Women’s Health: Interview with Autumn Vergo, MSN, CNM, APRN

Autumn Vergo of Women's Health at Cheshire Medical Center

From adolescence through the senior years, women have unique health needs and concerns. Proactive partnership with your healthcare providers can support a longer and healthier life.

The lives of women have changed dramatically in recent centuries. Average life expectancy for women has increased from about 50 years in the early 1900s to about 81 today. Women play a critical role in maintaining the health of their children, spouses, aging parents, and even their communities.

Yet, too often their varied responsibilities and focus on caregiving leaves their own healthcare needs neglected. It is important for women to take time to maintain their own good health and wellness. While men and women experience many of the same diseases, the symptoms and most effective treatments can be different. As she ages, a woman can also be at greater risk for a number of conditions such as heart disease, Alzheimer’s disease, osteoporosis, and depression.

The best way to understand women’s health is to look at it as a continuum across her life. As women grow older, their health needs change and require specialized care for their physical and mental well being. At Cheshire Medical Center, the Women’s Health team of certified nurse midwives (CNMs), obstetrician and gynecologists (OB/GYNs), and women’s health nurse practitioners (WHNPs) work in collaboration with specialists at Cheshire, and other members of the Dartmouth-Hitchcock Health system, to provide compassionate, high-quality care throughout all the phases of our patients’ lives.

Health+Wellness magazine recently spoke with Autumn Vergo, MSN, CNM, APRN, Chief of Obstetrics at Cheshire Medical Center, to learn more about Women’s Health at Cheshire. Here is her personal perspective on the delivery of care in the women’s health practice.

How would you describe the philosophy of care in Women’s Health at Cheshire?

We are a collaborative practice of OB/GYN physicians, nurse practitioners, and certified nurse midwives working together as a team, caring for all women in our community—all ages, all walks of life, and all health concerns. We’re people who live locally and are dedicated to giving back to the community.

The role of Section Chief in a healthcare environment is most commonly held by a physician. How does being a certified nurse midwife (CNM) affect your views and leadership in Women’s Health?

Collaboration is at the center of practice for nurse practitioners (NPs). As a certified nurse midwife (CNM), my training is really focused on how to be a good communicator with the rest of the healthcare team. While NPs and CNMs are independent providers caring for patients, we function best as a part of a healthcare team that includes physicians and other specialists. The perspective this brings to my leadership is an emphasis on how we can work together, including across specialties, to establish optimal plans of care for our patients. We take a team approach, collaborate, and include all of the stakeholders who need to be involved.

We often hear the term “collaborative care” when discussing healthcare teams. What exactly does it mean to Women’s Health?

There are two types of providers caring for our patients in Women’s Health at Cheshire, advanced practice nurses (APRNs) and physicians. The APRNs are nurse practitioners (NPs) and certified nurse midwives (CNMs) and they generally see patients for their routine care. NPs and CNMs focus on helping patients stay healthy and to reach their health goals through wellness enhancing activities and providing health education. Importantly, they have the time to concentrate on these topics during routine visits.

Our practice also includes a group of physicians who are experts in the treatment of gynecological conditions. They are surgeons and they provide treatment for people who are experiencing problems or complex, chronic issues and need a specialist level of care. Patients see both types of providers in our practice as needed. We all talk to each other and get to know our patients well. We collaborate in plans of care that take into account what patients need to treat disease and problems, and to enhance their wellness. This is what we mean by “collaborative practice” in Women’s Health.

How are women’s health issues different from men’s?

It is true that health recommendations and diseases are sometimes different based on a patient’s gender and there are differences emphasized in national guidelines for routine health screenings. Here in Women’s Health at Cheshire, instead of focusing on men’s vs women’s needs, we are taking the science into account while focusing on individualized care for every patient we see.

Speaking of the role of gender in healthcare, the cultural landscape for transgender people has become significantly more accepting. Yet, transgender people continue to face stigma, discrimination, and lack of access to quality healthcare. Does the Women’s Health team support the healthcare needs of transgender individuals?

I can’t say strongly enough that all patients that need our services are welcome here. Our support of the needs of transgender and gender nonconforming people begins with our fundamental belief in individualized care and includes our access to highly specialized services. Our providers and support staff are receiving ongoing training on how to best meet the healthcare needs of this patient population. There are a lot of details we need to take on, such as using language and forms that are inclusive of the experiences of transgender people. Our work to improve the delivery of care for these patients is ongoing.

At what age should women engage the specialized care provided in Women’s Health?

I think this is a little different for every patient. We do see younger girls and adolescents as needed. We’re fortunate to work closely with the pediatric group here at Cheshire. If a patient’s needs overlap between services in Women’s Health and family medicine and pediatrics, we have direct communication with those providers. While many primary care providers manage things like sexual health and birth control with their patients, that is often an entry point for patients into the Women’s Health practice.

How does Cheshire’s membership in the Dartmouth-Hitchcock Health system benefit Women’s Health patients?

The partnership provides our team and our patients with access to colleagues offering highly specialized care at Dartmouth-Hitchcock Medical Center. Telemedicine through Dartmouth-Hitchcock Health system’s Connected Care has greatly enhanced the services and care we provide to our patients.

Our patients can meet with a specialist, located elsewhere in the system, from an exam room here in our practice through the telehealth video conference screen. This innovation provides our patients local access to services like genetic counseling, maternal fetal medicine, and care for gestational diabetes. Another example is tele-neonatology in our labor and delivery unit. We don’t have a NICU (neonatal intensive care unit) at Cheshire, but we do have immediate access to the neonatology team at Children’s Hospital at Dartmouth (CHaD). Through the Connected Care system, the CHaD team can assess a baby with us in real time—they can see the baby, view monitors, and speak directly with our team to determine if the baby needs to be transferred for a higher level of care.

In addition to telemedicine, our patients benefit from specialist outreach. Johnathan Shaw, MD, Urogynecologist at Dartmouth-Hitchcock Medical Center, regularly schedules patient visits in our practice and performs surgeries here at Cheshire, allowing patients to receive this highly specialized care close to home. It gives us the best of both worlds. We get to live in this lovely community, and through our membership in Dartmouth-Hitchcock Health, have access to specialist services that otherwise couldn’t be offered in a medical center of our size.

Take active care of your health throughout your life

Every woman is unique, and her healthcare needs are equally distinct and deserve personalized care. As our bodies change throughout the stages of our lives, the changes can sometimes be overwhelming and may come with complications. It’s important for women to have support and education from providers who specialize in their needs as they navigate the phases of life.