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11 Pressing Questions for an Ob-Gyn

11 Questions for an Ob-Gyn

Abigail Ford Winkel is a general obstetrician-gynecologist in New York City, who handles everything from routine office visits to delivering babies. Here, she tells us what we want to know, including the best kind of underwear, funny smells and lightning-fast births…

First off, do you ever get grossed out? 
A good thing to remember is the doctor is never squeamish; it’s usually the patient that finds things shocking. There’s a lot of blood during deliveries, and there are uncomfortable smells. But it’s such a routine part of the work that I don’t even think about it.

Do patients ever get nervous about things they’re experiencing that are totally normal?
Earlier this week I had a patient come in and say, “You’re going to fall off your seat when I tell you this.” And I was like, “I’m sure I’ve heard it before.” Sure enough, she got a tampon stuck and couldn’t find it. Rule of thumb: If it’s happened to you, it’s happened to somebody else before.

How are you supposed to wash yourself?
Water, actually. I’d say the best thing is to soak in a tub of water with nothing in it. The vagina is a self-cleaning oven; you can let it take care of itself. Also, keep in mind, some variety in odor is to be expected, because there is a combination of different bacteria and yeast living down there. Your diet, your clothes and other exposures can change it. If you’re not feeling uncomfortable, it’s very likely fine.

What should a woman know before coming to her appointment?
It’s important to know that your gynecologist is not your priest or a police officer. No one is judging you. The more honest you are, the better. As much as possible, you should divorce the emotion from your reproductive health. Also, everyone — even married people and those in monogamous relationships — should get tested for STDs. It should be like brushing your teeth. I get tested every single year.

Are there certain questions you always ask patients?
I have a standard script — I’ll ask even a 75-year-old grandmother, “Do you smoke, do you drink, do you do other drugs? Pot, cocaine, heroin?” Like I’m asking her if she shops for tomatoes. But you have to get into sex, drugs and rock and roll in these conversations. If the doctor feels comfortable asking, the patient will hopefully feel comfortable answering. We want to help you, without bringing in any outside-world judgement. It’s true of depression, too — even if you look happy at your postpartum visit, I’m going to be asking you about depression.

What’s the best type of underwear?
Cotton underwear is going to help things breathe. There is a lot of bacteria down there, and if you seal it like a jar, it can make some of those naturally-occurring problems worse. Is synthetic underwear toxic? No. But I would say, unless you wear cotton underwear, don’t sleep in it.

Is there a “best way” to alleviate cramps?
Of all the over-the-counter painkillers, ibuprofen is the most effective for dealing with menstrual cramps, since it’s both a pain reliever and an anti-inflammatory. Sometimes if you start taking it before your period comes, it can have a better effect. You don’t want to wait until the pain is at its maximum. A lot of people also see relief from cramps on birth control pills.

What’s your vibe during a typical birth?
During pushing, the mom is like the rower, and I feel like the coxswain. “Go go go! Row row row!” As the ob-gyn, I’m like, we’re going to get you where you want to go, I’m just steering a little bit. It’s a fun place to be. I never even notice if it’s a boy or girl, that’s the last thing on my mind. I’m just obsessed with having everything go smoothly. Is the baby screaming? Is the mom feeling good?

Have you ever had a patient give birth in a cab? Our friend almost did!
I haven’t had any cab deliveries yet, but many people have gotten to the hospital seconds before their babies came. Usually, there’s a loud, chaotic scene between the patient in the throes of labor, the partner trying to help, and the nurses panicking that the patient is going to deliver in the hallway. One delivery I remember particularly well was when a woman was brought into the E.R. labor unit on a wheelchair. She was glorious with an African head scarf and a long, flowing dress. She wasn’t making any noise, or even grimacing, but she was snapping her fingers. I asked what was going on. She looked me in the eye and said only, “Baby coming.” She kept snapping her fingers in rhythm with what was going on with her body. As the nurse and I helped her move onto the bed, we realized she wasn’t kidding. The head was starting to crown. The baby delivered moments later. She took the wriggling, gorgeous messy bundle of a baby into her arms, and looked at me with that stoic expression finally melting into a broad, beautiful grin that I will never forget.

As a mother of two, did you feel especially prepared for your own children’s births?
With my first baby, I went to the hospital on the eve of the royal wedding. It was the perfect thing to watch during labor! I chugged along laboring overnight. Then, everything changed when I saw my baby’s heart rate drop dangerously low. My nurse noticed it, too, and went to get an oxygen mask for me. I transformed from patient into obstetrician mode, and started handing out orders around the room. I asked the nurse to get the doctor, my colleague to get a pair of gloves to examine me, and my husband to move me onto my hands and knees. My husband’s eyes widened but he did as directed. My daughter was born at about 5 a.m., just as William and Kate tied the knot.

What’s the one thing you’d like women to do that would help keep them healthy?
I don’t think people necessarily believe that stress has an outcome on their bodies. They think, “If it’s in my head, it’s just torturing me.” But stress isn’t good for the immune system. If we could re-frame self care as, “I am creating a healthy environment for my body” — which is also a place to nurture a baby — we might feel more comfortable and less guilty about taking care of ourselves.

Thank you so much, Dr. Winkel!

P.S. Ten lessons I’ve learned in my career, and what no one tells you about having a miscarriage.

(Illustration by Gemma Correll for Cup of Jo. Interview by Caroline Donofrio.)

  1. I agree that it is important to feel comfortable enough to be honest with your gynecologist. I think it would be difficult to reveal engagement in risky behavior that creates vulnerability to STDs. Even though sexual activity is uncomfortable to share, I think it is good to be honest with your gynecologist in order to ensure everything is normal.

  2. I really like what you said about being 100% honest with your OBGYN. The only way you can have questions answered, is if you ask them! It’s also good to know that it’s best to be tested every single year, so that you know about, and can take care of any STD’s. Thank you so much for sharing, it really opened my eyes on how important seeing an OBGYN is on a regular basis.

  3. Indeed, the doctor has seen this so many times, that they don’t really notice something as gross. If a OBGYN can’t stand the sight of blood, they are probably in the wrong profession. That, or they just have seen enough to get used to it yet.

  4. I’m getting married and need to find a gynecologist to check me out. Thanks for the advice about how the gynecologist will not judge you and that it’s best, to be honest with them. Hopefully, I get a good gynecologist that I’m comfortable with.

  5. mona says...

    like this! great post. One thing I wonder is what a OBGYN’s opinion is on the issue of intimate shaving/waxing/general hair removal. This is a big discussion over here in Norway where many are against intimate hair removal…any idea on what she thinks on this? Maybe a future post idea- ‘care, down there’. ??

    • Katie says...

      I am an OBGYN and wish most would leave it alone or just trim. I could save insurance companies millions on visits for infected hair follicles and ingrown hairs which most are worried is herpes. Trim if you must but the shaving/waxing is only a breeding ground for infection.

    • Abigail Winkel says...

      I basically suggest trimming, too. Shaving definitely risks those infected follicles that have brought more than a few women to the hospital with bad infections. You can exfoliate with a loofah which helps a bit to avoid ingrown hairs, but nothing’s perfect.

  6. this was amazing haha. i love the honest answers, as this is something a lot of people tiptoe around or feel awkward around!

    hammyta.wordpress.com

  7. Laura says...

    I love this interview so, so much! I’m the social media administrator for a very busy Ob-Gyn department in a teaching hospital. Would you mind if we shared this on our FB page?

    • Joanna Goddard says...

      of course, we’d be honored!

  8. Mara says...

    Loved this post so much… please do more interviews like this! I agree with another commenter about a wide range of careers…I’d love to read about a baker’s every-day, for instance!

  9. Naomi says...

    As a busy resident in a university teaching hospital I love this post! So much rings true :) Rules of thumb when visiting any physician:
    – the more honest you are, the easier it is for us to provide you with the appropriate medical care that you need.
    – this is our day job, nothing’s awkward or uncomfortable to us! :) We’ve seen it all & more. But we appreciate that as a patient this might be a new , difficult situation for you, and we will provide any reassurance or answer any questions that you may have.
    – bring anything with you that may help us with your care : list of prescriptions, prior medical records, medical equipment that you use at home etc…
    Always love reading your blog Joanna! -xo

  10. Annie says...

    Great article! Just wanted to say though re: the “priest or police officer” – priests are *not* supposed to judge you either! As a good friend of mine says – “the church is the hospital for the soul.” At least, it’s supposed to be.

    • You’re right on, Annie. They are not supposed to judge you but pass on the forgiveness and love of God. (You are, however, supposed to judge yourself before confessing, which can be quite difficult.)

  11. Kate says...

    One of my favorites!

  12. Emily says...

    Not all babies are pink, as Dr. Winkel states in the ‘typical birth’ question. It may seem like a small minor thing to comment on, but these small insidious details help perpetuate racism.

    • Kaela says...

      This probably mans pink as opposed to blue from oxygen deprivation. I have a little tan Guatemalan baby who was born blue, and I cannot begin to tell you how great it was to see him turn the healthy “pink” color that comes from oxygen in the blood. Even dark skinned babies start out lighter and their skin turns darker as they age. I don’t think this was a racist comment the doctor had said, but I can see your point that it might have been worded better.

    • Joanna Goddard says...

      yes, that is a really good point, emily. i’ll change it right now. thank you so much.

    • Abigail Winkel says...

      I just glanced at the comments and saw this — I want to affirm 100% I meant pink as in high oxygen saturation! In fact, most of my patients are not peach-colored ;) But thanks for catching that.

  13. Jane says...

    Great article. Informative and humourous. Excellent questions too.
    Agree with readers above- this could make a great series!

  14. lexi says...

    Too bad it’s basically impossible to find 100% cotton underwear these days. My fave Victoria’s secret cotton underwear now has spandex in it, and a year later the same thing happened with my Gap cotton underwear. Anyone have recs?

    • Marie says...

      petit-bateau panties – too bas there so expensive in the US whereas they are a staple in France :)

    • Chiara says...

      You should double check with the companies that make the underwear. I know I was shopping for underwear here in Canada recently and the salesperson told me that there are new rules around reporting fabric content and the spandex listed is in the elastic at the waist and leg openings, but the underwear fabric is still 100% cotton. Worth checking out!

  15. Kristi says...

    What a terrific interview! It’s comforting to have a doctor’s perspective in this arena.

  16. Alyssa Leister says...

    This was great! I love my gyno actually which is a change from my first appointment where I left in such pain and feeling awful about everything. Once I found a good one, I have requested her every time I go. She’s an NP and I seriously wish I could be her best friend. She’s never judgy, always asks about my job and life and is just super sweet!

  17. Joy says...

    I’m a doctor, and this is really such a great interview. She’s so right, and I especially love her comments about the mind-body connection. This is exactly what I try to be – approachable, and not embarrassed to cover all the hard/personal questions in a matter-of-fact way.

  18. Whitney says...

    I really love everything that Caroline writes, the tone is so refreshing. Where are you headed, I’d love to follow your writing as you go!

  19. Jane says...

    I live in the Bible Belt, and have had trouble finding GYN spaces that don’t feel judgmental—when I asked for a routine STD test last year, my doctor told me I didn’t want to do that because “if you do have one, you don’t want to know. Most don’t have that many symptoms, but knowing that you have one could ruin your life.” Needless to say I didn’t go back, but the visit made me anxious about hunting for a new doctor, and it really stuck with me as an incredibly negative and harmful experience. I’m glad to hear that there are good doctors out there.

    • BDubs says...

      Well that’s terrifying!

  20. Diane says...

    This was great! I was born in the elevator of the hospital – so glad I made it to the delivery room with both of my kiddos!

  21. Thank you this post!! I’ve been putting it off for ages and ages (I know, SO bad!) but have now made an appointment to get a Pap smear done. Never ever underestimate the impact of your blog!

  22. Julie says...

    I’m with the other commenters… Jo, I think this could make a great series! Q&As with all different career women.

    • julie says...

      Totally agree. Great article!

    • Sarah says...

      Also agree!

    • Carol says...

      I would love it so much! This post was great.

    • Gabriella says...

      Agree!

    • D says...

      Yes! Agreed.

    • Joanna Goddard says...

      yes, that is a great idea! we will do more for sure.

    • Would love to hear from a pediatrician (ok, I’m being selfish here because that’s my career choice.) But seriously, a well-seasoned pediatrician is a great resource for Moms (and budding MDs, haha)

  23. Laura says...

    I love the “self-cleaning oven” line and I’m totally stealing it. As a midwife and I do a lot of GYN visits in addition to all the OB stuff. My patient population is really ethnically diverse so I’m privy to all the weird and wonderful stuff women do with their vaginas worldwide. Many of my patients believe that they need to clean INSIDE the vagina on a daily basis. As in, shove a washcloth that has been sitting in your shower up inside and scrub with soap or other chemical cleaners. Many of them are also told they have to douche after every period. This results in an epidemic of Bacterial Vaginosis. It’s become a routine part of my interview to ask anyone complaining about a “bad smell” what their shower routine is and then I launch into a tirade about bad bacteria vs. good bacteria and Ph balance, but “self cleaning oven” would get the point across better!

  24. Kerry says...

    While it wasn’t in a cab, I did have my child in front of five burly firemen. NOT how I wanted things to go, but it all worked out.

  25. Liz says...

    “The vagina is a self-cleaning oven.” Good to know. lol.

  26. maya says...

    Nice article! And Jo – I did have a baby in a cab, in the brooklyn battery tunnel! March 2010, you even linked to it, since it was right before Toby was born. xo

    • Joanna Goddard says...

      no way!!! you are my hero, maya!

  27. What a great piece! Love her story of the quick delivery.

  28. freya says...

    as someone who has been struggling with fibroids, ovarian cysts, polyps, endometriosis etc, i wish more OB-GYNs would really treat the underlying hormonal imbalance causing these issues. it’s frustrating that their only solution is to dole out some form of birth control – while this may help in the short term, it ignores the problem in the long run.

    • Do you know about NaPro technology, based out of Creighton University? They do exactly that Here’s their website, with links to dr locations: http://www.fertilitycare.org/

    • Cag says...

      Most birth control hormonal (made of progesterone and estrogen) and is how hormone imbalances are treated. If you are talking about getting estrogen or testosterone alone, that is not very common because of the associated dangers. If you’re talking about thyroid problems it is probably a better question for your primary care doctor.

    • Kendra says...

      I’m so glad someone mentioned a FA method! Fertility Awareness Methods are amazing and birth control does NOT treat hormone imbalances. Through cycle tracking you can see the imbalance and thyroid issues!

    • Ali says...

      Yes! I completely agree. Loved this post but reading that birth control is a proposed solution to cramps gave me pause. It’s just covering up the symptoms rather than solving the problem. As a woman struggling with irregular cycles possibly linked to a decade of birth control use, I wish there were more information out there about the benefits of healthy periods and how to foster them. The books, “Taking charge of your fertility” by Toni weschler, and “The period repair manual” by Lara Bridens, are great resources that I wish would get more exposure.

  29. Katie Webster says...

    The best line in a blog post for years..”your vagina is a self cleaning oven”… Had me in stitches, oh my! Thanks! X

  30. Claire says...

    Thanks for this post and three cheers for the other readers who asked for more lightning speed q & a’s with other career women. I’d love to read q & a’s with anyone, from a baker to an accountant to a pro athlete. And I’d love to hear a day (or week) in the life of the COJ team – I’ve always wondered what your team’s workweek is like and how everyone collaborates to create this amazing blog!

    • wkwr says...

      Ditto to the idea for a “week in the life” of the COJ team! xx

  31. Lara says...

    I’m a medical student and before I started school I thought the whole gyn encounter would be super awkward and something I would have to get used to. Turns out, not at all! Getting an accurate and complete history from patients and doing a through exam is so important that I don’t even flinch when asking personal questions or looking at a cervix! It’s like a doctor’s office is an alternate reality where the normal rules of privacy are altered and suddenly asking about the number of sexual partners you’ve had is a professional question. Weird! But kind of great. I like that I don’t judge my patients, I’m just thorough so I can have their back.

    • Taylor says...

      I’m married to a medical student and it is so impressive to me just how clinical and professional they all already are. I used to be creeped out by male OBGYNs but now that my husband and his friends have done their rotations and some of them loved it, I’m so comfortable with the idea of going to a male OBGYN. Seeing their professionalism in casual settings, like hearing them talk about their patients over dinner (HIPPA compliant, of course ;)), even as MS3s really made a difference in how I see my providers. It has made me so much less afraid to talk about symptoms and concerns. And not skeeved out by dude OBs haha.

    • I accidentally made a patient cry for the first time doing an OBGYN interview as an MS3- I felt so awful! I think my problem is if you feel awkward about it, they will too- so try to be as cool about it as possible. And to the anonymous crying college student- I am SO sorry! I learned how to do those interviews the hard way :(

  32. I love information like this. I want to know what my OB-GYN wants me to know!
    It’s so true that stress greatly affects us as much as poor eating and lack of exercise does. Which reminds me that it’s time for me to take a walk.
    Thanks! :)

  33. A says...

    I’d love to know what advice she’d give someone getting over a terrible birth experience (crazy long labour culminating in some serious physical damage down there). The trauma is with me every day and has stopped me from bonding well with my baby, let alone having sex again.

    • Courtney says...

      Go see a counselor! When my baby was about two months old I finally broke down and made an appointment with someone who specializes in birth trauma. I went every week for about a month, once with my husband, and it helped immensely. I wasn’t depressed, but no one seems to screen for birth trauma, and it’s real.

    • katrina says...

      So worth it to get counseling. You will not regret getting help! You deserve to enjoy your new baby without fear and anxiety.

    • Paula says...

      Oh god yes. What they said above. Counseling. I have never thought I would need counseling in my life, I was such a very tough person. I had so many hardships in life in general, but such good attitude about them all. And unfortunately, a birth of a child, with 50 stitches and total vaginal trauma, it was a humbling experience to say the least. And one that broke me. Not to mention that it looked like my vagina went through her own personal WWII after apparently it “healed” and my OB that did the delivery (male) just said, welp, after you are done having babies, come to me and I will fix you up (cosmetically).
      I couldn’t walk, have sex, and while I didn’t have postpartum depression, I just had this general physical body image depression/birth trauma depression. I actually went to a regular psychologist, a female, and just talking with a third party, crying, screaming, laughing, whatever, helped tremendously.
      I did make changes for a second baby. I went through a number of female GYN/OBs, found one I liked, stuck to her, told her about my first experience, which she was horrified to hear about, and after delivering the second kid, she goes, okay, since I have you here, let me “fix” you down there-and she did. She fixed the shitty stitching of the previous doctor.
      You will get through this. Get help. You are tough but it’s okay to say that something is bigger than you.

    • Oh A, I am so sorry about your traumatic birth experience. I wish I was there to give you a hug and a meal!

      A compassionate counselor will be able to help you process the trauma and figure out what you need to move forward. I’d look for a therapist who specializes in post-partum depression and anxiety and who also has worked with trauma.

      There is a field called infant mental health that focuses on how you as a mom can better connect with your baby. Some counselors in this field will see you and your baby together to facilitate bonding.

    • Robin says...

      I’m so sorry your birth was so hard. I agree on counselling, and also wanted to let you know (if you don’t already) that there are pelvic health physical therapists out there. You shouldn’t have to just live with pain long term. The longest shortest time podcast did a series of great shows about sex after birth, including one about healing after trauma during birth. All the best to you. It’s so hard to deal with anything personal when you have a two month old to care for. Try to make sure you take care of yourself too.

    • Robin says...

      Just realized you didn’t say how old your baby is – regardless it’s hard to take care of yourself when you have to be there for a baby. Remember your health is important too.

  34. Haha, great post! OB visit make me faint-y, but I’ve gotten better at remembering to breathe and reminding myself that “they see these every day, calm down.” It’s so important to go regularly!

    Any tips on how to cope if you’re a squeamish patient? :)

  35. Josie says...

    Really enjoyed this post-thank you! A confidence boost for future appointments. The last point in particular really resonated with me.

  36. Loved this. It would be great if you decided to do follow up posts on this too. Saw a suggestion from another commenter about doing a post on STIs, which I think would be really good. But I think it would also be great to include some questions that help women who don’t fit the hetero or motherhood molds. All of us have to visit the gynecologist, but not all of us want to be mothers, and not all of us have hetero sex. Not that those things were necessarily implied in this post, but it could be awesome to make inclusion for everyone more intentional in conversations like this. <3

  37. Amy P says...

    I’d love more interviews like these! I liked her answer about stress, and the reminder to get tested even when monogamous.

  38. This was such a fun read! I always wonder what my doctor thinks of my, ahem, haircut. She never seems phased by anything and casually asks things like, “So, do you have siblings?” while she’s working away down there. It’s always such a comical (albeit al fresco) situation.

    • Madeleine says...

      Your gyno appointments take place outdoors? ;)

    • Sarah says...

      Madeleine! Your reply made me giggle hysterically!

    • RS says...

      I’ve always wondered this too. I always feel so self-conscious about the situation down there (grooming wise) and wonder how it compares to everyone else.

  39. This is brill, I love this. My French gynae has gone from being the person I most feared seeing once a year to the person who I enjoy chatting to bizarrely! it is quite common in France for woman to regularly see a gynecologist, much more so than in the UK. My husband also thinks she is great as she always tells me to pop my chanel lippy on and be more “romantic” with him. Jeez, these French!!

  40. As a mother who just gave birth to her 2nd and has been to the OB wayyy more than I any other doc in the last 3 years, I love this! It’s always a little awkward dealing with all the gross weirdness that comes along with pregnancy and childbirth, it’s so great to be comfortable with your OB!

    xoox http://www.touchofcurl.com

  41. b says...

    This is great! (And I just cried reading the birth stories. Apparently pregnancy hormones are in full effect at barely 5 weeks).

    • Taylor says...

      Ahhh congrats!! I’m 5 weeks too and starting to experience the random crying. It’s the only symptom I’ve had and it’s hilarious to try to explain since we haven’t told anyone yet!

    • Robin says...

      Congrats! I’ve already cried reading something in work newsletter this morning, of all things! 13 weeks with lots more random crying to go ;)

  42. Kristen says...

    I birthed a baby during the royal wedding too! She arrived right around the same time too. Thankfully, there were no complications. But it was quick- about 15 min after we parked my baby was in my arms!

  43. Lauren E. says...

    I actually always make myself feel better whenever I go to the gyno by telling myself, “This is not the worst thing she’s ever seen.”

    • Joanna Goddard says...

      hahaha i always say the same thing! also when i have gotten spray tans, when you’re totally naked posing in really weird/awkward ways!

  44. Celeste says...

    Whoa! So helpful. I’ve wondered a few of these things myself (should I get tested even though I’m monogamous? what kind of underwear is best?) so this was perfect. I’d LOVE more of these quick-hit interviews with experts — from doctors to aestheticians to massage therapists or personal trainers.

    Plus, the illustration! <3

    • Caitlyn says...

      Yes, I’d love to see more of these – hair stylists please!

  45. Jessica says...

    What an awesome lady!!!

  46. This is great, and both birth stories made me teary!

  47. Jo! I have an app soon and I literally googled “what to ask at gyro” this morning and a Teen Vogue article came up. Not what I was looking for. This made my day! :)

  48. Laura says...

    I’ve loved this post. Beautiful anecdotes and advices!

  49. Rachel says...

    I’m a nursing student (graduating next month!!) and just started my OB rotation today. Your posts are always so timely.

  50. LS says...

    I’ve been thinking it would be great if you did a post on STIs, I don’t think it’s something you’ve talked about on your blog which is such a beautiful open space to discuss so many personal things!

  51. elizabeth j says...

    Love the last comment. So incredibly true.

  52. jill c says...

    i loved this piece! thank you so much for posting this!!!

  53. Dottie Louise says...

    This is a great mix of questions and great answers! The last answer surprised me but it makes so much sense, thank your for the reminder lol!

  54. Irene says...

    As a fellow ob/gyn & longtime cupofjo reader, I love this!!

    • Joanna Goddard says...

      so glad you liked it!

    • Resi says...

      Me too! This is awesome. Greetings from an OB/GYN from Switzerland :)

  55. Mary Jenkins says...

    Ha, love this! Great questions!