Primary Care

Certified nurse-midwives are providers of primary health care of women and newborns. Care by nurse-midwives incorporates all of the essential factors of primary care and case management that include evaluation, assessment, treatment and referral as appropriate. The model of health care practiced by CNMs is focused on the ambulatory care of women and newborns and emphasizes health promotion, education and disease prevention and sees the woman as central to the process of providing such care.

Care by CNMs includes general healthcare, preconception counseling, care during pregnancy and childbirth, provision of gynecological and family planning services and care of the peri- and post-menopausal woman. With health education as a major focus, the goals are to prevent problems and to assist women in developing and maintaining healthy habits.

CNMs are often the initial contact for providing health care to women, and they provide such care on a continuous and comprehensive basis by establishing a plan of management with the woman for her ongoing health care. Such care by the CNM is inclusive and integrated with the woman’s cultural, socioeconomic and psychological factors that may influence her health status.

ACNM position statement. (1997)

Our Unique Approach

Believe Midwifery Services, LLC is eager to serve women between pregnancies or women who have not had, or do not intend, a pregnancy. We care for women from the onset of puberty through their final days of life.

Our primary care visits are scheduled for a full hour because we want the time to fully understand and evaluate your specific situation. We view this exam as time to discuss and exchange new health information about each woman’s health concerns. Depending on your health status, we may recommend follow-up visits so we can continue working on your wellness plan or we may recommend enrolling in one of our integrative and functional midwifery programs, such as our healing the thyroid or enhancing fertility programs.

Clients often comment that their exam with Dr. Lane was the most extensive and gentle physical exam they have ever experienced. As well, many have shared that through screening and counseling, Dr. Lane has better discovered and managed disease states than their previous medical providers. Our greatest compliment however, is to hear women express confidence in their newly gained knowledge and for the first time, take control of their health.

Dr. Lane has at heart an appreciation for integrative and functional midwifery, while also having training and experience in conventional medicine approaches. A plethora of options are discussed with clients for addressing various health issues including food sensitivity testing, evaluating toxin exposures, evaluating sleep, REM therapy, hormone and neurotransmitter testing, hair analysis, mineral assessments, exercise, sexuality, essential oils, botanicals and spirituality.

Dr. Lane’s approach to care prioritizes digging into the root cause of the problem for optimal health and wellness, and educating her client to not only understand, but take control of their health. Through consultations, Dr. Lane then creates an individualized treatment plan that blends integrative modalities with conventional therapies, respecting the goal and convictions of each client.

What is Integrative Medicine?

Integrative medicine is healing-oriented medicine that acknowledges the need to consider the entire person – the body, mind, and spirit. Integrative providers greatly value the partnership between the client and the practitioner and see it as absolutely necessary to healing. Integrative providers integrate conventional methods for healing, such as diagnostic testing and pharmaceutical therapy, with alternative methods, such as botanicals, essential oils, biofeedback, homeopathy, nutraceuticals and chiropractics. It is a philosophy that neither rejects conventional medicine nor accepts alternative therapies uncritically, but recognizes that good medicine is based on good science. Integrative medicine providers are critical thinkers, curious, and open minded. They prefer natural, effective, less-invasive interventions whenever possible and think of optimizing health in broader concepts than simply treatment of disease.

What is Functional Medicine?

Functional medicine is an evolution in the practice of medicine that better addresses the healthcare needs of the 21st century. By shifting the traditional disease-centered focus of medical practice to a more client-centered approach, functional medicine addresses the whole person, not just an isolated set of symptoms. Functional medicine practitioners spend time with their clients, listening to their histories and looking at the interactions among genetic, environmental, and lifestyle factors that can influence long-term health and complex, chronic disease. In this way, functional medicine supports the unique expression of health and vitality for each individual.

How does Integrative and Functional Medicine differ?

Dr. Lane describes this as being the difference between thinking more openly with regards to treatment modalities (integrative medicine) to thinking about why the disease is manifesting in the first place (functional medicine). Both modalities require a great deal of experience and expertise. Her career started as a midwife which at is foundation, is functional. Midwives trust physiologic birth and question any variation from the norm. This lends itself to a functional mindset in other aspects of healthcare, such as thyroid health, infertility, anxiety and depression, sexual dysfunction, and menopause. What is causing the thyroid not to function optimally and how can we work to optimize it’s health? Thinking beyond pharmaceutical management is functional medicine, and then utilizing alternatives or complementary treatment modalities is integrative medicine.

What is Functional Midwifery?

Functional midwifery is a term Dr. Lane coined a few years ago to describe her practice model. Midwives have always been healthcare providers to the community – to its women, its children, its elderly, its very young and even its men. Midwifery care has never been limited to simply catching babies or “boiling water,” as is the widely perceived role of midwives today. As nurses, midwives have always educated, counseled and provided treatment to anyone and everyone within their community. Why the perception today is that midwives have a very restricted scope of practice is perplexing, because people don’t think the same of nurses. Advanced training doesn’t negate all the education and experience the nurse-midwife previously acquired in undergraduate training and bedside experience as Registered Nurses. Potentially, this perception has stemmed from the fact that most job opportunities for nurse-midwives has largely been within labor and delivery units, within hospital wards supervised by obstetricians who also do not care for men, babies, the elderly or even extend primary care.

As a self-employed nurse-midwife, Dr. Lane has had the advantage of not only working to the full extent of her training, but broadening that practice with additional education, training and a growing depth of experience. She has had the advantage of meeting her clients where they are at, identifying their specific needs, and shaping her practice to meet those demands while fully exploring her own passions for healthcare. Functional midwifery has best met those needs in that it remains true to her midwifery roots and is cognizant of our changing healthcare system today. Functional midwifery appreciates not only that optimal birth outcomes respects the physiologic nature of childbearing, but also that optimal health is achieved not through putting a band-aid on the body’s alarm bells with pharmaceutical management, but works to identify the underlying cause and then treats the entire person.

Obtaining Complete Wellness

During each client encounter, Dr. Lane assesses nine essential ingredients for a thriving life, and assist in creating a plan for restoring health and harmony in one’s life.

  • Good food (and a healthy relationship with food)
  • Good quality sleep (and enough of it)
  • Autonomy, Social and Economic health, Purpose
  • Family history and Genetics and how that relates to you
  • Mental, Emotional Health, & Health Self-Perception
  • Physical Movement and Exercise
  • Rhythms, Routines and Cycles
  • Time in nature
  • Spiritual influences

The “body’s network” must also be evaluated, to assure each system is working effectively and in harmony to achieve and maintain optimal health.

  • Mind-body connection
  • Digestive health
  • Immunity and Inflammation
  • Hormonal balance
  • Energy
  • Structure

An annual exam or well-woman exam would also include:

  • review of health history
  • review of life-style habits
  • review and discussion of any specific concerns
  • head-to-toe physical exam
  • laboratory testing
  • prescription needs
  • additional specialty testing as indicated
  • referrals to specialists as indicated
  • education and counseling as indicated

In effort to ensure you get the most accurate Pap smear results, do not use vaginal douches for at least three days prior to your appointment, refrain from sexual intercourse for at least 48 hours prior to your appointment, and do not use tampons, birth control foams, jellies or lubricants for at least 48 hours prior to your appointment. These things make it difficult to collect an adequate cellular sample.

We encourage our clients to schedule their appointment about one or two weeks after their expected menses. If menses starts, and you know you are due for your Pap smear, please call our office to reschedule. However, if your Pap smear is not due at this year’s well woman exam, there is no need to reschedule due to menses. Write down any questions you may have for your nurse-midwife and don’t forget to share any concerns you may have about your health.

Recommended Preventive Health Care for Women

Our midwifery team respects individual circumstances and personal conviction regarding healthcare choices. We see our role as one that guides each woman in determining which options are best for her individual circumstance, without judgement. The recommendations below are broad; therefore, it is important to discuss with your provider which options are best for you.

Health Activity

  • Physical Exam annually, and as health demands
  • Eye and Ear exam, baseline by 39 then every 2-4 years
  • Dental exam twice each year
  • Skin exam annually (which can be provided by your midwife)

Immunizations

  • Tetanus/Diphtheria, every ten years
  • Influenza, based on risk and then annually after the age of 50
  • Measles/Mumps/Rubella, usually not needed
  • Pneumonia vaccine, usually not needed until 65

Labs

  • Cholesterol at age 20 for baseline, and then every five years starting at age 40
  • Blood sugar evaluation every 3 years at age 45, unless history of gestational diabetes

Osteoporosis Screening

  • Bone Density, baseline if at risk at age 50, otherwise age 65

Breast Cancer Screening

  • Clinical Breast exam annually
  • Mammogram at age 40 if history indicates, otherwise 50 baseline then every 1 to 2 years

Cervical Cancer Screening

  • First at the age of 21, then every three years until 30. After 30 every fifth years with high-risk HPV testing.
  • Pelvic exam depending on risk assessment

Colon Cancer Screening

  • Fecal Occult Blood Test, usually not needed prior to 50, then annually
  • Flexible Sigmoidoscopy usually not needed until 50, then every 3-5 years
  • Colonoscopy usually not needed until 50, then every 10 years
  • Double Contrast Barium Enema, usually not needed until 50, then every 10 years

Please visit our financial information page for specific fees associated with our office visits. Payment is expected at the time of service, including fees for labs obtained by our office. If insured, our laboratory will file your labs with your insurance company and you will only be responsible for our lab draw fee of $22. We will also offer a receipt for your services to share with your insurance company in effort to obtain reimbursement. Due to the complexity of some visits, additional visits may be required to obtain further information, or to create a management plan. These visits are an additional expense. Dr. Lane may also recommend enrolling in one of our healing programs which would offer the greatest opportunity for

If this is the first time visiting Believe Midwifery Services, LLC, our receptionist will provide access to the client privilege page where directions are provided for completing your medical records in our electronic health records prior to your first visit. Feel free to explore this page as it offers a number of resources, as does our blog.

Nurses top Gallup’s poll

For the 13th consecutive year, nurses top the Gallup poll of honesty and ethics in different professions. Our profession scored above medical doctors, pharmacists, police officers, and clergy. Nurses have topped the list each year since we were first included in 1999, with the exception of 2001 when firefighters were included in response to their work during and after the 9/11 attacks.

Our Speciality

Nurse-Midwives are primary healthcare providers, which is different from obstetricians who are specialist. Nurse-midwives are certainly experts in maternity care and gynecologic exams, but we are also experts in the full scope of women's healthcare issues throughout their entire life span. Dr. Lane further specializes in integrative and functional medicine.

Our most common visits include fertility consultations, anxiety and depression, adrenal fatigue and leaky gut, menopausal concerns, irritable bowel, fibromyalgia, chronic pain, migraines, chronic sinusitis, dermatology concerns, dyspepsia, chronic otitis media, rheumatoid arthritis, chronic fatigue syndrome, sexual dysfunction, vaginal discharge, polycystic ovarian syndrome, diabetes, and of course, thyroid conditions. For many clients, we offer extensive educational programs that include consultations, or we provide individual consultations and follow-up visits through resolution.

Affordable Care Act & Clinical Preventive Services for Women

One key set of provisions under 'Title IV: Prevention of Chronic Disease and Improving Public Health, Subtitle B: Increasing Access to Clinical Preventive Services' requires insurance coverage without cost sharing for proven clinical preventive services, including important services for women such as immunizations, cancer screenings including Papanicolaou tests and mammograms, bone density tests, iron deficiency and anemia screening, hypertension and lipid screening, depression screening, folic acid supplements and behavioral counseling regarding obesity, alcohol use and smoking cessation. This provision means that the majority of insurance plans in the USA must cover evidence-based clinical preventive services without copays, deductibles or other economic burdens to the consumer.

Starting January 2011, all Medicare, newly expanded Medicaid and nongrandfathered private insurance plans (including individual, small-group, large-group and self-insured plans) were required to provide benefits without cost sharing for: all items or services with an A or B rating from the US Preventive Services Task Force (USPSTF); immunizations recommended by the CDC Advisory Committee on Immunization Practices; and guidelines issued by Bright Futures for Children and the Advisory Committee on Heritable Disorders. In additional, a display of the ongoing politics regarding breast cancer screenings, the ACA mandates coverage for mammography screening from women in their 40s, contrary to most recent USPSTF recommendation that gives breast cancer screening in this age group a C rating.

After January of 2013, recommendations by the Department of Health and Human Services (DHSS) for diabetes screening at 24-28 weeks gestation; Human papillomavirus DNA testing for high-risk women; sexually transmitted infection counseling; annual HIV screening and counseling for sexually active women; contraception counseling for women with reproductive capacity, and all US FDA-approved methods of contraception and sterilization; breastfeeding counseling, consultation and equipment rental; and interpersonal and domestic violence screening and counseling should also be covered.

Certain religious employers, such as churches and other nonprofit organizations whose primary mission is the inculcation of a specific faith, are notably exempt from covering contraceptives.

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Questions?

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Food For Thought

Food for Thought

"It is much more important to know what sort of patient has a disease than what sort of disease a patient has."

Sir William Osler

 

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"Happiness is underrated and critically important to health. Seriously! Unfortunately, many people just have no idea how to be happy."

Aviva Romm

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"Physicians simply do not have time to be what patients want them to be: open-minded, knowledgeable teachers and caregivers who can hear and understand their needs."

Snyderman and Weil

Food for Thought #1

"They say that time changes things. But you actually have to change them yourselves."

Andy Warhol

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"To think is easy. To act is hard. But the hardest thing in the world is to act in accordance with your thinking."

Johann Wolfgang von Goether

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"Birth isn’t about avoiding one set of realities in favor of another. It’s about embracing all facets of birth--contradictory, messy, or unpleasant as some might be--as vital to the whole."

Rixa Freeze PhD

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"Why I appreciate being a certified nurse-midwife, as opposed to choosing another route for midwifery: I feel learning the science is vital so the art of midwifery is safe and effective."

Dr. Penny Lane, nurse-midwife

Food for Thought

"When the debate is lost, slander becomes the tool of the loser."

Socrates

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"To accomplish great things, we must not only act but also dream; not only plan, but also believe."

Anatole France

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"Science and uncertainty are inseparable companions. Beware of those who are very certain about things. There are no absolute truths in biological sciences - only hypotheses... 'We need to train medical students and residents more in the art of uncertainty and less in the spirit that everything can be known or that it even needs to be known.'"

Grimes (1986)

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"American physicians are rewarded for doing things to patients, not for keeping them well."

Grimes, 1986

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"The false idol of technology. 'Having a widget screwed into one's scalp has become an American birthright.'"

Grimes, 1986

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"Between 1985 and 1987, a hospital instituted a successful program to reduce its cesarean rate. The rate fell from 18% to 12%, losing the hospital $1 million in revenues - no small sum in those days."

Goer & Romano, 2012, p 37

Food for Thought

"Obstetricians are much more likely to perform a cesarean when they wrongly believe the baby weighs 4000 g or more based on sonographic estimates than when the baby actually weighs this much but the obstetrician did not suspect it."

Goer & Romaro, 2012, p 35

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"If you play God, you will be blamed for natural disasters."

Marsden Wagner (2006)

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"An education isn't how much you have committed to memory, or even how much you know. It's being able to differentiate between what you know and what you don't."

Anatole France

Food for Thought #3

"Birth is not only about making babies. Birth also is about making mothers - strong, competent, capable mothers, who trust themselves and know their inner strength."

Barbara Katz Rothman PhD (1996)

Food for Thought #4

"Believe there is always, always, always a way. When you have exhausted all possibilities, remember this: you haven't."

Thomas Edison

Food for Thought #5

"All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident."

Arthur Schopenhauer

Food for Thought #2

"Yet you brought me safely from my mother’s womb and led me to trust you at my mother’s breast."

Psalm 22:9