Here is one of the most revealing numbers in American women's health. During pregnancy, women average about 6.0 OB-GYN visits per year. During the menopausal years, that average falls to 0.3 — roughly one visit every three years. And according to the same McKinsey & Company analysis, primary care visits do not rise to fill the gap.
Read that again. The healthcare system engages women intensively for about nine months — then, across the decades that follow, through postpartum recovery, perimenopause, menopause, and rising cardiovascular and bone-health risk, it largely loses track of them.
At Anna Health, we have spent 20 years building a practice around the opposite premise: a woman's health is one continuous story, and it should be read by one team, in one medical record, from adolescence through menopause. This article makes the case that continuity of care is not a convenience or a luxury. It is a clinical advantage — and the research increasingly supports that.
One story, told in disconnected chapters
For many women, the journey looks something like this: a pediatrician through the teenage years, a campus clinic in college, a series of OB-GYNs as jobs and insurance change, perhaps a fertility clinic, a hospital team for delivery, a single six-week postpartum visit — and then years of near-silence until perimenopausal symptoms force the question of who to even call.
Each clinician along the way may be excellent. But each one starts nearly from zero. A population-based study in the American Journal of Obstetrics and Gynecology estimated that 35–45% of women use multiple providers for their healthcare needs — most often a women's health specialist for reproductive care and a generalist for everything else. That division of labor can work, but only when someone holds the whole picture. Too often, no one does.
Here is what the whole picture looks like, stage by stage — and what is gained when it stays in one place.
Adolescence (ages 13–19): where the record begins
A first gynecologic visit in the early teen years is usually a conversation, not a procedure: what a normal cycle looks like, HPV vaccination, nutrition, mood, and building trust with a physician she may see for decades.
Clinically, this is when the baseline gets set. Heavy, painful, or irregular periods in a 16-year-old are not just a teenage inconvenience — they can be the earliest data points for conditions like polycystic ovary syndrome (PCOS) or endometriosis, which often go years before formal diagnosis. When those early notes live in the same record the patient will still be using at 28 and at 48, nothing is lost to memory, a shuttered clinic, or a records-request fax line.
The reproductive years (20s–30s): pattern recognition
These decades bring contraception decisions, cervical cancer screening, and — for many women — the management of chronic conditions like PCOS, endometriosis, or fibroids.
The clinical value of continuity here is pattern recognition. Which contraceptive methods were tried, and why each was stopped. How cycles have shifted over five years, not five months. A family history that gains significance as new relatives are diagnosed. A physician who has known a patient across these years doesn't just have the data — she has the context to interpret it.
Fertility and pregnancy: history is clinical data
When a patient decides to try to conceive, a longitudinal chart is a head start. Years of cycle patterns, prior ultrasound findings, surgical history, and medication responses inform a fertility evaluation before a single new test is ordered.
And if she conceives, the same continuity carries into prenatal care: her true baseline blood pressure, her mental health history, the course of any prior pregnancy. At Anna Health, fertility evaluation, prenatal care, and delivery are managed by one team reading one record — so the physician at the delivery is not meeting the patient's history for the first time.
Postpartum: the stage where systems lose women
This is where the engagement cliff begins. Traditional care compresses recovery into a single six-week checkup, even though physical healing, sleep disruption, feeding challenges, and mood changes unfold over months. The American College of Obstetricians and Gynecologists now describes postpartum care as an ongoing process — a "fourth trimester" — rather than a single visit.
Mental health screening belongs at the center of this stage. Postpartum depression and anxiety are common and treatable, and detection depends on someone asking the right questions at the right time — ideally someone who knew the patient before pregnancy and can recognize when something is off. A team that cared for a woman through her pregnancy is also still her team a year later, when questions about cycles, contraception, or energy inevitably surface.
Perimenopause and menopause: context is everything
Perimenopause can span years and masquerade as many things: disrupted sleep, mood changes, irregular cycles, brain fog. Evaluated in isolation by a clinician meeting a patient for the first time, each symptom can invite its own separate workup.
Read against a decades-long record — this patient's actual baseline, her cycle history, her family history, her prior responses to hormonal treatment — the picture usually clarifies faster. Decisions about menopausal hormone therapy in particular are individualized, weighing personal and family risk factors that a longtime record captures and a new-patient intake form rarely does. This is the life stage where continuity pays its largest dividend — and, statistically, the stage where women are least likely to have it.
What fragmentation costs
Fragmented care is more than an inconvenience. A Danish nationwide cohort study published in BMC Medicine found that higher care fragmentation was associated with higher rates of potentially inappropriate medication and with increased mortality, even after adjusting for demographics and underlying illness. Patients who saw their usual provider for less than a quarter of their contacts had roughly 1.5 times the rate of potentially inappropriate prescribing compared with patients with high continuity.
The mechanism is intuitive. When no single clinician sees the whole picture, medications accumulate without reconciliation, findings fall between records, and subtle changes have no baseline to be measured against.
To be clear: research links fragmentation to worse outcomes on average — it does not mean any individual's care is compromised, and skilled clinicians work within fragmented systems every day. But the evidence points in a consistent direction. Continuity is protective, and it is worth designing a practice around.
The Anna Health model: one record, one team, every stage
Anna Health — formerly Annandale Ob-Gyn & Fertility — is a family-owned practice led by Dr. Anna Le. For 20 years, we have cared for women across Northern Virginia, and the numbers behind the practice reflect the model:
- 20 years serving Northern Virginia
- ~25 providers across the full span of women's health
- ~300 years of combined clinical experience
- Tens of thousands of patients cared for across every life stage
What the model means in practice is simple. One medical record follows a patient from a first adolescent visit through menopause care. One team shares it — so the physician managing a patient's perimenopause can read the notes of the colleague who delivered her children. Transitions between life stages happen as warm handoffs inside one practice, not records requests between systems. And the relationship compounds: every visit makes the next one better informed.
No practice can promise outcomes. What we can promise is that no one at Anna Health will ever meet you as a stranger.
Start the record now
Whatever stage you're in — booking a daughter's first visit, planning a pregnancy, or trying to make sense of symptoms no one has connected yet — the best time to start a continuous record is now.
Start your care journey at annahealthmd.com/start-here, or call (703) 642-7522.
For referring providers: we welcome co-management and are glad to coordinate records and communication for shared patients across any life stage.
Sources
- McKinsey & Company, "The $50 billion opportunity for US health systems to improve women's healthcare."
- Hall KS, Patton EW, Crissman HP, Zochowski MK, Dalton VK. "A Population-Based Study of US Women's Preferred Versus Usual Sources of Reproductive Health Care." American Journal of Obstetrics and Gynecology, 2015.
- "Healthcare fragmentation, multimorbidity, potentially inappropriate medication, and mortality: a Danish nationwide cohort study." BMC Medicine, 2023.
