Nurse-midwives give advice to young wives and mothers

SALT LAKE CITY — Premarital and pre-pregnancy exams prepare women for two of the most important events in their lives — marriage and birth — but young brides and young mothers are often too busy to schedule an appointment that could improve their knowledge and experience.

Examining the physical and emotional aspects of how such events will affect them can help smooth over potential challenges, according to Angela Anderson and Angel Murdock, two certified nurse midwives who answered questions Saturday for callers to the Deseret News/Intermountain Healthcare Hotline.

Anderson and Murdock are two of a team of nine nurse midwives at Intermountain Medical Center, who help women look for more of a "high-tech, high-touch" experience than they get with a regular obstetrician. They help women deal with all the physical aspects of pregnancy, and some of the emotional ones as well.

"We hear from a lot of women who want their daughters to come in and get started on birth control for family planning purposes," said Murdock. "The daughter is looking to have children within a specific time frame and is looking at what she should do to prepare."

Anderson said in Utah culture particularly, many young women are entering marriage as virgins and have little sexual understanding. "It's a great opportunity to have an open discussion about it," talking about issues many brides-to-be may never have thought about like female arousal. "We can help them have more realistic expectations in some ways," she said.

Young women often expect their first sexual experience to be something different than it is, if they have any expectations at all, so the two encourage the young women to bring their fiance along for part of the discussion. "We can tell them that if, at any point, she says, 'This is making me uncomfortable,' you need to understand this," Anderson said.

A pre-conception exam is advisable when women are preparing to conceive, looking at the medications the woman is currently taking to see if there are adjustments to be made, "and remove any hazards that could cause problems," Anderson said. "We also talk about fertility and timing of intercourse."

While it used to be standard practice, a pap smear is not now performed until a woman is 21 or until after she has had sexual experience. Unless women who themselves are virgins marry men who also have never had sex, they have likely been exposed to some type of the nearly 200 strains of human papillomavirus, or HPV, Murdock said. Some can cause cervical cancer, which a pap smear tests for.

Vaccines like Gardasil and Cervarix can prevent infection with the virus types that cause a majority of cancers. When the vaccines first became widely available, there was a political argument that vaccination would simply encourage people to become promiscuous.

"But what I like to tell moms is that 50 percent of women, at some point in their lifetime, will be sexually abused or assaulted, and this protects them there." Intercourse is not required to transmit HPV, Anderson said. It can be transmitted by skin to skin contact.

e-mail: carrie@desnews.com