Women’s Health Month: Time to reset your health care habitsDefense Health Agency’s Director, Navy Vice Adm. Raquel Bono (center, foreground) reminds everyone October is Women’s Health Month and a great time to remember that women owe it to themselves and their loved ones to make their health a priority. (DoD file photo) by: Navy Vice Adm. Raquel Bono, director, Defense Health Agency
I was recently a speaker at a women’s leadership symposium and was asked for strategies for proactively managing one’s health when faced with hectic schedules and numerous responsibilities. I could totally relate and the timing couldn’t be better! October is Women’s Health Month and a great time to remember that we, as women, owe it to ourselves and our loved ones to make our health a priority. Focusing on healthy lifestyle habits, ensuring we get regular checkups and immunizations, and being our own best advocates for care will help us live healthier and happier lives. Throughout October, we will feature stories about important women’s health topics. To start things off, I’m encouraging women to take command of their health by resolving to do three things today that will make a difference in your tomorrows.
First, get to the heart of the matter! Heart disease accounts for about one in every four deaths in women each year, making it the leading cause of death for women in the United States, according to the Centers for Disease Control and Prevention. But you can take steps to reduce your risk through healthier habits and lifestyle changes such as limiting alcohol consumption, saying no to smoking, eating plenty of vegetables and fruits, getting quality sleep, reducing stress, and exercising. As a bonus, these same habits reduce the risk of developing diabetes, chronic lower respiratory diseases, and other chronic conditions. Check out the resources TRICARE offers, including tools to help you quit smoking, as well as tools on health.mil to help you focus on your physical fitness and weight management.
Second, don’t slack off on preventive care, including regular checkups, cancer screenings including colonoscopies, and reproductive health care. TRICARE covers well-woman exams annually for women younger than 65. This can include breast exams, pelvic exams, and Pap smears as needed. Keeping up with immunizations is another essential preventive measure. Your doctor will advise you on scheduling immunizations during your regular checkups.
Finally, be a strong advocate for your own health. Some time ago, I was at my doctor’s office discussing a recurring issue I was having. Despite being a physician and hospital commander at the time, he doubted my problem because a lab result had not yet been added to my record. This kind of dismissal of a patient’s concerns undermines health care delivery. Which is why we, at the Defense Health Agency, are committed to ensuring that every member of our beneficiary population of 9.4 million people gets personalized, responsive, and respectful care. By taking charge of your wellness and lifestyle habits, and clearly expressing your health concerns and questions, you become an active partner with your provider in staying healthy.
Women’s Health Month can be your starting point to reset your habits – and make lifelong differences in your health and wellness. Let’s take command of our health!
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Military nurse midwives ride rollercoaster of emotions with their patientsArmy Maj. Lena Fabian (left), staff midwife, William Beaumont Army Medical Center in Fort Bliss, Texas, places a wireless monitoring system on Capt. Merry Fontenot, a staff midwife 36 weeks into her pregnancy. (Photo by Marcy Sanchez, William Beaumont Army Medical Center Public Affairs Office) by: Military Health System Communications Office
Air Force Lt. Col. Sarah Martin knows the joy and heartbreak of pregnancy. As a certified nurse midwife (and a mother herself), she gets to experience firsthand the highs and lows experienced by moms and moms-to-be. On one occasion, it struck particularly close to home for the certified nurse midwife consultant to the Air Force Surgeon General and now assigned to Brooke Army Medical Center in San Antonio, Texas.
Martin saw a young couple for their first pregnancy and did an initial routine trimester ultrasound. They were people Martin knew socially – they all lived on the same base.
“But unfortunately, it was not a viable pregnancy,” said Martin. “It was very upsetting, and it’s hard, not only as a provider but as their neighbor, having to break this news.”
Martin said the couple didn’t give up, though. Within a year, the woman came back pregnant, and Martin was able to help them through the pregnancy to a healthy and happy delivery. “Their little boy is three now. So that was very special for me: seeing them through that saddest time in their lives to a successful delivery. Nature finds a way,” she said with a smile.
Martin is one of a small group of providers in the Military Health System – less than 100 in all services worldwide – who are midwives. They specialize in low-risk pregnancy care and delivery, as well as obstetrics/gynecological care. Most patients come in for routine well-woman exams, as well as PAP smears, fertility and contraceptive education, lactation advice and help, and treatments for menopause. If the care women require elevates, midwives work with doctors to transfer that care without gaps. Martin pointed to her own irony that despite being a midwife, she had both of her children by C-section, demonstrating how midwives work with doctors to make sure that patient experience is the priority. She said her midwife was still part of the birthing process.
“We don’t just hand over patients; usually, we’re the first to assist on C-sections,” said Martin, adding her own experience helps her be empathetic to other moms. “I can counsel my patients that if they can’t have their babies naturally, there’s nothing wrong with that. Sometimes, things are beyond our control. But you’ll get through it, you’ll have a healthy baby, and you’ll be healthy. And that’s really the outcome we want.”
TRICARE also covers certified nurse midwife services, provided the midwife is certified by the American Midwifery Certification Board and licensed in the state where they practice, if required by that state. Certified nurse midwifes are independent practitioners who do not require supervision by a physician. However, midwife services by a registered nurse who is not a certified nurse midwife may be covered with a physician's referral and supervision.
Midwife services in the Military Health System have been recognized recently for several achievements. Army Maj. Elizabeth Nutter, a consultant to the Army Surgeon General for the Nurse Midwife Program, was the recipient of the 2016 Kitty Ernst Award from the American College of Nurse-Midwives. The award honors an exceptional, relatively new certified nurse midwife (certified for less than 10 years) who has demonstrated innovative, creative endeavors in midwifery and/or women's health clinical practice, education, administration, or research. Beaumont Army Medical Center at Fort Bliss, Texas, received the International Board of Lactation Consultant Examiners and the International Lactation Consultant Association Care Award, which recognizes maternity and community-based facilities worldwide that hire currently certified breastfeeding consultants.
“It can be very trying, but it also can be very rewarding,” said Martin. “Families rely on you, even when it’s not the outcome they expected or wanted.”
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