experience mood swings triggered and/or getting professional support is one of the healthiest ways to heal.”
by rapidly dropping hormones and
sleep deprivation known as the Help is available 24/7 by calling:
“baby blues.” • Metro Omaha & Lincoln: 402.717.HOPE
For a few (15 percent*), those feelings • Kearney - Richard Young Behavioral Health: 1.800.930.0031
of worry, unhappiness and fatigue • Grand Island - St. Francis Alcohol & Drug Treatment Center:
turn into something more serious– 308.398.5427
postpartum depression.
Seek immediate help if feelings:
“The excitement of a new baby comes
with physical and emotional changes. » Don’t fade after two weeks or get worse
It can become overwhelming and » Make it hard for you to care for your baby
confusing. At times these feelings » Make it hard to complete everyday tasks
will not go away on their own,”
said Chelsea Hunter, LCSW, » Include thoughts of harming yourself or your baby
CHI Health Licensed Independent
CHIhealth.com/PPD
Mental Health Practitioner.
*National Alliance on Mental Illness
CHIhealth.com • Better You 7NONPROFIT ORG
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Take a virtual tour
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throughout the CHI Health network
Have your baby close to home:
CHI Health has options where you are
Metro Omaha Grand Island Nebraska City
CHI Health Creighton University CHI Health St. Francis** CHI Health St. Mary’s
Medical Center - Bergan Mercy*** 2620 W Faidley Ave 1301 Grundman Blvd
7500 Mercy Rd Grand Island, NE 68803 Nebraska City, NE 68410
Omaha, NE 68124 Midwives - Coming Soon
Schuyler
CHI Health Immanuel Kearney CHI Health Schuyler
6901 N 72nd St CHI Health Good Samaritan** 104 W 17 St
Omaha, NE 68122 10 E 31st St Schuyler, NE 68661
Maternity Center & Birth Center Kearney, NE 68847
located within the hospital
Lincoln ** Level II NICU at this
CHI Health Maternity Center
CHI Health Lakeside*** CHI Health Birth Center
16901 Lakeside Hills Ct 8020 O St *** Level III NICU at this
CHI Health Maternity Center
Omaha, NE 68130 Lincoln, NE 68510
CHI Health Mercy Council Bluffs** CHI Health St. Elizabeth***
800 Mercy Dr 555 S 70th St
Council Bluffs, IA 51503 Lincoln, NE 68510You can also read
