Understanding Incontinence

Did you know that 50% of women have incontinence at some point in their life? Here’s what you can do to take control.

Incontinence is the loss of urine in an uncontrollable fashion. There are many reasons as to why people have it. Some of them are very easy to treat successfully and are easily cured, and some of them are very challenging to cure. But we can usually get significant improvement with treatment. Incontinence is one of my favorite conditions to see a new patient with; I can often cure them outright and almost always make a big improvement for them with fairly little intervention.

Most people put up with it and hope that it’s going to get better, or put if off until tomorrow, only to realize that several years have passed and it’s only gotten worse.

In generations past, people have looked at the loss of urine as a normal part of aging or normal consequences of childbearing, both of which I think are mistakes. What I would encourage people to think about is the fact that although incontinence is not painful, it’s not normal. People really don’t like to deal with it because it’s embarrassing. But they should realize, it’s very common, and often very easy to treat.

However, correctly treating incontinence means also that you have an understanding of what the true diagnosis is, very much like a headache. There are many different causes for it and the headache itself is usually a symptom of an underlying abnormality of some type, just as incontinence can be caused by many different things. 

Relief for women dealing with bladder control issues typically takes one of three routes:

• It can be as simple as a 10-minute outpatient procedure or a prescription for  medication.
• It may require a combination of therapies to get someone to a much better function.
• Sometimes we need to treat an underlying, undiagnosed urinary tract infection, which should be evaluated further, as it could possibly be a sign of other diseases such as MS or diabetes. 

There are varying levels of incontinence, all of which can be diagnosed and treated to help you return to a normal, active lifestyle.

Spasm and bladder irritability:

• Conditions where a person is urinating frequently and up a lot at night with a sudden sense of urgency (similar to the television commercials you see).
• Tends to be a neurologic, irritational aspect to the bladder.
• There are a handful of different medications that are typically used to treat this.

Stress incontinence:

• People leak a small amount of predictable urine every time they cough, sneeze, lift or jump.
• Will not get better with time.
• Often times this can be treated effectively with proper Kegel exercises, but a lot of times that treatment requires ongoing and continuous exercise by the person, and sometimes even then it won’t hold up over time.
• Should that fail, we can proceed with a small, 15-minute, outpatient procedure that is very successful (such as some type of sling procedure), which in the past was a very big surgery and nowadays really can be done quickly with a very fast return to full function status.

When incontinence affects how you function, what you’re doing, your clothing choices or travel plans, it’s just a shame not to get an evaluation and treatment—because so often, it is actually fairly easy to fix with many different treatment modalities. 

Suffice it to say, there are many treatments for many different causes in the many unique types of patients out there. But I would encourage readers to not for a minute think that this is a normal part of aging and something they simply have to “put up with.”  I would encourage them to seek medical evaluation and intervention, because if you’re thinking about the fact that you’re leaking urine, then it is probably affecting you on a daily basis.

Dr. Eric Eberts is an Obstetrician/Gynecologist at Women’s Care of Wisconsin.

The providers at Women’s Care of Wisconsin are devoted to you and your health. That means having the most advanced techniques, up-to-date educational information and a compassionate, caring staff. Our providers offer a well-rounded approach to your OB/GYN care, one that meets both your physical and emotional needs throughout every phase of your life. We call it our Circle of Care. And it begins with you.

Kaitlin's Surrogacy Story

And the last of the follow ups from our Mother’s Day contest, we had a conversation with Kaitlin about her surrogacy experience.

Her contest entry (and one of our favorites): “Mother’s Day is a reminder that giving birth is not the only way to become a mother. Whether it’s through adoption, surrogacy, becoming a step-parent, fostering… the list can go on, it’s about the person who chooses to love and protect her child unconditionally.”

In her own words, this is Kaitlin’s Story:

From little on, I feel like most girls dream of motherhood someday. I was one of those little girls. I couldn’t wait to become a mom. But my world came crashing down when I was told it would be unsafe for me to carry a pregnancy. So that was really difficult to go through, and then things snowball and really affect you not just emotionally but mentally as well. 

I want to mention Dr. Reed. I had been seeing her and when she found out the news, she gave me this big bear hug, and that's the first time I actually just let me emotions out, and sobbed. She just held me while I cried. I mean, she didn't have to do that. When people go out of their way to be kind, that's unfortunately a rarity nowadays, so that really stuck out to me. Later, she helped initiate our surrogacy journey. I haven’t seen Dr. Reed in a couple years, but she really played a key role—whether she knows it or not—in getting our little girl.

Once we decided to go the surrogacy route, which is intimidating, because it's considered so expensive (which it absolutely is), we decided to do it on our own rather than through an agency. Yes, an agency will do more of the work for you, and have everything set up and matched with a screened surrogate. But we decided to do that work on our end, as it was more financially appropriate in our case. First, before we went public with our surrogate search, we wanted to make sure we had viable embryos (which through the IVF process, we did), and five made it through the genetic testing. Then we started looking for a surrogate.

Our first thought was, “How the heck are we going to do this?” It’s not like you can go to your next-door neighbor and ask them questions about the surrogacy process. It’s kind of an unknown thing. That's why I'm always open to talking about surrogacy, because there's so many myths about it and so many hoops to jump through.

We decided to use the social media route to find a surrogate, posted a nice picture of Tyler and me, asked friends to share, etc. We had a ton of people respond, which was amazing, but very intimidating too. We are essentially trusting a total stranger with your child’s life, so how do you go about building that trust with those you are vetting?

The woman who ended up being our surrogate, Brooke, really stuck out to me and my husband. We met for dinner and she and her husband said this was something they really wanted to do. We just really hit it off. Our morals and values lined up, and it was one of those relationships where you don't have to try; it was very easy to communicate and build a friendship. So we got very lucky and were very blessed in that regard.

Later, we took care of the compensation portion of the surrogacy. If we used an agency, that agreement would have already been completed when matching with a surrogate. We started with fertility lawyers to assist with the surrogacy contract. It’s a hard conversation to have about the “what ifs” with complications of pregnancy. Every hypothetical situation had to have an agreement/ compensation. As our fertility lawyer put it, we’re compensating for her discomfort. We agreed on decisions as couples, and the lawyers wrote up a contract for us to sign. And we continued from there.

I was at every appointment, every ultrasound. Brooke was fantastic with involving me. She wouldn't have an appointment without me being there, which made me feel a little bit more at ease in the process. We got to see Gracyn before she even had a heartbeat, and then we came back a week later, and you could see her little heartbeat flickering. We knew at a very early stage when Brooke was confirmed pregnant. As the pregnancy progressed, I was honestly nervous all the time. Waking up nauseous, just praying this pregnancy was healthy. But once we made it past that first trimester, you feel a little less sick to your stomach every day.

Gracyn was a planned C section due to Brooke previously having one with her own child. The hospital was great in the delivery process. They had my husband and me put on sterile scrubs for the OR, as well as her husband. Once Brooke was prepped with an epidural, they brought me into the OR to be with her. Essentially, kind of in the role of the husband or the father. Where you sit by her head, hold her hand, and support her as much as possible. I wanted to be the best advocate for her, and make sure she was always okay. Both of our husbands were in the hallway and they could see in a little window. 

Once Gracyn was born, I noticed her little dimples right away, and fell in love. When she took her first breath, I kissed Brooke on the forehead while crying, and just kept telling her thank you. Then they had me and my husband go into a little side room where they take care of baby and brought her husband into the OR so he could be with Brooke. It was a really cool experience how they involved all of us, and being able to see Gracyn be born was jaw dropping and nothing less than incredible. 

It was different for what you imagine your life would play out to be, but it was absolutely amazing and such a beautiful, selfless process.

I did have some worries, like, how is Gracyn going to know I'm mom? That's a big thing that kind of sat in the back of my head. But as soon as I held her and we did skin to skin, she started crawling up to my chest and stopped crying when her ear was on top of my heart. That just made me break down because she knew, and I was instantly a comfort for her. That still gives me goosebumps when I talk about it.

We asked Brooke to be her godmother. So after Gray was born and we situated a little bit, we put her in a little onesie that said, “Hi, Auntie, will you be my godmother?” We wrapped her up in a little swaddle. So when Brooke was ready post op and feeling a little bit better, we brought Gray in to meet her. I told Brooke, “Look at her toes!” to initiate her to unravel it so she could see the onesie. We were so proud of Brooke, and the gift of life she gave us. 

I always get the same questions (and I’ve learned to feel the questions without people even asking them). I answer them like this: “Yes, we went through surrogacy. She was completely our bun. We just used a different oven.” It's just for people to understand more, because it's just not talked about, how many different ways there are to start a family. And now that I have a child myself, nothing's more special than the people around you who choose to love your child. 

When love becomes a choice, it’s such a beautiful thing. 

I was asked if I was to provide advice to someone in a similar situation, what would I say? I’d say take however long you need to grieve, to be upset, to try to understand what's happening, and then when you're ready, when it becomes a choice, to move forward and decide how you want to tackle it. Educate yourself—on surrogacy, adoption, fostering, whatever—and do your best to move forward with a positive attitude. Because getting that news can be so destructive and can really break you down.

But know this: when you're in the dark and feeling hopeless, all that goes away once you have your baby in your arms.

Amber's Story

"Being a mom is my entire world!"

So began Amber’s submission for our Mother’s Day contest.

In a 14-minute post-Mother’s Day phone call, she generously (and often hilariously) added detail.

Told in 14 quotes, this is Amber’s Story:

1. I struggled so long and never thought I would get the opportunity to become a mom. 
2. My husband and I tried for years to naturally conceive, and it just wasn’t working. Growing up you just assume it’s really easy to get pregnant. I spent all those years preventing it, and then you're like, “Okay, well, apparently it's not as easy as I thought.”
3. Unsuccessful fertility treatments were exhausting, both physically and emotionally. You plan everything out, and then you don’t get the results you want. It's so frustrating. And you're like, “Oh, these people keep getting pregnant. Why can't I?”
4. Towards the end of 2020, I stopped taking all the medications. And I thought, “If it happens, it happens.” At that point, I didn't even expect I was ever going to have kids, and I just kind of accepted it.
5. You know how at the end of the year you make your New Year's resolutions? I said to myself, “I'm gonna start working on myself, lose weight and just try to make better choices and be healthier.” So I started a new diet, was working out, and I lost 25 pounds. And then on Valentine's Day of 2021, I found out I was pregnant. It was exciting, but then I was like, “Well, there goes my hot girl summer.”
6. When I got pregnant, I sent my husband a picture of the test. I had so many tests. I pretty much bought in bulk on Amazon all the cheapy little tests, and I took, like, three of them, just to make sure. He thought I sent him a picture of an ovulation test, because I've sent those in the past. I have a picture of him holding the real deal with a surprised look.
7. It took six long years of fertility treatments and testing and I finally had my now three-and-a-half-year-old son, Austin. He made me realize how amazing motherhood is! He opened my heart up to so many emotions I never even knew I could feel.  
8. Literally the day that I had Austin, I looked at my husband and I said, “I'm ready for another one!” And he was like, “What?” But after having Austin I knew I wanted to give him a younger sibling to grow up with. Three years later I got to bless him with a little baby brother, Callum. He’s four months old now.
9. With my second child, I didn't do any fertility. I just was like, “If it's meant to be, it’s meant to be.”
10. Austin loves Callum. He is always talking to him and playing with him. Callum just smiles every time Austin talks. It's really cute. I think they'll grow up and love/hate each other.
11. Women's Care has been with me every step of the way and I am so grateful for every single person that works there. They were all so kind and helpful. I started with Elise (Gessler), and she was wonderful. But I had gestational diabetes, and she was not a high-risk provider, so I switched over to Gretchen (Augustine), who delivered both my children. I've had numerous providers for my appointments at Women’s Care, and I've never had a bad experience.
12. And I want to give a shout out to Alicia, one of the Medical Assistants. I really enjoyed working with her; she made me feel really, really comfortable. She’s so down to earth, just super easy to get along with.
13. I'm 38 now. Do I want another one, or do I want to be done? At first, my husband said, “We're done.” Then it was, “If you want one more, we can do one more.” But if it's going to be another three years, I don't know if I want to be that old having another baby.
14. My husband is older than I am and has kids from previous marriages. His 24-year-old son just had a baby a couple of weeks ago. So technically we’re grandparents with a four-month-old.

 

 

 

Jen's Story

"Motherhood is not knowing you could hold this much love in your heart for another human but not wanting anything different."

Jen posted those words for our Mother’s Day contest.

Here’s the story behind the sentence.

The Hardest Thing

The first thing you should probably know about me is that I am the most type A personality you could probably ever meet. I'm a 2nd grade teacher, so I just plan everything to the T. When we thought about what would be a great time to have kids, we thought if I could have a baby in April or May, that would be perfect, because then I would have two months of maternity leave and get the summer with our baby.

When we decided we wanted to bring a baby into the world, we got pregnant right away, and he was due April 2. Perfect timing, right? This is all going according to plan! But becoming a parent has taught me I can still be type A, and have a plan, but it is so okay to just go with the flow.

My baby is now my whole world, and he kind of directs the timing of everything, and that's a beautiful thing. So I think the hardest thing about becoming a mom was really just learning to give up my routine and the normalcy of the life that I had grown so accustomed to.

When I hit those first two weeks of being postpartum, where you go through the most intense hormonal changes of your life, and all the emotions that go with that, well, that was really hard. Trying to take care of my baby with the help of my husband while going through that taught me so much about really being selfless and giving up parts of me to take care of my baby.

And I wouldn't have it any other way.

It’s Not Just the Eggs Benedict

Luckily, my husband is so supportive.

I literally could not have done it without him. Through pregnancy, through labor and delivery, I mean

I didn't have a doula at the hospital, but he filled that position. I'm not kidding. I could not have done it without him. And that continued through postpartum, even now when he's back at work, back at his normal routine. He’s so attentive.

It’s all the little things. He made sure that I always had a snack and water when I sat down to feed Luke. He always made sure that the kitchen was cleaned up before I went to bed (because of my type A personality). He was just amazing. And he supported me, and continues to support me through this journey of motherhood.

So even on the hard days where I'm home and maybe Luke's been fussier than normal, and my husband knows that because I've been texting him, he comes home and he's like, “Let me take him. You go take a shower. I got this.”

One more small moment: During pregnancy I craved Eggs Benedict but stayed away from it. Two days after we had brought Luke home, my husband came in and gently woke me up. He made me homemade Eggs Benedict and a homemade latte. And he's an amazing cook!

Content or Fussy?

It didn't take very long for me to figure out Luke’s cues of when he's hungry, when he's tired, when he’s overtired. And he is a great sleeper. Like on Mother's Day weekend, it was the first time he slept five hours straight. So I slept five hours straight! It was incredible. 

He doesn't have a routine yet, because he's just seven weeks old, but I can be pretty certain that he'll take shorter naps in the morning, and then he'll take his one and a half to two and a half hour naps in the afternoon.

So he's been awesome from the beginning, and he’s even self-soothing. We put him in his bassinette at night and he just rocks, and he falls asleep by himself. He's amazing. He is such a content baby.

I remember taking him to his one-month pediatrician appointment, and they ask you if your baby is content or fussy, and I said, “Listen, he's content 90% of the time, and when he's fussing, I pretty much know what he needs to not be fussy.

And the pediatrician's like, “Well, just wait till six weeks, because that's usually when they become not so content.”

He's still content.

A Swift Decision

My husband is an intense researcher. After we found out we were pregnant, immediately he was like, “We gotta find the best!” 

So we did a deep dive about hospitals and providers in the area (we live in New London). We ended up choosing ThedaCare-Neenah. I knew I wanted a natural birth, but I wanted to do it in the hospital setting in case anything went wrong.

And when we looked at all the providers, we watched Dr. Swift's videos, read the testimonials on her page, and she just seemed like a perfect fit.

Like I remember in her video, she talks about being the pilot. She wants women to feel empowered, to have the birth they want, but also to trust that if things take a turn, that she's the pilot and she’s going to direct things to make sure everything goes smoothly. And that just resonated with me, even before I got her.

We called and made an appointment with her, and from the second we met her, I remember just feeling so at peace. I told her how I wanted to give birth. I wanted very minimal interventions and wanted things to go smoothly, but I also wanted a doctor who's going to support me yet be honest when things might need to take a turn.

And I remember Dr. Swift saying, “Girl, you can give birth on your head if you want to as long as it happens safely."

The Day You Become a Mom

The night before I went to the hospital I had my 39-week appointment because I thought my water broke at home, but I wasn't sure. And I thought, well, I'm seeing Dr. Swift in the morning; she'll tell me if that's the case. So I went in early the next morning, and she checked me and said, “Yeah, girl, you're water broke and you're already four centimeters. Call your husband, tell him to get his butt over here, and I'm sending you up to labor and delivery.”

And I just remember sitting there with this overwhelming amount emotion overcoming me and I was like, “Can I cry?”

And she said, “Girl, do whatever you need to do. Feel however you're going to feel. Now, let's go have a baby!”

My appointment was at 10:00am with her, and Luke wasn't born until 10:08pm, so her shift was well over. But there she was in our room, for three hours before he was born, sitting on the floor, walking around, sitting on the couch, encouraging me the whole time. She didn't have to sit in our room for three hours. She could have left. She has kids.

I remember looking at her one time, I think when I was about seven centimeters dilated, and I was like, “When is this gonna happen?”

She said, “It's going take time, and it's going get worse, and you can do it!” I was doing it all natural, so I appreciated her brutal honesty; she never sugar-coated things. But when I got to the stage of actively pushing, she was so encouraging.

I just knew I could count on her, not just to bring Luke into the world, but to help me bring him into the world.

And the Day You Have to Go Back to Work

I'm going to lay another whammy on you, because the planner in me is very stressed because I'm not going back to 2nd grade: I’m going to 3rd grade. I found out that news three weeks postpartum.

And I feel very honored to be selected. The principal knows I'll support the kids who are moving into that grade level well. I'll get to have some of my same kids back who had pushed me through my pregnancy, and that'll help. They met Luke last week. So that'll be really exciting.

It'll be a good learning experience, both to trust that someone else can take care of him and to go back to something I'm passionate about, balancing my two passions of being a mom and being a teacher.

But I think it will be the hardest thing I will ever do, leaving my baby with someone else.

It will probably be harder than giving birth.

What’s Up with the Dog?

Our dog has been our first baby. He's just turned four when we had Luke, so he's only known life as a single, with a young couple doting on him. When we brought Luke home, he was so excited, so happy to have this new baby. Wanted to just lick him and kiss him.

And then he went into a depressive state. For the first three weeks, he was like, “Oh my goodness, my parents don't love me anymore. They're just taking all their time on this new baby.” The picture I shared is when he was in the throes of that depression, but now he’s figured it out and fits in beautifully.

A Mother’s Wish

When I saw her at my six-week postpartum visit, I actually sent Dr. Swift a thank you in the mail with pictures of Luke and us, and I asked her if she got my thank you, and she said, “Yeah. And it made me cry, and I'm not kidding.” We sat there and we cried together, we hugged each other, and I just told her, “You feel like family. I know you have kids of your own. There's no reason you needed to stay there for me.”

And she said, “I know that it would have made all the difference for you if I wasn't there, and so I needed to be there for you.”

That's just her, you know. I don't feel like everyone gets that experience of genuinely feeling like their provider is family, and that's how she feels.

I wish every person could have the same experience.

One Final Thought

They say the second they put the baby on your chest, it's a love like no other. And that’s just how it is.

Naomi's Story

When we asked Naomi if she would provide a testimonial about her experience at the Women's Care of Wisconsin location in Berlin, she said she'd be happy to. And after she did so, she thanked us for the opportunity. C'mon, Naomi. We need to do the thanking. And we get the last word.

Well, actually, you do:

Dr. Effie and her team at Women’s Care Berlin provided exceptional care throughout both of my pregnancies. 

My son was born in 2021, during the height of the COVID-19 pandemic. With the uncertainty and fear that came with being pregnant—especially as a high-risk patient due to blood pressure concerns—I was incredibly grateful for the steady support and expertise of Dr. Effie and her entire team. From the moment I walked in, Georgia at the front desk greeted me with warmth and positivity—a smile you could sense even behind a mask. During my many appointments, Ami always was reassuring and attentive. After a long and difficult labor, I knew I was in the best possible hands. Dr. Effie’s calming presence and compassionate bedside manner made all the difference. I felt truly cared for and reassured every step of the way. 

When I became pregnant with my daughter, it was an easy decision to return to Women’s Care. This time, I had the joy of seeing their familiar, friendly faces without masks. Georgia continued to shine at the front desk, and Dr. Effie and her team once again delivered outstanding care—always pleasant, knowledgeable, and attentive. Even with the same high-risk considerations, I felt supported and confident throughout the entire experience. 

Thanks to their incredible care, I now have two healthy, beautiful children. 

I’ll continue to trust Women’s Care for all of my personal health visits, and I recommend them wholeheartedly. A sincere and heartfelt thank-you to the entire team at Women’s Care Berlin—you go above and beyond to make patients feel supported, heard, and cared for. I never left an appointment with unanswered questions, and I always felt like I was among friends who were genuinely invested in my wellbeing and my babies.

Dr. Effie on Miscarriage: You Need to Know You're Not Alone

Miscarriage is a hard topic, despite the fact that is much more common than people realize. As many as one in four people have experienced miscarriage. Each year, a million pregnancies in the United States alone end in miscarriages. That’s such a huge number. And often, it’s something that people don’t want to talk about.

We want you to know that at Women’s Care we have helped, counseled and talked lots of people through miscarriage situations. We want you to come in and talk about it. We want to hear your story. And we want to talk about the things we can do to help.

You need to know you’re not alone.

Causes

Miscarriage is an unplanned loss of a pregnancy early on. It is important to know that this is something that has happened, not something you have caused. Working, exercising, stress, arguments, intercourse, or morning sickness do not cause a miscarriage. The majority of miscarriages are caused by a random event in which the embryo does not develop, often because it received an abnormal number of chromosomes.

Most women who miscarry go on to have healthy pregnancies.

Signs and Symptoms

Bleeding is the most common sign of a miscarriage. Give us a call if you have any of these signs or symptoms:

• Vaginal spotting or bleeding with or without pain
• A gush of fluid from your vagina, regardless of the presence of pain or bleeding
• Passage of tissue from the vagina

A small amount of bleeding early in pregnancy is common and does not necessarily mean that you will or have had a miscarriage. Known as implantation bleeding, this spotting can occur when the fertilized egg becomes attached to the lining of the uterus.

Having a miscarriage can cause intense pain, which may present itself in many ways. You may:

• Feel sad or depressed
• Become angry with yourself, your partner or with other people
• Feel fatigued and become sick easily with colds or stomach aches
• Become forgetful or have a hard time concentrating
• Feel guilt that somehow you are responsible

“Getting over” the loss of your baby is not the goal, but rather moving through your grief to healing. The pain may never go away, but know you will someday make a place in your heart and mind for the memories of your baby, find peace and become ready to think about your future.

 Dr. Effie Siomos sees patients in Berlin. She has spent her entire career practicing in rural communities and enjoys the small-town feel. Effie has a special interest in pregnancy care, performing in-office procedures and minimally invasive surgeries, and consults with moms and daughters to manage heavy periods or discuss birth control.

Google Review (March 2025)

“Dr. Siomos is fantastic, very thorough, listens to all your concerns and makes you feel at ease. I would highly recommend her not only for yourself but also if you have teens.”

~Ashley B

 

 

 

Melinda's Story

Baby Grayson is 10 weeks today. Mom had left us a heartfelt Google review that began with, “Brubaker was my doctor through my first pregnancy.”

Later, we chatted with Melinda and asked her to talk about her experience in more detail. This time, she began with a car crash.

She already had us at “Hello.”

This is Melinda’s story:

I wasn’t quite expecting to be pregnant and didn’t find out until I crashed my car. I passed out because of my blood pressure and found out at the hospital, so definitely a surprise. After finding out I was pregnant, I knew I needed to find care. So I did my research, found highly rated providers in the area on Google and decided to go with Dr. Allison Brubaker. She had really good reviews, and after watching her video I thought she was the one for me.

And from there, it was a little bit scary at first, because I wasn't sure what to expect with pregnancy and knowing that I have a type of Crohn's disease where I already knew that I wouldn't be able to have a vaginal birth. So it was going to be a planned C-section, and I was really worried about that the whole time, but Brubaker made sure to ease my mind at every single appointment by letting me know what to expect.

When I hit about 20 weeks with him, they found out that he wasn't quite growing as he should be, so they ended up scheduling me two appointments each week just to make sure that he was going to be okay. Still, I was in kind of in a panic, worried that my body might not be okay for the baby. But at each appointment I would hear his heartbeat and see that everything was looking good.

Brubaker would also touch base with me and make sure that I knew that he was hitting his goals. Blood work was done to check my levels and make sure that I was doing okay too. Closer to the end of my pregnancy she was doing frequent NST checks.

Regarding the planned C-section, I was definitely scared about the procedure itself, of having to be awake. I was also concerned about the scarring because I have some body image issues, so I was worried about what that would look like.

As for the surgery, which ended up being at 37 weeks, I felt a little bit of the tugs, kind of a strange feeling but it didn’t hurt, and the next thing you know Brubaker is pulling my baby over and showing him through the see-through curtain. It was so precious seeing him for the first time. 

I had talked to her previously and one of the things I had really wanted was skin-to-skin contact, so they brought Grayson over to me for a short while, at least until he started turning colors. They took him back and found he didn’t have the stuff that coats his lungs (surfactant), so Grayson ended up going to the NICU for a week.

But only for a week, because he’s a little fighter. Five pounds, eight ounces.

Grayson is actually a really calm baby. Takes a lot of naps, and he only wakes up when he's hungry or if he's got some discomfort, like a wet diaper. He's doing all the things that he should be, he's discovering things, he's reaching for his toys when I put him on his play mat. He's hitting his goals, which is really impressive.

It was really nice to know that I had a doctor like Dr. Brubaker, one that was so reassuring to a first-time mom who was worried about everything. She's a very calm and attentive person. She answered every single question I asked, and she does it in a way where it's not doctor vocabulary.

My 6-week postpartum appointment went really well. I brought Grayson with and she was so happy to see him and to see how much he grew. Her reaction was so cool: “Oh my gosh, he was such a little peanut when I delivered him!” And she wanted to know if I was doing okay as well and made sure I had the resources I needed.

I’m so glad I found Dr. Brubaker. She seems more like a friend that is there for you, the way she goes about her care.

Note: Women’s Care of Wisconsin reached out to Melinda after seeing this Google review:

Brubaker was my doctor through my first pregnancy. As this was my first it was a little scary and being higher risk it was going to be overwhelming. Brubaker however was extremely reassuring through everything. Every question and concern I had was addressed and I felt comfort knowing she was making sure my baby was going to be okay. My pregnancy did result in a c section per my health and I was very worried about the entire experience at first and kept getting reassured step by step what the procedure entails and how it will look afterwards. On the day of my c section I was nervous until I was in the OR and Brubaker and the team were there to comfort and reassure me what’s happening as well as what I would be experiencing. The procedure went extremely well and Brubaker did an amazing job with everything. I did make request for when baby was born such as skin to skin and to see him when he was out and Brubaker made sure my requests were met. I had just taken off my dressing which can be scary to think what it looks like underneath; however, my scar is super minimal as she assured me and it looks great! I am extremely happy with her care and how attentive she is as a doctor and surgeon. I absolutely recommend seeing her for your pregnancy as she made mine a lot less scary and more enjoyable. I am so thankful to have had such a great doctor for my pregnancy and birth experience.

Endometriosis Affects 1 in 10 Women

Are you doubling over in pain during your period? Do you have cramps you just can’t seem to shake throughout the month? For 1 in 10 women, these killer cramps are a symptom of endometriosis. Although endometriosis affects 190 million women worldwide, many go undiagnosed. March is Endometriosis Awareness Month and the perfect time to educate about this painful, chronic disease. Here’s what you need to know to find out if endometriosis might be affecting you.

What is Endometriosis?

"Endometrial cells are what make up the lining of the uterine cavity," Women's Care of Wisconsin's Dr. Therese Yarroch explains. "In women with endometriosis these cells are found outside of the uterus, where they cause inflammation. Sometimes referred to as 'endometrial implants,' they can be found on the ovaries, fallopian tubes, bladder, bowels and anywhere else in the pelvic region. This inflammation can result in pain and significant scarring to the surrounding tissue."

What Causes Endometriosis?

"We do have evidence that there is an increased risk of endometriosis in women with heavy menstrual bleeding and longer or more frequent menstrual cycles," Yarroch says. "Doctors also know that estrogen plays a role and women who have a close female relative with endometriosis are 5-7 times more likely to have it themselves."

Spotting the Symptoms

"Although it’s a common misconception that endometriosis only occurs in women over the age of 20, the truth is that the disease can develop as soon as a girl gets her first period and can span the rest of a woman’s reproductive years," Yarroch says. "The most common symptom of endometriosis is pelvic pain. While this pain usually coincides with menstruation, some women can experience this symptom throughout their entire cycle.”

Other symptoms to look out for include:

• Pain during or after sex
• Severe cramps that do not go away with NSAIDs or that impede the activities of your everyday life
• A heavy menstrual flow
• Periods that last longer than 7 days
• Nausea or vomiting
• Urinary and bowel disorders
• Difficulty getting pregnant

Not every woman will experience all of these symptoms, but approximately 30%-40% of women who have endometriosis will experience issues with fertility.

Getting a Diagnosis

The only way to know for sure if you have endometriosis is through a surgical procedure called laparoscopy. Laparoscopy uses a small telescope that is inserted into the abdomen through a very small incision. It brings light into the abdomen so the doctor can see inside. Endometriosis cannot be diagnosed by ultrasound, x-ray, or other non-invasive methods.

Treating the Symptoms

There are a wide range of treatment options for endometriosis and your doctor may suggest a less invasive methods before ordering a biopsy. Some of the most common treatments include:

• The use of NSAIDs, such as ibuprofen (Advil, Motrin) and naproxen (Aleve). NSAIDs can help relieve or lessen the pain caused by endometriosis by stopping the release of prostaglandins, one of the main chemicals responsible for painful periods. While NSAIDs can help manage the pain-related symptoms of endometriosis for some women, it’s not effective in every case.
• Birth control methods such as the pill, the patch and the ring are often helpful to treat the pain associated with endometriosis because they reduce heavy bleeding. This method works best for women who only have severe pain during their period and not during the rest of their cycle.
• Progestins are recommended for women who do not get pain relief from or who cannot take hormonal birth control that contains estrogen (such as smokers). This synthetic form of the natural hormone progesterone is available by prescription as a pill or an injection.
• GnRH therapy uses medicines that work by causing temporary menopause. The treatment actually causes the ovaries to stop producing estrogen, which causes the endometriosis implants to shrink.

For some women, surgery may be the best treatment method. While there isn’t a cure for endometriosis yet, it is possible to remove some of the scar tissue and lesions with surgery.

If you have endometriosis, surgery could be an option if you:

• Have severe pain
• Have tried medications, but still have pain
• Have a growth or mass in the pelvic area that needs to be examined
• Are having trouble getting pregnant and endometriosis might be the cause

"It is important to note that there are other conditions that can cause many of the same symptoms as endometriosis," Yarroch says. "An OB/GYN can help determine if endometriosis is the appropriate diagnosis."

Seeing patients at Women's Care of Wisconsin's Appleton location, Dr. Therese Yarroch provides treatment for many gynecologic concerns, including fibroids, ovarian cysts, abnormal uterine bleeding, and much more. She has a special interest in gynecologic surgery, including hysterectomies, removal of pelvic masses, and repair of pelvic organ prolapse. Call or text 920.729.7105 to schedule an appointment. 

Best Practices in Care for Expectant Mothers

Every March we celebrate National Hospitalist Day and the teams that make up the hospital medicine community.  

This year marks the first anniversary of ThedaCare's Obstetrical Emergency Department (OB-ED) and Hospitalist Program, which operates around the clock and provides care for pregnant women facing obstetrical challenges.

Through the program at ThedaCare Regional Medical Center in Neenah, women more than 16 weeks pregnant that are presenting with a pregnancy-related concern will be directed from the traditional emergency department and go directly to the obstetrical emergency department area, which has onsite access to Children’s Hospital NICU if needed.

A high-risk obstetrician will evaluate a woman immediately without waiting for her doctor to arrive onsite or provide a consultation over-the-phone.

“Having an OB-ED and Hospitalist Program redefines the standard of women’s care in the hospital setting,” said Dr. Eric Eberts, Department Chair of the ThedaCare OB-ED and Hospitalist Program. "The OB-ED ensures that expectant mothers receive timely, specialized care for themselves and their babies."

The OB-ED supplements the care of a woman’s OB provider, who continues to provide care in the facility.

Bree's Story

“When you choose a doctor, you're trusting someone with your life and your baby's life. I didn’t realize how critical that was at first. It didn’t really hit me until I had complications.”

When Bree and her husband were thinking about having children, she asked her primary care provider if she had any recommendations for an OB/GYN. She told Bree to check out Women’s Care of Wisconsin.

That’s just what Bree did.

And we asked her about it.

This might take a while, and you have a three-month-old. Is this a good time?

Elsie’s not asleep, but if I need to pick her up, I will. Let’s just see how it goes:)

What was the first step you took in finding a provider at Women’s Care of Wisconsin?

I went to the website, checked out the videos, and came across Dr. Schloesser. Her statements were compelling and I thought she’d make a great doctor for me.

You said your selection was crucial. Can you explain what you mean by that?

With my first, Aubrey, I got high blood pressure around 20 weeks. Even though I wasn’t necessarily high risk, Dr. Schloesser kept a very close eye on me. I was so thankful she did because I was diagnosed with preeclampsia at 35 weeks.

Then when I got pregnant with my second daughter, Elsie, I ended up getting high blood pressure again. I always felt like preeclampsia was looming over me after having it once before, but felt safe with Dr. Schloesser.

Along the way, at some point during my pregnancy with Aubrey, she told me something that has always stuck with me. She said, ‘I know this is not your normal; this is not your every day. And so it is scary to you. But this is my every day. I got you.’ That allowed me to sleep a little bit more soundly at night, and definitely again during my pregnancy with Elsie.

With Dr. Schloesser, I felt very safe and cared for—most importantly, she always helped calm my nerves. If there's anyone who has high blood pressure or preeclampsia, I feel like Dr. Schloesser is definitely the right one.

You had a C-section with Aubrey. Tell us about that.

Aubrey was Frank breech, which means that she was not facing the right direction for a safe, regular delivery. Kind of folded like a taco, bottom down and legs up by her face. Anytime a baby is breech, it's not safe to have a vaginal delivery. My hope was always that Aubrey was going to flip around. If she didn’t, it was going to be a C-section. But in my mind, I just didn't want to believe that that was going to happen. I didn't want to have a C-section.

We had decided we were going to do a version at 36 weeks, a procedure basically where Dr. Schloesser pushes on my stomach to rotate the baby. But then I went in for my 36-week appointment. I had unfortunately gotten really sick the night before and didn't feel well, which was an indication my preeclampsia had gotten worse. And she was like, ‘Yeah, Bree, it's time. We’ve got to go have the baby.’  So we went upstairs, and after doing some additional tests she said, ‘It's your choice if you want to do the version, but there are risks involved with it.’ We decided to go with the unplanned C-section.

And it went well?

Yes, it went really well; however, I wasn’t thrilled with being awake for a major abdominal surgery.  Although every doctor and nurse in the operating room was incredibly calm and caring, I felt terrified. I’m truthfully just afraid of blood and surgeries. Thankfully, Dr. Schloesser really got to know me well throughout my pregnancy, so she came in beforehand and helped me stay calm. And prior to that when I was diagnosed with preeclampsia, she called me personally and let me know that pretty much moving forward, at every appointment, I’d need to have my bag packed. She let me know what to expect so I could be mentally prepared.

Did you have any anxiousness that you’d experience high blood pressure with your second pregnancy?

Dr. Schloesser let me know I was likely to get high blood pressure again, and it could be earlier (and she was right). Though I was nervous about getting preeclampsia again, I felt safe with Dr. Schloesser, who kept an extremely close eye on me throughout my pregnancy with Elsie. With the help of medication to help stabilize my blood pressure, Dr. Schloesser’s expertise, and a healthy(ish) diet, I was able to make it to 38 weeks when I delivered Elsie.

And you didn’t have to have another C-section with your second baby?

With a toddler at home and a C-section requiring a longer recovery, I wanted to experience a natural birth for my second child. Obviously I was going to do whatever was safest for us, but my preference was a VBAC (vaginal birth after cesarean). I was thrilled it worked out that way and was so happy Dr. Schloesser was there to deliver our baby. My experience was so empowering and she was such a great cheerleader.

I remember being so scared right before, especially when she said, ‘Hey, it's time.’ I'd been waiting all day in the hospital, it was taking so long, and I was convinced that we were going to end up in a C-section. Despite all the mental preparation, I started crying and said, ‘I'm so scared.’ And she was like, ‘Why are you scared? You got this! You're gonna do great!’ My doctor, my cheerleader, my friend.

Anything else you’d like to share about the experience?

Just to say that Dr. Schloesser definitely brought the calm. And not just the calm, but she really knows her stuff. Very fact-based, very up to date on research. For instance, the research regarding high blood pressure changed from when I was pregnant with Aubrey to when I was pregnant with Elsie. She was all over it, letting me know that they were going to intervene sooner to keep my blood pressure at a normal rate. She tested me throughout, getting the information we needed to help us make good decisions. She really helped me get through everything.

One final thought?

Yes! Pregnancy is wild. The hormones and emotions. Growing a life inside of you. It is amazing and incredibly special. However, having someone who you can trust and who you know actually cares makes all the difference.

Meet Caitlin Timmers MD

“I truly enjoy working through complex medical issues with my patients, as well as the typical day-to-day health questions," she began.

Meet Dr. Caitlin Timmers, Women’s Care of Wisconsin’s newest provider.

From a young age, Caitlin Timmers had a passion for caring for others. She anticipated going into nursing and was working as a certified nursing assistant by the time she was 16. Later she would work closely with a physician assistant and told her father that she had decided on her future.

“I’m going to be a PA! And I get to assist in the OR!” she told him.

His response, knowing his daughter’s fascination with anatomy and all science-related subjects, was immediate: “Well, why don’t you just be the surgeon?”

“What a concept!” she said. “I had no real clue what I wanted to do exactly, but just like that it all made sense.”

Caitlin entered med school thinking she was going to be a trauma surgeon and felt that way for a long time. That is, right up until her final rotation, which happened to be OB/GYN.

“That’s when I found my people,” she said. “I found where I needed to be.”

The field satisfied her two passions: first, that she could do procedures, and second—more importantly—that she would be able to form relationships with patients.

A board-certified OB/GYN, Caitlin cares for patients in all phases of life, from adolescents struggling with menstruation cycles, women of reproductive age requiring annual exams or obstetric care, and post-menopausal women dealing with a variety of concerns.

“I get to work with women and take care of them for their entire lives,” she said.

Caitlin relishes the development of deep relationships with her patients, who appreciate her wide-ranging expertise—which includes robotic surgery for complex cases—and her innate ability to create a warm and comfortable space where open conversations are the norm.

That begins with listening.

“I think it's really important to really listen to patients to get an idea of where they're coming from, to let them tell me what's going on, any factors that are contributing to their issue, how it's impacting their life, and what their goals are,” said Caitlin. “That’s how to start if you want to build a relationship. And that’s the most rewarding part of my profession.”

Caitlin shared something from her personal history that she said helped her greatly as a provider.

“I had a pretty major surgery in my early 20s, had complications from it, and had to stay in the hospital for a longer period of time than expected. That really put me in the patient's shoes and made me see just how difficult that can be, to not necessarily know the outcome, if I was ever going to be myself again, and what that may have looked like,” said Caitlin. “I understand how scary uncertainty can be, and I make sure my patients know I am there for them.”

Coming back to the area she called home (Caitlin is from Black Creek), Women’s Care of Wisconsin’s newest provider is hitting the ground running and accepting new patients immediately.

“I feel so honored to be in this profession. Obstetrics and gynecology has allowed me to develop lasting relationships with women and assist them through some of the biggest milestones in their lives."

Dr. Caitlin Timmers sees patients at Women’s Care of Wisconsin’s Appleton location.