Women’s health has been defined from a variety of perspectives. Women themselves describe articulately what it means to be healthy. Often their descriptions allude to experiencing the absence of illness or symptoms but more often to being able to perform their roles in life, having the capacity to respond to stress and strain, and experiencing high-level wellness.

This text originated in the 1970s as Catherine Ingram Fogel and Nancy Fugate Woods recognized the need for resources for nurses and nursing students who were interested in the emerging area of women’s health. The grandmother of this text was first conceived and birthed in 1981, revised and updated in 1995 and again in 2008, and has paralleled the history of the original editors and contributors, as we moved from our young adult years in the midst of the Women’s Health Movement of the 1970s and 1980s to our more mature years as we prepared this edition of Women’s Health in Advanced Practice Nursing and forged a new collaborative with editors of a younger generation.

Over the past four decades, nursing scholars have studied women’s health through the lenses of feminist theory, nursing theory, and now through critical, postcolonial, and womanist theory. In a relatively short period of history, and propelled by a fusion of the U.S. feminist movement of the late 20th century and the popular health movement, scholars redefined women’s health as more than women’s reproductive health to include a holistic view of what it means to be a healthy woman. Indeed, women’s health as a discipline has been transformed from gynecology to “Gyn Ecology,” an understanding of women’s health in the context of everyday life. An ecological perspective implies that the multiple environments in which women live their lives, including the influence of the society, culture, institutions, community, and families, need to be considered. During this period, women’s health scholars engaged women in redefining their own health as inclusive of well-being and not simply a compendium of women’s diseases. Clinicians and researchers alike redefined being healthy as the processes of attaining, regaining, and retaining health, consistent with the nursing theories of the time. Moreover, a life-span view became imperative as scholars came to appreciate that women’s health at one part of the life span influenced their chances for health later in life.

Thinking about women’s health from this new perspective implied putting women at the center of clinical services as well as research, focusing on women’s health in the context of their lives. New frameworks for understanding women’s health shaped by feminism and feminist theory now guide research and clinical scholarship. Scholars of revisionist views of feminist theory challenged investigators to consider the intersectionality of women’s identities and the consequences for health. One’s gender is only one component of who one is: gender, race/ethnicity, social class, sexual orientation and gender identity, and disability/ableness all intersect in influencing one’s chances for health. In addition, frameworks prompted by globalization reinforce the need to use many different lenses in viewing the health of women around the world. The efforts of the 1980s and 1990s to integrate women’s health literature across disciplines enlarged the perspectives with which communities of nurse scholars and clinicians have come to view women and their health.

Over the past four decades, we have seen dramatic changes in the nature of nursing practice, including that of advanced practice nurses. A rarity in the 1970s, advanced practice nurses are now an essential part of the health care workforce, providing an ever-increasing proportion of primary care for women. As educational programs transition, the push for educating all advanced practice nurses about women’s unique health care problems and appropriate models of care has escalated.

Part I, Women’s Lives, Women’s Health, views women’s health as inextricably linked to the context in which women live their lives, making it impossible to understand women’s heath without appreciating the challenges and opportunities they face in everyday living. Understanding women’s lived experiences has become key to understanding their well-being and chances for health. In this section of the text, we consider women and their health as viewed from a population perspective, using national data to paint a picture of morbidity, mortality, health, and well-being, as well as the use of health care. Women have long been attracted to work in health care, and both their distribution and the challenges associated with being a health care provider and practicing in one of the many health professions is explored. The emergence of a clinical scholarship of women’s health, in contrast to gynecology and obstetrics, gave rise to a need to transform women’s health research as well as models of care and health policy. Women-sensitive models of care have emerged over the past two decades; some of these have been influential in shaping the delivery of services in a variety of health care settings. Recognition of the diversity of U.S. society prompted consideration of health care for special populations of women, and appreciation of women’s rights to health care warrants our attention to the legal aspects of women’s health care, especially as the legal aspects of women’s health care continue to be contested. Feminist frameworks for women’s health offer an updated view of the many lenses through which we can understand women’s health as we care for women.

Part II, Health Promotion and Prevention for Women, draws attention to the work of health promotion and prevention, reflected both in women’s own self-care as well as professional services. Viewed through the lenses introduced in Part I, women’s health is a multidimensional experience, most of which is managed by women themselves, with occasional encounters with health professionals. What women do to stay healthy has been studied by numerous disciplines with a wide range of activities. Women often assume the role as agents of health for their families and demonstrate a high level of interest in health-related information. Indeed, they frequently justify paying attention to their own health in relation to their need to care for their families. They manage their own and family members’ illnesses, often simultaneously providing illness-related care to their children, partners, and parents. The everyday activities that create health are often the purview of women’s work; these include meal planning and preparation, family activities, sleep and rest patterns, and the like. Women are active in obtaining information about their health and often express a desire to work with a health professional who respects their knowledge about their own health and how to promote it. At the same time, women seek health-promotion advice from professionals to help sort out valid information and recommendations about keeping healthy. Women experience their health as embodied: We are and simultaneously live in our bodies. From the early days of the feminist movement of the 20th century, when women used plastic speculums to view their vaginas and cervices, demystification of women’s bodies became part of women’s health care. As women, we continue to be attentive to some of the unique aspects of our bodies, such as the menstrual cycle and menopause. In Part II, we trace experiences of health and health promotion in young, midlife, and older women as a foundation for understanding well-woman’s health. The emergence of the emphasis on the well women in wellness visits prompts us to consider the questions: What is a healthy woman? What is a mentally healthy woman? How does one attain and maintain optimal health? Health practices span nutrition, exercise/activity, and sleep, each of which demonstrably shapes our health. In an era of personalized health care, we examine the influence of the contemporary “omics” sciences as a foundation for understanding emerging approaches to diagnosis and delivery of health care. Women’s multiple roles in society commonly include employment, in addition to their family roles, and the majority of family caregivers are women: We examine both of these contexts for women’s health and the implications for health care. Women’s sexual health, including special considerations for women who are lesbians, transgender, bisexual, and questioning, warrants special attention of health care providers, as does the management of fertility. As women anticipate having children, both preconception health promotion and prenatal care are essential.

Part III, Managing Symptoms and Women’s Health Considerations, includes an array of problems that account for a growing portion of advanced nursing practice. Women may find that health professionals do not take their complaints seriously, promoting their frustration and dissatisfaction with health care. Part III includes information about topics that touch women’s lives and about which many seek information and validation from health professionals. Although women’s uniquely experienced reproductive health problems are important, so also are health problems that are not unique to women but may be experienced uniquely, such as heart disease. A variety of reproductive-related health problems, as well as general problems such as chronic illnesses, are the focus of many health care visits.

In Part III, we address an array of health problems that are unique to women (such as women’s reproductive health problems), are more prevalent in women (such as breast cancer), and are diagnosed and managed in different ways for women (such as thyroid disorders, diabetes, and heart disease). Among these considerations are those that are linked most directly to reproductive health care, including breast health, care for transgender and gender reassignment, sexual health problems and dysfunctions, vulvar and vaginal health problems, perimenstrual and pelvic symptoms and syndromes, urological and pelvic floor health problems, sexually transmitted infections, women’s experiences of HIV/AIDS, human papillomavirus, gynecologic cancers, menopause, osteoporosis, unintended pregnancy, infertility, high-risk childbearing, and intrapartum and postpartum care. In this section, we also recognize that many women’s health problems are not only those related to reproductive system function, but also those that include mental health challenges, substance abuse, violence against women, cardiovascular diseases, endocrine-related problems, chronic illness, and disability.

Several exciting online resources are available for each chapter. Case studies provide real-world application of the materials. Resources are available for literature, websites, and smartphone applications to access further information. Test bank review questions reflect the most salient points of the content. Additionally, PowerPoint presentations for each chapter can be used as instructional aids or for review of content. This ancillary material is available to qualified instructors by emailing Springer Publishing Company at [email protected].