Travis Baumgarten (Host): Welcome to Mile Bluff Unscripted, where we bring you real conversations with the people behind your care. I'm Travis Baumgarten. And today, I'm joined by certified nurse midwife, Lyn Wedyke, to talk about women's health and midwifery. Thanks for joining us, Lyn. To start off, tell us a little bit about yourself, your background, and what inspired you to specialize in midwifery.

Lyn Wedyke, CNM: I wanted to be a nurse since I was 16. My grandmother had cancer when I was that young, and she was my favorite person in the whole world. When the nurses were taking care of her, it really struck with me that that was what I wanted to do with my life. So, I graduated high school, and I was from a small town and from a humble home that didn't have a lot of money, so I decided to join the Air Force. And I did 28 years in the United States Air Force, traveling all around, got my nursing degree on nights and weekends, got my master's degree, and became a nurse and a nurse midwife in the Air Force.

During that journey, my first preceptorship was on labor and delivery, and that's all it took. I was in love, and I was going to do women's health.

Host: So, knowing a little bit more about your background now, how would you say those experiences influence your approach to patient care today?

Lyn Wedyke, CNM: Well, I think coming from a small town, a difficult childhood, and then traveling all over the world, I have met all walks of life of people. And I think that lets me relate with my patients very well, and that is what helps me give them good care.

Host: And for those who may not be familiar with midwifery care, how do you typically introduce your role and scope of practice to new patients, especially those who may only be familiar with the OB physicians?

Lyn Wedyke, CNM: As a nurse midwife, I'm an advanced practice registered nurse that specializes in midwifery and women's healthcare, much different than an OB doctor. Usually, as a nurse midwife, we handle the range of normal pregnancies, normal issues that women have. We have usually longer appointments. We can do anything from women's healthcare, GYN services, preconception, of course, childbearing years, postpartum, perimenopause, and menopause. From the adolescence to the mature woman, a nurse midwife can help her.

Host: Yeah. And expanding on that a bit, for someone newly pregnant, how do you explain the differences between care with a midwife, an obstetrician, and a collaborative midwife OB model, including how you handle those high-risk situations?

Lyn Wedyke, CNM: We have a collaborative practice here at Mile Bluff, and I absolutely love it. A nurse midwife, we handle, once again, I said the normal stuff, a normal pregnancy, which means a low-risk pregnancy. So as long as you are low risk and there are no high-risk situations like, you know, hypertension, gestational diabetes on insulin, those kind of things, then we are able to take care of you during your pregnancy.

But when there are high-risk situations, and sometimes normal low-risk females will suddenly be high risk, we have the option here at Mile Bluff. We have five family medicine physicians with OB practice that are absolutely phenomenal. I have total confidence in them. They are competent, efficient, and 100% can take care of any emergencies that we have.

Host: So, what are the most important questions you wish every patient would ask during their first prenatal visit with you?

Lyn Wedyke, CNM: I would like them to know a little bit about me at first just to see what my experience is, so they just don't walk you know, have some expectations. Like, "How many years have you did this? How many babies have you delivered? What do you do in emergency situations?" Those are the kind of things.

And then, also, I want them to reflect back on themselves. "Okay, I want to have the healthiest baby possible. So, how do I do that? How do I make sure that I stay healthy and my baby stays healthy? What kind of steps do I need to do?"

Host: And let's walk through the journey a bit. So, take us through your approach to managing a low-risk pregnancy from the first visit through delivery, including the key screenings and milestones that go along the way.

Lyn Wedyke, CNM: Okay. So, we start out with a new OB visit anywhere from eight to 12 weeks, and we talk about diet. A lot of it's education at this visit. We talk about diet and exercise, the changes your body's going through, testing that's available for you and your baby for genetic diseases and stuff. Then, I map out a plan of, you know, what the visits are going to look like. So, we see them every four weeks until 28 weeks, then every two weeks till 36 weeks, then every week until we have a baby.

Some of the milestones that you see that we test is we have an anatomy scan at 20 weeks that looks at the baby from head to toe to make sure everything is looking good. We do glucose tests and check for anemia between 24 and 28 weeks. And we do a group B strep test at 36 weeks. Group B strep's a bacteria that is normal on our bodies, but it's not normal if it gets in a baby's respiratory system. It can cause pneumonia or sepsis. So, it's one of the easiest tests that we do that can prevent harm to our babies.

Host: Yeah. And one topic that always comes up is pain management in labor. So, how do you counsel patients about the full spectrum of pain relief options that we offer?

Lyn Wedyke, CNM: Oh, that's a good question. So, midwife actually means with woman. And saying that is, I don't care how we get there, healthy mom, healthy baby is my ultimate goal. And so, saying that, we have a variety of methods available for pain control. One, of course, is the natural method. You're getting up, you're walking around, you're on the ball, you're in the shower, in the tub, those kind of things. You know, pressure, massage, all of those things can help. But then, when those can't help anymore, we have an IV medication that can help you. We have nitrous oxide, the gas, and you can get an epidural. We have all of those options available at Mile Bluff. And I don't care what you do. Let's just have a healthy mom and a healthy baby.

Host: And along the way, I imagine you have encountered a few misconceptions. What are some of the most common misunderstandings about midwives and midwifery care, and how do you address them with both patients and other clinicians?

Lyn Wedyke, CNM: A lot of it has to do is people aren't used to seeing nurse midwives. And when they hear the word midwife, they think we only do home births, you know? And I'm like, "No, we work in hospitals. We work along our colleagues and our OB and family medicine physicians." And so, I think that's probably the biggest thing, is that they think we only deliver babies, we only do home births, and we don't do the rest of women's healthcare, which in fact, we are educated, we have master's degrees, and we are well-credentialed to deliver care through the lifespan.

Host: And after delivery, there's a whole new phase of care, in the immediate postpartum period. What are your top priorities for the birthing parent and the newborn? And how do you help families distinguish between normal recovery and warning signs that need urgent care?

Lyn Wedyke, CNM: It goes down to two things, physical and mental. The physical, we're wanting to make sure mom and baby transition to this new time in their life, right? So, is mom recovering good? Is her bleeding okay? Is her blood pressure okay? Is she bonding with the baby? Skin-to-skin is so important. Same with a newborn baby. Are the vital signs stable? Has the baby transitioned to normal outside of the mom's belly? Are those things all going well?

And then, you know, we also look at the mental health. You know, for the first seven days, moms go through what I call the baby blues. You know, they're crying one minute, they're laughing the next, they're all over the place. And it's so normal because of hormones going up and down. And just normalizing that and letting them know, "Hey, that's normal. Don't worry about it." but the other thing is that, if after two weeks you're crying all the time, you don't want to hold your baby, you're not bonding, you're overwhelmed, then we have an issue. Come and talk to me. We have lots of different interventions we can do to get you back to where you're enjoying your baby and your family life.

And some of the warning signs you look for are sudden weight gain. You get home and all of a sudden you put on 20 pounds. You have a severe headache. You're bleeding more than soaking a pad more than an hour. You just don't feel good. You're nauseated. Something's going wrong. You got blurry vision. Anything like that should raise a red flag and you should come right back in.

And for a newborn, a lot of times newborns don't get high fevers, they get cold. So if they're cold, they're lethargic, they're not feeding well, then those are issues then that we want you to bring the baby in also.

Host: And many people may not realize midwives provide care beyond pregnancy. So, how do you introduce and structure visits for perimenopause and menopause? And what does midwifery menopause care typically look like?

Lyn Wedyke, CNM: This is one of my favorite subjects. So, perimenopause and menopause, it comes down first to talk about the definitions of those, right? So, perimenopause is about seven to 10 years before menopause. And you can have the hot flashes, night sweats, irritability, insomnia, all these things years before actual menopause sets in. And menopause is one whole year without your menses. And then, you're in the menopause range and your estrogen drops significantly. During perimenopause, your hormones are fluctuating. They may drop one month, they may go back up. So, it's very, very fluctuating. Where in menopause, you're definitely seeing the drop in estrogen. So, I educate my patients on the definition of both of those, find out what symptoms they're having, and then address those symptoms.

Host: Yeah. And staying with that stage of life for patients in perimenopause or menopause, how do you explain the pros and cons of hormone therapy versus non-hormonal options and tailor those recommendations to individual needs?

Lyn Wedyke, CNM: You know, it comes down to getting a really good history and a really good exam. You know, you want to take a look at each individualized patient, and then come up with a plan that is specific for them. Estrogen has been shown to decrease hot flashes, night sweats. We know that the studies show that estrogen works. So, it's just a matter of are you a candidate for those hormones? And some people aren't. Some people with a history of breast cancer or endometrial cancer, vein thrombosis or blood clots, liver disease, cardiac issues, they wouldn't be hormone candidates.

But then, we have non-hormone options. We have medication and natural methods that I can pull out of my toolbox and talk to you about and say, "Okay, let's try this." There is no one pill or one magic thing that's going to fix. Sometimes it's lifestyle, sometimes it's medication, sometimes it's combination of both. But we will find an answer for you.

Host: So when you think across the lifespan, what lifestyle and preventative health strategies do you emphasize at different stages from preconception to postpartum and even to menopause?

Lyn Wedyke, CNM: I like to take each stage of a woman's life, adolescence to early 20s, and talk about the changes that they're seeing and the things that are happening in their body. And I think that's a big part in every station that we go through, preconception, postpartum, perimenopause, menopause, is knowing the things that are happening with your body.

And to do that, you need to go see your doctor. You know, you need to have an annual visit. You need to talk these things through. And if you're not comfortable talking to your primary care provider, then definitely come see us as a nurse midwife and talk to us about youe issues as a woman, because we can address them.

Host: All right. And finally, as we close out today's episode, we'd love to hear your final thoughts. So, what would you like people to take away from today's conversation?

Lyn Wedyke, CNM: I would like them to know that I am passionate about women's healthcare, not just delivering babies, though that is one of my favorite things, is I'm passionate about women. Women in all stages of life have something wonderful to bring to the table. They need to embrace that power, stand up for themselves, and realize that they don't have to feel bad. If they're having symptoms of things that don't seem right to them, we can address that and we can help them. And I think that that's what I want people to know, is that you're never alone. You know, there are so many women out there and you're not alone. We've been through this. We can help you.

Host: And that wraps up this episode of Mile Bluff Unscripted. We appreciate you spending time with us, and we appreciate Lyn Wedyke for sharing her expertise. If you'd like to make an appointment with her, please call 608-847-5000. New patients are always welcome. To explore more topics and connect with our providers, visit milebluff.com. Take care, and we'll see you next time.