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.