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We Filled a Need

The first all-female-run OB-GYN practice in the area focuses on advanced, comprehensive, compassionate care for women.

LOUISVILLE Rebecca Terry, MD, is flooded with memories and mixed emotions as she reflects on what Women First of Louisville has achieved since its launch in 1988. When she and Sarah Cox, MD, co-founded this unique OB-GYN practice, staffed entirely by women, their aims were twofold. They wanted to meet women’s care needs through every stage of their lives and deliver excellent care built on a foundation of compassion and kindness. By all measures those aims and more have been achieved.

Within ten months of Women First’s opening, Rebecca Booth, MD, and Mollie Cartwright, MD, joined the practice after completing their residencies at the University of Louisville. Today the practice’s dedicated team includes 11 physicians, 12 nurse practitioners and physician assistants, plus an excellent support staff.

The group’s newest physician is Taylor Hodge Aiken, MD, who happens to share a unique bond with Terry. Early in Terry’s career she delivered the future doctor who would one day join her practice.

Terry’s voice cracks a bit as she talks about the lasting connections she has built with her patients and their families over her years of practice. “I’ve haven’t done OB for 22 years but continue to take care of many patients whose babies I delivered,” she says. “And, now I’m taking care of their daughters as patients too.”

Such long-term relationships are not unusual when you believe that the better you know your patients, the better you can meet their care needs. Terry has had patients tell her before coming to her

Rebecca Terry, MD, OB-GYN, co-founder of Women First of Louisville

practice they felt their concerns were sometimes “unheard and unseen.” It was not uncommon for patients to say one benefit of seeing a female OB-GYN specialist was knowing that you and your doctor may have faced similar health concerns.

“I believe women share an important connection as caregivers. There are other roles too, of course but as caregivers we can identify with one another’s experiences,” says Terry.

For instance, she recalls a patient who recently reminded her that during each of her own pregnancies there was always someone in the practice who was also pregnant. “You all always understood what it was like to be pregnant, to be working full-time when your legs are swollen and uncomfortable, or when you’re having Braxton Hicks contractions, or you’re just tired,” the patient said.

Four Decades of Game Changing Care

Throughout her career Terry has been front row and center during a revolution in women’s health care. One of the “biggest gamechangers” she has seen is the advent and progress of minimally invasive surgery. “It used to be if a woman needed a surgical procedure, it would involve a large abdominal incision that left a big scar and involved significant healing time,” she says. “Now that’s just so rare, thanks to advanced laparoscopic technology and techniques.”

Terry notes that Women First is unusual in the number of the team’s physicians who can perform minimally invasive surgery. Several practice members have had specialized training in a significant variety of procedures. “Patients can come in for a minimally invasive procedure done either laparoscopically or robotically and be able to quickly return to their normal activities instead of having a huge incision to deal with,” she says.

Women First meets patient care needs on a technical level by providing onsite mammography, bone density testing, ultrasound, and other advanced diagnostics. This provides patients with efficient, convenient care and makes it possible to refer them quickly for additional high-risk care or follow up as needed.

Another trend the practice embraced was providing patients with holistic care. They focused on meeting their needs beyond the limits of typical standard obstetrical or gynecological medicine.

An Ongoing Women’s Care “Revolution”

One growing trend Terry has seen unfolding is an overall increase in the number of women in medical practice. When she graduated from medical school about one-fourth of her class was women. The ratio of men and women graduates is now equal, and for some specialties women graduates outnumber men, particularly OB-GYN.

At the time she was finishing her residency training in-vitro fertilization was in its infancy. Fast forward to today, and fertility specialists have a wide range of tools and resources they can use to help their patients. “We now have the ability collect much greater and more specific data around in-vitro procedures,” says Terry. “Experts can look at the egg and the sperm and see what genetic material we have in order to make sure an egg does not carry a high-risk genetic component.”

Another emerging and growing subspecialized area of care is maternal fetal medicine and high-risk pregnancies. Women First works closely as needed with a high-risk specialist to develop care plans for patients who meet high risk criteria. Should it become necessary, patients can be readily transferred to the specialist for care.

One development she sees evolving is the growth of more subspecialties. One example of this is gynecologic urology, which had just gotten started around the time she finished her training but has recently become more prevalent. Another emerging subspecialty is menopausal care and medicine based on women helping other women through this major life transition. She notes there is currently no specific fellowship training for menopausal care but predicts it will be available in the near future. For now, providers can earn certification through the North American Menopausal Society. Terry feels this development is driven in part by today’s “baby boomer” demographics. She cites a recent New York Times article that reported millions of dollars are lost a year because of hot flashes and the lack of quality sleep women experience, along with mood shifts that can impact work performance.

“Women are looking for care that meets their needs at each transition of their lives, and we need to meet those needs,” she says

Another troubling development being seen is a significant increase in endometrial and uterine cancers. This may be associated with obesity and diabetes, which are both linked to insulin resistance. In response, Terry stresses to patients the importance of eating a healthy diet, watching their carbohydrate intake, and staying active with at least thirty minutes of exercise a day. These recommendations take on even more importance during menopause when hormonal changes can ramp up insulin resistance. One unfortunate and sad trend Terry has seen is a growing need for specialized obstetrics and gynecology addiction care. She is aware of only one specialist in the Louisville area who is currently delivering this specific type of care in the region. “Dr. Jonathan Weeks is with the Norton Healthcare system. He is doing excellent and important work as medical director of their Maternal Opiate Substance Treatment (MOST) Program,” says Terry.

Change Can Spur Blessings and Banes

A current trend that has affected her work has been a significant decrease in the number of primary care doctors in active practice. This development, driven by various factors, has spurred many OB-GYN practices to become de facto primary care providers.

It makes sense, explains Terry, because most patients routinely schedule an annual checkup with their OB-GYN care providers. This yearly office visit provides an opportunity to ask patients an important question: “How has your life changed since last year?”

She says, “The answers patients give us often set the stage for ways our doctors and staff can help address certain care needs that are going unmet.”

Many patients rely on Women First providers to renew their prescriptions for various medications. This is generally a “doable task,” but trying to take care of certain other care referral needs and insurance coverage questions can present bigger challenge and sometimes disheartening outcomes.

For example, Terry periodically sees patients whom she feels could benefit from psychological counseling or psychiatric care. Her training and experience lead her to conclude this type of care, paired with appropriate medications, is indicated for the patient’s optimal care. Yet, she knows there is often difficulty obtaining insurance approval to cover this type of care and medications. It is, as one might assume, a hard pill to swallow.

It is well known that women in our region face various health challenges. Some of these may reflect national trends, yet others — such as Kentucky’s high levels of obesity, heart disease and lung cancer — may be linked to lifestyle choices. Terry encourages patients to follow a healthy diet and stay active. She refers patients who smoke to the American Lung Association that has well-established “quit programs” and resources in place.

Taylor Hodge Aiken

A Louisville native, Taylor Hodge Aiken, MD, OB-GYN, joined Women First of Louisville in September 2022, where her practice is general obstetrics and comprehensive gynecologic care for women and adolescents. She attended Louisville Collegiate School and graduated summa cum laude with honors from the College of William & Mary in Williamsburg, Virginia, where she also played Division-1 field hockey. She received her medical degree from the UofL School of Medicine in 2018, where she was inducted into Alpha Omega Alpha and Gold Humanism Honor Societies. Aiken completed her internship and residency training at the UofL Hospital in 2022. Upon graduating, she was awarded the program’s “Golden Hands” Award, which is awarded to the graduating resident with the best surgical technique.

During medical school, Aiken received the Greater Louisville Medical Society Foundation Scholarship Award as a promising physician-to-be.

Aiken was delivered by WFOL cofounder Dr. Rebecca Terry who mentored Aiken throughout high school, college, and medical school. Aiken’s father is ENT surgeon Tony Hodge, MD, and her grandfather, deceased, was Dr. Kenneth Hodge.

Lauren Lewis

A native of Durham, North Carolina, Lauren Lewis, MD, OB-GYN, received her undergraduate degree at Duke University with a BS in biological anthropology and anatomy. She received her medical degree from Duke University School of Medicine in 2010 and completed her residency at Duke University Medical Center in 2014. Lewis was an OB-GYN physician and assistant professor at Duke Women’s Health Associates, Duke University Medical Center, Department of Obstetrics and Gynecology.

During her residency, Lewis received a Special Resident Award from the American Association of Gynecologic Laparoscopists. She participated in the Clinical Research Training Program at Duke University Medical Center and was recognized for her research, which was presented at the AOA Medical Research Day while she was a medical student. Lewis practices general OB-GYN.

What’s Next for This Medical Pioneer?

As she prepares to retire in October, Terry looks forward to enjoying more time with her children, her grandchildren, and her husband, who continues to practice law. Both her son and daughter are getting married, so she is excited to celebrate two upcoming weddings. She also has some much-needed knee surgery scheduled.

The closer retirement comes, the longer and later her days at the office seem to grow. “I’m seeing so many patients who want to be sure to see me before I go,” she says with a smile.

As she talks about the close relationships she has built with her patients and partners, she says, “Medicine is so all-encompassing. I’m sure I will miss this part of my life. I don’t have all the answers yet as to what comes next for me, but I know I will look at the resources available and get help as I need it.”

She has not ruled out the possibility of returning to practice on a part-time basis, perhaps with a focus on menopausal medicine. “I have a lifetime of learning and information that maybe someone will let me use in some way to help others in the future,” she says with a laugh. “I call it my database that I keep in my head.”

Terry feels that in most ways she has done in her career exactly what she was meant to do. She says that she has been incredibly lucky to work with brilliant partners including most recently a physician’s assistant who is “not only a lovely person but a skilled specialist in menopause medicine.”

She has loved the work and is very proud of what she and her colleagues have been able to achieve together.

“I’m very proud of what we’ve done,” she said. “I feel like we have let women know ‘you are important.’ We’ve set the standard of care for women in our community. We have created a unique practice. We saw a need and we filled it.”