This service within select UT Physicians women’s health clinics comprises 12 reproductive genetic counselors throughout Houston and represents one of the largest teams in the country. They focus on guiding patients through the complexities of understanding family history, genetic testing, and ultrasound findings while providing individualized support and resources. They also work to educate other medical professionals, the next generation of genetic counselors, and the public by participating in advocacy organizations, professional associations, and supervising and teaching genetic counseling students.

Blair K. Stevens, MS, CGC, director of UT Physicians Prenatal Genetic Counseling Services, considers it a privilege and a huge responsibility to ensure her team delivers excellent genetics care in the reproductive space.

“I am very proud that UT does it on such a huge scale for so many Houstonians,” said Stevens, associate professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at McGovern Medical School at UTHealth Houston.

Value of collaboration

Genetic counseling, by nature, is a multi-disciplinary field that can’t be done without maternal fetal medicine specialists, sonographers, obstetricians, and more. Having genetic counselors in-house at UT Physicians, rather than outsourcing genetic counseling services, provides a number of benefits to patients. For example, patients who are concerned about an ultrasound finding or their family history often benefit from speaking with both a maternal fetal medicine specialist and a genetic counselor. Communication between specialists is crucial for enhancing the quality of personalized care.

“Using this team approach, we can relay the patient’s values and needs to each other plus we can strategize the best management plan,” Stevens said. “I wouldn’t have it any other way for our patients.”

For Aarti Ramdaney, MS, CGC, assistant director of Prenatal Genetic Counseling Services, part of her mission is focusing on outreach to local providers and other physicians in Texas to inform them that genetic counseling is an option through telemedicine. She is thrilled they can provide accessible care to Texas families who have previously struggled to access genetic counseling expertise. Although Houston has a large genetic counseling community, there are many parts of Texas where genetic counseling is not easily available. 

Compassion and care

Genetic counselors also provide much compassion. Ramdaney considers the psychosocial aspect of genetic counseling as her niche in the field. Health care is more than logic and facts, she says. The field can present challenging realities for families where critical findings on an ultrasound might reveal concerns for a life-limiting diagnosis.

“There’s so much emotional conflict that can be going on in challenging situations,” said Ramdaney, assistant professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at McGovern Medical School at UTHealth Houston. “It’s helping families process what is often very unexpected information, providing reassurance, and validating their testing and reproductive decisions.”

Ramdaney said often the big question is “why?” Patients ask, “Why is this happening? How do we best take care of our baby? What’s the chance for this to happen again in another pregnancy?” She believes genetic counseling has so much utility for families, when answering those questions is so vital.

“Those are the cases that stand out to me,” Ramdaney said. “How do we accompany them on that journey and make sure they still get what’s important to them.”

Balancing hopes and fears

Stevens said she tells her students that their job is not to make patients feel better. Many times, the news they share with patients doesn’t make them feel better.

“Our job is to make them feel empowered by information and help them realize there is always something to hope for – even in the midst of a diagnosis or a birth defect,” Stevens said. “It’s making sure they find the resources to balance those hopes and those fears.”

For information-seeking patients, Stevens said they appreciate getting a wealth of information before delivery to help them with the adjustment. Knowing a diagnosis ahead of time allows patients to emotionally adjust, do research, and find support networks.

“I love being there when patients don’t know where to turn, and when they are desperately seeking information and support,” Stevens said. “It’s what I love best about my job.”

Cardiovascular disease is actually the No. 1 killer for women in menopause and the post-menopause age group, according to Sandra Hurtado, MD, OB-GYN with UT Physicians and assistant professor at McGovern Medical School at UTHealth Houston.

This focus on women’s health and cardiovascular disease is especially timely, said Hurtado, based on themes presented at the North American Menopause Society’s (NAMS) annual meeting she recently attended. Concentration on cardiovascular disease was one of several significant takeaways she brought back from the meeting.

“We know that the incidence of cardiovascular disease increases with menopause and after,” Hurtado said. “We’re not going to give women estrogen to prevent heart disease, but it is important for them to know it’s an added benefit.”

Recent studies reveal women who begin hormone replacement therapy (HRT) during the transition of menopause, versus waiting 10 years out, see a benefit and a decrease in all-cause mortality and a decrease in heart disease, according to Hurtado. She believes it’s important for women to be aware of this and understand the benefits. This is in addition to other benefits provided by HRT including decreased risk of osteoporosis, treatment of hot flashes, night sweats, and vaginal dryness.

The new recommendation, she continued, is to look at each patient individually to understand their effects from menopause, their symptoms, family history, and other risk factors.

“We want to look at the benefits versus the risks of taking hormone replacement therapy to see if it’s a good idea for them and engage the patient in that conversation,” Hurtado said.

Taking action for cardiovascular health

Controlling high blood pressure can reduce the risk of heart disease by 40%, according to statistics from the NAMS conference. Hurtado said hypertension is what really leads to causing cardiovascular disease and death. She stated that 56% of women aged 55-64 have hypertension, while 65% of women aged 65-74 have hypertension. And the rates continue to increase with age.

Women can develop positive lifestyle choices to achieve good cardiovascular health by following the top five factors: healthy diet, regular exercise, appropriate weight, not smoking, and adequate sleep.

Maintaining average cholesterol levels along with normal body mass index (BMI) are important for preventing cardiac disease, said Hurtado. This translates to keeping BMI under 25 and exercising regularly. New recommendations reveal 150-300 minutes a week of sustained aerobic exercise.

“That’s a lot more than we used to say,” Hurtado said. “That is basically one hour of exercise, five days a week. That’s going to be the most helpful for prevention of heart disease, along with a healthy diet.”

A Mediterranean diet and the Dash diet are two examples, said Hurtado, including low cholesterol, no salt, modified carbohydrates, and limiting alcohol.

Normalizing menopause

Another takeaway important to Hurtado was the misconception of menopause being a negative life event for women. This can translate to discrimination, especially in the workplace, she said, in terms of women being older, having hot flashes, and not thinking as clearly due to potential brain fog. It’s not like women are no longer useful or can no longer fulfill their job, she said.

“We need to have more cultural awareness of menopause, that it’s an accepted life change and not taboo,” Hurtado said. “The conference was pushing for more public awareness of what menopause is for women, which I really liked.”

Breast screening guidelines are different based on your risk

For screening purposes, women fall into two risk categories for breast cancer — average risk and high risk. Each risk category comes with different screening recommendations.

“A woman is considered at average risk if she does not have a personal history of breast cancer, a strong family history of it, chest radiation therapy, or a genetic mutation that would increase her risk,” said Katz.

Screening recommendations for women who are at average risk are below:

• Ages 40 to 44 – mammogram screenings are optional
• Ages 45 to 54 – annual mammograms are recommended
• Ages 55 and older – mammograms can be done every other year or annually
  • Screenings can continue as long as you are in good health

Women who are at high risk for breast cancer have several possible risk factors. These include having radiation therapy to the chest area between the ages of 10 and 30, or being diagnosed or having an immediate family member diagnosed with a BRCA1 or BRCA2 gene mutation, Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalcaba syndrome.

Starting at age 30, both a breast MRI and a mammogram are recommended annually for women who are considered high risk. Those with genetic risks for breast cancer may need to be screened as early as age 25. Consult with your physician for more information.

Types of screening tests

You can get screened for breast cancer at a clinic, hospital, doctor’s office, imaging center, or even an equipped mobile van. The main purpose of a screening is to check a woman’s breasts for any signs or symptoms of cancer. When an issue is diagnosed early, it is easier to treat. The screening you need differs based on your age, health, lifestyle, or other personal risk factors.

“There are different types of screenings available, and each one has its benefits and risks,” said Katz. “Talk to your doctor to discuss what screening option is best for you.”

Mammogram

A mammogram is a digital X-ray of the breast that can find lumps that may be too small to be detected or felt during a self-examination. While this type of screening will not find everything, it is still considered the best way to screen for breast cancer. These digital 2D mammograms are standard. In comparison, 3D mammograms utilize the latest technology in digital breast imaging and improve detection capabilities.

Breast ultrasound

An ultrasound uses sound waves to detect changes in the breast that may be harder to identify from a mammogram, such as differentiating between fluid-filled cysts versus a solid mass.

Breast MRI

An MRI uses radio waves and strong magnets to screen for breast cancer that cannot be seen in a mammogram. MRIs are used as an additional screening tool for women who are considered high risk, alongside a mammogram.

Self-examination

A breast self-exam helps you understand the usual look and feel of your breasts. If you notice a change that seems abnormal, speak with your doctor. Self-exams are not considered a reliable way to detect breast cancer. But, it is important to be familiar with and aware of the normal consistency of your breasts.

Early detection can save your life and your breasts

Screening cannot prevent cancer from happening. If breast cancer is detected early, you have more treatment options available.

A breast cancer screening is quick

The screening process only takes about 15 to 20 minutes. A mammogram can be uncomfortable for some, but your test results are ready quickly. Knowing your current breast health can be reassuring, and if there is a problem, finding out early increases the treatment options you have.

Mammograms are covered by most insurance

Medicare, Medicaid, and most insurance companies cover the cost of mammograms. Please check with your insurance company to determine which locations or types of screenings are covered.

If you don’t have insurance or your current insurance doesn’t cover screening, you may be eligible for free or low-cost screenings in your area. Visit CDC.gov for more information.

Men at high risk should get breast cancer screenings too

Even though it is rare for men to get breast cancer, the most common kinds of cancer in women can also occur in men. Generally, breast cancer screenings are not recommended for men unless they have a BRCA1 or BRCA2 gene mutation.

Getting your test results

If your results are normal, you are all clear. You can schedule your next routine screening. If you had an abnormal screening result, there is a good chance that it is noncancerous or just normal breast tissue. Your doctor will have recommendations of what to expect for follow-up steps to get you diagnosed and treated.

“Most of the time, abnormal results do not turn out to be breast cancer,” said Katz. “The only way to know for certain is by performing follow-up tests to rule out or confirm a diagnosis.”

For Breast Cancer Awareness Month, Jessica Trevino Jones, MD, oncologist and assistant professor with McGovern Medical School at UTHealth Houston, compiled the following researched tips to help reduce your risk! Before starting any new routine, speak with your physician.

Skip morning meals!

Try 16/8 intermittent fasting. Consume your meals from 11 a.m. to 7 p.m. (or noon to 8 p.m.) to help control your insulin and blood sugar levels — and weight! Eating your first meal late in the morning lowers the chances of breast cancer and cardiovascular disease!

Add the EVOO!

Cook with extra virgin olive oil. This Mediterranean staple is rich in healthy fats and antioxidants. Eat a Mediterranean diet to further reduce your risk of breast cancer. High in plant-based foods and low in saturated meats, this diet better protects your body against disease.   

Wine down!

Limit your alcoholic beverages. Seven or more glasses of wine a week can increase your threat of breast cancer by 50%. This is because excessive amounts of alcohol can alter hormone levels and promote cancer growth. Drink no more than four servings of alcohol a week.

Break a sweat!

Stay physically active. Women who engage in 30 minutes of brisk activity three times a week have a 12 to 21% lower risk of breast cancer than those who don’t. Anything that makes you break a sweat counts, whether it is biking, dancing, or mowing the lawn!

Stop “weight”ing!

Lose excess weight now. As people age, weight gain can raise breast cancer risk. In addition to a healthy diet and exercise regimen, consider seeing a weight loss specialist to help lose any stubborn pounds. Consider weight loss medication, or, if necessary, surgery.

D-fend yourself!

Get plenty of vitamin D. Low levels of this nutrient are linked to breast cancer as well as other cancers and degenerative diseases. Ask your doctor to check your vitamin D level to find out if you need more D-quenching sunshine and/or over-the-counter supplements.

Be proactive!

Know your risk. Is your breast tissue dense? Do you have a family history of breast cancer? If the answers are “yes,” your odds increase more than 20%. Discuss the factors with your physician to see if you need dual screening (mammogram and MRI) each year.   

Try preventive medicine!

Ask about medication. Taken daily, certain prescribed medications can reduce a person’s threat of breast cancer by up to 50% over a period of five years! If you run a higher probability, ask your doctor if you are eligible. Prevention is still the best medicine!

Jones is also the founder of the Breast Cancer Prevention program at UTHealth Houston. It offers consultation and care for women susceptible to breast cancer as well as genetic, nutrition, and weight loss counseling.

To schedule an appointment with the breast cancer team, call UT Physicians Multispecialty — Bayshore at 713-486-6325.

What are the warning signs?

“Symptoms of ovarian cancer are very vague and can easily be dismissed,” explained Rosa A. Guerra, MD, gynecologic oncologist with UT Physicians. “Which explains why sometimes it can go undetected until its later stages.”

If you’re experiencing any of the following symptoms, be sure to let your OB-GYN know. While they may not be an indicator of ovarian cancer, it’s always best to keep track of changes in your body.

• Bloating
• Abdominal or pelvic pain
• Feeling full quickly
• Constipation or other changes in bowel habits
• Abnormal uterine bleeding
• Weight changes

Who is at high risk?

Although ovarian cancer can affect anyone, certain genetic and lifestyle factors do play a role in a person’s overall chances of developing the disease.

“Patients who have a strong family history of ovarian cancer may carry a genetic mutation that puts them at an increased risk,” shared Guerra, assistant professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at McGovern Medical School at UTHealth Houston.

Additional risk factors include:

• Older age (63 years old and greater)

• Never having children
• Obesity
• Endometriosis

How is it diagnosed?

Unfortunately, screening for ovarian cancer is not as straightforward as tests for breast or cervical cancer are. Guerra stresses the need for routine pelvic exams with an OB-GYN and vocalizing any new or worrisome symptoms.

A diagnosis can be confirmed through tissue diagnosis via surgery. Treatment depends on the stage upon discovery and includes surgery and/or chemotherapy.

“Our experts are here to not only help, but to listen to your concerns about your body,” said Guerra. “Don’t hesitate to schedule an appointment if you feel like something isn’t quite right.”

For more information on UT Physicians Women’s Centers or to schedule an appointment, call 832-325-7131 or request one online. To learn more about ovarian cancer, visit our medical conditions glossary.

“It was a lot to take in. I felt very alone 24/7, nothing made me happy, and I was irritated all the time,” Masera said. “I would get really sad randomly and feel very anxious. My emotions felt uncontrollable, if that makes any sense.”

Masera said she would get frustrated with her new son, because she was sleep deprived and tired. He would cry, which made her want to cry. Masera connected with Kailey Caplan, MD, reproductive psychiatrist at UT Physicians, for assistance. Caplan diagnosed her with postpartum depression, which she had about two weeks at that time.

“Postpartum depression is an enormous problem. Around 1 in 8 women meet criteria for the disorder, so the fact that there is so much more research being done specifically into postpartum depression, is important and needed,” said Caplan, who is an assistant professor with McGovern Medical School at UTHealth Houston. “Especially since maternal suicide counts for 20% of postpartum deaths.” Caplan said in Texas, particularly, the state has a large maternal mortality problem.

Caplan joined the UT Physicians Women’s Center as a reproductive psychiatrist –a new shared role between OB-GYN and psychiatry. She will primarily focus on reproductive psychiatry issues like managing medications in pregnancy, managing postpartum depression, and psychosis issues related to infertility, grief, and loss.

Masera felt better after talking to one of her mom’s friends and Caplan.

“I don’t feel as sad and alone, because I realized I have to ask for help,” Masera said. “You can’t do it by yourself, no matter how bad you want to.”

New treatment option on the horizon

The Food and Drug Administration recently approved a new medication to help moms who are suffering with postpartum depression. It is hoped that zuranolone will provide faster relief from symptoms than other drug therapy options.

Caplan explained that future advancements could hopefully lead to treating women quicker and more effectively.

“One-fourth of the nation’s syphilis cases come from Texas,” said Irene Stafford, MD, OB-GYN and maternal-fetal medicine specialist with UT Physicians.  

Stafford has always had a special interest in perinatal infectious disease, specifically syphilis, because of its effects on fetuses and newborns. If physicians can get patients screened for syphilis and treated in a timely manner, Stafford said it will help prevent congenital syphilis.

“The sooner a pregnant woman can get tested and treated, the more likely we are to have a completely treated woman, and the baby will not be impacted at all,” said Stafford, associate professor in the Division of Maternal-Fetal Medicine at McGovern Medical School at UTHealth Houston. “People need to realize there is a lot of syphilis in our community right now, and it’s all hands on deck.”

The Houston Health Department issued a press release in July 2023 reporting a syphilis outbreak in Houston regarding the 128% increase. Statistics show a nine-fold rise locally just in congenital syphilis: 16 cases in 2016 to 151 cases in 2021, the most recent year of data. In Stafford’s maternal-fetal medicine clinic, she sees two to three patients a week testing positive for syphilis. And it’s 100% treatable with a penicillin injection. When not treated, syphilis in pregnancy can lead to stillbirth and newborn death. Babies born to women with syphilis can have blood problems, bone problems, inflammation in the organs, neurological conditions (blindness, deafness, meningitis), developmental delays, and even seizures.           

Understanding the challenges

Like other sexually transmitted infections (STIs), Stafford said syphilis disproportionately affects minority, underserved populations, based on a variety of factors: people living in areas without easy access to health care clinics, high immigrant population, and neighborhood clinics closed as a result of COVID-19. In addition to the minority underserved populations, syphilis and other STIs are also on the rise among adolescents.

Making a difference

Stafford is excited to receive a $3.3 million grant for a multicenter study, “Modernizing Perinatal Syphilis Testing,” that provides syphilis patients surveillance and care in one place. The study examines molecular diagnostics for syphilis as well as neurodevelopmental outcome testing on newborns exposed to perinatal syphilis infection.

As a result of this funding, there are a few immediate outcomes. First, Stafford said it’s brought more awareness of the infection in southern states, Texas, and specifically Houston — as well as the need for better and improved diagnostics for syphilis, especially congenital infection. It also allowed Stafford to develop a syphilis program in July that established a perinatal syphilis program once a week in the medical center.

“I’m thankful for the support by Dr. Blackwell (department chair), the nursing leadership, and other physicians allowing us to implement a program at UT for a patient-centered care approach,” Stafford said. “Through this program, we’re going to have better outcomes, and hopefully reduce the burden of infection, especially in our city.”

Recognizing a need, Stafford worked with Harris Health System leadership to create a best practice alert within the electronic health record at Ben Taub Hospital and Lyndon B. Johnson Hospital. If a syphilis screening hasn’t been done at intake or 28 weeks for pregnant patients, it alerts physicians when they log in. This need was based on the huge increase in syphilis cases in these local hospitals.

“Every day, living my life — I’m trying to make a difference with syphilis,” Stafford said. “It’s really exciting, because we’ve actually reduced congenital syphilis. Things like that make an impact, but it’s a struggle because not all states follow the same mandate.”

Focusing on the patient

Stafford encourages sexual health to be a priority for every health visit. It’s not any less important than cholesterol or diabetes, she said. Physicians need to promote screening for STIs annually to get ahead of the problem.

“We keep the fight going because this infection is really a challenge, mainly because it’s quiet,” Stafford said. “It doesn’t hurt. It doesn’t burn. The majority of my patients don’t even know they have it, because it’s quiet, it’s silent.”

The goal for the syphilis program is to follow a patient-centered care approach where Stafford can talk to the patients, educate them, conduct an ultrasound counseling session, and treat them all in one day. This addresses transportation issues that some patients experience. Their partners also can attend and get treated by the local health department, as well, since UTHealth Houston has an agreement with them to help pregnant women and their partners.

“So far, the patients attending the new program are happy, and it’s been incredibly successful,” Stafford said. “I’m hoping this integrative approach where we talk to them — not just as someone treating their infection, but also as someone who’s caring about them, their baby, talking to their partners, and engaging them in health care — will be an improvement in health care.”

Pamela D. Berens, MD, OB-GYN with UT Physicians, supports this development. Opill will serve a need for those who lack access to care by not requiring the time and cost of an appointment.

“I’m very supportive of a progestin-only birth control option being offered over the counter,” said Berens, the Dr. John T. Armstrong Professor in Obstetrics and Gynecology at McGovern Medical School at UTHealth Houston. “It’s a big advance for women’s health care. But, of course, it’s still a good idea to see a health care provider for counseling.”

Berens emphasized the importance of talking with providers about sexually transmitted infections and other things that come with being sexually active. Providers can counsel women if they experience irregular bleeding and review risks and benefits of birth control options.

What is appealing to many is that Opill is a safe option that has been around for a long time. And because it’s progestin only, Berens said it doesn’t have some of the risks associated with it, like other forms of hormonal contraception.

“Many hormonal contraceptive options have both an estrogen and a progestin, so some of the risks are related to the estrogen,” Berens said. “The most important thing for women to know is that progestin-only options may cause irregular bleeding. That’s the most common side effect.”

As Berens shared with CBS Evening News, Opill is a safe option, even though it may not be a perfect option. Unlike other forms of oral contraception, Berens said Opill must be taken at roughly the same time every day. Other pills with progesterone and estrogen by prescription are more forgiving, she said.

“It’s a great option for women who need access to birth control without having to see a physician,” Berens said, “but it’s not going to be right for everyone.”

“It is a very unfortunate situation,” said Angela P. H. Burgess, MD, a maternal-fetal medicine specialist with UT Physicians. “Tori is a great example of how it can happen to anyone during pregnancy, since she was at the peak of health as an Olympic athlete, although severely underweight at time of delivery.”

Burgess, assistant professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at McGovern Medical School at UTHealth Houston, said it appears Bowie had a seizure and most likely pulmonary edema, which led to respiratory distress. Bowie also had a history of bipolar disorder, which Burgess says is important to mention, as it also played a role in her pregnancy outcome.

“A lot of women don’t feel comfortable taking their medication during pregnancy, so they end up stopping,” Burgess said. “There are many medications that are safe to continue during pregnancy, and it’s more beneficial for the mom, as well as the baby, to continue it based on the very, very small medication risk. So, it’s important to discuss with a provider before self-discontinuing any medications.”

Risk factors

About 10% of women in the United States will experience preeclampsia during pregnancy, according to Burgess. In 2021, preeclampsia was responsible for 1,250 maternal deaths per 100,000 births in the United States. Burgess describes four factors that can contribute to pregnant women having a higher risk for developing preeclampsia:

• Chronic hypertension
• Diabetes
• African American ethnicity
• Preeclampsia in a prior pregnancy

Researchers are exploring why African American women are at a higher risk for preeclampsia. One area, Burgess said, is the level of stress and how much it contributes to and predisposes pregnant Black women to getting preeclampsia/eclampsia.

“There can be factors related to life stresses, systemic racism, and different stressors within the system that can combine to an already difficult situation,” Burgess said.

Prenatal care definitely plays a factor in a healthy pregnancy, according to Burgess, since providers can recognize potential issues for early intervention. She said it doesn’t mean Black women do not get prenatal care and that’s what leads to disease.

“That’s not the case,” Burgess said. “But we do know prenatal care, in general, helps to reduce these factors that lead to preeclampsia.”

Controlling what you can

It can be overwhelming to think about dangers related to pregnancy, especially at a time usually devoted to joyful planning. Burgess recommends to control what you can. In terms of prevention, a daily low-dose aspirin usually helps when patients have risk factors for preeclampsia.

Her primary recommendation, however, is to record blood pressure daily during pregnancy. This is regardless of any risk factors in place. This daily routine provides a baseline number, so if it gets elevated, it’s a sign to go to the hospital.

“A number like 140/90 is a warning sign that it could be getting a little high. At 160/110, that’s an indication of an emergency,” Burgess said. “It could cost you your life or your baby’s life, so go to the hospital to get it checked.”

Headaches in pregnancy can be worrisome, although many women brush them off, since it seems like a common pain. If a headache is not getting better after treating it with Tylenol, Burgess said it can signal preeclampsia. “This commonly happens after a woman delivers a baby, and there is a pretty high risk for preeclampsia after delivery,” Burgess said. “If blood pressure is high and there is a headache, absolutely run to the hospital. That requires medical treatment.”

Making a difference

Burgess has a passion for eliminating health disparities in health care. Since November 2021, she has been working on a project with Morgan Foreman, PhD candidate at McWilliams School of Biomedical Informatics at UTHealth Houston, exploring how to help African American women recognize certain symptoms and bridge gaps to work collaboratively and communicate with their doctors providing care. The goal is to use digital health theories to build out culturally tailored solutions for these women with an app or other technology solution to make collaboration and education simpler.

In addition to research, Burgess said there are things everyone can do to make a difference, so no one experiences pregnancy alone.

“If there is someone around you who is pregnant, think about different ways to support them,” Burgess said. “Support is needed — community support, partner support if a partner is present, taking care of the baby, helping them out if they’re stressed. Pregnancy is definitely something that shouldn’t be done all alone. It takes a village.”

Certified nurse midwives are advanced-practice registered nurses who play an essential role in a patient’s pregnancy journey — before, during, and following labor. They also provide care for women throughout their lifespan including addressing gynecological problems, performing well-woman exams, and discussing contraception options.

“Our approach to childbirth is considered holistic with necessary medical intervention,” Rigby explained. “The goal of a midwife is to provide the safest and most compassionate care possible for those who choose to deliver their baby in a hospital setting.”

During the prenatal phase, CNMs work with patients on what to expect in the different trimesters, outline a birth plan, discuss pain management, and prepare for going home with a baby.

While in labor, a CNM can provide hands-on assistance and moral support in addition to delivering a baby.

“We provide personalized care for the whole family during the labor process. If mom-to-be wants to deliver on her hands and knees, feels like she needs to walk around, or even wants to sit on a yoga ball, we’ll facilitate that so it happens in a safe manner. We’ll also coach their support person so that they are more involved,” Rigby said.

One common misconception surrounding midwives is that you can’t have one if you choose to receive an epidural or any other pain management medication.

“Whether a patient chooses a natural or medicated birth, that’s completely fine with us. We’re here to support whatever decision they make,” she said.

In the postpartum period, CNMs ensure a support system is in place for their patient once they are home, offer breastfeeding support or referrals to a lactation counselor, and monitor for signs of depression.

“Although pregnancy is a miraculous and beautiful thing, it can also be complicated and scary. We are here to be your advocates during that journey,” Rigby shared.

To request an appointment with a certified nurse midwife, call 832-325-7131 or book online.