Well Woman Care

Shari Long Romero, CNM, DNP

Shari Long Romero, CNM, DNP

Annual assessments with a Certified Nurse Midwife (CNM) at Denver Center for Birth and Wellness provide an excellent opportunity to consult about preventive care, build a relationship, obtain laboratory screening and diagnostic tests, and obtain referrals for any other services that may be needed (Mammography, Pelvic Floor Rehabilitation, Specialists, etc). Assessments may include screening, evaluation, and counseling based on age and risk factors. The interval for individual services varies. 

Preconception Counseling

Visiting your provider when planning a family is a great way to start or build a relationship, prepare your body, and begin the work of creating a nourishing physical and emotional space for your future baby. In addition to a complete physical exam, during a preconception counseling visit you are invited to discuss fears, hopes, questions, or concerns and will consult with your midwife on everything from nutrition and lifestyle to optimal methods and timing for conception. 

Routine Pap Smears

The current recommendations per the US Preventative Services Task Force, American Society for Colposcopy and Cervical Pathology and the American Cancer Society are based on age and risk factors and serve as a framework for care to screen for early detection and prevention of cervical cancer. 

Many women are confused about the frequency of the pap smear. The current recommendations are as follows –

20 years and younger – no pap

21-29 years – pap every 3 years, cytology only

30 years and beyond – pap every 5 years with cytology and HPV


Annual Visits

Despite the longer interval for pap smear screening  it is a good idea to schedule an annual visit because you are more than a cervix! The pap smear is only one component of women’s health care. You have other physical and emotional and mental needs that may be addressed at the annual exam. It also keeps your provider up to date with your health status. The following is Denver Center for Birth and Wellness’s recommendation for topics that may be addressed during an annual visit based on age or lifestyle

Age 13-18 years

Screenings as needed, may relate to sexual activity

Discuss Immunizations

Evaluate normal puberty development and any concerns

Evaluation of any needed counseling

Physical examination

Age 19-39 years

Screenings as needed, begin pap testing at 21 years, chlamydia and gonorrhea testing, HIV testing


Family planning

Sexual function/concerns

High risk behaviors

Physical fitness

Lifestyle and stress

Personal relationships

Family history and associated risks

Physical examination

Age 40-64 years

Screenings as needed, mammography, bone density, lipid blood testing

Menopausal symptoms

Sexual practices


Pelvic prolapse

Family history /genetic concerns

High risk behaviors

Physical fitness

Physical examination