From the Author
Historically, women's health was framed within a biomedical model by clinicians. Textbooks typically used a biomedical framework to present women's health content. Although this approach can be useful on many levels, it also has limitations that can have significant negative effects on women's health, particularly gynecologic health. A biomedical model is disease oriented and focuses on curing illness--an approach that risks pathologizing normal aspects of female physiology. When a biomedical lens is used to assess women's health, there is a risk of essentializing women and reducing them to their biologic parts. As an example of this proclivity, women's health is frequently used to mean reproductive health, regardless of whether the woman plans to bear children. This reductionism transfers to practice when a woman's parts become the focus of diagnosis and treatment. The meaning of the diagnosis to the woman, as well as the impact that the diagnosis has on her, her significant others, and the work she does, is not addressed in this approach.Feminist theories about women's growth and development provide a different perspective from earlier male-oriented models because they include women's lived experiences and the importance of relationships to women. Recognizing each woman as an expert knower supports women's agency. The focus with this approach is holistic, with health being assessed within the context of each woman's life. It is important for our readers to know that we, as the editors of this book, are experienced women's health clinicians whose practice philosophy is grounded in caring for the whole woman within her lived experience. As teachers, we were repeatedly frustrated by our inability to locate a gynecologic textbook that we felt was suitable for our course. Many of the books that were available were written primarily from a biomedical perspective and, in our opinion, did not provide sufficient content about the normalcy of women's reproductive physiology. Books such as those authored by the Boston Women's Health Book Collective were extremely helpful with ideas about health and holism, but lacked the necessary content to educate student clinicians. Other books did not provide the health-oriented perspective that is vital to the philosophy of care espoused by nursing and midwifery, in which we both strongly believe. Additional books provided elements of both biomedical and health-oriented views and had very useful decision trees or categorization of concerns or problems. However, we felt that these books would not encourage students and practicing clinicians to think critically and to appreciate the importance of making decisions based on the most recent evidence.For these myriad reasons, we embarked on producing a book that presents women's gynecologic health from a woman-centered and holistic viewpoint. Our goal was to create a book that emphasizes the importance of respecting the normalcy of female physiology, and provides clinical content appropriate for assessment, diagnosis, and treatment of pathology. We believe this book embodies these perspectives and underlines the importance of collaboration among clinicians.Some aspects of this feminist approach will be obvious to our readers, whereas others may be more subtle. For example, we used illustrations of whole women, rather than pictures of only breasts or genitalia, when possible. We refer to a woman who has a specific condition rather than referring to the woman by her condition. For example, we speak of the woman who has HIV, as opposed to the HIV-positive woman. We use the term birth as opposed to deliverybecause it situates the power to give birth within the woman versus transferring it to the clinician. We purposefully use women's rather than gynecologic as the first word of this book's title. Our intention in making these deliberate choices was to encourage readers to keep first in their mind that they are treating a whole woman, not her body parts, and not just a condition. We hope that this approach emphasizes the importance of treating women holistically within their lived experiences.We were fortunate to have many excellent contributors to this book. Some are nationally known; others might be new to many readers. The common thread among all of our contributors is their expertise in their respective areas and their recognition of the importance of evidence-based practice. Our contributors are expert clinicians, educators, and scientists. Frequently co-authored chapters represent a clinician and researcher team, whose collaboration provides readers with a real-world view that is grounded in evidence.This book encompasses both health promotion and management of gynecologic conditions that women experience. All of the content is evidence based. The first section introduces the feminist framework that permeates the book and provides readers with a context for evaluating evidence and determining best practice. The second section provides a foundation for assessment and promotion of women's gynecologic health. The third section addresses the evaluation and management of clinical conditions frequently encountered in gynecologic health care. The fourth section provides an introduction to prenatal and postpartum care.We are gratified by how well the first two editions of this book were received by clinicians, students, and faculty, and it was an honor to receive the Book of the Year Award from the American College of Nurse-Midwives for both previous editions. In this third edition ofWomen's Gynecologic Health, we have updated, and in many cases extensively revised, all of the chapters from the second edition to ensure comprehensive content that reflects current standards of care. For example, the chapter on health care for individuals who are lesbian, bisexual, queer, or transgender has been extensively updated, as have the chapters on intimate partner violence and sexual assault. In response to requests from a significant number of educators and readers, we have added four new chapters that provide an introduction to pregnancy and postpartum care.We believe this edition builds upon the precedents set in the previous editions and hope it contributes to women receiving evidence-based, holistic, gynecologic care within their lived experiences. As before, we welcome feedback from our readers that will help us in future editions.Kerri Durnell Schuiling, PhD, NP-BC, CNM, FACNM, FAANFrances E. Likis, DrPH, NP-BC, CNM, FACNM, FAAN
About the Author
Kerri Durnell Schuiling, PhD, NP-BC, CNM, FACNM, FAAN, earned her master’s degree in advanced maternity nursing from Wayne State University and a PhD in nursing and graduate certificate in women’s studies from the University of Michigan. She received her nurse practitioner education from Planned Parenthood Association of Milwaukee, Wisconsin, and her nurse-midwifery education from Frontier Nursing University. She is dually certified as a women’s health care nurse practitioner and nurse-midwife, and has been an advanced practice registered nurse and educator for more than 35 years. She has presented numerous times to national and international audiences on topics that focus on women’s health, and twice was invited to provide formal presentations to maternal child health committees of the Institute of Medicine. As a member of the American College of Nurse-Midwives (ACNM) Clinical Practice Committee, Kerri assisted in the development of ACNM clinical bulletins related to abnormal uterine bleeding and has been an item writer for the National Certification Examination for women’s health care nurse practitioners. Kerri has authored several articles and book chapters that focus on women’s health. She has received numerous awards for her work including a Clinical Merit Award from the University of Michigan for outstanding clinical practice; the Kitty Ernst award from the ACNM in recognition of innovative, creative endeavors in midwifery and women’s health care; the Esteemed Women of Michigan award from the Burnstein Clinic for her significant contributions to women’s health; and, most recently, the inaugural Distinguished Service to Society Award from Frontier Nursing University. She is a Fellow of the ACNM and the American Academy of Nursing. Currently she is Provost and Vice President of Academic Affairs at Northern Michigan University and Co-Editor-in-Chief of the International Journal of Childbirth, the official journal of the International Confederation of Midwives.
Frances E. Likis, DrPH, NP-BC, CNM, FACNM, FAAN, earned her bachelor’s and master’s degrees from Vanderbilt University and her doctorate in public health from the University of North Carolina at Chapel Hill. She received her nurse-midwifery and women’s health care nurse practitioner education from Frontier Nursing University, and she earned a certificate in medical writing and editing from the University of Chicago. Francie is a women’s health care nurse practitioner, family nurse practitioner, and certified nurse-midwife, and she has been an advanced practice registered nurse for more than 20 years. Her clinical experience includes family practice in community health and urgent care centers, performing sexual assault examinations, and midwifery practice in a freestanding birth center and a large obstetrics and gynecology group practice. Francie has authored numerous journal articles, systematic reviews, and book chapters related to women’s health, and she frequently gives presentations at national meetings and invited lectures. Her awards and honors include the Student Choice Award for Teaching Excellence at Frontier Nursing University; selection as a Vanderbilt University School of Nursing Top 100 Leader, one of 100 distinguished alumni and faculty honored in commemoration of the School’s Centennial; the Kitty Ernst Award from the American College of Nurse-Midwives (ACNM); the Vanderbilt University Alumni Award for Excellence in Nursing; and induction as a Fellow of the American College of Nurse-Midwives (ACNM) and the American Academy of Nursing. Currently she is the Editor-in-Chief of the Journal of Midwifery & Women’s Health, the official journal of the ACNM, and an Adjunct Assistant Professor of Nursing at Vanderbilt University.
