Category: News

Western OB/GYN, a Division of Ridgeview Clinics, proudly celebrates its 50th anniversary this year — a milestone that reflects five decades of compassionate, community-focused care. Throughout those years, its providers are estimated to have delivered more than 30,000 babies.

Established in 1975 by Dr. John Watson and Dr. Robert Nordland, the practice began as a small, independent clinic sharing space with Lakeview Clinic in Waconia. “There were very few specialists in the area at that time, and there was a clear need in the community, which was evident early on with our high patient volumes. Waconia was still quite rural, and we were fortunate to grow alongside it. We had strong support from Ridgeview leadership and a shared commitment to advancement and patient care,” Dr. Nordland shared.

Over the years, Western OB/GYN has welcomed many dedicated providers, including medical students and residents, as it was important for the practice to maintain an educational focus, according to Dr. Nordland. As the Waconia area grew, it became a destination where not only did providers want to work, but they also desired to live in this growing community.

Dr. Nordland, who retired in 2010 after more than 40 years of practicing medicine, reflects fondly on the relationships built over the years. “I had so many wonderful, loyal patients, and I had the privilege of caring for multigenerational families — delivering babies of patients I had once delivered myself. Often, I knew their family history without having to ask, as I had already cared for their grandmothers, mothers, aunts and sisters,” Dr. Nordland said.

Andraya Huldeen, MD, has been a long-time provider at Western OB/GYN since completing her residency in 2008. She joined the practice in preparation for Dr. Nordland’s retirement. Dr. Huldeen shared, “Many of my patients have been with Western OB/GYN for decades. I recently saw a patient who has been with us for the entire 50 years since we opened our doors. Experiences like this are not uncommon here — I hear similar stories regularly, and it is a privilege to be part of a practice with such a longstanding reputation for excellence.” She continued, “Our growth has been driven largely by word-of-mouth and patient referrals, a testament to the quality of care we provide. We remain committed to serving our communities and look forward to continuing our legacy for at least another 50 years.”

Today, Western OB/GYN is proud to be an all-female practice with 11 providers serving patients across five clinic locations in Belle Plaine, Chanhassen, Chaska, Delano and Waconia. The team includes board-certified obstetricians and gynecologists, certified nurse midwives, a certified family nurse practitioner, and a certified physician assistant. Together, they offer comprehensive care for women at every stage of life — from adolescence through menopause and beyond.

Front row, from left: Heidi Edsill, MD; Krista Kranz, MSN, CNM; Louise Ou-Yang, MD; Jennifer Embry, MD; Gina Edison, MSN, CNP, FNP-BC; Kim Maletta Shibley, MD. Back row, from left: Sarah Bot, PA-C; Andraya Huldeen, MD; Sarah Rose Labine, DNP, CNM; Tara Denke, MD; Rebecca Baudoin, MD.

Tara Denke, MD, is now seeing patients at Western OB/GYN, A Division of Ridgeview Clinics. She sees patients at the Chaska and Waconia clinic locations.

Dr. Denke practices full scope obstetrics and gynecology from adolescence through menopause, including well-women exams, normal and high-risk pregnancies, polycystic ovary syndrome (PCOS), abnormal pap smears, endometriosis, fibroids, menorrhagia, LGBTQ+ care, urinary incontinence, perimenopause and menopausal care and more.

To schedule an appointment with Dr. Denke, call 952.442.2137.

Menopause is a journey that can bring a range of challenges and surprises. From the first signs of perimenopause, your body is changing in ways that may be unexpected and difficult to navigate. With the right tools and approaches, you can embrace this next phase of life and feel like yourself again.

The journey to menopause

Before a woman reaches menopause, she goes through a stage called perimenopause. This typically begins when a woman is in her 40s and can last anywhere from several months to several years. This time is characterized by the infamous hot flashes, irregular periods, uncomfortable vaginal dryness, disruptive night sweats and difficulty sleeping — not to mention the emotional turmoil you may experience at times.

All these symptoms can be attributed to estrogen — the hormone your body slowly stops producing as you enter perimenopause. This results in fewer and fewer menstrual cycles, until you no longer have a period for 12 consecutive months. At this point, you have reached menopause, and your ovaries are no longer releasing eggs.

The best treatment for symptom relief

While many women may dread this journey through menopause, there are treatments and methods that can greatly improve symptoms. “In general, we tend to blame hormones a lot of our lives for being bad, or a reason we don’t feel well. The truth is women often feel better on a certain level of hormones — estrogen in particular,” Rebecca Baudoin, MD, Western OB/GYN, A Division of Ridgeview Clinics, explains.

Hormone Therapy (HT) is the best treatment to relieve menopause symptoms. HT is a medication typically given in the form of a pill or a transdermal patch that contains a safe level of female hormones (estrogen and/ or progesterone) to help reduce and improve symptoms of menopause. Everyone’s health care needs are unique, and your women’s health provider can help you determine if HT is a good treatment option for you.

Progress in women’s health research

In 2002, the Women’s Health Initiative (WHI) made headlines when they published a study which reported that HT increased women’s risk of breast cancer, uterine cancer and heart disease resulting in a dramatic decline in the use of HT. Unfortunately, after the WHI study was reanalyzed, experts determined this was a flawed study from the start and the findings do not completely hold true today.

Fortunately, as research regarding women’s health continues to progress and improve, this notion that HT is dangerous for ALL women has largely been debunked. This has been a huge disservice to women for the last few decades when the WHI study was released. Even the same authors of the study have looked back on their own data and retracted many of their conclusions because this was a flawed study to apply generally to a population of women, particularly to women who are perimenopausal or in the immediate post-menopause timeframe, Dr. Baudoin explained.

Much of this has to do with the age of women who are receiving HT and the types and dosages of hormones used. In today’s world, we know we can’t use estrogen alone in someone with a uterus; we need to pair and balance the estrogen with progesterone. If someone has had a hysterectomy and no longer has a uterus, they do not need the balance of progesterone because they don’t have a risk of uterine cancer.

Dr. Baudoin explains the types of hormones used, saying, “Today, HT involves the use of bioidentical estrogen and bioidentical progesterone, compared to the synthetic hormones that were used previously and contributed to the increased risk of cancers in the original study. These hormones are used together for women who have a uterus and have not had a hysterectomy, and in a significantly smaller dose than was previously used.”

Aging in a healthy and comfortable way

Many women may feel like menopause symptoms are all just part of the aging process and they just have to deal with it — but that could not be further from the truth, and women deserve better. “So many women deal with these symptoms because we are told it is a normal part of life that every woman has to go through.

In recent years, as more and more women are trying to age in a healthy way and maintain their activity, research on menopause and treatment is finally receiving the attention it deserves and we are able to safely help women feel better and get their sense of control back, Dr. Baudoin said.

If you need help managing symptoms of menopause or determining which stage of menopause you are experiencing, take control of your health by scheduling an appointment with the team at Western OB/GYN, A Division of Ridgeview Clinics.

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A new advanced minimally invasive hysterectomy procedure is now available at Western OB/GYN, A Division of Ridgeview Clinics. Providers Rebecca Baudoin, MD, Heidi Edsill, MD, and Andraya Huldeen, MD, offer vaginal natural orifice transluminal endoscopic surgery (vNOTES), the latest in innovative technology.

vNOTES requires no abdominal skin incisions, providing many health benefits to patients. This includes fully eliminating scarring, reduced pain and risk of infection, faster recovery time and a shorter hospital stay. vNOTES is performed under general anesthesia, and patients are often discharged the same day as the procedure.

“Women without excessive scar tissue in their abdomen are often good candidates for the procedure,” shares Dr. Baudoin. “With this advanced technology, my patients have such little pain after the vNOTES procedure relative to other methods — often rarely even needing to take ibuprofen.”

To learn more, or to find out if you may be a candidate for vNOTES hysterectomy procedure, schedule an appointment with Drs. Baudoin, Edsill or Huldeen at Western OB/GYN, A Division of Ridgeview Clinics. To schedule, call 952.442.2137.

For centuries, midwives have provided support and care for pregnant women through the labor and delivery process. When most people think of the term midwife, they tend to relate it to a setting involving an in-home, unmedicated birth. However, certified nurse midwives (CNM) do not facilitate home births, they only deliver babies at a hospital, and according to Krista Kranz, CNM, Western OB/GYN, A Division of Ridgeview Clinics, only about half of the pregnant women they see intend for an unmedicated birth experience.

A certified nurse midwife is board certified and trained in two disciplines—nursing and midwifery. The certified nurse midwives who practice at Western OB/GYN all hold a bachelor’s degree in nursing and additionally, a master’s degree or a doctorate in midwifery.

Women’s contraceptive options go far beyond “the pill.” While many people associate birth control with the prevention of pregnancy, these methods also provide solutions for other health concerns. Gina Edison, FNP-C, Western OB/GYN, A Division of Ridgeview Clinics, shares, “Many patients use birth control for other reasons than preventing pregnancy, such as managing painful and heavy periods, regulating your menstrual cycle, treatment for acne, and relief for some kinds of headaches and migraines.”

Generally, there are five categories of birth control methods: one-time use, short-term, long-term, permanent and emergency. Each method works in a different way and can be used for various reasons. This article will focus on short-term and long-term options.

Short-term options:

+ Contraceptive pills: Commonly referred to as “the pill,” it is one of the most used birth control methods. This hormonal pill is taken at the same time of day, every day.

+ Skin patch: This method uses a transdermal patch that you replace every week. Transdermal simply means the hormones are absorbed by your skin from an adhesive patch that can be worn on your belly, buttocks, arm or back.

+ The Ring: A vaginal ring is a small, flexible ring placed inside your vagina that releases hormones into your body. For the ring to be most effective, you must make sure you are properly inserting it and refilling it on time—this will depend on the type of ring you use.

+ Injection: The depo shot (Depo-Provera) is an injection that contains the hormone progestin, which prevents ovulation. This injection is done once every three months.

When used correctly, these options are about 99% effective. Because short-term methods require a strict schedule, their efficacy is more likely around 91% as many women do not methods consistently follow the required regimen. The benefit of short-term options is that you can try several over time to determine the one that best suits your lifestyle and needs.

Long-term options:

+ Intrauterine Device (IUD): IUDs are one of the most effective options for women. An IUD is a small device (shaped like the letter T) that is inserted into your uterus. An IUD can last from three to 12 years, depending on the type you have.

+ Implant: The Nexplanon implant is a very thin rod, about the size of a matchstick, that is inserted into your arm. The implant releases hormones into your body and lasts up to five years.

IUDs and implants have an efficacy rate of about 99% and can be removed at any time should your contraceptive needs change. “Women have busy lives and busy schedules. These long-term options are a great choice for those who want an effective option that does not require such a strict regimen,” Edison said.

Determining the best option for you

Having so many options can seem overwhelming at first, but it’s important to remember that having options gives women a say in their health care treatment. “You have to consider your quality of life,” Edison said. “Every women’s health needs are different, which is why being able to choose the best method for your situation is so valuable.”

There are several factors to consider when choosing what method is right for you. A few considerations include determining what works with your schedule and routine, whether you can and want to use hormones, and your personal comfort level in regard to insertion/removal. For women who are interested in starting birth control or changing the method they are currently using, Edison offers three pieces of advice:

+ Do some research: Look into what options interest you—creating a pros and cons list is a great way to figure out what might work best for your situation.

+ Seek advice from other women in your life: Your trusted friends and family can be a great resource to get insight into what worked or didn’t work for them.

+ Talk to a women’s health provider: Bring the information you have gathered to a women’s health provider who will answer any questions and help determine what method is best for you.

If you are interested in starting or trying a different birth control method, schedule an appointment with a provider at Western OB/GYN, A Division of Ridgeview Clinics.

Whether your baby is six weeks old or six years, you still may be thinking about getting your body back to its pre-baby shape. However, many women suffer from diastasis recti (abdominal separation) following pregnancy which can complicate a full return to exercise and even challenge everyday function. It’s not surprising that abdominal muscles separate during pregnancy and may need some extra help to return to their previous state. Diastasis recti is more common in women who have had a cesarean section birth, a multiple birth pregnancy or those who have had multiple pregnancies.

Left untreated, there can be lingering health concerns

When left untreated, diastasis recti can lead to chronic low back or hip pain, constipation, urinary incontinence and can affect the ability to return to regular exercise routines. But a timely connection with the right physical therapist can change those results.

Physical therapy can improve diastasis recti

At 12 months postpartum, about 30 percent of women still have diastasis recti, according to Tina Gapen, PT, MPT, a pregnancy and pelvic health expert with Ridgeview’s Rehab Department. “Research suggests, if it is still present at eight weeks postpartum, it will be present at one year. As with many injuries, beginning treatment sooner rather than later can improve your outcome and get you back to a better quality of life sooner,” she explains.

Women experiencing abdominal or pelvic pain or weakness postpartum should be evaluated by a physical therapist. During a functional assessment, a physical therapist will assess movement, strength, and pain and help create a road map to assist in meeting goals for post-baby performance and comfort. “I try to reduce fear in women by explaining that the actual measurement of the diastasis recti ‘gap’ is less important than being able to create tension in the linea alba—the soft tissue that connects the left and right abdominal muscles—to support functional activities,” Gapen said.

Successfully managing diastasis recti

Physical therapy, using breathing techniques and core exercises, helps to reduce pain and correct the problem. “We want women to focus on practicing good breathing techniques and avoid breath holding. Breath exhalation activates our deep core muscles, which generates tension through the linea alba,” Gapen said. Engaging in certain exercises too soon may be harmful. A physical therapist can help you choose what exercises are right for you and when the right time is to increase the challenge.

If you are newly postpartum and have concerns about diastasis recti, talk with your provider at your six-week checkup. However, even if your baby is not so much a baby anymore, it is not too late to correct your diastasis recti and regain functionality. Through physical therapy, you can manage this condition successfully, and get back to a full range of function and ability to exercise.

To learn more about physical therapy at Ridgeview’s Rehab Department.

You may have thought about your birth plan shortly after you discovered you were pregnant or maybe your plan is to simply have “no plan” and that’s okay too. A birth plan can be a useful tool to help inform your provider and the Birthing Center team of your preferences for labor and delivery. It can be very detailed and specific, or it can be open-ended.

Shelby Erickson, MSN, RNC, nurse manager at Ridgeview’s Birthing Center shares, “Some women feel strongly about developing a birth plan and some do not view it as essential. Either way, our nurses are equipped to walk you through the process and help you with each expected (and sometimes unexpected) turn of events during labor and delivery.”

Here are five factors to consider while preparing for your childbirth experience.

1. Environment. When you think about your baby’s birth, what do you picture? Dim lights? Soft music? Scents from essential oils filling the room? You also want to consider who you want present. Many women choose to only have their partner there to support them, while others include another family member or hire a doula for additional support. In the event of a cesarean birth, you will be limited to one support person in the operating room.
2. Pain relief. There are multiple options for pain relief. Some women labor without, some request pain medication immediately and many women fall somewhere in between. Ridgeview offers choices for pain relief—including epidural, IV pain medicine, hydrotherapy (laboring in the shower or bathtub) and nitrous oxide.
3. Labor preferences. Every woman labors differently—some prefer to walk or stand as much as possible, while others prefer to rest in bed. Ridgeview’s Birthing Center has various amenities to aid in your labor, ranging from birthing stools and squatting bars to in-room full-size bathtubs.
4. Cutting the cord. Cutting the baby’s umbilical cord can be very symbolic, but it’s not for everyone. Consider if you or your partner wish to do so. It is becoming more common for providers to wait 30 to 60 seconds before clamping the umbilical cord to allow more blood to transfer from the placenta to the infant, which has numerous health benefits including a decreased risk of iron deficiency anemia.
5. Newborn care. Consider how you plan to feed your baby once he or she is born—breast, bottle or both—and whether you want your baby to use a pacifier. Additional health considerations such as immunizations and circumcision for males are important decisions you should consider in advance.
   Plan or no plan, it’s important to keep an open and relaxed mind when preparing for the birth of your child. “Things can change quickly during labor and delivery, and having mom feel comfortable with her provider and her team of caregivers helps when the unexpected occurs,” Erickson explains.

Download Ridgeview’s birth plan checklist as a guide to help you develop your personal birth plan. If you have any questions or concerns regarding labor or delivery, discuss them with your provider or send us an email, and our Birthing Center team will follow up with you.

Take a virtual tour to see why Ridgeview’s Birthing Center is preferred throughout the Twin Cities and beyond.