1. WHY, OH WHY?
What was that? Why do you need a premarital exam anyway?

“It really is so important,” says Jana Sund, a certified nurse midwife with Intermountain Healthcare’s New Beginnings Certified Nurse Midwife Clinic. “We offer so much education about the wedding night and about birth control. We help girls prepare for sex in both a physical and emotional way.”

2. SCARY, SCHMARY
So you know those horror stories you’ve heard? Toss them away like a bridal bouquet.

“One of the biggest misconceptions about premarital exams is they’re horribly painful,” Jana says. “And most of our brides leave saying, ‘Oh, it wasn’t that bad at all!’ It’s not usually painful, and it’s not awkward like you think it’s going to be. We really try to make people as comfortable as we can.”

3. SAVE THE DATE
As with most things in life, the sooner you make your appointment, the better.

“If it’s at all possible, we’d really like to see you three months before the wedding,” Jana says. “But if that’s not possible, that’s OK. We’ll take you anytime we can get you.”

4. HERE COMES THE PACKET
Once you make your appointment, it’s time to get prepared for it.

“When our girls schedule their appointment, we send them a packet of information that will help them get ready,” Jana says. “It’s great for them to read up on what we’re going to be discussing.”

5. THEN COMES BABY?
Birth control is an important issue to discuss with both your fiancé and physician. Make sure you and your honey are on the same page, and read up on the various methods available so you can come to your exam prepared with questions.

6. OPTING OUT?
Even if you decide to opt out of birth control, the experts at the New Beginnings Certified Nurse Midwife Clinic say seeing a health professional before entering a long-term sexual relationship is still absolutely necessary.

7. PHYSICAL EDUCATION
Your doctor’s appointment will most likely include a physical (just to make sure everything is in order) — although that won’t necessarily include a pap smear.

“We won’t do a pap smear unless the woman is 21 or if they’ve been sexually active for three years,” Jana says.

8. STAND BY YOUR MAN
Think you have to go it alone? Think again.

“It’s wonderful if they can bring their fiancé to the exam. We spend at least 45 minutes just educating the couple on what’s to come, so it can be extremely helpful to have both partners there,” Jana says. “We’ll have him step out for the exam part of the appointment, but it’s great to have him there for moral support.

9. OUT IN THE OPEN
The sensitive subject matter can have a tendency to be taboo, but a premarital exam can help you feel comfortable and excited for what’s to come.

“We prepare them in ways a lot of girls aren’t prepared at home,” she says. “We’re very open in talking about the wedding night in a comfortable setting, and it’s a really healthy way for brides to start this new phase in their lives.”

10. QUESTIONS?
There’s no such thing as a dumb question. So get asking!

11. LOVE AFTER MARRIAGE
You’re likely to have questions, concerns and queries after you say “I do,” and the nurses at the clinic say their help doesn’t stop with the premarital exam.

“We are here for them every step of the way,” Jana says.

12. THE NEXT STEP
When you’re ready to take that next step and start a family, the certified nurse midwives at Intermountain’s New Beginnings Clinic are equipped to help with prenatal care, hospital deliveries and postpartum needs.

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Before your exam
Jennifer recommends scheduling an appointment two to three months before the wedding.
“It saves some stress right before the wedding, and it gives the woman’s body time to get used to the birth control,” Jennifer says.
Once the appointment is scheduled, the New Beginnings Clinic mails a premarital packet with information about sexuality and birth control. By reviewing the materials, you’ll be prepared to ask questions or discuss concerns on the day of your appointment. And it doesn’t hurt to involve your fiancé. Jennifer encourages women to bring the fiancé or mother to the counseling portion of the visit.

What to expect
during the exam
For each patient, the nurse midwives discuss medical history and general health, including chronic conditions and medications. The health professional will also provide counsel on the female anatomy and sexual response cycle. After the physical exam, there is time to ask any unanswered questions, discuss myths about sexuality, and learn about different types of birth control.
“One of the things most women really want to know is how to stop and start birth control,” Jennifer says. “They want to know what is the right method for them as a couple, or if one pill is better than another.”
Among women who choose to use birth control, the pill continues to be one of the most popular forms. The NuvaRing is also becoming very common, especially among women who may have a tendency to forget to take the pill. The Ortho Evra patch is a hormonal method applied once a week. The Mirena IUD is another hormonal option that requires even less maintenance, but is not used as commonly in newlyweds. Non-hormonal options include condoms, diaphragms and a Paraguard IUD.
Every type of birth control has pros and cons, and the certified nurse midwives are prepared to explain the differences. This will help each patient determine which option is the best fit.
Your health care professional can also discuss prescriptions for antibiotics to have on hand during the honeymoon in case of a urinary tract infection.

Following up
More questions may arise after you’ve been married, so the midwives are prepared to talk by phone or appointment. Follow-up on birth control may be necessary, depending on side effects or first time use. Certified Nurse Midwives are also on hand for preconception counseling, annual physicals and pregnancy exams.

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