HER Expert Panel
Winter Roundtable

HER Health Collective roundtables provide an opportunity for us to bring our panel of experts together to discuss important issues that are relevant to mothers in our community. The topics discussed in this session include: Improving access to care – reaching low-income mothers and families, improve collaboration in the health and wellness industry (when and where to refer), changing societal conversations and the structure of an antiquated system.

Featuring:
HER Expert Panelists

Introductions

Crissy:

Thank you so much everybody for being here. We are so excited to jump into our fourth round table of 2020.

 

Very quickly, just to introduce HER Health Collective, our mission is to revolutionize the way moms take care of themselves. We do this by providing a supportive community, and trusted experts and resources. Our mission is supported by our HER Expert team, which is a collaborative effort of women’s health experts from a variety of different industries all working together to serve moms and provide them with the care they need and deserve.

 

We are based on three core values, the first of which is a holistic approach to health. We recognized the importance of balancing physical, mental and emotional health. Second, is empowering women. We know that women can make informed decisions if we give them access to trustworthy knowledge and a supportive community along the way. And finally, and perhaps most importantly, is respecting each mother’s unique story and where she is at in her own personal journey. Every woman is unique and we believe that our approach to health and wellness needs to reflect that.

 

We are honored to be joined today by our 2020 Expert Panel and I have to say that this particular roundtable is probably the one I have been most excited about simply because of the importance and timeliness of the topics.

 

So without further ado, I’m going to turn this over to our panelists and quickly let them introduce themselves before we go ahead and dive into our first question.

 

I believe we are starting with Adrienne. Do you want to go ahead and introduce yourself?

 

Adrienne Alden:

I am a couples therapist who works mainly with sexual dysfunction though I do see individuals with the hope of understanding relationship struggles and sexual struggles as well.

 

Dr. Amanda Seavey:

I’m Amanda Seavey and I am a licensed psychologist.

 

Anna Lutz:

I’m Anna Lutz and I’m a registered dietician that specializes in family feeding and eating disorders.

 

Dr. Lindsay Moses:

I’m Lindsay Moses and I am a physical therapist that specializes in pelvic health at Grace Physical Therapy.

 

Dr Sierakowsky:

Hi Everybody.  Dr. Elizabeth Sierakowsky. I’m also pumping because “moms groups,” there’s that (laughing). Very exciting. I’m a doctor of family medicine, conventionally trained, as well as a functionally trained physician and I also own a practice in North Raleigh.

 

Dr. Lindsay Mumma:

I’m Lindsay Mumma. I’m a chiropractor and I specialize in core health and women’s health in North Raleigh.

Question #1: Improving Access to Care

Cindi:

I’m going to go ahead and get us started on our first question, because this is such an exciting roundtable to be part of today. This question is not going to be directed to any particular expert, so I’ll just say the question and if you have anything to add, feel free to hop off mute and get the discussion started.

 

What do you see as the biggest financial struggle families face due to health care needs?

In a perfect world, what do you envision as a solution?

 

Dr. Sierakowski:

I read a headline this morning that said that by 2040, one in three dollars spent on anything in the United States will be spent on health care. One in three dollars spent on literally anything. We already knew that as of the 1950’s a very small amount of money was spent on healthcare and a very large amount of money on what we ate and how we took care of ourselves. This is very much reversed in general in most of America.

 

I think for me, doing what I do and this is difficult sometimes, I run a cash only membership type clinic and that has a connotation to it. I won’t go down that rabbit hole for why I choose to do that, but it’s largely because I can affect care that way. I used to work in lots of different capacities. All of my training was in underserved really difficult populations. I’ve done a lot of work with the homeless, underserved inner-city, coal miners, and power plant workers.

 

Very much, the solution to me is empowerment to the individual. The reason we never used to spend money on healthcare is because it wasn’t available, right? Your doctor was really far away and really expensive and probably wasn’t going to help anyway. You learn as a family how to take care of injuries and what herbs are available when you have indigestion and how not to poke your eye out, I guess, but there’s a level of self-knowledge that we’ve gotten away from while simultaneously becoming hyper-aware of every body function and how all of it should be a particular way. I use that word  “should” on purpose because I don’t like the word “should.” Every body is different. Personally, I think the solution, 100% is empowerment, not disempowerment. We need to spend less, because we need it less. That would be my hope, my dream.

 

Adrienne Alden:

I just finished taking a long training at the Racial Equity Institute in Greensboro, which I highly recommend everybody take that powerful, life-changing experience. I think if you are saying in the “perfect world,” what do I envision as the solution? I say some collaboration.

 

I think on purpose historically our country has separated people so that they can’t work together, because that keeps the people in power that want to be in power. I think learning, looking at and getting creative about ways for people who have been purposely separated to be able to get together. For example, for poor white people to be able to collaborate with people of color which has been purposely separated for a long time. I think it would be pretty powerful to counteract some of that.  It’s my perfect world “idea.”

 

Dr. Mumma: 

I had a cash practice for the first seven years of my practice and it was really great because there was very low stress, very low overhead. I wanted to be able to help more people. I had the idea that I wanted to be able to accept medicaid. I still do not accept medicaid because the number of hoops to be able to jump through in order to be able to see patients is astronomical.

 

Something that I have found is that, (and it is something that I knew before I got into network insurance companies) in the past year of being a network provider, I have found some sad statistics just within my own practice in that I actually had to raise my prices when I started accepting insurance because of the legal contracts that I signed with insurance companies.

 

Insurance pays for short term problem solving and it doesn’t pay for long term solutions, so we end up in this kind of rock-and-a-hard-place of “I can’t afford to do these things, but my insurance will pay for this other thing and then therefore I can afford it because I have my insurance,” but the insurance is not paying us [doctors] fairly for top of line care or clinically informed best decision making care. Insurance is really paying for a kind of low-lying fruit.

 

There are some wonderful life-saving procedures that insurance does pay for but when it comes to the upkeep of general health and wellness, insurance doesn’t really pay for that.

 

As a society, we’ve gotten really used to expecting that since we pay into the system, we would get things out of the system and we would be able to rely on our insurance to help take care of us, but it doesn’t. And then because it’s expensive to pay for our insurance, we don’t want to pay out of pocket for things, but if we don’t pay out of of pocket for them then our health care costs will only continue to go up and so it is this rock-and-a-hard-place that a lot of families struggle with of not being able to pay for out of pocket costs for things that insurance doesn’t pay for, but not paying for them leads to further detriment in our health because so much of our healing doesn’t occur in those short term problem solving things that don’t have long term solutions.

 

I don’t have a perfect world solution for this because I think it is such a multifaceted problem, but I think recognizing that I don’t expect my insurance to take care of me on a personal basis, because I expect my insurance to only save me from catastrophe. I can’t count on it.

 

I see Dr. Sierakowski because she is the best of the best. She doesn’t accept insurance but I need to pay for the care that she gives because that’s the top of the line care that I want for myself and that’s something that my family has to budget for in order to make that happen because she is worth that. That’s not always available and I get that. I don’t have a perfect world solution.

 

I think it’s just a common struggle that regardless of circumstance we are all in this position of having healthcare that looks more like sick care but only getting sick care paid for, so then living in this kind of “low level of not quite well but not fully sick” is where most of society tends to find itself.

 

Dr. Sierakowsky:

I can kind of piggy-back on this a little bit. I had two further thoughts. One has to do with the nature of the question you asked and it’s really the struggle that a family faces and a family’s struggle is different than an individual’s struggle right now.

 

I had another interesting conversation this week where somebody told me “I basically have to pick my favorite child and get that one the special care. Then what do you do with the other ones, do you kind of let them go through the regular mill because they don’t need as much?” It was kind of a microcosm of what you see in society, that the squeaky wheel gets the grease kind of thing and so someone who has the most need gets the most attention, and the family members or the individuals who have less need just don’t get paid attention to. There’s no focus on the physiology, the optimizing. We’re so busy scraping people off the floor.  That hasn’t changed in a long time and … mom brains, I completely forgot what number 2 was…sorry! Man, it was a good one. I don’t remember…Oh well, I’ll think about it.

 

Crissy: 

We can always come back to you, Dr. S…

 

Well thank you very much everybody for hopping in on this. This next question is kind of in the same vein, so if at any time that thought comes back to you…You’ve got it? Go!

 

Dr Sierakowski:

Nurse Practitioners, PAs. Somehow the letters MD has still superseded everything and that’s a problem. It’s a major problem. People do not need my expertise for all of their issues. I have a phenomenal Nurse Practitioner who works with me who costs less than I do because her training cost less than mine did. She’s not triple board certified. She didn’t need to go to school for as many years as I did and that’s the point.  If we’re able to utilize varying levels of training and let people be experts in what they are and expand that and the respect for every person and their role, phenomenal.

 

There’s a number of people that I try to refer back out to go pay a health coach. Here’s your plan from me and somebody who costs a lot less than I do can help you with the nitty-gritty. I have people call me and say, “but I need you to tell me what tea to buy at the grocery store because I don’t trust anybody else.”  I’m not kidding!

 

That’s why it’s expensive. You don’t need me to tell you that.  Anyway, a lot of people, a lot of levels of expertise and I think we can levy that. It would be really helpful.

Question #2: Creating More Equitable Care

Crissy:

Thank you, everybody. The second question: According to CDC, black, American Indian, and Alaskan Native women are two to three times more likely to die from pregnancy related causes than white women. This disparity increases with age. What changes need to happen to create more equitable care for mothers?



Adrienne Alden:

I would say, education. I need to stay committed to learning about what is going on with people in my community, people of color. I need to understand what the issues are and I need to stay committed to doing that for my entire career. I think we need to ask everyone who is taking care of people to do the same. It’s life and death.



Dr. Sierakowsky:

Adrienne, I’ve not had some of the specialized training that you’ve had. I’ve had some kind of sprinkled throughout my career in places that it comes up. But ultimately, what I’ve found is being the educator, I’m an outsider, always.

 

Many times, I can show up as passionate and loving and kind as I can possibly be, but if that knowledge is perceived as coming from “somebody else in some other community.” I’m sure that applies to me and clearly not to this community for whatever reason, we’re going to have a really hard time. I think it’s why La Leche League did great work and there’s some other community based…New Zealand, phenomenal, phenomenal stories, and the way that some of their more indigenous people have then become part of politics. They’ve become empowered to make changes in their community because they’re already respected there. I think the power needs to go back to those people and let the education come from within.



Adrienne Alden:

I was just thinking about these disparities. I’m just remembering it was not until 1963 that black doctors were allowed access for their patients to the technology in white hospitals. That was not that long ago. I think it’s just a helpful reminder of where we are in this journey. There is work to do.

 

Dr. Seavey:

One factor I’ll just throw out, that I think you guys are touching on more broadly is this idea of the social determinants of health. There’s so much complexity. We think about some very limited things as impacting our health, when to the earlier question even, like our mental health actually determines a lot of what our physical health is doing.

 

Talking about these things as separate, and not talking about families, and communities, and systemic racism, and all of these things, they all impact health. It’s complex and I certainly don’t feel like I have a good sense of where the answers lie, but I think that talking about it and allowing for that complexity and  looking at it that way is a place to begin.

 

Dr. Mumma:

I completely agree with us recognizing how many different facets affect our health and talking about it. When I first learned about the racial disparities that face the women that I’m primarily seeing, I just started talking to all of my patients about it and  I include it in my childbirth education. If it’s a group of white women in my class, I’m still going to talk about the racial disparities in our country because it might not affect them in their body but it’s affecting their community and being aware of that.

 

Also ensuring that my patients do know about that. It surprised me the number of patients that I told that statistic to who were completely unaware of that. So, regardless of the care that they have letting them know, ‘Hey, at this point in our country, you are more likely to die giving birth than I am as a white woman. We need to do absolutely everything within our power to ensure that you are with a provider who is hearing you and who is acknowledging the things you are bringing into their office or into their triage and that the entire time you are there, you are being respected in your full humanity, because if not, it is time to get a new provider.”

 

You need to be adamant about not allowing providers who are displaying any of the biases to continue those practices and so ensuring that patients are aware that a yellow flag very quickly becomes a red flag. If they are not sensing any of the flags, that they are aware of what these early warning signs can actually be telling us.

 

I’m not sure who said it in the beginning (Adrienne) but it is a matter of life and death. Ensuring that patients are actually educated about statistical information the same way that I inform my patients of the statistical information that is available regarding different procedures. I want to let them know what their statistics on survival rates on pregnancy and the early postpartum time period are.

Question #3: Perfection, Vulnerability & Mentality Shifts

Cindi:

Does anyone have anything more to add to that question? All right then, we’ll move on to our third question. It is…Why do so many mothers feel pressure to be perfect? Why is it so hard for so many women to be vulnerable? What needs to be done to shift these mentalities?

 

Dr. Seavey:

One of my favorite topics. No one is surprised to hear me speak on this one. I think this idea of perfectionism is really interesting and often misunderstood. We think of it as this sort of like, relentless pursuit of success, right? Having this desire for achievement. But I think that really what’s underneath that is more fear and avoidance…the fear of rejection, of abandonment, of judgement, of loneliness, of all sorts of things. I think it’s driven by a deep sense of unworthiness and the idea that these are really old stories for a lot of us. They are probably decades old for many.

 

I think that we tie our achievement to our self-worth, we think of what we do as who we are, and that becomes hugely problematic because that is not the case at all. What I do and who I am are very, very different things. I think that is something to kind of dig into there.

 

I also think there is this piece of vulnerability. Vulnerability begets vulnerability as they say. But also, vulnerability is the way that we connect. That’s it. It is a prerequisite for connection. Without that vulnerability we are not able to form relationships.  Relationships are formed through like, “Hey see that person over there. She seems super perfect and intimidating. Right? It’s almost like “Oh my gosh, they are like me, thank goodness I’m not alone” and we reach out and we connect that way.

 

I think that it’s looking at vulnerability and imperfection as opportunity, as really the glue that holds us all together to one another. I think there’s so much opportunity there. So much so, that I don’t actually talk about it with people, this idea of “we must accept that we make mistakes, that we aren’t perfect.” No, no, no. Celebrate it. Congratulate ourselves on our mistake making because I actually think that means we are putting ourselves out there and challenging ourselves and taking risks and really living life to its fullest.

 

Dr. Moses:

I had a patient come in last week and she is 14 weeks pregnant with her first child. She showed me on her phone a picture of an influencer that she follows that had just given birth eight weeks ago and this woman was showing off her very defined abdomen. She said, “What do we have to do to get me ready to look like that when I come back and see you postpartum?” And my mouth just dropped.

 

I wish I could say that it was the first time I’ve had that conversation with patients, but it’s really not. I talk to so many women both pre and postpartum and a lot of women come in with their birth plan and a plan of what they want their postpartum period to look like. It’s this checklist… “I want this to happen, I want to be breastfeeding, I want a vaginal delivery, I want the baby in the room if I’m delivering in the hospital right after, and by six weeks I want to be getting back into my exercise program.“

 

I think what we can do as providers is just start to have conversations early on, that there are so many options and there’s not a right way to do everything. If it doesn’t play out this way, here’s option A, B, and C and this is how that might play out, and these are what the repercussions of that might be. Just kind of allow women to explore all the options that are out there so if their plan doesn’t go as they intended it to, that they are not distraught by that. So they’re not feeling that disappointment and failure that comes along with some of these things, like not being able to deliver vaginally.

 

Anna Lutz:

And I think to your point, so much of this perfectionism comes from social media which is getting us more and more detached from each other. We’re less vulnerable because everything is kind of glossy through social media.

 

In this Responsive Feeding Conference I’ve been doing the last couple of days, the speaker showed a picture of what a school lunch looked like in the 90s and it was like a brown bag with a peanut butter and jelly sandwich, a bag of chips, and a couple of oreos. You can imagine what a lunch is supposed to look like now. It’s a multicolored rainbow bento box, you know, it looked “perfect,” But these are the messages we are all seeing, and then we think that as a mom we need to do all the things Dr. Moses just said, to have the baby. And then we also need to then feed our children in this certain “perfect” way. I think that pressure has such a health consequence on us as moms but then certainly has a health consequence on our children, because they feel that.

 

I’m trying to remember the last part of your question which was “what’s to be done to shift that.” I think that real connection, which is what Dr. Seavey was saying, is real conversations and getting away from social media and this kind of perfect parent culture that I think our generation is experiencing way more than in generations before us.

 

Dr. Sierakoswky:

I just want to reiterate what Dr. Moses just said. There is not a perfect way to do anything. This concept that there is some kind of perfect way to do everything and that’s what we’re all supposed to be is pretty mind-blowing.

 

And Anna, the brown paper bag is such a prime example. I was just having this conversation with my mom who was talking me down from the ledge being like, “Elizabeth. Stop. Stop. You have a baby. You have multiple jobs, you’re a business owner, you’re la-la-la,” She goes, “Ya know when you grew up, we didn’t have a cute yard, the house wasn’t put together. We had kids everywhere, and the bush was mangled because kids kept running into it with their bicycles, and it was fine. That’s how you grew up.”

 

But I think so much of this is that water level. I find that a lot of women don’t think they are trying to be perfect. A lot of times they don’t. I think they are just trying to survive. But the concept of survival is that my yard is put together because I am an appropriate member of my HOA, and my kids are not the smelly kids in class and they at least decently look nice and they don’t have greasy hair. I don’t know, it was just different. We just have a different concept of what it is to survive now and it is way out of whack, way out of whack.

 

Anna Lutz:

You know I want to make the point, because of what I do, I see that pressure for women to have to look a certain way, but also they have to have children that look a certain way and their bodies need to look a certain way, and they need to eat a certain way, and that as a mom I’m a total failure if my child doesn’t eat Kale and Quinoa and all the things. The immense pressure that it is then putting on the next generation in addition to our generation of mothers. And again, I really attribute this to the bigger culture of moms, and what it means to be the perfect mom, or what it means to be “a good mom.”

 

Dr. Moses:

That patient that I was just referring to, I grabbed my phone and opened up Instagram and I pulled up the Vagina Whisperers page. If you don’t follow her I highly recommend it. But, she’s been doing what she calls V-Hive unfiltered and she’s been posting real pictures of real moms postpartum. So when my patient was showing me the picture of the influencer with the six-pack, I was like, “This is probably more like what we are looking at…and that’s ok.”

 

I am going to make a more conscious effort as a provider to pull up more of those pictures and say this is more real and this is normal and healthy. And, yeah, I do think that social media unfortunately is to blame for so much of this perfect image. I appreciate people like [the Vagina Whisperer] on social media for giving us a different perspective to look at.

 

Adrienne Alden:

I think we all know this, but for people who will watch this later, there’s a lot of people and organizations that stand to make a lot of money for us women to not like ourselves. I haven’t looked at the stats in the last couple of years, but the last time I looked, I think it was 2016 or something, but it was just the diet industry. Just diets, not gyms, plastic surgery, wrinkle creams, just diets. It was like $17 Billion or something.  Like we wouldn’t be buying all this stuff if we liked ourselves. So, just a reminder…that’s part of it.



Dr. Mumma:

I think Dr. Moses explained about putting information out on Social media. I think as providers, I take it as part of my responsibility. Not all of my patients follow me on social media and not all my followers are my patients, but I am a professional in the face of taking care of families and so I want to share honestly and openly about how things are from other accounts that are sharing wonderful things, like the Vagina Whisperer, but then also on my own personal account.

 

I very much do not share a highlight reel on my social media very much on purpose. There are several reasons. One, because I recognize the need to show great things. The more unpolished and unfinished the information was, the more interactions I was able to have with people which then led me to believe that if I was putting out this perfect product, people were less likely to actually engage with it. They might look at it, they might click on it, but they’re not necessarily getting as much out of it because it looks a little too good to be true and I don’t like that approach to things. I want things that are honest and open. And so I share my own stuff. If I’m having a bad day, and I’m breaking down and crying, I have no problem with being on social media and talking about that because sometimes that’s part of being a parent and I’m just having a hard day right now, and life is not easy. If I’m having a really joyful day, sharing that, but that’s not always what I share. I like to share other accounts that are very real and raw and vulnerable and open, and I like to take that approach to my own social media channel.

 

2018 was the first time I did a “SHOULD” detox. I actually just talked to two of my friends about this and we are doing it through Christmas. Anyone is welcome to join us if you would like to. I would catch myself saying, “Oh, I should do…fill in the blanks…” not even if I said it out loud, but the thought that “I should do something” and then I would ask myself “says who?” And if it wasn’t something that was necessary, then why “should” I and so I kind of stopped “should-ing” on myself.


I did it for a month in 2018 for the first time and it was such a game-changer for me. It allowed me to let go of a lot of the things I was holding onto to be perfect and explore the reasons as to why I was chasing those things down. I also think that Carol Dweck’s work on this is really helpful. She wrote the book MindSet and talks about a growth mindset. It goes back to what Dr Seavey was talking about and recognizing we can celebrate our failures as opposed to just accepting them. I think the world would be a lot better if everyone had a copy of every single Brene Brown book because then we could all hear about how we are able to derive connections through vulnerability. I think those are really, really helpful things.

I need to stay committed to learning about what is going on with people in my community, people of color. I need to understand what the issues are and I need to stay committed to doing that for my entire career. I think we need to ask everyone who is taking care of people to do the same. It’s life and death.

- Adrienne Alden

Question #4: Improving Collaboration & Maternal Care

Crissy:

Thank you so much, everybody. Does anybody have any final thoughts on that question before we pose our final question? Ok. What do you envision as an ideal model of care for moms. What needs to happen to improve collaboration across the health and wellness industries?  How can we modify the structure of our antiquated system to better benefit mothers?

 

Dr. Moses:

I can kick this off as far as physical therapy goes. In most European countries, it is very standard of care for women to receive six free postpartum physical therapy visits. I think in this country you are lucky if the average provider asks any questions at your six week postpartum visit, with the exception of some wonderful doctors locally. But I don’t think that is the norm. For my postpartum visit, I was asked if I needed some birth control. I think that was the extent of it. Women, of course, are embarrassed to ask some of the questions and talk about some of the topics that are plaguing them in the postpartum period.

 

I think that it is crucial, as providers, we try to get ourselves out there and market our skills and our services. I know at Grace PT we go to Emerald Doulas quarterly and we talk to their pregnancy group and we just let women know that these are some common issues that you might experience postpartum. Although they’re common, they’re not normal. If we can catch those women in that postpartum period and identify those issues I think we are saving them from a lifetime of some really debilitating problems.

 

I see women in their 60s, 70s and 80s that have been incontinent since they were in their 20s and 30s but they assumed that was just par for the course because their moms told them that you have a kid and you pee on yourself and you laugh and it’s normal. Normal, no. Common, yes. Trying to identify these issues really early on in the process I think would be a really good step in the right direction in our health system.

 

Dr. Seavey:

As a provider it’s pretty isolating out there in the private practice world. Knowing other providers and other fields to be able to refer to or consult with, just have a conversation with, I think is so important. And unfortunately it is surprisingly difficult. Which is why I think this is such an amazing thing that we’re doing here. I mean there are so many faces here of people that I didn’t know before, that now I have mentioned to patients and will continue to in the future saying things like, “Hey, you know who you should reach out to,” and “Let’s put you in touch with…” I think there is an issue there of isolation that you have to fight against to make those connections so that you can offer that sense of community to moms who come in and really want to know where to go, who do I get help for this or that, and just knowing the people in the community who are providers is so important.

 

Anna Lutz:

I think having an element of peer support. Some of the birth centers do that, having groups available for women at certain stages, either before they have their baby or postpartum, because I think our more traditional model is just kind of “check off these boxes” and ”ask these questions” and you are so, so isolated. But if you had a community of people who could talk about what is going on, going through the same things, know ahead of time what you are going to deal with…

 

I remember when I had my first child, who is now 14, I had no idea what postpartum was going to be like. I think it would have been so helpful to have had at least one woman who could tell me what postpartum was going to be like. I think that both the peer interaction and a connection with other providers so the information is flowing, going back and forth, and people are feeling supported.



Dr. Sierakowski:

I absolutely agree that peer collaboration and peer comfort has to exist because how else, as an individual mom, can you know what’s out there if you don’t know what’s out there? I remember being very feisty. Part of it was the hormones and I was very pregnant and there were commercials that were getting banned about Frieda Baby and the peri bottles and various things. It was not a graphic commercial. It was a commercial of a mom. It did show the underwear, there was nothing in it. The concept of her sitting on the toilet, very uncomfortably, with a brand new baby and the baby is crying and she is trying to do all these things, and the whole concept…it said, “It doesn’t have to be this hard. We’ve got stuff.”

 

The comments were: Nobody needs to see this. Unless they need it. Basically if you are a mom, and you need it, you can go find this information by yourself. But if you don’t know it’s out there, you can’t look for it. Right? This is the whole concept of what the problem is. I mean, I remember growing up and tampon and pad commercials were horrifying and they weren’t out there because nobody needs to see that. But, guess what? We do!

 

And so, normalizing motherhood transitions and all parts of it, not just around prenatal and postpartum, but also about being a mom and having children, whatever that means for you. If it means trying to raise, or teach, or work, or maybe care give for other sick, older…there are so many aspects to being an adult woman who identifies as a mom for whatever way. And that requires information, it requires an outlet and it requires groups.

 

It’s almost like women are sponges for the first baby, right? The first one it’s, “I don’t know anything. I need to know everything,” and then you do it, you get through it and then somehow it’s almost like, I guess it was fine. It’s was fine enough that I don’t need to ask any more questions. It’s not a sensation of “I’ve got this.”  It’s more like “I feel like I’m supposed to got this,” so “I’m not going to ask anybody any questions.” And that’s a major problem. Every kid is different, even if you have a really great first one, every experience is different and being able to do that.

 

You know, every time you get your knee operated on they don’t go “well you did rehab once, you don’t need to do that again.” I think normalizing the questions [are] really important.

 

Dr. Mumma:

Dr Sierakowski just pointed out something so important which is, the learning that happens for subsequent pregnancies is often overlooked because you made it through the first one. It doesn’t necessarily mean that it was a wonderful experience and… I joke that I have no idea how I got on this mailing list, but I’m on the Massachusetts General OB-GYN mailing list, I don’t know what class I did or how I got on it, but I get it. It’s a nice newsletter and they share relevant studies and information, so it is quite valuable, and whenever I get a good one, I usually will share it on my social media. I shared one, I think it was earlier this summer, and they talked about how there were women who were at greater risk of having preterm birth. They interviewed these women and they were women of color who have not been informed that they were at greater risk of subsequent preterm birth, despite having already had a preterm birth, which increases the likelihood of preterm birth and there are racial disparities for this as well. They all said that they were given pamphlets when they were at the hospital. So I think that there is this element of “Education” that happens through handing someone a flyer. The same way that we ask the postpartum depression screening question at baby’s first visit. We are kind of overlooking a very broad opportunity of education of parents because they are in the complete overwhelm of new parenthood.

 

When we have opportunities to connect with these parents, when they are not immediately postpartum, or when the visit isn’t actually scheduled for the baby at the pediatrician, we could do a better job. Not just because somebody has already made it through pregnancy and postpartum and “X” number of years of parenting, that we assume that they know things, but maybe asking questions if they want a different situation this time. “Do you want a different outcome? Do you want your birth to look like the first time?” And even if they had a good experience, maybe they don’t even remember all the pieces and parts that made it great because they haven’t slept in two years, or whatever the case. Having in-depth conversations with providers is important, not just for the first time parents but also in subsequent pregnancies in order to insure that patients have as much information as they want and as much information as they absolutely need.

 

Dr. Sierakowski:

I was reading over the question again and “What needs to happen to improve collaboration?” As providers, we have tremendous responsibilities. I think we can continue to work on that, but I think we can also spread the word that there’s a lot of “taking back your data” and reminding the people that we do interact with and they can remind other people. We can spread this really quickly. “Your data is yours. Your health appointments are yours and your feelings are yours. They are valid and real and they need attention. If you have an interaction with someone who is supposed to be an expert or know more than you do, and they don’t make you feel heard or any better, or you leave feeling small or insignificant, you absolutely have the power and right to seek another opinion. And so, as a person, as a human being, you deserve to be heard. You can take your health records with you. No one needs to own that for you.” It’s really important.

 

Adrienne Alden:

What you were just saying reminded me, I think we can all normalize asking providers to collaborate. Like asking your psychologist to call your gynecologist…Asking your therapist to call your doctor…I highly encourage all of us to do that. And to remind patients to remind their providers of that.

 

Cindi:

Yes, it would be so wonderful if all of our providers collaborated. And as we are looking at the time, we just want to be extremely respectful to everyone. It is so hard to imagine and to  comprehend that we are wrapping up our fourth and final roundtable of the year 2020, and oh, what a year it is.

 

We are so grateful to all of our expert panelists. You have just been amazing to work with this year. It is through this collaboration that HER Health Collective will be able to bring change to the way moms take care of themselves.

 

We are trying to educate moms on the important topics as well as providing them with efficient access to a library of highly recommended professionals. This will help moms feel less overwhelmed and more empowered about decisions concerning their health and the health of their family. With us providing this to the moms, we’re hoping that they will in turn take better care of themselves, and this will therefore ripple out to affect their family and community and ultimately the world. Again thank you so much! We are really grateful to everybody that participated, all of the members that joined in, and came to watch. Thank you so much for everything. This has been wonderful.

Full bios on each of our expert panelists and access to their individual pages can be found here.

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