The importance of conversation in women's reproductive healthcare

·4 min read

Jun. 5—MORGANTOWN — The ability to have open, comfortable and timely conversations regarding women's reproductive health can result in the treatment or prevention of health conditions sooner rather than later, local medical professionals say.

According to the World Health Organization (WHO), reproductive health is a term used to refer to a state of "complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes."

WHO also says the term implies that individuals are engaging in satisfying and safe sexual activity and that they are capable of reproducing and determining if, when and how often to do so.

Dr. Ryan Heitmann, medical director for the Center of Reproductive Medicine at WVU Medicine, said the term "women's reproductive health " has a variety of different definitions. It can refer to women's health in general, which encompasses every aspect of a woman's well-being, or it can refer to more specific reproductive issues.

These include difficulties conceiving a child, difficulties with maintaining a pregnancy and concerns regarding the menstrual cycle.

Heitmann said women might feel that it's inappropriate for them to discuss aspects of their own reproductive health outside of a medical setting because of the societal expectation that women refrain from speaking about their periods or their struggles with getting pregnant.

"I don't know if those subjects are still thought to be taboo. I think we see that, still, with women who try to breastfeed in public. I think we've overcome some of the barriers in that realm before, and maybe this is the next barrier to overcome in women's health, " he said.

He said that the biggest consequence of women feeling uncomfortable discussing their reproductive health is their silence, which can lead to a lack of help or resolution for the health issues they're facing or concerns they have. If they wait too long to speak up about what's going on, it might be too late to receive the help they need.

"We hear lots of times here, 'I didn't even know that this existed, or that I could get help, ' or, 'If I had only known a few years ago, ' things like that. We hear that very commonly, " Heitmann said.

Sarah Highlander, nurse midwife and nurse practitioner at Mon Health Obstetrics & Gynecology, said it is especially important to focus on women's health prior to conception. Mon Health has seen many patients who aren't in the greatest state where their health is concerned when they come in with a new pregnancy.

Newly pregnant women have presented with health issues such as diabetes, cardiovascular problems, poor diets and substance abuse. These could be handled with lifestyle changes that would ultimately help decrease the complication risk of a pregnancy if they are addressed beforehand, said Highlander.

She said a lot of times, women do not admit to headaches during pregnancy. That symptom can clue doctors into cardiovascular issues or the potential development of preeclampsia.

"Sometimes women are in tune to those bodies and don't give us the signs that we can prevent an early delivery, or even the [woman ] having seizures and becoming very sick, because she just does not know to report those signs, " she said.

If healthcare providers could encourage women to receive preconception counseling, they might begin to see some healthier pregnancy outcomes.

According to Highlander, healthcare providers can do this by discussing preconception and the specifics of a healthy pregnancy with their patients at annual well-woman visits.

Alternately, women can call their healthcare provider for a preconception visit outside of their well-woman visit to discuss issues that might need to be adjusted, medications that might need to be changed and other things they can do to encourage a healthier pregnancy.

Highlander goes above and beyond to make sure her patients are comfortable speaking with her about their reproductive health. She arranges visits centered on developing trust and the patients' confidence levels prior to exams which require the patient getting undressed or discussing sensitive, intimate topics.

"I have met people in a clothed situation in an office instead of in an exam room, in a gown, where they're vulnerable. I try to develop that trust before we get into those issues, " she said.

Highlander also encourages her patients to approach her with any questions, concerns or potential symptoms that they have or are experiencing.

She often tells her patients, "The only crazy or weird question is the one that's not asked, " because worse things can happen as a result of withholding those questions.

Even with practitioners like Highlander who strive to foster a comfortable, honest environment among their patients, she still feels that there is a lot of taboo and stigma surrounding reproductive health, especially concerning postpartum depression, sexually transmitted infections and young people being taught about their bodies.

"I feel like if we would take those stigmas away and start educating earlier, people would be more knowledgeable and empowered with making health decisions, " Highlander said.

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