Ep. 116 & 117 Healthcare Through the Different Stages of Motherhood, Roundtable (Part 1 & 2): Preconception, Pregnancy, & Postpartum

Show Notes:

This HER Health Collective Roundtable features the following HER Provider Directory Experts:

• Dr. Courtney Hinton, DO, MBA
• Brittni Winslow MS, OTR/L
• Kate Williams Stone, Non Diet Perimenopause Coach
• Rachel Jerozal, PT
• Brook Orvis, PT
• Ally Raven, Doula
• Christy Lowry, Parenthood Transition Coach
• Megan Davis, LCSW, PMH-C
• Stephanie Opper, Esthetician 

To connect with any of our experts, please go to our ⁠website directory⁠. 

Today’s episode includes a discussion of the following topics:

• Introduction and Expert Introductions
• Preconception Care
• Pelvic Floor Health Preconception
• Mental and Emotional Considerations Preconception
• Prenatal Care and Pelvic Floor Changes
• Mental Health During Pregnancy
• Sensory Changes During Pregnancy
• Postpartum Care and Mental Health
• Grief and Postpartum Adjustment
• Sensory Management Postpartum
• Shared Responsibility and Mental Health

Episode Resources:

Postpartum Support International

• Dr. Courtney Hinton, DO, MBA – Founder and CEO of The Snatch Back LLC
• Brittni Winslow MS, OTR/L – eMERGE Pediatric Therapy, The Therapeutic Edge Collective
• Kate Williams Stone, Non Diet Perimenopause Coach
• Rachel Jerozal, PT- Durham Pelvic
• Brook Orvis, PT- Flora Physical Therapy
• Ally Raven, Doula
• Christy Lowry, Parenthood Transition Coach – Founder of The Parents Table
• Megan Davis, LCSW, PMH-C
• Stephanie Opper, Esthetician  – Skinsational Esthetic Skin Spa

Transcript:

SUMMARY KEYWORDS

pregnancy, postpartum, important, postpartum period, birth, mom, pelvic floor, work, body, care, sensory, mental health, skin, great, support, grieve, preconception, experience, life, hear

SPEAKERS

Dr. Brook Orvis, Stephanie Opper, Kate Williams Stone, Cindi, Ally Raven, Christy Lowry, Brittani Winslow, Dr. Rachel Jerozal, Megan Davis, Crissy, Dr. Courtney Hinton

Crissy  

HER Health Collective hosts four roundtables each year in an effort to bring together our experts and dive deep into the topics that matter to moms the most. We have found that these roundtables are often our most well liked episodes. Each of the experts represented in our roundtables have different professional backgrounds and specialties when they come together and discuss an issue pertinent to moms, you can expect to get different perspectives based on their area of focus. This is also a time for the experts to collaborate with professionals from other industries in order to create a more holistic model of care. Our goal is to expand not only the experts referral network, but to emphasize the importance of collaborative care in our roundtable today, we are discussing healthcare through the different stages of motherhood, preconception, pregnancy, postpartum, perimenopause, post menopause, and what moms need to pay attention to, because it’s not always obvious to us. We’re going to gradually work our way through the various stages of motherhood, beginning with preconception, then on to pregnancy, postpartum, perimenopause, and ending with post menopause. Today, we are honored to be joined by several of our her experts. We’re going to take a few moments to let each of our experts introduce themselves and share their area of expertise so that our listeners can hear each expert’s voice and have a better idea of who is speaking during our upcoming conversation. So we’re just going to start off in no particular order, except for how you appear on my screen, and we’ll have Brittani.

Brittani Winslow  

Hi, I’m Brittani Winslow. I am the owner and the executive director of eMERGE Pediatric Therapy and an Occupational Therapist by trade. I also own The Therapeutic Edge Collective, which is an online continuing education resource center for pediatric providers.

Dr. Courtney Hinton  

Hello, everybody. My name is Dr Courtney Hinton. I am the founder and CEO of The Snatch Back LLC, which is an entity that provides the pathway to healing for historically marginalized birthing people who are recovering from the NICU and premature birth. Along with that, I am the interim medical director of North Carolina State University Campus Health and so I’m happy to be here with all of you today.

Kate Williams Stone  

Hi everyone! My name is Kate William Stone. I am a Non Diet Health and Life Coach focused in perimenopause. And so what that means I help women do is to calm the mental chatter around all the perimenopause symptoms like, What the heck is happening to my body right now so that you can feel at home and at peace in your body. I have training in intuitive eating, body image work, and I take a non diet approach to healthy habits. So I’m so glad to be here. 

Dr. Rachel Jerozal  

Hi everyone. I am Rachel Jerozal, better known as Dr Rachel. I am a doctor of Physical Therapy and owner of Durham Pelvic as you can likely tell by the name, I am a Pelvic Health Physical Therapist, and I’m located in Durham. I see patients one on one in my practice, and I work with women all the way from preconception through pregnancy through postpartum, all the way to menopause and just all the pelvic floor issues that arise during those states. I’m here to help support because you don’t have to live with them. So I’m happy to be here today.

Megan Davis  

Hi there. My name is Megan Davis, and I’m a Licensed Clinical Social Worker and Certified Perinatal Mental Health Specialist. So I’m in private practice in Raleigh, and I work with, I say moms across the lifespan, because I see a lot of moms who were newly pregnant or in the postpartum period. But as we know, postpartum doesn’t really ever end. So I’m happy to be here.

Dr. Brook Orvis  

Hey, y’all. My name is Dr Brooke Orvis. I am a Board Certified Pelvic Floor and Women’s Health Physical Therapist. I am the owner of Flora Physical Therapy in Durham, North Carolina. So again, I really work with everyone that has pelvic floor issues, which is everyone, we all have the pelvic floor. Everyone poops, pees and has sex. So I’m really passionate about providing equitable care to folks and just helping to support people, especially people that are trying to conceive during pregnancy, postpartum, menopause, perimenopause, because those are prime time for pelvic floor issues to pop up. 

Christy Lowry  

Hi everyone. I’m Christy Lowry, founder of The Parents Table, and we support those entering and exploring the early years of parenthood with online and virtual personalized coaching and community. So I’m a Personal Growth Coach for parents, and I focus on the parenthood transition, basically from pregnancy to preschool, like Brooke said. And Megan said, I believe it’s a longer transition, and takes longer than than we think it does. So in that time frame, I come in with systems for personal growth, parental leave, planning at work and at home, creating shared and strength based and equitable division of labor at home and grieving many things grief is often not talked about enough in this postpartum phase, so I like to bring that in and then also rediscovery of yourself in this often messy transition. So I’m also very grateful to be here today. Thank you so much for having me.

Ally Raven  

Hi. I’m Ally Raven. I’m a Certified Birth Doula, Childbirth Educator and Breastfeeding Counselor here in Charlotte, I own ally Raven doula services, so I specialize in pregnancy and labor support for all of my expecting parents, and I also offer childbirth education courses. I also just started a birth partner course, which is aimed at birth partner support and teaching the birth partner how to be a support person. And yeah, I’m excited to be here. Thanks for having me.

Stephanie Opper  

Hi, I’m Stephanie Opper. I am a licensed esthetician, and I own a skin spa and Wake Forest, Skinsational Esthetic Skin spa, and I work with women, and actually young women of all ages through all phases of life, and really working with them. And as I’m discovering myself with my changes in my skin and everything else going on, but working with women to really get through those challenges of all the changes happening to their skin and their body as well. And I’m really excited to be here, because there’s a great group of expertise here.

Cindi  

It is such an honor to welcome all of you to this roundtable, and we’re going to go ahead and get started with our first question, which is going to be on the topic of preconception. So preconception refers to the stage prior to conception. It’s during this time when an individual’s health can be assessed to determine if there are any medical conditions or health concerns that may affect the future pregnancy. Dr Courtney, I’m going to direct this to you to start off with as a board certified physician. Will you please share when it’s best to begin receiving preconception care and what an individual should pay attention to in regard to medical condition, conditions or health concerns and their physical health?

Dr. Courtney Hinton  

Absolutely! So, I am a firm believer that preconception care starts way earlier than any of us often think about. I think for someone that is seeking parenthood at some point in their life, you can actually start about preparing for conception many, many years prior. It’s and it also can be very specific to the person. As an example, I mentioned that part of my work is working with college students. There are plenty of students currently that I see who have no interest in being parents right now, but even if they’re seeking that a decade from now, the types of medication decisions and chronic disease management that I’m doing with them now, I’m starting them on a medicine that they may be on for the next 20 years, and I’m already thinking about making sure I’m choosing something that is going to be healthy and consistent with a pregnancy in the future. It’s also important to think about what it looks like if they have to come off of that medication in the future. A good example of that is going to be something like medications for various mental health conditions. There are some that are studied way more than others when it comes to how they impact a pregnancy, both for the person carrying the child and for the child themselves. And so I often today, I’m having conversations about what that research looks like, so that future mothers, future parents, can make informed decisions about the things that they take. Another great example of that is going to be thyroid disease. Thyroid disease is very, very common in our community, and one of the things that a lot of people don’t know is that once someone is pregnant, your thyroid medication absolutely you can expect that it’s going to be different as you move through that pregnancy that has to do with that hormonal shift that occurs that can impact the thyroid. And it’s common that your dose actually changes and increases during your pregnancy, but if someone is not prepared for that or asking those questions, then you know they can worry that that means that they’re just getting sicker, as opposed to the body kind of physiologically responding the way it should during a pregnancy. So ultimately, when I think about when should preconception care start, really, I think as early as possible, and what we as future parents can do for our for those that we care for. Is to make sure that you’re asking questions early, that you’re going to get your physical every year, that you are not thinking that because you’re healthy, you should only go when you get sick, right? Making sure that you have a health care routine established way early on makes it much easier to get the care that you need when, ultimately, there is a pregnancy to be thinking about. So my overall answer is, as early as possible. 

Cindi  

That’s all a wealth of information, right there, Dr Hinton! Thank you so much, and I’d love to direct my next question to Dr Brook, taking a look at the pelvic floor. Or Dr Rachel, if you would like to jump in as well. Is there anything that we need to consider preconception wise with our pelvic floor as we consider conceiving a baby?

Dr. Brook Orvis  

So I see a lot of folks in the clinic that are coming in for different types of pelvic pain, and we know for folks that are struggling with pelvic pain that there potentially is going to be issues in terms of the sexual response cycle, which is really, really important for folks that are thinking about trying to conceive. We know that the pelvic floor muscles are really important during orgasm, we get a contraction and release of those muscles with orgasm and just sexual response, and also contraction oscillation of the uterus, which, again, is really important when it comes to conception. So a lot of times people that are coming into the clinic working with me, a lot of times we’re just kind of working on addressing any type of pelvic pain that they might be struggling with. Because, again, it’s like, if you aren’t enjoying yourself when you’re trying to be intimate with your partner, like it makes sense that you probably don’t want to be doing it and having sex and intimacy. And so for a lot of people that I’m working with at the end goal is, okay, I’m trying to get pregnant, then we obviously need to address the underlying issues of why they’re having the pelvic pain and just tension in the muscles and potentially those hormonal changes, which is where lovely physicians like Dr Hinton come into play with having those conversations with clients too.

Cindi  

Thank you so much, Dr Brooke. I also would like to take this and look at it from the mental and emotional considerations that we have to keep in mind prior to pregnancy. And I’m going to actually direct this to Megan, there are so many life events that can impact a person’s mental and emotional health in the preconception stage. Will you please share some things that we should keep in mind for mental health prior to conception, and perhaps share some tips to prepare for the parenting journey with our mental health. 

Megan Davis  

Yes. So even just in the preconception stage, as Dr Courtney mentioned, you know, the medication that some individuals are on for mental health reasons might need to be changed, and so just being aware if that is the case, and to have a good support team with a therapist, psychiatric provider, you know, other medical professionals to provide that support, because for some people, it can be a pretty difficult transition coming off of medication that has worked well for them. Also something that I see a lot is a lot of anxiety around just trying to conceive. And oftentimes, if we are kind of like high achievers and you know, have our plans and we are very organized, trying to conceive can be a real stressor and really difficult to cope with, because it is something that, to a large degree, is out of our control. So just kind of having support, whether it’s through, talking with a mental health professional about what that’s like. Learning some ways to be able to set and tolerate the uncertainty around the actual process of consumption can be really helpful.

Crissy  

Thank you so much for that, Megan and everyone! That gave us some insights to that preconception stage we’re going to shift over now into prenatal care. The pregnancy stage of motherhood is a time when an individual goes through tremendous changes, both physically and emotionally and it let’s be honest, it is wrought with so much emotion. It is up and down and scary and exciting and completely overwhelming all the time. So it’s a really important phase that we spend some time exploring and touching on hormonal fluctuations are a huge aspect of what an individual is going through during this time in this stage. So we touched on the pelvic floor health and. Mental and emotional health with preconception, and I want to touch on that again in this pregnancy phase, because it’s such an important piece. Dr Rachel, this is directed to you. The pelvic floor has started getting some well deserved attention over the past several years. Thankfully, we all need to know about the issues that arise with the pelvic floor. It has become much more studied. It has a huge impact on the person’s life, and we’re seeing it in the news and social media more and more. Will you share with us changes that the pelvic floor experiences at this stage during pregnancy, as well as some common issues that a woman might experience? 

Dr. Rachel Jerozal  

Absolutely! I’m so here for the pelvic floor getting more attention, as I’m sure Brooke, and honestly, everybody in this room is so during pregnancy, you know, there’s two major shifts that affect our pelvic floor, and the one you had spoken about Chrissy is hormonal fluctuations. So that doesn’t only affect our mental health, it also affects our physical being. And I know everybody hears about relaxin, but there’s other hormones than just relaxin that do make the pelvis more mobile, and that’s a great thing, you know, that prepares us for birth, however, that can take away a lot of the inherent stability that our bodies have prior to conception, that can just bring up a lot of symptoms such as pain, such as leakage, such as, you know, core weakness with the diastasis. Diastasis is just an opening of the abs, which is completely normal during pregnancy, but it does make us a little less stable. So there’s kind of that factor. And then the other factor is you’re gaining a lot of weight, and not only, you know, you do gain widespread but it’s very centered in the belly, which means the pelvic floor is having to support it. And so our pelvic floor normally supports our organs, but during pregnancy, we have a very heavy organ that’s getting heavier and heavier as we progress through pregnancy. And so the pelvic floor might have been totally fine preconception, and then with all this extra demand it’s being placed under, we’re starting to see those symptoms crop up. So the biggest thing that I want to say to the mamas here is, or the people hoping to become mamas one day, is that, you know, oftentimes we’re given this advice, like, Oh, it’ll get better after pregnancy. Like, just, you know, that’s pregnancy. Like, big deal, you know, you’ll, you’ll figure it out after and I and Brook, we work with people during pregnancy to help you feel as good as you can feel. And certainly, there are always those things that it’s like, oh yeah, this weird rib pain, and it’s just completely resolved after I gave birth, of course. But there are a lot of things that can get better and better through working with a skilled physical therapist, and you know, you don’t have to wait, you don’t have to suffer all through your pregnancy. You come work with us, and then you also, there’s more to it than just kegels. So please don’t just say, like, I’m just going to do my kegels. I’ll be fine, because that is not always appropriate.

Crissy  

Thank you. Dr Rachel, yes, the whole don’t just do Kegels is such a valuable I mean, I remember pulling up to the stoplight and let me do them, because that’s what I heard. Because that’s what I heard on the radio I’m supposed to do so thank you. I think that’s very important message, because I am not a person that is supposed to be doing people. I’m going to turn this over to Megan. Now for the mental and emotional health piece, will you get us started discussing the mental health considerations that we should be paying attention to during pregnancy. How is knowing how to advocate for oneself and understanding perinatal mood and anxiety disorders important at this stage?

Megan Davis  

Well, one and five birthing persons will experience a perinatal mood and anxiety disorder, and non birthing persons, it can be one in 10. So it’s definitely something that is gaining more attention with advocacy, which I think is really great, that more OB practices are screening, but they don’t always know what to do next. So it is really important to be your own advocate. And if you feel like you can’t do that, see if your partner can advocate, you know, at appointments. But definitely, some things to take into consideration are, if there is a history of a mental health diagnosis, specifically, depression, anxiety, OCD, bipolar disorder, things like that. That’s something that is a risk factor for a perinatal mood and anxiety disorder during pregnancy and postpartum. So it’s really important to get connected to a mental health professional who can just kind of keep an eye on things and check in, because along with all of the hormonal shifts, there are just so many changes that even those of us who might not have, you know a history of depression or anxiety or anything like that, it’s it’s a lot to navigate. So having that extra support can be really helpful if there. As any type of history of sexual abuse or trauma, that’s also an important consideration, making sure that you find a an OBGYN or practice that’s trauma informed and can really be there for you in ways that are helpful. That’s also where I think having great doulas, you know, are important to help advocate as well. But at any point, if you are starting to notice that you’re just not feeling yourself, or you’re maybe having a lot more difficulty sleeping or eating or trouble concentrating things like that, or even noticing any type of like suicidal thoughts, definitely reach out. And a great organization is Postpartum Support International, which has both a warm line and hotline, and they have a abundance of resources and support groups. So it’s really helpful to start getting established during pregnancy, because a lot of mental health symptoms can really start during that time that might not have ever been there.

Crissy  

Such important information. And yes, PSA is a great resource. Thank you for mentioning that. We will definitely make sure we link that in the show notes for any anybody that needs it.

Ally Raven  

 I’d like to add something from a doula side. A lot of what Megan said really resonates with me as a doula, because a lot of what I’m doing during pregnancy is making sure that my clients are reaching out to their therapists and to their mental health providers to make sure and not a medical professional, I am here to support you and educate you on childbirth and prepare you for all of it, but at the end of the day, having that relationship with your therapist throughout pregnancy and preparing you for being prepared mentally for childbirth and postpartum, I feel like a lot of my clients, especially, it’s Hard to understand how much of an impact that support and help is in the prenatal space, and how much it impacts going into postpartum and like psi, I give that to all of my clients, and I’m like, just look at it, please, because it’s one of those resources that you don’t know that you need until you Need it, or until after you already need it.

Dr. Courtney Hinton  

I also just wanted to say in the prenatal space, you know, for moms that have births, unfortunately, that do end up with babies in the NICU and or any sort of prematurity, everything that’s been said is times 10 for my own background. I am a mom of former Nikki Beatty’s twins, and I will say that it’s so important to establish care if you don’t already have mental health support during pregnancy, as soon as that unexpected event happens, it is imperative to establish that care before you even realize that you need it like do it, even if it’s not something that is resonating with you yet, because the fallout emotionally from that is tremendous, and it’s something that you can’t anticipate. And then those early phases, particularly if baby is in NICU, having difficulties, so much of your focus is on just the minute to minute of what’s happening there that it’s easy to say, I’ll do that later. And the unfortunate part is, you really need it immediately. You really need that support right away. So I just really want to say it’s so important for all mothers and in situations that have those unexpected things that you just can’t prepare for. I mean, truly, day one, I would contact someone for that support, because you’re going to need it. There’s a lot of grief. I know Christy mentioned grief early on, and there’s a lot of grief that comes in that phase. So I just wanted to really push everything that has been said so far.

Cindi  

There is so much in this particular stage. Brittani, I know that sensory wise things change in pregnancy. Hormones change. It changes the way that we respond to everything around us. Do you work with people in pregnancy? How would someone’s sensory response change when they are building, creating, growing a human inside of them.

Brittani Winslow  

 Yeah, so there’s definitely tremendous changes that happen, I think, during pregnancy, because of the hormones, like you said, and then especially then, you know, before you have children, you might be managing your sensory overwhelm and not even realize that’s what it is in different ways, by just how you live your life and the choices that you make and then moving into, then having a newborn, there’s a it’s a very sensory, rich experience. So we do not typically get referrals for women who are pregnant, who are. Wanting to kind of address that early on, but it would be fantastic if the trim move more in that direction, because if people better understood how sensory input impacts their day to day life, and what those triggers are and how to manage sensory sensitivities, than being able to go into a very sensory, rich experience when you are very low on sleep and you know, you’re likely not meeting your own basic needs because you’re taking care of someone else. You need to have a strategy going into it. So you can obviously get a strategy in place once you’re in that phase of, you know, having a newborn, experiencing that world. But it would be so incredible and so powerful if people had that prior to going into it. Because honestly, we see a lot of parents now that their children are older, they’re three, four or five years old, and they’re starting to just understand that some of the issues they’ve been dealing with are related to sensory processing differences, because there’s just so much more dialog around that now than there was before. So yes, huge advocate for people being able to figure out what works for them as early as they can.

Cindi  

Great. Thank you so much for that. And Stephanie, I would love to get your feedback on the skin, the hormones not only change us internally and our moods, but I have to say, when I was pregnant, I noticed a lot of spots all over my body, and I was just hoping that you could talk a little bit about skin changes that happen during pregnancy?

Stephanie Opper  

Sure, so that is really something that I see a lot of so I have clients that come to Me that are expecting and dealing with all those hormonal changes that create pigmentation. So we hear melasma and pregnancy math a lot, and that does happen. Well, news slash. It actually happens all throughout now, with all the hormone changes, but during pregnancy, it’s a big thing that does happen, and we experience that, and we have to be careful on how we treat it. And fortunately for most, it does go away or lighten when your hormones balance back after you have your children. And the other piece, though, is I’ll see clients that have acne, so they’ll they’ll come to me and they’re so frustrated because they’ve never had acne in their life, and all of a sudden they’re expecting and now they have all of this congestion, and they don’t know what to do. So there are things you can do, so taking care of your skin, getting your skin healthy before pregnancy, during pregnancy, and then after as well, all those phases of life, keeping your skin healthy, just like you’re keeping the rest of your body healthy, so that it can respond better, instead of all of a sudden, you have all of this acne or all of this pigmentation, and it’s just exasperated because of these changes that are happening. So taking care of your skin at home, taking care of yourself as well by, you know, doing skin treatments and things like that. It’s all really great self care.

Cindi  

And we’ll be talking more about skin changes later on. Because, yes, as you become perimenopausal and into menopause, there’s more things that happen to our skin. So we’ll be touching back with you. The next phase that we’re going to go into is postpartum. And the National Library of Medicine defines the postpartum period as, quote, the period after delivery when maternal physiological and anatomical changes return to the non pregnant state. Some professionals say six weeks to six months that that’s the postpartum period. This is a pretty arbitrary number. I personally believe that once you’re a mom, you’re always a mom, and that you’re always postpartum. We can discuss that more if you’d like to, but let’s explore healthcare through this stage of motherhood. It’s a time of so many changes and adjustments you now have a human that you are responsible for. So Ally, I’m going to come back to you. How does the childbirth experience impact a mother’s mental health, both immediately after childbirth and moving forward in the parenting journey?

Ally Raven  

We all know that childbirth can be fun and exciting and beautiful, but it can also be very scary and very unexpected. So having a birth experience not necessarily going as you planned or has you ahead hoped it would, can be a little bit detrimental to a lot of people. So a lot of times when you’re looking at, you know, how is your experience impacting your mental health? We talk about, or I especially talk with my clients about how their birth experience was for them. And we can prepare all day long. We can make your birth plan, and I can help prepare you for every single scenario that May. Or may not happen. But at the end of the day, most women have some kind of idea in their mind of how they want their birth experience to go, or how they hope it will go. And during childbirth, if it doesn’t go like that, or if it does go like that, if it goes perfectly as they had wanted it to as they planned, then that may either help or hurt their postpartum period, and they’re feeling postpartum so big one is obviously for women who plan to have a an unmedicated birth or a vaginal birth and then it turns into a cesarean. It’s very common for a lot of people to feel like they almost failed as a mother or failed as a woman that their body wasn’t able to let’s say their cervix wasn’t able to dilate, or they weren’t able to push their baby out. So if their birth didn’t go have they intended, and they had some unexpected things come up during that birth, then that will lead them to feeling like they may have failed, or like they are not worthy of being a mom to their child, and that plays a big role in their recovery postpartum, because if you are constantly trying to make up for how your birth experience was, or if you’re trying to find ways to replace your birth experience, then that can lead to a lot of mental health concerns down the road, and that’s why, again, it’s so important to have that mental health connection in the prenatal period to help give you those foundations that you will need leading into postpartum if your birth doesn’t go as planned. Also something that may not be focused on a lot, but is just how physically tiring childbirth can be. And a lot of people don’t realize that going into childbirth unless you’ve done it before. You don’t realize how physically tiring it can be. So going from, you know, having a kid, being in labor for anywhere from two hours to 48 hours, when you are done laboring, you still have to be responsible for a child, and you still have to be awake and you still be focused. So if you have an experience like I mentioned before, where it didn’t necessarily go to plan, and you feel like you may have failed, or you feel like you aren’t good enough, then you may be trying to find ways as a new mom that you can counteract that failure that you feel, or you may be searching for ways, or have fears that you’re going to fail being a mom too, since you may have failed birthing your child, also. The last thing I’ll talk about is a lot of people stress about the immediate skin to skin period, which is tremendously important. I always recommend that all my clients do the golden hour. But for some women, you don’t get that opportunity. So whether you had to have a C section or something happened where they had to take baby away very quickly, some women lose out on that immediate skin to skin, and that immediate bonding period. And for a lot of people that they have to grieve that, and they don’t understand, or they don’t feel like they’re able to grieve it, because they have to now be a mom so making sure that they have that space to grieve it, they understand that, yes, you have a healthy baby. You are healthy. And a lot of people will say, Okay, well, your baby’s fine, so it’s okay, but you’re still allowed to grieve that period and grieve what you lost, and having that support system around you that understands that you need to go through this grieving period to be a healthier mom, to be a healthier parent.

Cindi  

Go ahead, Dr Rachel.

Dr. Rachel Jerozal  

I just wanted to say that, and hopefully we’re moving away from this. But I know there’s that six week checkup at your OBGYN, and just people get this in their head about like, six weeks I should be back to normal, whatever that is, even though we’ve discussed that your whole new body postpartum, and six weeks is so, so, so fresh, you know. So I actually put the rehab, the back to normal feeling at more like 12 to 18 months. And when people first hear that, they usually their jaws drop and they’re like, what I I want to go back to CrossFit at, you know, at 10 weeks, and that’s a grieving process as well, because if you weren’t educated on that, and if you know you have a gym community, or that’s a big part of your life, you know it can certainly feel like you’re just super out of touch with your body, and that can be very frustrating. But I just please, please give yourself grace, because you know you just grew and birds a child, and now you’re taking care of a child. So so you know it is, it is not six weeks to be a magically rehabbed. And certainly we hear the stories. We hear those stories of people who bounce back, but those are the exceptions, and Brooke and my practices are filled with people who do not bounce back, because that’s normal. That’s very normal. To have to rehab your body, especially if you had a C section, or if you just had some birth trauma where it wasn’t as smooth of a birth as you could have. You know, certainly that’s an injury, and we’re rehabbing, so please give yourself Grace postpartum. Give yourself at least a year, if not more.

Christy Lowry  

Can I say something?

Cindi  

Absolutely Christy! 

Christy Lowry  

Yeah, both of the things that you hit on is the timeline and grief and timeline and timeframe of postpartum. I feel like once I started to learn about horticulture time versus industrial time, I really understood that my pregnancy and my birth experience and my postpartum experience wasn’t on this fixed timeline, because I am not a fixed person, and I’m a very variable human being. And so, you know, when we look at horticulture time and women’s bodies, you know, we flow with the moon, we flow with the seasons. We’re energetic beings. We are not on this Monday, the eight to five industrial time, and that’s what it is. And we get so focused on things have to happen in eight to five. Things have to have to happen on this due date calculator, the company policy on parental leave is when I’m supposed to be back and ready to go. The six week checkup is, oh, I’m good to have sex with my partner, right? Like things are great. We’re moving No, you have to step back. You have to pause, and you have to feel that intuition and know, find that knowing within to say, okay, am I ready for this? And start getting curious with yourself and kind of become your own detective and your own advocate in that way, the other piece that I love hearing and I love talking about grief. I know that’s very odd, probably, but I think it’s a really special and meaningful and important piece that we do not talk about enough and we don’t know how to experience because of the lack of communication and visibility in it. And you know, when something doesn’t go the way you hoped or that you planned, there is going to be grief, and you’re going to yearn for that experience. I work with motherless mothers based on my own experience, and those who have lost their mothers before and after birth. I lost my mom after birth, and there’s a whole host of of experiences and circumstances and complications that come with grief in that respect, but also just grieving what you used to have in this postpartum life. You know, there’s a lot of changes we’re going through, and whether you had an experience in your birth or with your baby, or whatever the experience was that didn’t go right, you’re also yearning and grieving the life that you had before you were a mom, and so just allowing those things and those emotions to come up in addition to your birth experience in the postpartum phase. 

Megan Davis  

This is Megan, and I just wanted to add in I could talk about this, probably for like six hours, but I’m going to spare y’all, you know, I think in the postpartum period, so many moms can feel isolated or just not know, like, is this normal? Is this not normal? And definitely, if you are noticing that you’re feeling off, just not yourself, especially after the first two weeks postpartum, like there is help out there, and whether it’s getting on some medication or getting into a pelvic floor PT or getting mental health support or whatever it may be, you know, a lot of moms can really notice improvement and kind of the postpartum period, but also another piece of it is really just loading on the self compassion, which is a practice. There’s this concept of matrust sense around becoming a mother. So it’s not just birthing a baby, but birthing a mother. And there are so many different physiological changes. Our brains literally change as well. And on top of that, we get a lot of different messages from society about what a mother is or isn’t or should or shouldn’t do. So you know, these are all different things to just really be kind to yourself, because it is a lot of change and there, there are a lot of different messages that can kind of cloud the skies. So definitely get in to speak with a mental health professional, or just find a group of moms who you feel like you can be really real with.

Cindi  

Thanks so much. Megan, I’m going to circle around to Brittani. We’ve talked a lot about the different changes that happen once you have the baby. It’s a pretty intense time. There’s lots of big emotions, and now you have a lot of additional responsibility, also irregular sleep. So this all comes. Pounds to some major sensory overwhelm. And I was just wondering if you have tips that you can provide us where you can tell moms here, here are some tips to manage your own sensory overwhelm. 

Brittani Winslow  

Yeah, absolutely. I mean, I think when we think about sensory overwhelm, we kind of default to thinking about overstimulation in, you know, some of you know, basic senses, right? So things are too loud, you’re touched out. You know, there’s just a lot of that that happens that contributes to that sensory overwhelm piece. And so for that, it’s being able to recognize and taking that time to realize, okay, things are really loud. I’m getting overstimulated by this. It’s okay giving yourself that permission to then do something to like. Is there a place I can go do I need to set the baby down in a safe space, or have someone else with the baby so that I can walk away and I can try to regulate my nervous system communicating that I think that a lot of parents think that they’re just are being labeled as just being like, you know too much, or you know dramatic, or you know you’re having this really big reaction, and there’s no acknowledgement of the fact that that Extreme Nervous System dysregulation that’s happening. So having conversations, you know, with your partner, with people that you trust, to help build that language, build that safe space, to stay like I am touched out. I’m really overstimulated. I need X, Y or Z. So I think first comes with communication, acknowledgement, taking some time to examine what works for you, and knowing that my body is different as a parent now versus pre being a parent. So I could go to loud concerts, and I could have the bright lights and all of those things were fine for me at one point in my life, but that has really changed for me now, having three kids and so giving yourself that space, I think the grief process, I think that’s a, you know, also a tie in there. So I think focusing on that, what are my triggers? What is too much accepting that that’s the case. You know, there’s things you can purchase, like loop ear plugs, that help to decrease down the decibels in which you’re hearing and experiencing your space. You can think about modifying your environment, turning lights down. You know, there’s a lot of different strategies you can do that way to really think about, how can I model this to support my own sensory system and what my sensory system needs? And on the other side of that, a good way to tackle sensory overwhelm is to think about what is regulating to my nervous system. And so the proprioceptive system, getting a lot of good input through your muscles and joints, is naturally going to be regulating for all people. So you think about yoga, taking a walk, just being able to get away and just again, examine yourself as a person, and realize what does my body need to feel just right? And then building an opportunity, you know, use your village find ways to be able to get a lot of those types of sensory experiences that are going to regulate your system. Because for me, if I’m feeling overwhelmed as a person, I am touched out too loud, too bright, all the things I know, if I just go for a walk, it doesn’t have to be strenuous. I’m going to get some sensory input that is going to make me a better mom, a better spouse, a better boss. So we have to be able to put ourselves first, sometimes be a little selfish, understand what our body needs, because we’re not going to be able to be our best selves for those that we’re taking care of and supporting, if we are not feeling just right in our own bodies, empowering people to do that. Thank you so much for that, Brittany, I think that’s a really important message to hear in that phase and in all phases.

Christy Lowry  

Something that you have said of just taking time for yourself and being selfish, and being selfish is not selfish. I guess when you need that care and you need to value your time and you need to rest and all that that you need to do and notice your needs. But there was a study when you were saying that that came to my mind about how the inequity at home that we see and how much that’s impacting mental health and the ability to rest as moms and get that time to ourselves right. And so the study is called cognitive household labor, gender disparities and consequences for maternal mental health and well being. It’s very long name, but mothers who reported a greater share of the mental load, the emotional labor and the physical workload at home, experienced significant symptoms with depression, stress, personal burnout, lack of satisfaction in the relationship, lack of satisfaction at work, and reduced mental health. So I wanted to throw that out there that this time for yourself is imperative because it impacts not only you as a human being and your you know, and your mental health, but it will transpire in your home, with your kids, with your partner, and so having that shared responsibility, shared systems with your partner, or if you don’t have a partner, with your care network. Your neighbors, your family, your friends, is really important, and it’s okay to ask. 

Crissy

Absolutely! Thank you for sharing that. Christy.