Becky Carter: Outlining What Well-Woman Care Looks Like throughout the Lifespan

By Becky Carter
Chief Executive Officer/Chief Nursing Officer, Blue Ridge Regional Hospital

On May 14, we will appreciate the mothers in our lives – whether they’re our biological moms or simply women who are like mothers to us. May is also, quite fittingly, National Women’s Health Month, which makes me reflect on the fact that so many women take care of others’ needs before their own. This month I want to talk about how each season of a woman’s life requires that she pay attention to certain health issues and get screened for age-appropriate health conditions.

In her twenties and thirties, a woman must be cognizant of fertility issues, from deciding if and when she wants to have a child, what form of contraception she needs, and when she will get a Pap test, which tests for cervical cell abnormalities. If she plans on becoming pregnant, she should discuss proper nutrition with her physician, especially the role that folic acid supplements play in reducing the risk of neural tube defects in a developing fetus. All women should begin good habits early and continue them throughout their lives. Avoid tobacco, wear sunscreen and wear a seat belt.

The guidelines for how often women should get a Pap test have changed, and now the recommendation is for women to get their first one at age 21 and if test results are normal, they should be retested every three years. However, an annual visit to the OB/GYN is necessary for women to discuss other health concerns, such as getting tested for sexually transmitted diseases and breast and pelvic exams. Additionally, skin exams should start during this phase of life to prevent melanoma. If a patient’s dermatologist can get a baseline picture of the condition of her skin, they can create a preventive strategy together to avoid melanoma, like daily use of sunscreen.

When she reaches her forties, a woman is often in the middle of her career, possibly raising a family, and may increasingly be caring for older parents. Self-care that involves finding some time for herself becomes more important, whether that means 20 minutes of meditation each day, a relaxing bath or coffee with a friend. In terms of health screenings, the most important one is getting her first mammogram. If she has a family history of breast cancer, screening should start even earlier and an appropriate schedule can be determined with one’s physician. Even though our schedules are full, it’s important to reserve this time each year for this important screening. Perimenopause starts in this decade of life as well, so women should discuss any period irregularities, mood changes or other symptoms with their physicians.

As women enter their fifties, menopause is often a prime topic of patient-physician conversations. They may start experiencing hot flashes and night sweats, sleep disturbances, lowered sex drive and more mood changes. There are a range of treatments women can take advantage of to increase their comfort during this life transition. At 50, a woman should schedule her first colonoscopy, the screening that checks for colon cancer. Women should continue to see their gynecologist annually, receive annual mammograms and begin screenings for cardiovascular health. Awareness of blood pressure and cholesterol levels also become more important so patients can know their risks for heart attack and stroke.

Women in their sixties and seventies continue to need annual mammograms and pap tests on a schedule determined by their doctor, as well as a colonoscopy every 10 years. Bone density tests are also necessary to check for osteopenia – a precursor to osteoporosis, a condition in which decreased bone density puts women at risk for bone breaks and fractures, or osteoporosis itself. Immunizations recommended include the shingles and pneumonia vaccines.

In every phase of a woman’s life, she should enjoy a fruit and vegetable-filled diet, regular exercise and adequate rest. These practices support long-term health and lower risk for diseases like cancer and diabetes, as do limiting alcohol and continuing to refrain from tobacco use. Finally, every conversation at her yearly checkup should include screening for depression and other emotional health issues, and an opportunity to discuss whether she’s experiencing any interpersonal violence at home.

Blue Ridge Regional Hospital is here for the women in our community, no matter where they are in their life’s journey. By partnering with their physicians, women can take part in their own care to maintain good health no matter what their age.


Becky Carter


Rebecca W. Carter, MSN, RN, FACHE, is Chief Executive Officer and Chief Nursing Officer of Blue Ridge Regional Hospital in Spruce Pine. Carter has served in senior hospital management for over 20 years and previously served as Chief Operating Officer and Chief Nursing Officer of Transylvania Regional Hospital in Brevard, also a part of the Mission Health system.

Ms. Carter is board certified in healthcare management and is a Fellow of the American College of Healthcare Executives (FACHE). A native of North Carolina, she holds undergraduate and graduate degrees in nursing from the University of North Carolina at Chapel Hill. Ms. Carter is currently a resident of Burnsville.