Many women, by choice or by necessity, will seek out the women's health care provider as their source of primary care. This third edition of Women's Health: A Primary to Clinical Guide is designed to help meet the needs of these providers who offer women more than basic reproductive health care. It covers the traditional reproductive and gynecologic content as well as selected common medical, psychosocial, developmental, and political problems, issues, and needs. We have updated every chapter, and, at the request of readers, included a new chapter: Chapter 5, Integrating Wellness: Complementary Therapies and Women's Health. To maintain a reasonable length of the book, we had to choose a chapter to omit, unfortunately. Since legal issues are covered well in most references on the role of the nurse practitioner, we now refer readers to such references for this topic. We hope to bring legal issues back in the future in an expanded manner with role and policy components specific to women's health.
Part I, Women, Health, and the Health Care System, begins with a chapter on the major historical and contemporary changes in health care relating to women, focusing on the important societal, economic, and political factors that will affect health needs for the end of this century and into the next. Chapter 2 discusses women's health and development through the life cycle, followed by Chapter 3, specific to the adolescent woman. Chapter 4 deals with incidences of diseases, general guidelines for health care screening, and interventions. Information on the revised 2001 Bethesda Guidelines for reporting and managing cervical cytology is included. Chapter 6 covers sexuality facts and issues. Chapter 7 concerns the health needs of lesbians.
Part II, Promotion of Gynecologic Health Care, delves into the more traditional health problems and needs of women related to the reproductive systems. Chapters 8 through 15 cover menstrual concerns, fertility management, infertility, sexually transmitted diseases and vaginitis, including the 2002 STD guidelines from the CDC, the special needs of women with HIV, pelvic and abdominal diseases, breast concerns, and the health concerns of perimenopausal and older women.
Part III, Promotion of Women's Health Care During Pregnancy, details uncomplicated and complicated pregnancy care, postpartum needs and problems, lactation issues, and fetal surveillance.
Primary Care Problems Affecting Women's Health, Part IV, was significantly expanded in the second edition to address even more of the medical problems frequently encountered in primary care of women such as headaches, anemia, hypertension, asthma, and dermatologic conditions. Chapters 21 and 22 are dedicated to current information on common medical problems. Selected psychosocial problems, such as violence, depression, and eating disorders and their impacts on women, with insights into related health care needs and therapies, are discussed in Chapter 23. Chapter 24 reviews unique care concerns of women with disabilities and chronic illness. The appendices address emergency childbirth (Appendix A), assessment of the newborn (Appendix B), and selected laboratory values commonly referenced in women's health (Appendix C).
We particularly intend this book to be a handbook, a resource that allows any primary health care provider to retrieve basic information easily. We see it as a reference with enough depth to be useful in a clinical setting, serving as a source of teaching advice for clients, including differential medical diagnoses, screening and early intervention measures, and guidelines for referral. Some of the chapters fit more easily into an outline format for diseases or other conditions, whereas many chapters conform to a more traditional text format or a combination format for presentation of issues.
We wish to remind the reader that the scope of advanced practice nursing varies from state to state, and the individual practitioner is responsible for knowing his or her legal limits of practice. Also, recognizing the rapidity with which new knowledge becomes available and standards change, the practitioner must stay ever alert.
Women's health care providers are continuously challenged to expand their knowledge and ability to help women fulfill a wide spectrum of needs, both physical and psychosocial. Women's health is no longer limited to reproductive organs. The broadening scope of women's health care is a critically important issue in this period of rapidly changing health care systems. Resources are burgeoning, empowering women to become more informed consumers in the health care arena, yet attaining holistic care to meet basic needs remains a struggle for many. We, with the contributing authors, hope that you as primary care providers in a rapidly changing world of health care will find this book a useful and an effective resource in your endeavors to provide women with the health care they need and deserve.
Our sincere thanks go to our excellent contributing authors. Their outstanding expertise and effort have made this book the useful clinical reference we envisioned. We also wish to thank the fine editors and staff at Prentice Hall Health and Pine Tree Composition, Inc., for their support and many hours of work on this project. Last, our deep appreciation goes to our families who encouraged us during the months of preparation and work. A special note goes to our inspiring "little women," Alicia, Valarie, Julianne, Emily, and Annie, who join the women of the twenty-first century in deserving the best health care of the new millennium.
Ellis Quinn Youngkin
Marcia Szmania Davis