Midwives: Care Throughout the Lifespan

When thinking of a midwife, the first thought of many is the extraordinary care they provide to mother and child before, during and after delivery. But let us not forget the expert and compassionate care they provide to gynecologic patients as well. Today, we share Diana’s story:

“I was a nurse for 40 years and worked with Jenny Taubel when she was just getting started. In working with her, it was so easy to see the rapport that she had with her patients. It just so happened at that time I didn’t have an OB/GYN, and one day I just asked her if she’d be my provider. ‘Of course!’ she said, and that’s kind of how we started. She’s such a sweet person, so easy to get along with and easy to talk to. She listens to your story, listens to the problem, and then she gives you the options. And she takes her time with you and forms a bond. Having been through some tough times herself, she has such empathy. I drive from Fond du Lac to see her and I’d drive a lot further if I had to. I just love her to death.”

Note: Diana has been retired for three years now. With grandkids involved in sports and in the arts, she keeps busy indeed. She and her husband love to ride their motorcycle. They have been involved with a group that rides for St. Jude’s Children’s Hospital, 232 bikes strong and growing. This year riders raised $1,300,000 for St. Jude.

Tayler’s Story: A First-Time Mom Calls the Midwife

For National Midwifery Week (October 6-12, 2024), we reached out to patients and asked them if they would share their midwife experience. Tayler responded just as we had hoped (“I’d absolutely love to!”) and generously spoke about how she found her provider, Elise Gessler.

Note: Elise has stopped her OB practice and is working in the role of a nurse practitioner at our Appleton clinic. She can still see pregnant patients for occasional visits but is no longer available as a delivering provider. Elise still provides care for women throughout the lifespan.

How did you arrive at using the services of a midwife for your pregnancy?

I started with a lot of information on the internet because, honestly, I didn't really know anyone that had used a midwife before. But I had heard a lot of good things about them, like how they are an extra layer of support during the birthing process. And being a first-time mom, I was like, oh, I need all the support I can get! I just hopped on Google and was looking at different midwives, and I kept seeing Women's Care Wisconsin. Fantastic reviews online. So I was like, okay, let's give it a try here. I requested Elise Gessler after seeing her on the website and looking at the reviews of people that had seen her.

And how did it work out for you?

It was such a good experience with Elise, because she was so involved. An important thing about a midwife that I learned through my research was that no matter what time of day or night you're giving birth, they're going to be there. I wanted that consistent person that was going to be with me, for my appointments, through all the struggles and whatnot, and to deliver my baby. Elise was that consistent person, that extra layer of support that I wanted.

What else can you share about your experience?

So I made my appointment, and then I saw Elise for the first time, and she kind of just explained to me what her role was in the birthing process, how I would be seeing her for all of my appointments, what to expect. Anything that I should need while I was pregnant, I could reach out to her. She was very available, which I really loved as a first-time mom when everything seems really scary. You're just not sure what warrants concern and what is completely normal. And so I liked that she was always available for anything, for questions, concerns, whatever. Yeah, at that first appointment I was like, this is fantastic! Exactly what I want. And then throughout my pregnancy I had some complications. She was always very supportive and always let me know my options. And it was always up to me how I wanted to proceed. But I really leaned into her expertise and fully trusted her opinion.

What was the delivery experience like?

At delivery I was induced, and then I actually ended up being in active labor for four hours, which is like the max amount of time they allow you to push before they have to intervene. That's a really long time to push, by the way. And I will never forget what Elise said: “We have 10 minutes to get this baby out or we need to call the doctor.” If you've never met Elise before, she's a very soft-spoken person. Delivery Elise is different. She was the intense cheerleader. “You got this Tayler, you can do this! Just think about her coming out and getting to hold that little girl that you've been waiting for for the last nine months!” Honestly, her words are what did it for me. I pushed as hard as I possibly could, and it happened. I truly believe the pep talk that she gave me right towards the end was what pushed me across the finish line.

Bet you can’t summarize things in a single sentence, can you?

Now I have this perfect girl, my baby Shay, and this perfect boy, my stepson, so I feel very content.

5 Myths About Midwives

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. At Women’s Care of Wisconsin, we believe education is a powerful tool, so we’ve teamed up with our three certified nurse midwives to set the record straight! 

Jenny Taubel, Kay Weina 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.

If you’re interested in seeing one of our certified nurse midwives, you can schedule your first appointment by calling or texting 920.729.7105 or request an appointment online by visiting our website.

What is Endometrial Ablation?

Abnormal uterine bleeding, in the form of heavy menstrual flow or irregular cycles, is one of the most common complaints that bring women in to see a gynecologist. A procedure called an endometrial ablation is a minimally invasive treatment option that uses technology to destroy the lining of the uterus to reduce menstrual flow. It can be performed right in your doctor’s office without the use of general anesthesia and with minimal down time.

Endometrial ablation in general refers to any procedure that destroys (i.e., ablates) the endometrium (uterine lining). When this technique was initially introduced, laser was used as the energy source. This limited the performance of endometrial ablation to operating rooms that were equipped with expensive and oftentimes cumbersome laser equipment.

More recently, newer ways of achieving quick, effective destruction of the uterine lining using other energy sources, such as heated fluid and radiofrequency electricity, have allowed physicians to offer endometrial ablation safely in an office setting.

Endometrial ablation is not appropriate for every woman suffering from abnormal uterine bleeding. Premenopausal patients with a normal uterus, without evidence of cancer or pre-cancer and who have completed childbearing, are considered candidates for this procedure. Your physician will run tests, such as a pelvic ultrasound and a biopsy of the lining of the uterus, to determine the advisability of ablation in your particular case.

Endometrial ablation itself does not provide effective contraception and any pregnancy that occurs after a woman has had an ablation is extremely dangerous. Therefore, your doctor will often recommend permanent sterilization as well if you have not already undergone tubal ligation, or your partner has not had a vasectomy.

For more information, click here. To schedule an appointment, call or text 920.729.7105.

The Circle of Care: The Patients Speak

In a recent blog we asked our providers to share what the Circle of Care means to them. Following this, we asked our patients to do the same. Some of their stories are brief, some lengthy, but all contain powerful messages and are told with an authentic, genuine voice.

Today, we share Paula's story:

“I needed to have an in-office surgery performed by Dr. Yarroch for some postmenopausal bleeding I had been having. Needless to say, I was extremely scared as I’d never had this problem before, but the staff at Women’s Care was unbelievably compassionate. A week before the procedure Sarah, Dr. Yarroch’s nurse, called me and explained what was going to be done, explaining that it could be performed under nitrous oxide. On the morning of the procedure, Heather (the CMA) got me checked in and again went over exactly what was going to be happening. For whatever reason the nitrous didn’t work as planned for me, possibly because I was so anxious, so after the nerve blocks were placed, Sarah stood next to me throughout the entire procedure, explaining exactly what Dr. Yarroch was doing and why. Whenever there was a gap in the conversation, she continued to ask me questions to keep the conversation going just to keep my mind off what was happening and it worked like a charm. In no time at all I heard Dr. Yarroch say 'Okay, that’s it, we’re finished.' I couldn’t believe I had made it through. Dr. Yarroch, Sarah and Heather kept reassuring me throughout the entire procedure of how well I was doing and how much longer it would be before we were finished. All three of these women made what was an extremely stressful situation for me so much more bearable. 

I truthfully can’t say enough good things about these women!”

Meet Adriana Schaufelberger

“What do you think your patients appreciate most about you?”

She didn't expect that question right off the bat.

“Ooooh. Not sure,” she said. “Maybe that I try to make things lighter and take any embarrassment out of it. There’s no shyness here. Tell me what you’re thinking. Out with it. Go for it. And that’s where we’ll both laugh. I think that’s a big thing.”

Thus begins a discussion with the board-certified OB/GYN, someone who truly loves every part of her interactions with patients at Women’s Care of Wisconsin.

The ability to connect is clearly a strength of Schaufelberger’s. Her patients feel this in their first visit and understand in short order one of her essential mantras.

“I’m not about rushing. I don’t like to be rushed. I don’t like to rush my patients,” said Schaufelberger. “My routine is to come into the room, sit down, and then . . . we talk. And if you cry, there’s a good chance I’m going to cry with you." 

Schaufelberger loves to talk and is laser focused on chatting about patient care, yet she does sprinkle in the personal: she’s an identical twin, first generation Hispanic, who worked 40 hours a week while taking full credit loads to earn her two degrees.

“I started out in nursing school, getting into Purdue’s nursing program by accident. I didn't apply for it, but I was in. So I took it as an omen,” said Schaufelberger.

She loved everything about nursing (“I was good at it too!”) but a nudge from her mentor put her on a different path. She was told quite simply that she should go to medical school. Her response was perhaps typical of a different era.

“I’m a girl. I can’t be a doctor,” was her reply.

After a sideways glance accompanied by a “Seriously!” and then a more benevolent “Of course you can!" Schaufelberger set her sights on a new career.

“And when I graduated from med school, my mentor walked me across the stage,” she said.

Schaufelberger veers once more into the personal, acknowledging that she’s obsessed with her children and loves her dog way, way too much. And she talks about her father, a pipe fitter, who when injured looked to his daughter to take care of things.

She shifts gears, returning to the topic of her patients, the conversation accompanied by the clatter of pots and pans. The interviewer notes this and inquires.

“Oh, I’m multi-tasking. I need to be busy or I don’t do well,” said Schaufelberger. “But as I was saying, I’m old, I’m relatable, I’m not intimidating, I don’t scare people, and maybe that’s why people I don’t know connect with me. Because I can talk to them.”

This segues into a nice little discussion about a shoulder injury that took Schaufelberger out of action for five months.

“All I could think about was seeing my patients,” she said. “I love them all.”

One of the patients who acutely felt the pain of Schaufelberger’s shoulder injury was Morgan, who became a patient following a recommendation.

“It was very important to me when I switched that I click with my new provider and feel an immediate sense of trust. Within, oh, about 20 seconds of meeting her, I knew she was incredible,” said Morgan. “She literally pulled out a piece of paper, we went through every one of my concerns, wrote them down and said, ‘This is our plan for this' and ‘This is our plan for that.’ She was listening. I knew I was in good hands.”

In the eighth month of Morgan’s pregnancy, Schaufelberger admitted she would not be able to deliver the baby because she needed a procedure to repair her shoulder.

“It was instant tears for me, and she was tearing up too,” said Morgan. “But she said she was still going to be there for me. And she was true to her word—any time I needed her or her reassurance, she was just a phone call or text away.”

Speaking of reassurance, another patient (Sarah) recalled a simple sentence that Schaufelberger returns to again and again.

“Dr. Schaufelberger always says, ‘I trust a mother’s instinct.’ That’s so reassuring to hear,” Sarah said.

Schaufelberger ends the chat by emphasizing the importance of a welcoming atmosphere, one with the power to create an immediate connection that can lead to a lifelong bond.

“Okay, I admit that I really want you to like me when you come in. But more significant is that you feel safe and secure, so you can be honest and ask whatever needs asking, and we can be friends.”

Sarah's comment confirms this.

"What sets Dr. Schaufelberger apart from other doctors is that she doesn't just get to know you as a patient," said Sarah. "She knows you as a person and she knows and cares about you and your entire growing family."

Dr. Adriana Schaufelberger is a board-certified OB/GYN and sees patients at Women's Care of Wisconsin locations in Neenah and Waupaca. To schedule an appointment with Dr. Schaufelberger, please call or text 920.729.7105.

They Said What?

A good way to understand our Circle of Care—and your part in it—is to hear from our providers in their own words.

At Women's Care of Wisconsin, we empower women by involving them in all of their health care decisions. We strive to know our patients well, helping them achieve their personal goals and live their best lives. Our doctors, midwives, and nurse practitioners offer a well-rounded approach to OB/GYN care, one that meets both the physical and emotional needs of patients throughout every phase of life.

We call it our Circle of Care. And it begins with you.

Caroline Abel APNP
“Empowerment is at the heart of our Circle of Care. I work in partnership with my patients to create individualized plans of care that help them to be successful in their healthcare journey. I learn from you and you learn from me. Together we can get you where you need to be.”

Gretchen Augustine DO, OB/GYN
“The Circle of Care is our vision to take care of the whole patient on the whole journey, instead of just a piece of it.”

Allison Brubaker MD, OB/GYN
“The Circle of Care means developing a rapport with patients. They keep coming back to you—for their pregnancy, afterwards for postpartum, later on for their GYN care, you see them when they’re going through menopause, and then you start seeing their daughters and their granddaughters.”

Eric Eberts MD, OB/GYN & Practice Founder
“I care about how the teamwork happens. We’re all partners here; we support one another. We have strengths, specialties, and the trust in each other to do the best for every patient that walks through our door, no matter the issue. Your patient, my patient. That’s completing the Circle.”

Valary Gass MD, OB/GYN
“I want my patients to feel that they were heard. There’s no one single fit for everyone, so I educate them on treatment options so they can choose what’s going to meet their goals and fit their lifestyles.”

Elise Gessler CNM
“I want to learn more about my patients and spend more time with them, and being a midwife I can really get to know them and care for them through all aspects of their life. To me, that represents what the Circle of Care is all about.”

Amanda Reed MD, OB/GYN
“At Women’s Care of Wisconsin, I have support all around me, and that also supports our patients, who are taken care of every step of the way. We really have it together here, and I hear that from patients all the time.”

Adriana Schaufelberger MD, OB/GYN
“I love being there for the patient. I get to see them through their life span, so many important moments. It’s critical to have that connection.”

Marissa Schloesser MD, OB/GYN
“We’re following women through their life, through various journeys, from teenage years to reproductive years through menopause. There’s so much joy in each of those journeys, but the transitions can be difficult or stressful for patients, who look to us to help guide them through these challenging moments. We may not always have the answer for them, but we can always help them through it and help them get to a place that they need to be.”

Effie Siomos MD, OB/GYN
“Something that doesn’t get emphasized enough in health care is teamwork. All of us at Women’s Care understand the importance of each moment in the patient journey and use those as opportunities to elevate the experience.”

Sara Swift MD, OB/GYN
“It’s not just caring for women from their teenage years to their menopausal years, but it’s also caring for a woman as a whole, not just physically but mentally and emotionally as well.”

Jenny Taubel CNM
“The Circle of Care is about developing long-lasting relationships with patients. That begins by listening.”

Pa Kou Thao APNP
“Everybody who walks through the door to see me is like a family member, right? I'm going to treat you like you are my family, because that's how I would want somebody to treat any family member of mine if the roles were reversed.”

Caitlin Timmers MD, OB/GYN
“It's important that patients feel comfortable talking with me and asking the hard questions, the questions they might not feel comfortable asking anyone else. That kind of open conversation allows us to get to the bottom of  what's going on.”

Maria Vandenberg MD, OB/GYN
“Building life-long relationships with my patients is an important part of my practice. There is no greater privilege than standing next to a woman as she transitions to adulthood, becomes a mom, and lives a healthy life.”

Kay Weina CNM
“It's your body and it's your baby, and it's your choice. These decisions are up to you. I'm just there to help you figure that out and to answer the questions that you might have.”

Therese Yarroch MD, OB/GYN
“We go through some critical times with our patients, and we are there to make a difference.”