Melanie Cole, MS (Host): we're here to talk about the community members that MIT Health's OBGYN department supports, as well as services offered for different stages of life. And that's all here on Conversations with MIT Health. I'm Melanie Cole, and joining me today is Jennifer Shark.

She's a certified nurse midwife at MIT Health.

 Welcome, Jen. I'm so glad that you could join us today. I'd like you to start by telling us a little bit about yourself and how long you've been with MIT Health.

Jennifer Shark, CNM: Well, I'm a certified nurse midwife, which means that I am. I'm a registered nurse with advanced training in obstetrics and gynecology. I have been at MIT Health for about 10 years. My first few years here were as a contractor from Mount Auburn Hospital where I did deliveries and my current tenure is full time in the office seeing patients for prenatal care and gynecology other types of gynecologic care.

Melanie Cole, MS (Host): Thank you so much for sharing that. So how can patients schedule an appointment with MIT Health's OBGYN department?

Jennifer Shark, CNM: So the best way to schedule an appointment with our department is to call us. There are appointments that you can schedule online through the MIT Health Portal, but we do not have as many appointments online as some of the other services because we do see pregnant patients. So to be seen sooner, we recommend calling.

Melanie Cole, MS (Host): Tell us about the different MIT community members that you help support. Tell us how you support patients through all stages of life.

Jennifer Shark, CNM: So we really support anyone who was assigned female at birth in our department and sometimes people who are not assigned female at birth. We see people who've From the beginning of their menstrual cycle, all the way to the end of life. So we see people who are students at MIT, people who have insurance or their spouse has insurance through MIT, people who are retired from MIT.

So we will see anybody who in the MIT community who uses the MIT health insurance plan.

Melanie Cole, MS (Host): Jen, some services can be supported through primary care providers, but more specialized services are supported through the OB GYN department. Can you give us some examples of when MIT health patients should seek support through their primary care provider and when they should really go to the Department of OBGYN?

Jennifer Shark, CNM: Common reasons why you might want to see a provider and would probably be better served by seeing your primary care provider. is for, for example, routine testing for sexually transmitted infections, urinary tract infections, and even pap smears. All of our primary care providers do offer pap smears and if you are a healthy person with no abnormal history, you can usually get in to see a primary care provider for a pap smear faster than you're going to get into a specialty service for that.

Melanie Cole, MS (Host): This is such great information. I'd like you now to tell us about MIT Health's OBGYN services. What are some of the most common services that you offer patients?

Jennifer Shark, CNM: So, I would say that our most common service for our younger population is So teens, college age is usually contraception. We offer a wide variety of contraception here. You can basically get anything that is approved for use for contraception in the United States with us. That includes IUDs and implants.

For people in their 30s, we are seeing a lot of contraception as well in family planning. Also pregnancy, that's probably our most common thing that we see people in their 30s for, but, you know, the whole host of normal GYN services, as we get into perimenopause and menopause, We see women in their forties and fifties and beyond for therapy to help to treat their symptoms.

And all the way up into the end of life, we will monitor the health of the breasts and the vulva and vagina because that's what we want. Things can change that are associated with age that a primary care provider may not be trained to see.

Melanie Cole, MS (Host): How often should patients come in for their well visit?

Jennifer Shark, CNM: So that depends. For a routine breast and pelvic exam, most people can do that with their primary care provider. during their annual physical. Some people do prefer to have their breast and pelvic exams done by a specialist in OBGYN, whether it's a physician or a midwife. so they will come to us for their breast and pelvic exams and their pap smears, but their primary care provider will take to the rest of their care.

And in those cases, we recommend you come see us annually, even if you're not due for a pap smear.

Melanie Cole, MS (Host): Jen, if someone is worried that they might have an STI, how can MIT Health help them?

Jennifer Shark, CNM: Well, we have a lot of resources for that, which is great. If you are an MIT student and you are worried that you may have been exposed to a sexually transmitted infection, You can get testing through Student Health. You can schedule an appointment with Student Health and they can order testing for you.

It's very easy. You can self swap so you don't need to actually have an office visit for that. If you're not a student, then you can schedule it to be done either with your primary care or OBGYN if you happen to be an established patient with OBGYN. If you have symptoms of a sexually transmitted infection, then you should definitely be evaluated in person by a provider.

And probably the best place for that is going to be OBGYN, but that is something that you could do with your primary care provider as well.

Melanie Cole, MS (Host): If someone is considering pregnancy, can they come in for a preconception planning session? What might that involve?

Jennifer Shark, CNM: Absolutely, and we highly encourage people who are planning pregnancy within the next three to six months to have a preconception visit. This allows us to go through your entire medical and surgical history to determine if there may be anything that could get in the way of you becoming pregnant. It allows us to get genetic testing done so that we can determine if you are a carrier for any diseases that could potentially harm a child.

In the future or at birth, some of these diseases can have, very serious medical implications for babies. So we recommend getting that test done before you become pregnant so that we can know if you and your partner carry a particular disease that we can help you to avoid passing that disease on to a child.

it also helps us to let you know what our pregnancy service looks like. We have a partnership with Mount Auburn Hospital, and our patients who get their prenatal care at MIT Health have their deliveries at Mount Auburn Hospital. The vast majority with the midwives at Mount Auburn Hospital, and we have two midwives from Mount Auburn Hospital who We come here on a regular basis to see patients for that.

We do have an OBGYN physician as well for higher risk pregnancies who also does deliveries at Mount Auburn Hospital. If you wanted to have a birth somewhere else, because you live far away, that is also your option too, but you would want to get your prenatal care with them. In terms of pediatrics, we have several pediatric healthcare providers here at MIT Health.

So your baby can see a pediatrician, a family doctor, or a family nurse practitioner for their care. And you can meet the pediatricians at our event called Baby Talk, which happens quarterly. And it gives you a chance to better understand what our pediatric care looks like here at MIT Health.

Melanie Cole, MS (Host): Jen, you're such a wealth of information, and you and I have spoken many times as you're a midwife, and we've learned so much from you about midwifery. being a midwife. Now, if someone thinks that they are perimenopausal, and I know that you know so much about all those stages of life in the reproductive years and beyond, what is some of your best advice about symptom management?

What would you like us to know about coming to see you when we're starting to experience some of these symptoms?

Jennifer Shark, CNM: Many,, many people suffer with perimenopausal symptoms like hot flashes, night sweats, vaginal dryness brain fog and more. So the good news is that you do not need to suffer and you shouldn't suffer. This is a great reason to come and see us in the OBGYN department. We have so many safe treatments for perimenopause and menopausal symptoms that can make your life so much better.

That there's no reason to suffer and, you know, try everything over the counter when you can come in and we can make a real treatment plan that is going to improve your quality of life. I have spent quite a lot of time in the last several years, learning a lot about menopause therapy and, you can see me, you can see a physician, but you don't necessarily have to see a physician. You can see me as well and we will get you taking care of for sure.

Melanie Cole, MS (Host): Jen, do you have some final thoughts for the viewers, for the listeners, what you would like them to know about MIT Health's OB GYN department?

Jennifer Shark, CNM: So our department. is very unique within the MIT Health Building. we are very small, but we are a very close department. We all work very closely together. We're very collegial. Whether you're a nurse or a medical assistant, a midwife or physician, we all work very closely together. Work very closely together so that we are making sure that patients get their best care.

We try to treat the individual. We have lots of time to treat you. We have nice long appointments like the rest of MIT Health, but there's a smaller group of people who are going to be involved in your care. it's kind of a special touch that we have and. We have a lot of very loyal patients who have been patients of ours for 10, 20, 30, and more years.

I have seen patients here in the OB GYN department from about the age of 14 to 100 and these are people, especially on the older end, who had their babies with us, you know, 30 or 40 years ago and are now headed into their, to the elderly period of their life. So when people come back for that long, you know, we have something special.

Melanie Cole, MS (Host): You certainly do. And thank you so much, Jen, for joining us today and for sharing your incredible expertise. And patients can schedule an appointment with MIT Health's OB GYN department by calling 617 253 . 4481. That concludes this episode of Conversations with MIT Health. You can always head over to our website at health. mit. edu for more information. I'm Melanie Cole. Thanks so much for joining us today.