Dana's Story

“Mindful, functional and beautiful solutions for experiences are my passion.” That’s Dana, the product designer and business owner, on her website’s homepage. A promise to deliver on her clients’ goals and objectives, Dana’s words could also describe what she was looking for as a mom—and also a surrogate—when she found her OB/GYN, Dr. Valary Gass. Her thoughts will be enlightening for anyone searching for the right provider.

Before you found Dr. Gass, things weren’t clicking with your first OB/GYN. What were you looking for in a provider?

I needed a provider who was more on my wavelength with how I wanted pregnancy and deliveries and things like that to go for me. I mean, if it was up to me right now, I’d probably do a home birth with Dr. Gass. I want the best of both worlds. I was really looking for a provider who would let me set my goals and intentions and respect them. That’s when I started asking around to people, reading the bios on websites and watching the videos, and I decided just to schedule an appointment with Dr. Gass and try her out. She was just this ray of sunshine.

Not sure we need to steal from “Casablanca,” but this sounds like it was the beginning of a beautiful friendship.

Yeah, Dr. Gass is my girl. She was great during that pregnancy because a number of things came up. She was just so confident in her approach and didn’t jump to conclusions or make assumptions. She always waited until we had all the evidence and would present it to me just that way. That first delivery with her was magical, everything I could have ever wanted. Now, Dr. Gass knows everything about me and my life. Literally a few weeks ago, when I delivered as a surrogate, I told her I loved her after I had the baby.

Okay, so what do you mean when you say the birth was “magical.”

I remember her coming in. She was very prompt, because my first baby was born in like two and a half hours, start to finish. I think I was in the hospital for maybe 18 minutes before my second, Brooks, was born, and she was there, ready to go. And I don't even think she was on that night, but she knew I was anxious about everything. And it was during covid. Dr. Gass was just so calm and chill about it all. She didn't make me do any sort of IVs or anything I didn't want—she knew my preferences—and advocated for me with the nurses, which was just incredible.

You mentioned “surrogate.”

I told Dr. Gass I wanted to be a surrogate shortly after Brooks was born. She said I’d be wonderful. My husband and I just love being parents; we love our kids so much. I’ve had easy pregnancies, pretty easy deliveries, good recoveries. Birth is the most empowering thing I've ever done in my life. So we decided we wanted to pay it forward to other couples who were struggling to become parents that wanted to have a biological baby. I ended up hemorrhaging after both of my surrogacy deliveries, but never once did I or my husband get scared, because Dr. Gass is just on it.

And you just delivered your second belly buddy last month?

I sure did. I had my first belly buddy, a boy, when Brooks was 18 months old; that was January of 2022. Last month I delivered a girl. And for the follow up question I know is coming, the answer depends on which me responds to the question. If you ask logical me, I’d say we are done with pregnancies. Hormonal me, however, would be willing to do a sibling journey for those wonderful people.

Is there anything else you’d like to share about your OB/GYN?

Okay, going back to when I had Brooks. I remember the nurses asking Dr. Gass if she needed the light, or did she want me to scoot to the end. And I remember her standing back so calm and just saying, “No one needs to be born with the spotlight. Baby's gonna come.” She was just the perfect amount of hands-off, because she knew that's what I wanted, but she was right there, ready when it was time to do all the important parts. I felt like I had a home birth but in a hospital setting, which was exactly what I wanted.

One final thought?

Maybe I can sum it up this way: Dr. Gass has this confidence about her that makes me feel comfortable, even when I'm gushing out 2,000 milliliters of blood after I have a baby. I'm like, ‘She's got me. We're good.’

She’s just that incredible. 

Meet Caroline Abel, APNP

Caroline has spent the majority of her career in the women's health setting. She empowers women by providing education and expertise so they can make informed healthcare decisions. A people person by nature, Caroline provides a level of care and comfort to her patients so they feel they can open up to her and tell her anything they need or want to.

Caroline received a Bachelor of Science in Nursing and a Doctor of Nursing Practice Degree from the University of Wisconsin - Oshkosh. She is board certified as a Nurse Practitioner through the American Nurses Credentialing Center.

Outside of work, Caroline enjoys traveling, coffee and animals, although not necessarily in that order.

Well, this morning maybe it's coffee.

To schedule an appointment with Caroline, please call 920.729.7105.

Meet Colin Johnson MD

Women’s Care of Wisconsin is proud to announce that Dr. Colin Johnson has joined the team. A fellowship-trained Urogynecologist and Reconstructive Pelvic Surgeon, Dr. Colin Johnson specializes in the diagnosis and treatment of pelvic floor disorders. He provides advanced medical and surgical treatments for a variety of conditions including pelvic organ prolapse, urinary and fecal incontinence, recurrent UTIs, and many more.

This quick Q & A will help you get to know Dr. Johnson, who will see patients in our Appleton location at 3232 N Ballard Road.

Can you describe the journey that led you to Women’s Care of Wisconsin?

I’m originally from Kohler, Wisconsin, grew up there, went to high school there, then went to Grinnell College in Iowa and started as a math major. But I knew I wanted to do medicine. My parents were physicians and they both had very rewarding careers, so I knew I was going to make that happen. I did med school and residency at Medical College of Wisconsin, then was a general OB/GYN in Minnesota while my wife did her dermatology fellowship. She’s originally from Appleton, so coming back home just made sense.

What services will you be offering at Women’s Care of Wisconsin?

So I’m a little different from all the other providers at Women’s Care. I’m a urogynecologist, which is a relatively newer specialty that’s essentially a subspecialty of OB/GYN. We specialize in the treatment of pelvic floor disorders. Though I’m a board-certified OB/GYN, I will focus exclusively on urogynecologic patients at Women’s Care.

What are some of the pelvic disorders you treat?

I do both medical and surgical treatments for urinary incontinence, fecal incontinence, urinary retention or voiding dysfunction, recurrent UTI’s and many more. One of the most common disorders I treat is pelvic organ prolapse, where one or more organs drop from their normal position due to a lack of pelvic floor support. Despite the fact that it’s quite common, pelvic organ prolapse is a condition that still isn’t talked about very much.

What causes pelvic organ prolapse?

The most common cause for pelvic organ prolapse and most other pelvic floor disorders is vaginal childbirth.

What kinds of treatments are offered for common pelvic floor disorders like pelvic organ prolapse and urinary incontinence?

Pelvic floor disorders are almost always quality of life issues. When I see patients, I like to educate them on the many options that are available and give them the autonomy to choose what’s best for them. There are many conservative, medical and surgical approaches to treating pelvic floor disorders. I encourage my patients to make their choice based on how much it affects their daily life. In some cases, patients will choose not to do anything at all, kind of a wait and watch approach, and that is very reasonable. For those who find their issue very bothersome, there are a number of things we can do to significantly improve their quality of life. And I find that very rewarding.

Okay, now let’s hear about you in a non-medical way.

My wife and I have a three-year old and a five-month-old, so let’s just say we are always pretty busy. But now that we are back in Appleton, we have a ton of family around, which is so nice. Some other things about me: I played tennis collegiately at Grinnell (and still try to play racquet sports when I can); I love to cook (I stick with simple, healthy meals); I enjoy reading, especially fantasy novels (Have you read The Will of the Many?); and I’m always up for playing a board game with my wife (Settlers of Catan is a favorite).

One final thought?

So many of things I help patients with are concerns they once thought were just part of getting older. They were embarrassed about it, so they didn’t talk about it, not with friends and not with family. By seeking answers—which is a courageous thing to do—they learned that there are so many treatments available to them, and that they didn’t have to suffer in silence.

Jennifer's Story

Because we wanted to know more, we reached out to Jennifer after reading her FB comment:

Dr. Yarroch is the best - wish she could be our everything doctor. She is always so down to earth. When I had an unplanned C-section she was there holding my hand through all the prep. I wouldn't have two healthy babies without her.

Here, in her own words, is Jennifer’s story:

I didn't have an OB when I first started the pregnancy journey after my husband and I got married and started trying. I was referred to Dr. Yarroch by one of my best friends, who was a patient of hers. We both went through seeing Dr. Yarroch with both of our kids at the same time, so that was really cool. I didn't really know what to expect when I first got there, but she was super down to earth and friendly. She did not make me feel lesser for not really knowing how the process worked or what to look forward to.

I have a few different health concerns, and after learning about that from me Dr. Yarroch said, ‘We’ll work through it; we'll figure it out.’ Immediately she made me feel a lot more relaxed about the whole process.

With my first child, we did the induction process, with multiple hours of pushing, and then it got to the point where Dr. Yarroch had a conversation with me and my husband and suggested a C-section might be the best route for me and the baby.

I just started crying; I was terrified.

I think everyone goes in with this plan of how everything's going to happen a certain way, and when that changes, it's really scary. But Dr. Yarroch was really confident that the C-section was the best route for both of us. So now it’s 1:00am and I’m heading into a C-section. It was all kind of a blur, but I remember during the spinal Dr. Yarroch taking the time to hold my hand and talk me through the process and just reminding me that everything was okay and that she had my back, that she wasn't going to let anything bad happen to me or the baby.

That was really a relief. She made a very scary process—and I'm not saying it wasn't scary going forward—a little easier. And I knew I could really count on her.

Fast forward to my second delivery with Dr. Yarroch, which was a planned C-section. It was a totally different situation, honestly. I think I went in there with a lot less anxiety because it was planned, but still very nervous everything was not going to go as planned like the first birth. It actually went so smoothly. The difference between the two was crazy!

Dr. Yarroch is so down to earth. She’s always making jokes, loves quoting a show that we all really like—even did that throughout delivery! She keeps it real and relaxed. And she’s a good listener. Honestly, I take her advice and recommendations very seriously, but she always says, ‘These are my thoughts. What do you think?’

Yes, I’d love for Dr. Yarroch to be our family doctor. I’ve mentioned that to her. And by the way, my sister and cousin also see Dr. Yarroch and she has delivered 7 babies in the past 3 years between all of us!

Midwifery Myths

Even though midwifery has evolved alongside today’s modern health care system, many myths surrounding this profession are based in common misunderstandings that are centuries old. Women’s Care of Wisconsin believes that education is a powerful tool, so we’ve teamed up with our three certified nurse midwives to set the record straight! 

Kay Weina, Jenny Taubel and Elise Gessler have more than 50 years of combined experience as certified nurse midwives and are passionate about the work they do.

Myth #1: Midwives are just untrained labor coaches.

Despite this myth’s popularity, certified nurse midwives often start out as labor and delivery nurses. While labor and delivery nurses are required to hold a bachelor’s in Nursing, certified nurse midwives go back to school to get their Master of Science degree in Nursing (MSN). They are also required to pass a national certification exam and maintain that certification by meeting continuing education requirements.  Combined with their training and medical expertise, this qualifies them to deliver babies.

“I think a lot of nurse midwives were labor and delivery nurses to begin with, like us,” said Kay, who was a labor and delivery nurse for 10 years before going back to school. “When you’re a labor and delivery nurse, you get that patient to delivery, and when you get to that point, the doctor comes in to catch the baby. I always thought -- well gosh! -- that’s the best part! I could do that!”

“I like to think of our role as an OB-GYN Nurse Practitioner, with the added special perk of delivering babies,” said Jenny.

Myth #2: Midwives can only deliver babies at home.

“We do not deliver at home, but we can refer you to some of the licensed professional midwives in the area that would provide you with that type of care,” Jenny said.

According to the American Midwifery Certification Board, 94.1% of CNM-attended births occurred in hospitals in 2017. That same year, 3.2% occurred in freestanding birth centers and just 2.6% occurred in homes.

At Women’s Care of Wisconsin, our certified nurse midwives’ practice is strictly hospital births only, with Kay primarily delivering at the ThedaCare Regional Medical Center-Neenah and Jenny going back and forth between ThedaCare Regional Medical Center-Appleton and ThedaCare Regional Medical Center-Neenah. Elise has stopped her OB practice and is working in the role of a nurse practitioner. She can still see pregnant patients for occasional visits but is no longer available as a delivering provider. Elise works out of Women’s Care of Wisconsin’s Appleton clinic and still provides care for women throughout the lifespan.  

Myth #3: If I choose to have a midwife, my birth has to be all natural.

“I think a lot of people wonder, if you choose a midwife, do you have to have a natural birth? And I think a lot of women probably seek out midwifery because they’re looking for a non-medicated or low-intervention birth, but we certainly can provide medications,” Kay said.

While you can choose to have a natural birth with your midwife, certified nurse midwives are licensed, independent health care providers who can prescribe medications in all 50 states. This includes IV medications and epidurals, which can be an option during labor even for women who originally wanted a natural birth but change their mind during the delivery.

“I think the biggest thing about midwifery care is that we want to listen to the women, we want to give them options, and we want your birth experience to be the most positive one because you’re telling your birth stories forever!” said Kay.

“I like to think of myself as a ‘travel guide’ through a woman’s pregnancy, labor, and delivery journey,” said Jenny. “I’m here to offer comfort, support, encouragement, education, and help in making decisions when needed.”

Myth #4: If I choose to have a midwife, I am putting my baby at risk if something goes wrong.

If you’re considering working with a midwife, but worried about what would happen to your baby if something goes wrong, you can relax! Our certified nurse midwives partner with Women’s Care of Wisconsin OB-GYN physicians through collaboration and referral to provide the best possible care.

“We have a great group of very supportive physicians that are on call and available to us around the clock, so if you develop a concern, such as high blood pressure, preterm labor, or a problem during labor, we have those physicians to consult with,” Jenny said.

While this doesn’t necessarily mean your certified nurse midwife will transfer care, it could mean you will have a team of people working with you to ensure you have a healthy pregnancy rather than working with just one healthcare provider.

“There are some situations where a pregnancy starts off as low risk, but a new problem causes it to become high risk, and then we transfer care to the physicians,” said Jenny.

Certified nurse midwives are also available to assist physicians in the event of a C-section.

“If patients have had a previous cesarean delivery, and would like to schedule a repeat C-section, I can still see them for prenatal care and be there to assist in the surgery with the MD, which is really nice,” said Jenny.

Myth #5: Midwives only work with women who are pregnant.

“We see patients from adolescence all the way up to menopause,” said Elise.

While many people think of midwifery as a practice solely focused on pregnancy and childbirth, nurse midwifery actually encompasses a full range of gynecological health care services.

“We offer contraceptive counseling for all methods and procedures to insert or remove IUDs and Nexplanon, screen for and treat STIs or vaginal infections, do preventative wellness exams, and treat menopausal issues,” Elise said.

The services midwives offer also include primary care, gynecologic and family planning services, preconception care and postpartum care.

Your Child's First GYN Visit

For many young people with a uterus, the thought of seeing a gynecologist for the first time can feel scary or even embarrassing, but this should be a time when they feel comfortable and able to ask questions about development and body changes. We talked with Dr. Valary Gass of Women’s Care of Wisconsin to provide you with the information you need to help your child feel more positive and less stressed out about the first gynecologist visit.

At What Age Should I Schedule the First Gynecologist Visit?

“The American College of Obstetrics and Gynecology recommends that people with uteruses between the ages of 13-15 visit with a gynecologist,” Dr. Gass explains. “For many parents, a reasonable time to talk about scheduling this first appointment is after the first menstrual period. The real purpose of this appointment is to establish a relationship between your child and the gynecologist so they can feel comfortable asking questions and learn about what changes to expect as time goes on.”

Preparing for Your Child’s First Gynecologist Visit

The most important thing you can do to help ease your child’s nerves is talk about the visit. Explain why this visit is important and what can be expected. Having an open dialogue with your child will encourage questions and increase comfort about the experience.

It is also a good idea to have your child create a list of questions for the gynecologist before the visit. Sometimes being nervous can cause us to be forgetful, so writing these questions down on a piece of paper will help make sure everything is answered.

Common topics for questions include periods, hormones, birth control, sex, and sexually transmitted infections. These are all normal topics for your child to have questions about. Remind your child that anything discussed with the gynecologist is protected by privacy laws. The gynecologist should be a safe and judgement-free space, so your child shouldn’t feel embarrassed about asking questions.

What Your Child Can Expect During the Visit

“Most of the time, a child’s first gynecologist appointment does not involve a pelvic exam,” Dr. Gass says, “but it should include taking a careful medical history, addressing any concerns like bad periods, and considering things like HPV vaccinations.” During your child’s first gynecologist visit, expect to have a general physical exam where the nurse will record height, weight, and blood pressure. The gynecologist may then check for common health problems and talk about any medical history. Listening to heart, lungs, and feeling the abdomen should be expected. Sexually active persons under age 25 should have annual gonorrhea and chlamydia screening. This can be done at the visit with a simple urine test. The gynecologist will ask about sexual activity and address any need for contraception.

The most important thing to keep in mind is that this visit is an opportunity for your child to speak openly with the gynecologist and ask questions.

When Is a Pelvic Exam Necessary?

“The American College of Obstetrics and Gynecology suggests that most people with a cervix begin regular Pap smear screening at age 21,” Dr. Gass says. At that point, regular screening should continue every three years until age 30 when they can switch to having a Pap smear with HPV co-testing every five years. Your child most likely will not need a pelvic exam during the first gynecologist visit, unless there are complaints of lumps, bumps, pelvic pain, or abnormal discharge. In these instances, the gynecologist may decide a pelvic exam is necessary. Our office offers nitrous oxide to help patients relax during exams or procedures if needed.

When Should My Child Stop Seeing the Pediatrician?

Once your child is seeing a gynecologist regularly, you may wonder if they need to continue seeing the pediatrician. This is largely up to you and depends on the specific needs your child has as well as the gynecologist’s preference for their practice. It is perfectly normal for your child to continue seeing a pediatrician into college and it can be helpful with a complicated medical history. Just make sure your child continues the annual gynecologist visit as well.

For More Information:

https://www.acog.org/womens-health/faqs/your-first-gynecologic-visit

https://www.acog.org/womens-health/experts-and-stories/the-latest/should-my-teen-see-an-ob-gyn-heres-what-i-tell-parents

Schedule An Appointment

If you would like to schedule an appointment with Dr. Gass, please call or text us at 920.729.7105.

A Conversation About Fertility

Dealing with fertility problems is hard. About one in six couples are troubled with fertility issues, and it affects both men and women equally. 

Simply put, a lot goes into the conception process. There’s the egg, sperm, fallopian tubes, fertilization, the women’s embryo, hormones, and not to mention each of those pieces needing to be in a healthy state. All but one of those parts could function properly and infertility could still be the result. We at Women’s Care of Wisconsin are here for those times. We specialize in the diagnosis and treatment of infertility and will help you navigate this journey to make your dreams come true.

In having a conversation about fertility, here are some common questions regarding the process, treatments, and how we’re here to help.

How long do you wait before speaking with a doctor about possible fertility issues?

Fertility can happen at many points within a lifetime, and infertility issues differ at each of those points as well. A general rule of thumb is if you are over or under the age of 35. Couples under the age of 35 statistically have better chances of conceiving, yet should look into additional options after a year of actively trying (actively trying means you are having intercourse around ovulatory times month by month). Patients over the age of 35 should intervene just after six months.

Can you explain the difference between IUI and IFV?

The big technical difference is where the fertilization of the egg and sperm takes place. During IUI, the doctor inserts the sperm directly into the uterus to fertilize. With IVF, the egg and sperm are manually combined in a laboratory dish and then transferred to the uterus. We can facilitate any IUI treatments by providing medication, tracking cycles, and stimulating the ovulation cycle while collecting and processing the sperm to be placed in the uterus in our own office. If you were to choose the IVF route, we would be the helping hand in that process of referring our best local clinics in the area to take care of you, then assisting once you choose your preferred facility.

When would you recommend IVF to a patient?

We recommend each individual go through the initial testing and treatment options, then work in a conversation about additional options following those. Usually, we would like to start an IVF discussion with a patient after 3-4 rounds of insemination. However, time frames will be individualized to each couple depending on a multitude of personal factors.

So, no matter if you’re just starting to think of the conception process or you are months or years in, Women’s Care of Wisconsin is here to provide education, diagnosis, and treatments, and be with you every step of the way. It’s our goal to make your dreams of having a baby a reality. More information can be found in our fertility booklet.

To schedule your own personal consultation, call or text 920.729.7105 to set up an appointment with one of our three fertility specialists. Click on the provider names below to learn more about each.

Dr. Allison Brubaker 

Dr. Amanda Reed 

Dr. Sara Swift