My mom still makes fun of me for my reaction after my first gynecologist appointment. “That was heaven!” I exclaimed, coming out of the office. Needless to say, at the time, she was probably more disturbed than amused about her 18-year-old’s enjoyment of the get naked, spread your legs, insert speculum routine. But I was just happy that it didn’t hurt. After all, I had expected the worst.
In retrospect, my reaction could probably be viewed as one of the first hints of my passion for women’s health. Not everyone, I realize, is exactly pumped to go to the gyno.
But if even if you’re a healthy gal just looking for a pap smear, you have another option who might just give you the kind of satisfaction I experienced during my first trip: a midwife. Contrary to popular belief, most midwives don’t work in homes—they work in hospitals and physician practices, and they are trained and licensed to do much more than manage women during pregnancy and childbirth.
Like your gynecologist, certified nurse midwives (a common type of midwife whose training generally exceeds that of a registered nurse) can perform physicals, write birth control and other prescriptions, and order lab tests. And, according to Loral Patchen, a hospital-based midwife at Washington Hospital Center in Washington, DC, many of the skills taught in midwifery training are things “like counseling and identification of what the individual’s priorities and needs are…they’re the same kinds of skills that you need for other [non-pregnancy-related] aspects of women’s reproductive and sexual health.”
But unlike your gynecologist, who is an expert in illness, midwives are experts in wellness. In the same way they approach childbirth from the perspective that it’s part of a normal life cycle, they conduct routine gynecological exams with the expectation that what you’ve got going on down below is normal.
As Patchen explains, “It’s easy sometimes to forget that normal has many different faces and you have to do enough of it to recognize that normal is normal,” and there isn’t always some pathological condition there.
That’s not to say that midwives can’t pick out when something is wrong—quite the opposite, in fact. Because they care for so many healthy patients, their alarm bells sound when they see one who might not be. And if something appears to be outside of your midwife’s scope of practice or in need of medical intervention, she’ll consult with or refer you to a doctor or another health care provider who can help.
So why not consider seeing someone whose expertise lies in your non-condition—that is, your health? “I don’t think that midwives are just about childbirth,” said Patchen. “We are about taking care of women. There’s a whole lifespan.”
Knowing that midwives provide these services—and that they’re covered by Medicare and the majority of private insurance companies—doesn’t just open up your options when you’ve run out of birth control or you need that annual exam. It also gives you an option to have a different kind of experience altogether. (Yes, an “appointment” can turn into an “experience.”)
What if my first annual exam had been with a midwife? Loral predicts that I would have had the option of inserting the speculum myself, and perhaps would have even gotten a peek at my own cervix with a handheld mirror. (I wonder what my reaction would have been after that.)
Of course, not everyone wants this kind of care—some of us just want to get it over with. But the point is: You have more options than you might think.
Anna Miller is a health writer in Washington, D.C., where she's been published in The Washington Post and US News & World Report. She is a proud Michigan Wolverine, beer enthusiast, and two-time marathoner who can’t go a day without peanut butter. On any one day, you may find her rehearsing for a community theater musical, working her way into an embassy party, running around the Washington Monument in her underwear (ok, once! For charity!), or listening to a panel at the National Press Club. For these reasons, she has been called “a weird-stuff-o-meter” and takes it as a compliment. Follow her @AnnaMedaris.
I stumbled across this article in my search for a new health care provider after relocating, and I see you're in DC. I just moved to DC from the Chicago, and I'm curious to try a midwife/nurse practitioner over a gyno--are there any local midwives you can recommend, or a resource for finding one?
Thanks!
Sarah
