Delivering babies, even at 2 a.m., is the highlight of her job, says Emily Strehle, DO, an obstetrician-gynecologist with AFA Obstetrics and Gynecology. But there is a lot more to her practice, where she does a lot of talking with adolescents, sees women through nine months of pregnancy and beyond and, increasingly, counsels women on how to manage the symptoms of menopause.
What drew you to obstetrics and gynecology?
I went to medical school knowing that I wanted to practice ob-gyn, despite the schedule, which is less than desirable. I like doing surgery, I like taking care of women and adolescents, and I like the continuity of care that comes with following someone from before she has babies, throughout her pregnancies, to postpartum and as she gets older. I knew I wanted to be in private practice at a community hospital as opposed to working at a big center where you don’t know your patients.
Are there notable trends in ob-gyn at Emerson?
There’s a strong desire for natural childbirth and minimal interventions, which we try hard to support. The guidelines for calling a c-section recently changed; the pendulum has swung back to letting women labor longer. Obstetricians should say to their patients “I’m on call until tomorrow morning, so don’t worry.” Making nitrous oxide available really helps women during that transition when they are starting to break down and feel they can’t labor anymore. It’s a good way to take the edge off the pain, and it has no effect on the baby.
You have a number of clinical interests.
I’m interested in high-risk obstetrics and appreciate having maternal-fetal medicine specialists from Brigham and Women’s Hospital here. Obesity is a touchy issue; women don’t realize its impact on their pregnancy. We try to begin the education pre-conception and often connect patients with dietitians and diabetic educators. I love taking care of adolescents, which is largely about preventive health care and begins with a birth control talk. When I tell them that I’m not going to examine them during that first visit, their shoulders drop, and they relax.
I’ve taken an interest in peri-menopause and menopause because women in their fifties describe hot flashes, feeling like they’re in a fog and vaginal dryness. Today there is a huge amount we can do for these patients, such as the Mona Lisa laser, which is effective for vaginal atrophy. I perform quite a bit of minimally invasive surgery, mostly for menorrhagia, and I’m a proponent of VBACs — vaginal birth after a c-section. A VBAC is not for everyone, but I love to offer and support it to women who are candidates and express interest.
Is practicing ob-gyn what you expected it to be?
I’m surprised by how close I’ve gotten to some of my patients. Of course, we’re often talking about intimate, important things in their lives, and I become a sounding board for a lot of different issues. I’m exhausted at the end of the day, because appointments can turn into mini-therapy sessions. When you’re with someone through their entire pregnancy — at least 13 visits — you get to know them very well. When the pregnancy is over, and I’m not going to see them until their next annual, I often feel sad about that. But that’s what I wanted: to take care of all a woman’s needs, the whole breadth of it.
What do you enjoy in your time off?
There’s been a moratorium on travel because of all the children that have entered my life, but my dream is to get to Greece and Italy at some point. I spend my day off with my kids. I like to eat, and I like to cook.