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Woman's health during pregnancy

There is an important link between a woman’s oral health and her overall health, says Dr. Jana Gyurina of Oak Park Dental in Madison.

“The mouth is frequently the entry point for bacteria to enter the body and has been strongly correlated with systemic diseases including diabetes, cardiovascular disease, stroke and pregnancy omplications,” she explains.

As a result, maintaining good oral health can be vital to a healthy pregnancy. Gyurina says physicians typically encourage women to get a dental checkup and cleaning during their pregnancy.

“Dental health professionals can help minimize any negative effect oral bacteria, infection and disease could have on both the mother and the baby,” Gyurina says.

Many women experience an exaggerated immune response during pregnancy due to increased hormone levels. Often called “pregnancy gingivitis,” this reaction can cause painful, swollen gums with increased bleeding. And when the gum tissue is inflamed in this way, the potential for periodontal disease increases dramatically if not treated, which in turn can create complications during pregnancy.

“Pregnant women with periodontal disease are more likely to have pre-term deliveries or babies with a lower birth weight,” Gyurina says.

In addition, a woman’s oral health is influenced by hormones throughout her life. When estrogen and progesterone are at higher levels – for example, during puberty, menstruation and pregnancy – a more thorough oral hygiene routine can minimize the effects of hormone-related responses, Gyurina says.

Other aspects of pregnancy benefit from a cover-all-bases approach, which SSM Health provides.

“We really work well as a team, which is phenomenal in women’s health care,” says Kimberly Bertram, SSM Health certified nurse midwife.

Bertram is one of three midwives to join SSM Health as part of a new midwife program. The health care provider added midwifery to provide women with a full range of care.

“It definitely gives women a full range of options on what is available to them,” she says. “Some women feel more drawn to midwives. We feel women should have that option.”

The midwives see women throughout their entire pregnancy, including during childbirth and postpartum. They can also assist with annual exams, pap smears, family planning and other women’s health concerns.

The biggest benefit of working with a midwife throughout pregnancy is the relationship that is established between the midwife and the mother and her family, Bertram says. In fact, Bertram and her colleagues each meet with a mother at some point during her pregnancy and the on-call midwife will assist with labor and delivery.

“Having a midwife for care is really having a partner in the process,” she says. “We develop a close relationship with the women and their families and get to know their unique needs and desires to help them through the process.”

Informing expectant mothers on good nutrition, exercise and stress reduction is also a midwife’s role. And their work continues after the baby is born. Midwives help assess the mother postpartum to see how she is doing both physically and mentally.

This is important because postpartum depression affects about 21 percent of women, Bertram says. “We think of pregnancy as this joyful event, but it doesn’t always go perfectly or feel perfect to someone. We help with that psychological aspect and get women connected if they do feel that they need help,” she says.

The midwives work in close collaboration with physicians, obstetricians, gynecologists, nurse practitioners and physician assistants to optimize the health of their patients. If the mother is developing some high-risk factors, for example, the midwife team can consult with or refer her to maternal fetal medicine specialists who specialize in high risk disorders in pregnancy.

The connection that all the different departments have is what makes SSM Health stand out in women’s health care, Bertram says.

“The midwives provide excellent care, but we can’t do it alone,” Bertram explains. “We have so much support from our physician colleagues and our interdisciplinary team works really well together, which is fantastic for patients.” —

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