College of Nursing faculty member receives grant to fight opioid abuse among pregnant women

Kristin Ashford, PhD, APRN, WHNP-BC, FAAN, associate professor and associate dean of Undergraduate Faculty Affairs in the UK College of Nursing, has been awarded the Hillman Innovations in Care Program grant from the Rita & Alex Hillman Foundation for her work in addressing the opioid epidemic and its impact on maternal-fetal health.

The $600,000 award will enable Ashford to continue to expand both the Perinatal Assistance and Treatment Home (PATHways) and Beyond Birth programs. The PATHways program integrates evidence-based knowledge through a comprehensive approach to perinatal opioid use disorder, offering buprenorphine maintenance treatment for both opioid use disorder and neonatal abstinence syndrome, peer support and education, legal support, prenatal and postnatal health services for mother and baby, and health system navigation during delivery.

PATHways has been expanded to include the Beyond Birth program, which provides wraparound services and access to resources to aid in maintaining recovery in the two years following delivery. 

“After women give birth, they experience the highest amount of stress in their lifetime, and this is when they need the most support in their recovery,” said Ashford.

The grant will be used to expand access to the program in communities that may not have the resources available to provide this type of multidisciplinary care to mothers with opioid use disorder. The grant will also be used to provide training to clinicians in high-need low-resource communities including Hazard and Morehead.

“The most important part of this program is helping mothers be the parents that they want to be,” Ashford said. “The Hillman Innovations in Care Program grant will enable the team to reach and help more women.”


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Eat more plants for a healthier heart, says UK’s Dr. Gretchen Wells

Dr. Gretchen Wells

Written by Dr. Gretchen Wells, director UK Gill Heart & Vascular Institute’s Women’s Heart Health Program

Most people don’t realize that the power to prevent many diseases is in their own hands.

By exercising – even a little – and quitting smoking, you greatly reduce your risk for diabetes, heart disease and even dementia. But perhaps the easiest way to tip the odds in your favor is to change your diet. If you’re looking for a way to eat healthier, consider a plant-based diet.

A plant-based diet is based on fruits, vegetables, whole grains and legumes. It excludes or minimizes meat, eggs and dairy products, as well as highly processed foods like bleached flour, refined sugar and some oils.

Numerous studies have linked a plant-based diet to lower risks of diabetes, high blood pressure and heart disease – as much as 30 percent, according to one Harvard study.

Don’t know where to begin? Here are some guidelines:

  • Veggies: Any vegetable, especially leafy green or yellow vegetables with high water content.
  • Fruits: No limits here, but deeply colored berries are a plus.
  • Starches: This includes starchy vegetables like potatoes as well as whole grains like oats, rice or quinoa.
  • Beans and legumes: These are starchy, but generally have a higher protein content. Consider beans, lentils and dried peas.
  • Nuts and seeds: Use sparingly to avoid weight gain.

You can adjust slowly to a plant-based diet. Adopt the popular “Meatless Mondays” trend in your home and add Tuesday, Wednesday, etc. as you go. Or experiment by adjusting your favorite recipes to be plant-based: make your chili all beans, or prepare a stir-fry with tofu or edamame instead of chicken.

Heart-healthy cooking demo at UK HealthCare

If you want some ideas, come to UK HealthCare on Saturday, Nov. 18, for “Feeding Your Heart and Soul” featuring best-selling cookbook author Jane Esselstyn. Esselstyn, who has spent most of her life advocating for a plant-based, meatless, whole-food diet, will demonstrate recipes from The Prevent and Reverse Heart Disease Cookbook, which she co-authored with her mother, Ann. You’ll also get the opportunity to taste some of her dishes and see for yourself that a plant-based diet can be healthy and delicious.

The morning will begin at 8 a.m. with an optional free yoga session. Esselstyn will take the stage for a brief lecture at 9 a.m., followed by a cooking demonstration at 10 a.m. and tastings at 11 a.m.

The registration fee for “Feeding Your Heart and Soul” is $15 and includes a free copy of The Prevent and Reverse Heart Disease Cookbook and tastings.

For more information or to register, call 859-218-0121.


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Midwives offer care alternative for women at all stages of life

Joanne Burris, APRN, CNM

In honor of National Midwifery Week, we asked certified nurse midwife Joanne Burris of the UK Midwife Clinic a few questions about midwifery as well as the care and services offered at the UK Midwife Clinic.

UK HealthCare is proud to work in collaboration with the midwives at the UK Midwife Clinic. The partnership began this spring as the clinic, formerly Womankind Midwives, merged with UK HealthCare to promote positive health experiences for women and provide more opportunities for research and exceptional, compassionate care.

What kind of training do midwives go through?

There are several different types of midwives, but all of the midwives at UK are certified nurse midwives. This means our midwives have attended nursing school to earn their registered nurse (RN) license as well as graduate school to earn a Master of Science in Nursing (MSN) specializing in midwifery. Additionally, CNMs must pass a national board exam after earning their master’s degree. They are then called advanced practice registered nurses, or APRNs.

What kind of services can a midwife provide?

From the American College of Nurse-Midwives (ACNM): Midwifery as practiced by certified nurse midwives (CNMs) encompasses a full range of primary health care services for women from adolescence to beyond menopause. These services include primary care, gynecologic and family planning services, preconception care, and care during pregnancy, childbirth and the postpartum period.

How is the midwife approach to care different than that of a traditional obstetrician?

Certified nurse midwives are experts in normal pregnancy. We care for healthy, low-risk women. One of the hallmarks of midwifery is refraining from intervention in the absence of complications, so we value allowing nature to take its course when things are going well.

A physician is an expert in pathology and we are grateful for our collaborative relationships with OBs when our patients present with risk factors.

Can I deliver at a hospital if I use a midwife?

Absolutely! According to the ACNM, 94 percent of CNMs attend births in hospitals. All of UK’s midwives attend births only at UK Albert B. Chandler Hospital.

Can my midwife prescribe any medications that I may need?

With the exception of some controlled substances, midwives with the proper certification can prescribe most medications.

Who should seek midwifery care?

Midwives are experts in low-risk, healthy pregnancies. Women who have known high-risk factors would be better served by an obstetrician.

What’s a doula, and do we have them as part of our UK midwifery practice?

A doula provides continuous non-clinical support to women during their birth. They offer education, physical and emotional support, and advocacy. They should not offer medical advice, perform clinical exams or speak for the patient. We do not have doulas as a part of the UK Midwife Clinic staff, but some insurance policies will cover the cost of a doula and we encourage our patients to use them.


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breastfeeding latch

Breastfeeding? Try these tips for getting a perfect latch

Breastfeeding is a healthy choice for both you and your newborn, but learning how to do it successfully can be challenging.

One important aspect of successful breastfeeding is getting the proper latch. Here’s how to do it:

  • While holding your baby belly-to-belly, line them up nose-to-nipple and wait for them to open their mouth wide before attaching.
  • The latch should be deep enough that your nipple reaches to their soft palette. This will keep you from experiencing pain while nursing.
  • Your baby’s chin should touch your breast first. Their head will then tilt back.
  • Their lower lip will turn outward when they’re correctly attached.

Positions for breastfeeding

There are several positions you can use to feed your baby:

  • Laid back: This is similar to the skin-to-skin position. Lay back and use pillows to support you. Place your baby face-down between your breasts and allow them to move into position to attach. This is an easy first feeding position.
  • Cross-cradle: Place your baby on a pillow in your lap so they are at breast level. Place them tummy-to-tummy with you and line their nose up with your nipple. Support their head with your hand at the base of their skull. Form a C with your thumb and forefinger around your breast but away from your nipple. Once your baby latches on, you can release your breast and use this hand to help cradle your baby.
  • Football hold: This is position is great if you have had a Cesarean section, because it keeps pressure off your incision. Place your baby on a pillow at your side with their legs under your arm. Support their head and neck with your hand by sliding your hand under your baby’s back.
  • Side-lying: Lie on your side with pillows supporting you. Turn your baby toward you on their side facing your nipple. You may need to place your arm behind them for support. Line them up, nose-to-nipple.

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toxic shock syndrome

Toxic shock syndrome can affect anyone. Know the symptoms.

Joanne Brown DNP, APRN

Joanne Brown DNP, APRN

Written by Joanne Brown, DNP, APRN, an adjunct instructor in the UK College of Nursing and women’s health nurse practitioner at University Health Service.

Toxic shock syndrome, or TSS, is a life-threatening illness that occurs when poisonous toxins are released into the bloodstream, potentially damaging skin tissue and harming vital organs, such as the lung, liver and kidney.

It’s important to remember that toxic shock syndrome can affect anyone. The disease can occur in women, men and children of all ages.

It was first reported in children in 1978, but it was later identified in women who were using tampons during their menstrual periods. However, after highly absorbent tampons were removed from the market, the number of TSS cases associated with the use of tampons has declined. In fact, 50 percent of TSS cases today are not associated with menstruation.

Risk factors, symptoms of toxic shock syndrome

Risk factors for TSS include:

  • Recent childbirth.
  • Skin infections, cuts and burns.
  • Wound infection after surgery.
  • Viral infections, such as the flu or chickenpox.
  • Use of contraceptive sponges, diaphragms, super-absorbent tampons, nasal packing and other foreign items.

Common symptoms of TSS are:

  • Sudden high fever.
  • A rash resembling a sunburn, especially on the palms and soles of the feet.
  • Peeling skin one to two weeks after the onset of acute illness.
  • Low blood pressure.
  • Redness of the eyes, mouth and throat.
  • Vomiting or diarrhea.
  • Seizures.
  • Confusion.
  • Headaches and muscles aches.

There is currently no test used to identify TSS. Clinicians can make a diagnosis based on a physical examination and the patient’s symptoms. Some examinations may include blood tests to check organ function or swab samples from the cervix, vagina and throat.

Treatment for TSS

Treatment includes removal of foreign bodies and drainage of infections. Patients may be prescribed antibiotics to fight bacterial infections in the body as well as dialysis, intravenous therapy and medicines to control blood pressure. Patients with a severe condition might need to stay in the hospital intensive care unit for monitoring.

Anyone who notices signs of TSS should see a doctor immediately, especially if the person has a wound or skin infection or has recently used tampons. TSS can cause severe health concerns, such as liver, kidney, and heart failure, and shock or reduced blood flow through the body. TSS is a medical emergency that can cause death if untreated.

TSS can reoccur. To lower the risk of menstrual TSS, avoid using highly absorbent tampons, change tampons frequently and alternate using tampons and sanitary napkins.


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benefits of breastfeeding

Breastfeeding gives your baby the best possible start

Did you know that breastfeeding is a healthy choice for both mom and baby?

Celebrate National Breastfeeding Month by learning more about breastfeeding’s benefits. Breastfeeding provides warmth and closeness, and the physical contact helps create a special bond between you and your newborn.

Benefits for babies

  • Breast milk is easier for your baby to digest.
  • It doesn’t need to be prepared.
  • It’s always available.
  • It has all the nutrients, calories and fluids your baby needs to be healthy.
  • It has growth factors that ensure the best development of your baby’s organs.
  • It has many substances that formulas don’t have that protect your baby from diseases and infections. In fact, breastfed babies are less likely to have:
    • Ear infections.
    • Diarrhea.
    • Pneumonia, wheezing and bronchiolitis.
    • Other bacterial and viral infections, such as meningitis.
  • Research also suggests that breastfeeding may help to protect against obesity, diabetes, sudden infant death syndrome (SIDS), asthma, eczema, colitis and some cancers.

Benefits for mothers

  • Breastfeeding releases hormones in your body that promote mothering behavior.
  • It returns your uterus to the size it was before pregnancy more quickly.
  • It burns more calories, which may help you lose the weight you gained during pregnancy.
  • It delays the return of your menstrual period to help keep iron in your body.
  • It provides contraception, but only if these three conditions are met:
    • You are exclusively breastfeeding and not giving your baby any other supplements.
    • It is within the first six months after birth.
    • Your period has not returned.
  • It reduces your risk of ovarian cancer and breast cancer.
  • It keeps your bones strong, which helps protect against bone fractures in older age.

UK HealthCare is Baby-Friendly

At UK HealthCare, we’re committed to ensuring a happy, healthy start for newborns and their mothers. In fact, we’re a Baby-Friendly USA® hospital, which is a prestigious acknowledgment of the top-notch care that we provide.

Baby-Friendly USA is a global initiative sponsored by the World Health Organization and the United Nations Children’s Fund (UNICEF). The initiative encourages hospitals to provide breastfeeding mothers with information, confidence, support and skills necessary to initiate and continue breastfeeding.

Find out more about the Baby-Friendly initiative.


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postpartum depression

If ‘baby blues’ persist or worsen, it’s time to talk to your doctor

From sleep deprivation to learning how to breastfeed, you face a lot of challenges as the mother of a newborn.

As you adjust to these challenges, it’s not uncommon to experience mood changes or feelings of sadness. These “baby blues” will often go away after a few weeks.

Sometimes, though, mothers of infants can develop symptoms that are more severe and last longer than baby blues. This is known as postpartum depression. One study has shown as many as one in every seven mothers of newborns suffer from this debilitating condition.

Luckily, most women find that treatment helps.

What is postpartum depression?

Postpartum depression can start at any time during your baby’s first year. Usually, you’ll start to feel its effects during the first three weeks after birth.

You might feel sad, hopeless or guilty because you may not feel like bonding with or caring for your baby.

Postpartum depression doesn’t just affect first-time moms, either. You can experience it even if you didn’t have it with your previous children.

Why does it happen?

There are many causes of postpartum depression, including:

  • Hormone levels. Your hormone levels increase when you’re pregnant. After your baby arrives, they drop suddenly. This quick change can trigger depression in some women.
  • A history of depression. If you’ve previously had depression or if it runs in your family, you may be more susceptible to postpartum depression.
  • Other stress and problems. If you didn’t want to be pregnant or if your partner and family aren’t helping you care for your baby, you’re more likely to become depressed as a new mom. Postpartum depression is also more common among women with other stresses such as financial issues, problems with drugs or alcohol, or relationship troubles.

Symptoms

Postpartum depression varies among women, but here are some of the most common symptoms:

  • Sadness, loss of hope or despair.
  • Feeling unable to care for your baby or do basic chores.
  • Crying a lot, sometimes for no obvious reason.
  • Trouble bonding with or feeling close to your baby.
  • Less interest in other things you used to enjoy.
  • Too much sleep.
  • Trouble with focus, learning or memory.

Diagnosis and treatment

Only a doctor can diagnose you with postpartum depression. But if you think you have it, make an appointment right away. There are treatments that will get you back to feeling like yourself. They include:

  • Medication. Your doctor might decide to prescribe you antidepressants. If you’re nursing, be sure and tell your doctor. He or she can prescribe an antidepressant that is safe for nursing mothers.
  • Counseling. Talking to a psychologist or therapist can also help. You can learn ways to recognize when you’re having negative thoughts so you know how to better deal with them.

Postpartum psychosis

Postpartum psychosis is a rare and serious form of mental illness that can happen with postpartum depression. Symptoms often begin during the first two weeks after your baby is born and are more severe than those for postpartum depression. They include:

  • Frequent crying and irritability.
  • Lack of energy.
  • Trouble concentrating and making decisions or confusion.
  • Inability to sleep.
  • Feeling hopeless.
  • Lack of interest in eating.
  • Thoughts of harming yourself or your baby.

Postpartum psychosis is a medical emergency. If you think you might be experiencing symptoms of postpartum psychosis, call your doctor immediately.


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Following a positive birth experience with a certified nurse midwife (CNM), JoAnna Burris felt called to become one herself. Now, she works as a CNM at UK.

Positive birth experience inspires woman to become a UK midwife

Certified nurse midwife JoAnne Burris describes birth as a poetic paradox: an instance of power and vulnerability in a woman’s life. This important scale can tip in favor of vulnerability or empowerment, depending on the woman’s sense of control and support.

After the birth of her first child in 2005, Burris related giving birth to feelings of vulnerability, frustration and helplessness, which stemmed from a traumatic birth experience in which healthcare providers dominated the decision-making.

Determined to have a more positive birth experience, Burris sought care from a certified nurse midwife (CNM) when she became pregnant with her second baby in 2008. She partnered with Melissa Courtney, a certified nurse midwife who was in her first year of practice at Lexington Women’s Health. CNMs place emphasis on the individual needs, birth vision and preferences of the patient, designing a custom birth experience for each woman all while ensuring a safe passage for mother and baby. For her second birth, Burris decided to use hypnosis, a natural relaxation technique to help control labor pain, and Courtney embraced the practice as part of the delivery plan. Burris also brought concerns stemming from the trauma of the first delivery, and Courtney addressed each concern with respect and consideration.

“Each prenatal visit, I felt like I would come to Melissa with a new fear,” Burris said, recalling her first birth. “At each appointment, she didn’t dismiss my fears. She treated me as an intelligent woman with valid concerns.”

Also distinctive from the first birth experience, Courtney reinforced Burris’ confidence with encouragement and affirmation that she was capable of having a natural birth. Burris never questioned whether she was in control of her body, her medical care or the details of her birth experience. This patient-centered emphasis continued into the actual birth experience. Burris remained in control of every decision, such as her preference for her birthing position, and Courtney followed her lead.

“We try to listen and meet women where they are,” Courtney said. “We try to build their confidence in themselves so they realize they are very capable. It’s the strong belief that if a woman can have a positive experience in her birth, it then sets her up for her motherhood experience.”

Patient-centered care leads to empowerment

Burris said she went into labor confident in her ability to deliver her son in a manner consistent with her preferences and beliefs. With relief she gained through the Hypnobabies technique, she was able to truly enjoy her natural birth. After her son’s birth, she wrote a letter to Courtney expressing gratitude and insisting her support made a difference. She said Courtney reduced the feelings of vulnerability and tipped the scale in favor of empowerment, which led to the success of the delivery.

“During my birth, when I was ready to push, all I remember hearing from Melissa was reassurance,” Burris said.

Burris was forever changed by her birth experience with Courtney. With two drastically divergent birth experiences, she believed the patient-centered preparation, supportive care and freedom to choose her own path pointed her toward a positive, redeeming birth experience. She felt a spiritual calling to help other women experience pregnancy and birth as a natural – not scary or traumatic – life stage and realize their potential to remain in control of their health with the supportive partnership of a CNM.

“How many other people go home and night and say, ‘Today I empowered a woman in the most important moment in her life?’” Burris said. “That is what (Courtney) did for me. I want to give that gift to other women.”

A year after the birth of her son, Burris quit her nine-to-five job and started the process of becoming a CNM. She returned to college to complete her associate’s degree in nursing, then acquired the years of labor and delivery nursing experience required before attending midwifery school. Her midwifery training was done at Womankind Midwives, the practice Courtney established in 2011. Last fall, she was hired at the UK HealthCare Polk Dalton Clinic.

Provider and patient now practice together

Now, with a new partnership between UK HealthCare and Womankind Midwives, Courtney and Burris, formerly provider and patient, will partner together as colleagues empowering women throughout Central Kentucky. The UK Midwife Clinic will provide midwifery services through four full-time CNMs, including Courtney and Burris, and additional resources and expertise through access to the UK Department of Obstetrics and Gynecology and the only Level IV Neonatal Intensive Care Unit. Courtney sees the collaboration as benefiting patients who want more options when considering a delivery experience. The merger also benefits both organizations, as CNMs will have the opportunity to teach holistic, natural birthing techniques to medical residents and increase the acceptance and integration of these techniques, and the large academic hospital expands its realm of women’s health services to include midwifery.

“I think it’s awesome that we get to work together now, being able to develop this program at UK with JoAnne is super exciting,” Courtney said. “We are not only impacting Lexington, but we will hopefully impact the residents that we will work with and take that experience to their future practices.”

Burris also looks forward to promoting positive health experiences for women beyond childbearing. The UK Midwife Clinic, located at 141 N. Eagle Creek Drive in Lexington, will provide a variety of services, such as general obstetrics and primary healthcare across the lifespan. Patients will deliver babies at the UK Birthing Center with the care of a midwife. From her personal experiences, Burris knows putting women at the center of their care and encouraging them to believe they are in control are crucial first steps for ensuring positive outcomes.

“This field focuses on empowering women through health education and promotion,” Burris said. “If we can provide a sense of control and empowerment while providing safe, high-quality care, it will affect their whole family. We are treating the whole woman so she can be a force for positive health change in her family.”

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  • UK Midwife Clinic provides patients with exceptional, compassionate care. Learn more.
  • The UK Polk-Dalton Clinic provides a wide range of primary medical care services, including obstetrics and gynecology. The clinic also features a certified nurse midwife.
April is Women’s Eye Health and Safety Month, the perfect time for women to learn more about eye issues that affect them more regularly than men.

Women, here’s what you should know about your eyes

Dr. Shaista Vally

Dr. Shaista Vally

Written by Shaista Vally, OD, an optometrist at UK Advanced Eye Care.

Eye health and vision issues can affect everyone, but there are certain conditions that are more common in women than in men. April is Women’s Eye Health and Safety Month and a great time for women to learn more about the issues that uniquely affect them.

Dry eyes, migraines

With women’s hormonal changes being so frequent throughout their lifetime, including changes associated with birth control, it’s no wonder that women experience eye and vision issues linked with hormonal changes. Two such issues include dry eyes and migraines.

Dry eyes can be annoying and debilitating, but the good news is that they are easy to treat. Artificial tears, emulsions, gels and ointments can offer relief for dry eyes. If heavy lubrication with artificial tear eye drops is not working to manage your symptoms of burning, redness and irritation, speak with your eye doctor about alternative treatment options.

Migraines are severe, painful headaches sometimes accompanied by symptoms of nausea, numbness, light and noise sensitivity, and vomiting. But they can also cause visual disturbances known as scintillating scotomas. These moving lights and patterns, sometimes called a visual aura, can mimic the signs of a retinal detachment or tear. If you see flashes of light or spots in your view, be sure to have a dilated eye exam within 24 hours of these symptoms.

Eye issues linked to obesity

With diabetes and cardiovascular disease on the rise, Americans – both men and women – are struggling with obesity. However, overweight young women of child-bearing ages are at an increased risk for a condition known as idiopathic increased intracranial pressure, or pseudotumor cerebri. This condition causes an increase in brain pressure, damaging the optic nerves and potentially leading to blindness.

Women with pseudotumor cerebri often complain of headaches, ringing sounds in their ears and mild visual blurriness, though sometimes visual symptoms are not present at all. If you think you may be at risk for this condition and are experiencing any of these symptoms, contact your eye doctor to schedule a comprehensive eye exam.


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Kentucky’s death rate from cervical cancer ranks among the top 10 in the nation. But many of these deaths are preventable by regular Pap smears.

Pap smears: Your best weapon against cervical cancer

It’s an unfortunate fact that Kentucky has one of the highest cervical cancer death rates in the country. The good news is many of these deaths are preventable through regular screenings called Pap smears.

Pap smears collect cells from the cervix, which are examined under a microscope to find cancer and pre-cancer. If pre-cancer is found, it can be more easily treated, stopping cervical cancer before it really starts.

There are no obvious symptoms of cervical cancer until it reaches advanced stages, so having regular Pap smears is important. Federal guidelines recommend women ages 21 (or three years after first intercourse) to 65 have a Pap smear every three years during their annual pelvic exam. Individual circumstances can vary, so talk to your doctor about how often you should have a Pap smear.

Ways to improve test results

According to the American Cancer Society, there are several ways to make your Pap smear results more accurate:

  • Try not to schedule an appointment for a time during your menstrual period. The best time is at least five days after your menstrual period stops.
  • Don’t use tampons, birth-control foams or jellies, other vaginal creams, moisturizers or lubricants, or vaginal medicines for two to three days before the Pap test.
  • Don’t douche for two to three days before the Pap test.
  • Don’t have vaginal sex for two days before the Pap test.

Check with your doctor

Because Pap smears are often done during pelvic exams, many people confuse the two. The pelvic exam is part of a woman’s routine checkup that may help find other types of cancers and reproductive problems. During a pelvic exam, the doctor examines the reproductive organs, including the uterus and the ovaries, and may do tests for sexually transmitted disease.

Be sure to check with your doctor to see if you had a Pap smear during your pelvic exam.


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