Postpartum Care, Battling Burnout & Barriers to Care:
A Roundtable Discussion

The second HER Health Collective Roundtable of 2022 discusses how mothers can best navigate the postpartum period, who should be a part of that postpartum care support team, how parents from different socioeconomic backgrounds can access the care they need, different approaches to finding balance in life (particularly as a parent), and how to approach difficult parenting decisions when overwhelmed by information from outside sources.

Featuring 2022 HER Expert Panelists

The second HER Health Collective Roundtable of 2022 featured the following HER Expert panelists:

 

  • Emily Chaffee – Certified Birth & Postpartum Doula, Massage and Bodywork Therapist, Certified Educator of Infant Massage, Fertility Specialist, founder & owner Carolina Birth & Wellness
  • Blair Cuneo – Functional Medicine PA 
  • Kerry Jones – RD – Pediatric and Maternal Nutrition – Milestones Nutrition
  • Maris Feeley – Birth and Postpartum Doula and co-owner of Carolina Birth & Wellness
  • Erayna Sargent – Founder Hooky Wellness
  • Dr. Lisa Folden – Licensed Physical Therapist, NASM Certified Behavior Change Specialist, owner Healthy Phit Physical Therapy
  • Katherine Andrew- RD – Digestion and Hormones – Katherine Andrew Nutrition
  • Dr. Florencia Segura – Pediatrician at Einstein Pediatrics
  • Dr. Holly Durney – Physical Therapist – Women’s health and orthopedics 
  • Dr. Erika Aragona – Dual board-certified family medicine physician with a focus on preventive medicine and women’s health

Transcript:

Crissy  

HER Health Collective host 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 actually found that these roundtables are typically our most well liked episodes. Today, we are delighted to discuss how mothers can best navigate the postpartum period, who should be a part of that postpartum care support team, how parents from different socio economic backgrounds can access the care that they need. Different approaches to finding balance in life. Balance might be a laughable term, we’ll talk about that, but particularly as a parent, and how to approach difficult parenting decisions when overwhelmed by information from outside sources. Today, we are honored to be joined by several of our 2022 HER  Expert Panelists. We are 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 experts voice and have a better idea of who is speaking during our upcoming conversation. So in no particular order, Emily, can you hop off and say hi, please?

Emily Chaffee  

Hi everyone. I am Emily Chaffee. I am a birth and fertility doula and I co own Carolina birth and wellness.

Crissy  

Thank you, Blair. 

Blair Cuneo  

Hey, guys, my name is Blair Cuneo. I’m a functional medicine pa treating pediatrics and adults. I work at Carolina Total Wellness in Raleigh. Thank you, Carrie. Hi, I’m

Kerry Jones  

Kerry Jones. I am a pediatric and maternal registered dietitian and I’m the owner of milestones pediatric maternal nutrition.

Crissy  

Thank you, Maris.

Maris Feeley  

Hi, I’m Maris Feeley. I am a birth and postpartum doula as well as the other co owner of Carolina birth and wellness.

Crissy  

Thank you Erayna.

Erayna Sargent  

Hi, I’m Erayna Sargent. I’m the founder and chief anti burnout champion at hooky wellness. Yes, like play hooky. I focus on helping high performance professionals understand what burnout is isn’t and what they can start doing about it.

Crissy  

Love it. Thank you. Dr. Folden. Are you able to say hi?

Dr. Lisa Folden  

I can and true mommy passion. I’m driving from carpool but I’m Dr. Lisa Folden. I’m a licensed physical therapist and an NASM certified behavior change specialist or health coach. I own healthy fit physical therapy and wellness consultants in Charlotte, North Carolina and I specialize in helping busy moms find their healthy without dieting.

Crissy  

Thank you, Katherine?

Katherine Andrew  

Hey, I’m Katherine Andrew. I’m a registered dietitian in Raleigh and I own my own practice, Katherine Andrew Nutrition and focus specifically on digestion and hormones.

Crissy  

Thank you. Dr. Segura.

Dr. Florencia Segura  

Hi, my name is Dr. Florencio Segura. I’m a pediatrician at Einstein pediatrics in Virginia, who sees and takes care of many new parents and their babies.

Crissy  

Thank you Doctor journey. Hi, my

Dr. Holly Durney  

Hi, my name is Holly Durney. I am a doctor of physical therapy, specializing in women’s health, specifically, the orthopedic aspects of women’s health and postpartum recovery and injuries during pregnancy.

Crissy  

Thank you and Dr. Aragona. Are you able to Okay. Hi. Hi, how are you?

Dr. Erika Aragona  

I’m Dr. Erika Aragona. I’m a family medicine physician focusing on women’s health and obstetrical care.

Cindi  

We’re going to go ahead and just dive right in and get started on postpartum and what should postpartum care look like? We would specifically love examples from your respective industries, on how things are done in other countries, perhaps research you’ve seen about treatment modalities, etc. Who should make up the ideal Postpartum Support Team? And what should the baseline standard of care look like? That’s kind of loaded question. But any of you if you have something to say, we’d love to hear from you.

Dr. Erika Aragona  

 I do OB care. So it’s standard of care for us to have a six week postpartum visit, where we build in questions, specifically screening every single mom. And that way we capture any changes in mood or concerns that the patient might have or their partner. But what I’ve noticed a lot of the time is we’re missing that first six week window, right? Like what’s happening right after delivery. So the most success that I’ve had is building in my practice working with a pediatrician in my same building that sees the babies within the first week of follow up. And because we share the same hallway, we have been able to screen the mom when she’s having the baby at their first checkup if mom brings in baby. And if she has any concerns at all, I’m able then to schedule a sooner follow up. Because a lot of the time we dismiss those first couple of weeks as the adjustment period, when really the mom is struggling with postpartum significantly, but we’re dismissing it as she’s recovering from a C section and she’s exhausted or she’s recovering from a difficult vaginal delivery. So what I’ve tried to incorporate into other practices for women’s health and obstetrical care is not waiting until that first follow up visit with mom, but really capturing it with any other clinic follow-up she’s going to have with baby. And then also impatient, it’s huge, to not neglect it when they are still in the hospital. Right? We’re exhausted. I’ve had kids, I was had a C section and I was just, it was done. I want to go there. That’s a whole different topic. But you’re tired, your body’s been through torment, and you’re in a lot of pain, you’re exhausted if you’ve been up all night, or several nights, depending on how struggling your delivery was. Is it mood? Is it pain? Is it recovery? Is it stress of trying to have milk let down? Is it a combination of all of it. So we really try to now screen all moms during her OB care before she even goes into delivery or her planned or emergency c-section? Have they had a history of depression or anxiety? Have they been on medication before? And if so everyone in the care team needs to be aware to look for that because the higher propensity of then developing postpartum is there. So screening them in the building before they’re discharged with their baby is so critical. And when I say screening, I mean a doctor who knows them well who they’re comfortable talking with, if you have a random hospitalist, who does your delivery, why would you ever tell them how you’re feeling? Most people don’t, because it’s a brand new doctor. So we struggle with that. So open communication from their primary care or their main OB, documenting it in the chart. So every doctor who sees that woman is aware of her condition, or perhaps her propensity to have depression, or postpartum depression. So really, it’s those checks and balances. So in a nutshell, what I would love to advocate for is open communication from every healthcare member, and every part of the healthcare team, so that a woman who goes into the hospital already has that in place. She’s already on a medication, she’s been counseled on it. She’s not blindsided by it when she has this new baby in her arms, her body’s going through hell. And then she has to admit, you know, something that a lot of people are afraid to talk about. So we’re trying to advocate for open communication and not missing it until that six week follow up. So that’s kind of where I’m at.

Cindi  

Thank you so much, Dr. Aragona. Did anyone want to share what Postpartum Support looks like within your particular industry? What basic guidelines there might be? Whether you’re the nutritional, therapeutic, medical, what should be routine for new moms and postpartum care?

Dr. Lisa Folden  

I just wanted to jump in really quick. This is Dr. Lisa. And I think Dr. Holly would agree with me. I think that what we lack sometimes in America is that follow up with physical therapy, I don’t know but for whatever reason, we don’t treat birth even C section as like an actual major disturbance to our body’s muscles and our lifestyles really, and our functional abilities. So I would love to see more physicians, referring patients, at least for just an evaluation to a women’s health physical therapist to really ascertain how she’s doing with that recovery. And to kind of help heal the muscles of the pelvic floor and get her back to a comfortable space. I think a lot of times we just kind of dismiss like, oh, you know, you’re having incontinence issues, oh, it’s fine. You just had a baby, or oh, you know, you’re having issues, a lot of ladies with diastasis recti. And, you know, we just kind of brush it off, because it’s normal and expect it and I would really love to see us spend more time educating our patients, you know, our moms at their follow ups and making sure they’re getting, you know, the care at the very least, and evaluation.

Dr. Holly Durney  

Yeah, I’ll piggyback off of that. Dr. Lisa, definitely agree, I think that it’s it is standard, it at least in the UK, that Physiotherapy is joins the midwife team and just helps the mom understand how to recover and recoup. And rather than waiting for there to actually be an issue or traumatic delivery to refer that it’s just Okay, your six weeks post op, you’re going to have your follow up with your OB and then you’re gonna go to PT have two or three sessions, bring your baby and you’re exhausted, you know, we’ll just going to teach you a few things just to understand how to get your body back because the one of the biggest questions with which I think is a question later that I get in my profession is okay, when can I exercise, because I want to move. Um, uh, you know, I need to get my anxiety out my depression out or I want my body back, or, you know, maybe it’s actually because of an issue, but a lot of times, it’s because they, you know, just want to feel like that sense of normalcy again. And so I think just making sure there isn’t an injury or an issue down the line, that it’s a huge injury to the body to go through what the body goes through during pregnancy and delivery. And to just treat it like that. Again, I use the example you wouldn’t just let an ACL rehab itself, like in that’s a knee, you know, this is like your entire midsection. And so that is the center of back pain and sacral pain and everything. So I just think physical therapy, adding with nutrition and psychiatry, and everything should be a great part of the rehab team for postpartum.

Dr. Florencia Segura  

Yeah, I completely agree. I’m a pediatrician. And, you know, moms are asking for that. And, you know, unfortunately, it’s not as common, you know, especially depending on where you practice, we don’t have access to all of those resources. But agreeing with Doctor Aragona gonna add that screening, we are on the pediatrician side, it’s now pretty much routine for all every pediatrician visit to screen moms. And we do that with questionnaires so that it’s not like on the spot like, Hey, how are you feeling? Because if someone asks you that, you’re probably, you know, the moms gonna freeze up and say, I’m okay, I’m tired, you know, but actually doing a questionnaire where you know, moms are, you know, hopefully, you know, can think about some of, you know, what they’re going through, as well as, you know, obviously, their care, their OB care, their baby’s care, their physical therapy, also lactation, I think, would also be a very important just part just just to have moms explore that as a possibility. You know, for some moms, it’s obviously not, you know, they have trouble, the baby has trouble. But I think at least getting that getting, exploring that option. A lot of moms have doulas. So having the doulas kind of involved as well, not just at the labor, but also postpartum is also helpful as well.

Maris Feeley  

I think related to that, as a doula something that we hear and see a lot is that in line with this continuity of care, and the safety net of care that I think everyone’s speaking to, it’s really common, particularly in non western countries. I know the Philippines and Chinese culture come to mind first, just off the top of my head, to have this collective care for parents postpartum of just resting with mom and baby and having the friends and families, the women in the community care for parents postpartum by providing not just obviously, hopefully encouragement around this medical and the physical recovery aspect of it. But you know, those essentials of food, rest, newborn care so that parents can engage in self care. And that kind of social support that I think nowadays with folks moving out of their hometowns or across states all over the US at least, do doulas and that kind of social support, like the HER Health Collective right, providing that space to find that community and to find that encouragement for care. I think also prenatal planning for this too, right? Not having these conversations just postpartum. Research shows that spending 15 to 20 minutes prenatally talking about postpartum recovery, mental, emotional, physical exponentially decreases the risk of mood disorders and helps assist in that postpartum recovery and that preparation so that in addition to these postpartum screens that is incredible to see implemented, we’re also preparing and myth busting a little bit prenatally so that parents don’t put as much on themselves postpartum to be able to bounce back and do it all and all these other myths that we see.

Katherine Andrew  

Second, everything you said. And I was thinking earlier about just the cultural norms and our country in terms of the expectations that we ourselves as mothers put on ourselves postpartum to kind of jump back into everything and be able to handle it all, and be able to take care of our other children and get them to activities and sort of the multitasking that goes on. And when I hear about like nutrition to me like that is so far down the line, because all I want a woman to do is to be able to make space to eat something right to be able to like sit down and have a meal and prioritize just those daily rhythms in the space in their day and in their night to be able to get some support. And I think so much of that, as you pointed out, Maris comes from that like, understanding that it’s going to be it’s going to take more than you that you’re going to need support from someone else. And obviously, our country doesn’t do a great job with that financially. So how can we do that for each other? How can I set that up for myself? Or ourselves going into pregnancy and beyond? So I would just say yes to everything you said as well.

Emily Chaffee  

I was also going to just piggyback about the postpartum planning prenatally. That’s a huge thing that we talked with all of our clients about and having these realistic conversations, you know, not just like, oh, what color is your nursery walls going to be? And you know, that fun stuff to talk about? But like, what’s it going to be like, when you have six weeks ish of bleeding? What’s it going to be like, if you’re recovering from a cesarean birth? You know, who are the people who are going to realistically show up? And then what about planning for those people, My mother in law, who are not helpful, like, right, how do you plan that they still need to be in your life? But how do you set these kinds of boundaries up so that you’re not only having to negotiate your how to recover with your body and everything, but also dealing with these unhelpful people. And I think, you know, getting on the same page with partner also having a postpartum doula can be really helpful, because we’re able to kind of have these like mock conversations, and put out those resources and be like, hey, this seems like a little bit like not at not totally within what I would like to see during this time. Have you seen a PT? Have you heard of a PT? Have you talked to a dietitian, you know, find helping people find these resources that they don’t even necessarily know that exist, I think is really important as well.

Kerry Jones  

I second Katherine seconding everyone else that I think we all would agree we all can contribute to the postpartum space. And I love the idea of having the conversation ahead of times, especially new moms may not know what to really expect, because we get the kind of glamorized version when we’re looking on social media, or we’re looking even at maybe our friends posts, and we see Oh, it’s just okay, it’s gonna be like this. But really, that’s not kind of grounded in reality. So I think definitely taking the time to build out your village of support, so that you are really setting yourself up for success in that postpartum period is so helpful. So that when it is you’ve got the million things going on, and you’re recovering, and you are not feeling your best that you’re really you’ve already kind of taken care of yourself, then because we know, mom is so well taken care of in the prenatal period. I feel like we too often forget about mom, and we signed the switch to focusing on baby. But really, we need to think that, again, they’re both of their care matters. And we really need to support moms so that they both can thrive.

Burnout is a very complex and personal thing. And so while there are common symptoms, it can look different, we all carry different weights at different times, we all juggle different balls, and only you know, when things start to go awry.

- Erayna Sargent

Cindi  

What about parents from different socio economic backgrounds? How can these individuals seek out and advocate for the same level of care? Many times, people can’t take off their work, they have to get right back to work, after they have a child their job might not have any maternal leave in there. What do you advise in these situations?

Kerry Jones  

I think quality health care and parental support should be a right not a privilege. And so I think this is something that all of us as a country and society need to just advocate for so that we really can support these families that don’t have necessarily the resources that other families may have to kind of get the support that they need. But if someone is in this situation where they may not have the resources, or potentially, they’re kind of struggling financially, or they have multiple jobs, and they’re really navigating, I think reaching out to your health care providers. Luckily, we have made some strides that a lot of the wonderful services and health care providers have talked about, like IBCLC’s are now required to be covered by insurances. So it’s kind of a free service to kind of support you in that way. So I think reaching out to providers and organizations, whether or not they have the free resources that are covered by insurances like Medicaid, or if they have a fee-for-scale, so that you can again, at least get that health care team kind of being set up around you.

Dr. Florencia Segura  

Yeah, I absolutely agree, reaching out to your health care provider. Now at my previous job, we had a whole fortunately, group of resources, of lactation consultants that would work with our patients and support groups. And, you know, our social worker would also work with new moms. So there is there is stuff out there, it’s a little bit harder to find. Unfortunately, it should not be like that, it should be a right. And it should exactly like you said, and it should be accessible for everyone, but definitely reaching out to your OB, healthcare provider or pediatrician is probably the first step.

Dr. Lisa Folden  

I was also going to suggest to, because I know in some cases, people, especially if they’re in a situation, where they don’t feel, I don’t know, seen or heard by their healthcare practitioners, or they just don’t have a very comfortable relationship with them and don’t necessarily feel like you know, they can share and be open about their situation. You know, Google can be you know, a good friend, because you guys are right, there are tons of programs out there, you just, they’re just not mainstream, we don’t always know about them. And for people who are local, I partnered with an organization called Families Forward Charlotte, and they have a great program specifically targeted to families that are living in poverty, to help them and it’s literally help them with everything. So if it’s, you know, paying bills, if it’s, you know, getting education, if it’s getting a new job, if it’s, you know, does postpartum care, like they try to connect you with experts and resources, and I personally do speaking engagements with them, where I talk about, you know, topics related to motherhood and things like that. So, getting out there to these organizations, and these these companies and these, these grant programs, you know, that have been put together to kind of help give people the support they need. And yes, it can be tough to find, but they do exist. So the more of us that know about them, the more we can share with our clients and advocate and you know, be a representative in these organizations that may need some help on the health care front, giving people access to information that they may not be getting already.

Crissy  

Thank you so much. We are going to shift gears just a little bit. This is a power packed virtual room. There’s a lot of impressive individuals here. You are all balancing parenting, family obligations, personal hobbies, and life demands with running your own businesses and or intense work schedules. How do you balance parenting with your professional lives? And even more particular, how do you avoid parental burnout or burnout in your work life?

Erayna Sargent  

I think I’ll jump in on this one. I can talk about burnout. The Parenting angle of it is something I’m learning every day as a new mom of a four month old, it definitely gave me a different lens and appreciation for the clients that I serve. So one of the biggest things is fundamentally regardless if you’re a parent or not, but especially as a parent with limited times like it, it really is a matter of practicing what you preach and taking the actions that you know to take. What I find so often with clients and even with myself is we know we should be taking more breaks we know we should be prioritizing our well being. We know we should be meeting with the practitioners like all of the women on this call to discuss our well being and to discuss it in advance versus after there’s a problem, but it’s a lot harder to put into practice. And so what I have found as a new mom and as a new parent is the more limited my time, the more requires me to be intentional with the actions that I’m taking, and how I’m filling up my calendar. And so with that intentionality comes putting intentionality on yourself, and making sure that you are taking time for yourself and recognizing how much you have on your plate. I think with a lot of people there, a lot of us, we’re used to juggling a lot, we somehow make it work, even though we surprise ourselves and surprise those around us. And when parenting is in the mix, it’s you’re not only juggling everything for yourself, you’re juggling it for your family and for your child as well. And so it becomes a balance or what I am learning, it becomes a balance of not just doing it all. But also what is the illustration, what do I want to represent for the child that I am rearing. And so if I want my child to understand how important well being and wellness is in their life, I have to embody that myself. And so some of it requires me to remind myself of not just can I handle it, but what is the illustration of what I want, what is the illustration I want my child to see, so that he can live up to it and embrace it and have it in his life like that allows me to say no more often. That allows me to give myself permission to choose me more often. There are a lot of things that I would like to do, but recognizing I don’t have the capacity to do it. Or at least not to the level in which I would feel a success. And in some of those are like fundamental things. So the saying No, prioritizing yourself, reminding yourself that you’re not just doing it for you, but for your children. And a lot of times I find my clients are, we’d get so focused on the basics of like, I have to put food on the table, I have to make the money, I have to do the most in order to provide. But if you aren’t fully present, if you are draining yourself in order to do X, Y and Z, how are you being fully present for your child. And so it is a fun balance that I can tell you because money is important. And as an entrepreneur, that is something I’m always dealing with. But it really fundamentally comes down to being intentional with your time how you’re committing your energy, so that you’re not wasting it. So if you are going to commit, what is how much time are you going to commit? What does success look like for you. So that when you are giving your time away, and it’s taking away from your kids, you know it is for a purpose, and you’re not just spinning your wheels. I’m one that that does a lot. But I can tell you, that list got a lot shorter, because if I’m not with him, I’m doing something else. So what is the most important thing and making sure that you are on that list as well as some of the biggest things. But last thing I would say, especially when it comes to burnout is being careful not to just discount burnout and view it as just stress. Because burnout is a result of untreated chronic stress. Versus stress is something that is more of a short term thing that can have a quick fix. So when it comes to naps, when it comes to small breaks when it comes to taking walks, yes, that will help with stress. But when you get into more intense stages of burnout, that requires a lot more intense recovery and relief periods. And so I call that out because people are so now that we’re talking about it, I find it it’s getting sugar coated and discounted is like Oh, I’m just burning out, you’re like, No, no, you’re stressed. If you were dealing with burnout there, that is where you start to get into a place of potentially feeling more empty or feeling like your time and your energy is for naught and feeling like no matter how much amount of sleep, you’re never quite rested, just to name a few. There’s other commonly overlooked symptoms that are even closer to PTSD like symptoms. And really can can trigger some other deeper mental health challenges and issues and physical issues that I’m sure a lot of these doctors have seen with clients as well. So recognizing how much you have on the plate, recognizing it when it is not just normal stress is the thing that can help you go depth help you avoid going down that slippery slope that is burnout. That is a just more intense recovery process. So those are a couple dots as a new mom in balancing burnout, how to avoid it and how to give yourself that grace to choose you more often.

Blair Cuneo  

That was awesome. This is Blair Cuneo speaking, I 100% You know, that recognition and that creating space, just just describe it by Erayna. I really love the idea that I love lists, I love checking them off. I love the goals, the prior priority, and what my children say, you know, four weeks of learning that was cool. And now what is reality? Learning that I had to create the space for that list to not be completely checked off. And then that was okay. I you know, I A sense that my, my children will see the running the running of the brain or what I need to get done. And I could see that it would affect them that they would be cautious to bring something up to me. And that really brought me in touch with, I have to, I have to make a change so that they see that no matter what my household chores, or my work to do is the charts to complete, that is never as important as that interaction with my child to let them know that they are seen and they’re heard by me. And that has helped me also let go of what happens if the list isn’t completely checked off, and everything is okay. And I have to tell myself, it, whatever needs to get done will get done that day. And I think that grace that Erayna you just that word at the end, that grace that we give ourselves is so important. I’ve also learned that I have to communicate with my partner, when I am feeling it. And fortunately, I mean, we’ve had 10 years now to figure this out. But we are getting better and better at sensing it. But at the end of the day, I still have to tell him, hey, it’s been a day, I have this on my plate. And he’ll let me know, can I meet you there? Can I can I take over dinner tonight? Can I put the kids to bed or if he doesn’t have it and then can just kind of anticipate the needs of both parties. So I’m not silently resenting that he’s not helping me more something. And then finally, speaking to speaking to professional burnout, the ideas of putting in those boundaries to work, no more email checking on the weekend, and also releasing myself that I am not the result for my patients in the professional life. It’s not ultimately 100% up to me, that gave me a lot of grace and permission to take some of that pressure off. But something that I’ve integrated into some self awareness of that restorative piece with adrenal function, adrenal dysfunction, and that physical burnout, that Eryana distressing is using Infradian Rhythm Awareness, the awareness, that menstruating woman is going to have certain times during their menstrual cycle, where they are able to push it, they are able to do more with healthier cortisol levels, and the time during their menstrual cycles that we are already running high naturally on high cortisol and we really need to check in, reduce either our personal or work schedule, engage in more of the napping now is not the time to go try to do that HIIT exercise. So in working with both the physiologic awareness of what is happening within the woman’s body during menstrual cycles, has built in some intentional rest for me, or some intentional, I can I can take on these projects right now. And Infradian rhythm is a blending of the circadian rhythm with the women’s natural menstrual cycle. It’s amazing. And I can post some resources on learning about Infradian rhythm.

Emily Chaffee  

I love the cycle tracking. That’s a big part of my work as well as with my fertility education. And like understanding that there’s going to be certain times where you just don’t have it in you. So I think that’s a really powerful thing. Because yeah, you can have your list of 100 things and be like, Okay, this client needs this, this client needs that. And then everything else, but I think that we like aren’t checking in with our bodies. So we’re not like, I don’t have it in me today. Like someone else said, or it’s not, it’s not the time of the month to deal with that. But I think also, you know, these to do lists are great, but making them realistic. And then also including something for ourselves. I know, Maris and I talk about this all the time, like we’ll put the we make these master giant lists, but there’s never anything about what I’m doing for myself. And so I think just kind of like integrated into a list like okay, it’s really important for me to go walk and pick up my son from school every day. So 2:45 I’m walking, and that’s my time. And it can be so easy to be like oh no, I’ll just drive like it’s fine, but kind of reminding ourselves that like we matter too and that we’re important too. And yes, clients are important everything but we matter. Moms matter too.

Crissy  

Thank you so much for that, Emily. Yes, absolutely. Moms do matter. I love everything that was mentioned in this conversation. I think unfortunately, a lot of the discussion around burnout and what a mom or a professional can do to avoid it can kind of feel like it’s coming from a place of privilege, because certain individuals from a lower socioeconomic background might not have as many opportunities to engage in some of these behaviors that can help alleviate some of these burnout symptoms. So how might burnout look different for parents from low socioeconomic backgrounds? And what might those parents do to combat burnout?

Erayna Sargent  

I like the perspective and understanding the nuances of the different socio economic backgrounds. I think that’s a really important thing, because you’re absolutely right. Often the conversation around burnout, what do you do about it is just go to the spa. And I jokingly say, the way my bank account is, I can’t just go to Bali, every time I burn out, like just I don’t care what job I have, it doesn’t work that way. Now burnout looks similar, regardless of your socio economic status, what you can do about it can also be similar, from the fundamental pieces, the number one thing that can help you with a mitigating, navigating, avoiding finding relief with burnout is self awareness. And one of the other women also spoke to it as having an awareness of self. So burnout is a very complex and personal thing. And so while there are common symptoms, it can look different, we all carry different weights at different times, we all juggle different balls, and only you know, when things start to go awry. And so if you’re starting to say, I feel off, that is a signal, something is really off, if you are recognizing it, pay attention to it. Because so often people dismiss it, and they say, I’m fine, I’m fine, I’m fine. And then it’s, oh, my God, I’m falling apart. And so there is this gap of time and of stages, that typically happens, where we go from I’m fine to, everything’s falling apart, I feel like a failure. But those are, there’s like three stages in between, or eight phases, depending upon which research you look at. And so it’s in the recognition of my normal, I am no longer at my norm. And so by recognizing that it causes you to step back and say, start to unpack what, wait a minute, what might be driving it, because the some some of the complexity of burnout is that it manifests in different ways. It’s emotional, physical, and mental. And so by saying, Oh, wait, I’m off, oh, is it a mental thing? Am I Am I getting brain fog? Oh, is it emotional, I’m no longer able to connect, or I don’t want to connect, or I don’t want to engage with other people? Or is it physical, where it’s manifesting more in physical symptoms throughout your body, whether it’s your back or ailments, or headaches or things that are all of a sudden popping up that have no explanation, when you start to recognize something is off, then you can say what is off? Once you start to understand and unpack what is off, then you can start to understand well if this than that. So if I have physical ailments, I can go to my physical therapist, Dr. Folden and say, hey, yeah, that back or hip problem I have, it’s back and not going away. Or if I’m having more cognitive fog, where things just aren’t clicking, and I’m not able to think strategically as I normally can, maybe there’s something I need to talk to my therapist about. So I take a very pragmatic framework approach, I’m very much an MBA. So for me for complex problems, if I can have a framework, and I can start to unpack it into little things, smaller chunks. That way you can start to make dents in different ways. It is a very hairy thing. It is a lot. But we can’t just avoid it because it’s a lot so we can break it into smaller pieces, we can start to go to our different support systems. Because similar to the first question, this is all about holistic care, burnout and managing it. So you will have your physical doctors you will have your mental doctors, you will have physical therapy, you might have lactation, I was dealing with lactation issues. And I can tell you that affected me in my my motherhood, because I also had a preemie. So because I was able to get that support. After understanding which piece of it I can start to tackle. That is how you can start to wrap your head around it. And it does not matter how much money you make, to start building up that self awareness to notice and recognize something is arrived, so I can start doing something about it. Other things, someone else said boundaries are a big thing. If you start to tackle burnout, if you start to deal with burnout, you have to say no to something. And while it may not be as easy for you to say no to work, maybe there’s something else you’re doing in your free time quote unquote, or you’re volunteering that has to say you just have to say no or not now. So those type of things are very tactical and practical and overlooked as things that combat burnout that don’t cost anything. If you can go to Bali. That’s great. Put me in your luggage. That is a great way vacations and excursions are known for helping alleviate stress and mitigate other symptoms of depression and anxiety. So that’s amazing if you can But even if you can just take a half a day or an hour for yourself to sit in stillness, those type of things can do wonders and are a great place to start.

Dr. Lisa Folden  

I wanted to piggyback on that Erayna and say to when we’re talking about like, all of these practices, you know, to prevent burnout to manage our self care, you know, we have really, capitalism has really made self care, this very luxurious scenario, that yes, means you’re very privileged, means you have a lot of money, means you have a lot of time and a lot of energy, you have a whole team, a nanny, a cook. And really like that is not necessarily self care, sometimes those things take away from our self care, because of the planning, and the work and effort that’s required to even orchestrate it all. And so my favorite way, you know, to look at self care is to look at it as accessible and sustainable. Things that I can fit into my everyday life all of the time. And that might be as simple as stepping outside onto the front porch to take 10 deep breaths, and some fresh air. That might mean sitting on my back porch to look at birds fly in the air, like these things don’t require money, you know what I mean? That may be like, Honey, I need an extra hour this morning, can you get the kids ready, because I need to sleep in, you know, little things that you can do that really have no impact on your socio economic status, no impact on how much money you have available to you, no impact on whether or not you have a therapist that you can go to, you know, you can create these opportunities, I like to call them like creating, like joyous moments throughout the day, something to look forward to. And that’s particularly important, if you are struggling with your mental health or with your joy or with your happiness, or your you know, your mental state, you know, as a whole, it’s just recognizing that self care does not need to be extravagant, expensive, luxurious, or require a lot of effort, you can feed these things into your every every day, every hour if you want to. And sometimes self care is like doing a responsible thing, sometimes my self-care sitting down and organizing my bills and paying them because then guess what, I don’t have anxiety about Oh, my God, did I forget to pay this? Or did I forget to pay that it takes a load off. So it gives me some joy. And it frees my mind up, you know, for more happy thoughts and, you know, positive experiences.

Cindi  

Thank you, everyone. That was that was so great to have those very tactical suggestions. And I’m going to piggyback on all of that, because burnout goes very well, with pressure that we put on ourselves, moms are notorious for putting pressure on ourselves regarding all types of of topics. And the topic that we particularly want to talk about is decisions regarding their family. One prime example is family size, whether it’s to have a child at all, to have more children, to have less children, to have a child of a certain sex. Have you ever experienced pressure around this topic? And we just would love to open this conversation up on what types of parenting decisions you may have experienced pressure around?

Dr. Florencia Segura  

Well, as a pediatrician, I think I see this a lot. I treat families. So I see a lot of families, you know, they’ll have two boys and you know, they’ll say, Well, we’re getting, you know, family pressure to go for the girl, you know, but you know, I don’t think we’re ready yet. Or I think everyone tends to really settle into their family size. So everyone kind of has very strong opinions about their family size. And so that can obviously, sort of pressure other like the people around those people, depending on you know, so like if this, your one friend has one child, and they’re very happy, they are going to be very strong, maybe they might be very strongly, you know, very strong for, you know, the one child. And then the other thing we don’t realize is also fertility, right. So there are a lot of families that maybe one child is all that they can have, or because they went through 10 cycles of IVF. And so it is something that you have to be very delicate about how you bring up. Very often sometimes I’ll hear colleagues say oh, don’t worry, you know, we all know that it’s really hard when you’re a new mom and you have your first baby. Don’t worry when you have your second baby, it’ll be so much easier. Well, you know, I mean, we don’t know that and it’s very difficult to assume. So I think that my sort of takeaway from this is don’t assume. Everyone has their own fertility journey. Everyone has different financial resources, and just being supportive for everyone’s kind of fertility and family decisions. Sometimes families have an oops baby, and they might not have been planning for that third baby and that this is sort of the situation that they’re in. So I just think being really compassionate, empathetic, and maybe not asking too much, unless, you know, people offer that and they want that advice

Erayna Sargent  

Oh, just briefly talk. Um, so I, my husband and I have been together for 12 years and married for eight. So you can imagine the questions that have come. So definitely had the pressure of the when are we going to do the grandbaby. Not like Dr. Folden has mentioned we didn’t haven’t had any parents sue us, which I didn’t know that was a thing. But interesting thing in the news. But we definitely had grandparents who were just eager. And on my side, thankfully, my I’m the baby of three. So my parents heck had grandparent grandkids, though, it’s been a minute, my husband is oldest had his parents had not. And so we got the most pressure on it ironically from his dad. But even within the pressure, we got to a point of respect. And so we were able to just say, Yes, it is in the plans. We were clear on that, because we knew we wanted to do it. But we had decided we wanted to live our life. And it would happen when we decided was ready. And so by just being we were able, thankfully to be transparent, and and to communicate that and say, All right, take the pressure down. Please don’t ask us every single time we talk. And I’m very grateful that my in laws respected it. And so the jokes still came every so often as the grandbabies will pop up across his his, across the uncles and aunts and my father in law was jealous, basically. But he was always respectful. And I know that all family members aren’t. So we were able to communicate it, which is one of the biggest things because if you never say for us, we recognize that we didn’t say anything at all, it wasn’t going to change. And so now everybody’s super happy because we have a new baby in the family. But I think if you have a space that you can communicate and you feel uncomfortable, just let people know, and you can do it respectfully. Because if you don’t, people just won’t know.

Maris Feeley  

I would also say something that I find really helpful as a reality check is comparing Do you am I wanting something or navigating this decision because of the norms set by my environment and my community. I personally grew up in small town, Indiana, where my sister still lives. She’s in her early to mid 20s about to have her first baby and she feels behind. Because everyone we graduated high school is it’s like on their third baby already. Meanwhile, I have friends in DC and New York where I went to school and have a lot of friends sharing a meme circulating the internet right now saying, you know, being pregnant in your early 30s in New York is really weird because all of my friends think I’m a child having a child and my doctor says I’m a geriatric pregnancy. So this concept that wherever you’re at, you know, my friends from high school are definitely already have kids, my friend from college or like maybe in a serious relationship now thinking about children as something for their late 30s. And the norms set by the community around family size, or around when to have children or to stop having children or what that looks like. I think concentrating on just almost stepping back and saying like, well, what’s right decisions for us, you know, for my partnership, for my relationship, for my family, if we were to move elsewhere, am I going to suddenly feel a fish out of water there? Like, it’s not about everyone else, like the grass is greener where you water it and figuring out what’s right for you and your body and your family as well as I think, to everyone else’s point, working with in the sensitivities and the individual journeys to come to that point. And so that sense kind of also staying in your own lane when it comes to looking at what other people have to and having opinions on it.

Cindi  

Maris that’s a great segue into a follow up question that I have for everybody. Because you brought up the strain of outside forces that cause this pressure on what you believe to be best for yourself and the environmental impacts from where you live that can impact that as well. What do you do when you have outside pressure? And you need to shut out that pressure in order to choose what’s best for your particular family around various different decisions such as health and parenting? I know a struggle for us is electronics right now. The kids are getting phones. And we’re trying to push back on that. So what are you all struggling with? And how do you shut out that outside pressure to decide what’s best for your families?

Blair Cuneo  

I think something that’s been really important for me in navigating professional influx, and then also parent influx, I need to back away from social media. That means that if you are lucky enough to get a one second scroll, maybe a couple of likes, but I’m going to miss a lot of people’s lives, and maybe some baby pictures or some events that they’re doing. But for my own, I found that I was it, whether it’s a FOMO, or I should be doing this. And I just feel better and better when I am disconnected from social media. I’m not 100% disconnected, but I appreciate choosing my time in places where I feel restored and nourished. And that really is when I’m tuning in on the immediate relationships within the neighborhood, within the school or within the family. That has been helpful for me. And then in regards to professional. Gosh, in functional medicine, we’re working with both evidence based medicine from conventional traditional Western medicine, but then also learning integrative medicine and therapies and including learning alternative therapies. And that is just a lot of wormholes to go in. Professionally, as well. So I really have to focus in on organizations, and just picking sources, picking sources and credibility. And again, probably pulling myself out of the depths of the internet is helpful for my professional and personal sanity.

Erayna Sargent  

I’d say one quick thing. It I mean, it’s not always easy to block out external pressures, because they come from all around, especially social media. One thing that’s been working for myself and my husband is like, what do we believe, and that we are on the same page with it, because our opinions are the ones that matter the most. So when it all comes down to it, if we’re feeling pressure we check in with each other was is a really big thing. In one of the most important things that has helped to block out the pressure, or direct and recognizing when you’re feeling the pressure is another big one of, Wait a minute, is this even my opinion? Or is this what I feel like I have to do, which is similar to what Maris was saying about where you’re coming from and how your raised and the expectation and oh, wait, is this what I want? Or is this what I believe I’m supposed to do? So having some of those introspective thoughts has been really helpful in making decisions, we have a lot more decisions to come all of them. So hopefully, this continues to work even as the pressure turns up, but it has helped thus far. And then one of the last things is I am very grateful for my husband, because when things can turn up, and I need him to handle it, he can handle it. So sometimes when pressure is coming from his side, I just give him the eye and it’s like, I need you to have that conversation. Because all conversations aren’t for me to have and on the same side, sometimes I need to talk to my side. So being able to tag team it has been really helpful in if it’s not blocking out but mitigating the pressures and being able to say I got this because that I’ve seen that breakdown for other relationships, so I was able to learn from them, so that we can tag team it and handle our sides respectively.

Crissy  

There’s something very, very special about that “eye”. To wrap us up today, we would love to just kind of go real quickly through from your respective professions. What is the main question you get asked from moms? I know you get all kinds of questions, but what is one that you hear repeatedly? And what advice, in general, Do you provide moms that come to you with that question?

Emily Chaffee  

I think a big thing that we get as doulas is “Is this normal?” and kind of separating the difference between common and normal just because my sister in law’s best friend’s cousin did this. That doesn’t make it a normal aspect. Or people read online like oh, well after birth. You’re supposed To pee in your pants and so therefore, I shouldn’t seek out pelvic floor PT consultation or consult because it’s normal. And it’s normal and you know, separating like, yes, it may be normal, but that or may be common. But that doesn’t make it normal. And I think that’s a really powerful thing as doulas we’re able to be like, okay, so what you’re experiencing is something that a lot of people experience, but that doesn’t mean it’s something that you need to experience. Here is a dietitian, here’s Kerry’s phone number, you need to talk to her about this. Or here’s a pelvic floor therapist, you need to do this and like, kind of empowering people to like, be like, Okay, no, I know my normal, I don’t need to compare myself. Like what Blair was saying, like, I don’t need to compare myself on social media. I know my normal. And I’m going to seek out normal. So that’s a big thing as doulas we help navigate.

Kerry Jones  

I totally agree with that. But it’s the comparison of like, Oh, I saw that this mom ate this for breastfeeding. And then she just had the greatest supply ever. Or, Oh, I saw that you shouldn’t do this. So really, again, I totally second thing you said of really everybody’s body is unique. And just making sure that the source that you are getting that opinion from like, that’s great that that worked for that mom, but just because it worked for her doesn’t mean it’s going to work for you. And so making sure that you get that second validated credible opinion. Facebook groups are great, but you know, everybody’s got opinions. So just making sure that you’re double checking that before we’re implementing it.

Blair Cuneo  

This is Blair, the most common question that I get from moms is what supplements should my kid be on, they are definitely interested in — being inundated probably from either the neighbor, the family, the social media feed of this supplement fixes this disability fix is this. And so, fundamentally, the first thing that I hope to convey in a conversation with a parent is we cannot out supplement an inflammatory lifestyle. So it is checking in on the basics of good sleep hygiene, of nutritious foods, and checking in on the stress in the family unit, and the stress in the individual. And usually they still want supplements after that. So I will say a good multivitamin, good probiotic, Omega three, and vitamin D during winter.

Dr. Lisa Folden  

Holly mentioned before she left, that as a PT, the one of the most common questions we get is when I can return to exercise and I would second that, you know, that’s an individual process. Again, everything everyone is saying just kind of echoing the idea that you have to take this, this journey one day at a time, and consider that you’re gonna be different than your mother was, or sister was, or your friends were. So being very intentional about listening to what your body is saying. I will say the other thing that I get asked as a health coach, when I’m working with moms, they typically come to me for that question like, When can I get my body back? Can I snap back? Can we, you know, when can I do this? When can I do that and my best advice. And of course, I’m biased because I come from the Health at Every Size world and this idea of wanting to remove the stress that mothers feel when they are postpartum and wanting to, you know, lose weight really quickly and things like that I give them the advice of taking things slowly and recognizing that, you know, your body’s just did a very miraculous thing. And you may or may not return to your pre partum body, and it’s okay, so developing an attitude of respect around that, and acceptance and then just understanding that your body, you know, is is far more than an ornament, and it requires time to heal and recalibrate. And your body is supposed to change a little bit over the course of your life. So making peace with that, that’s that’s one of the biggest things we dig into.

Dr. Florencia Segura  

As a pediatrician, I the most common question I get is, Am I doing this right? And I would say that there’s very few black and whites in parenting, you know, for feeding and the new work period, I you know, it’s feed the baby, you know, whether it’s formula or breast milk, we just need your baby to grow. So I find just reassuring families, that finding sort of what works best for your family and what works best for your child is the way to go. And I have a million examples from toilet training. You know, some kids 3 day method works and some kids it takes six months. You know, I think it’s really hard. I think a lot of us have mentioned social media. I think it’s an incredibly difficult time to be a parent now with so much information out there. There’s so much information overload there’s lots of comparison. I read somewhere, like Comparison is the thief of joy like I think a lot of parents are just not feeling confident in their decision making because there’s almost a little bit too much out there. So kind of just bringing up like a lot of you guys have been saying back to the basics, and really kind of using that mom instinct and finding what works best for your family.

Cindi  

Well on behalf of Crissy and myself, we would like to extend our sincere gratitude and just immense appreciation for all of you spending time with us today. My heart is just so full seeing all of your faces on the screen. We know all of you are so busy, and by spending this time with us today, it shows that you have such dedication to collaborative efforts, and you’re interested in influencing the care mothers receive and we just really appreciate all of that. So thank you for your insights, your expertise and all that you do.

 

HER Health Collective host four roundtables each year in an effort to bring together our experts and dive deep into the topics that matter to moms the most.

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