Dr. Jessica (00:00):

People can have every sort of emotion and you can hold multiple things that seem to conflict in the same space. Like I really love my baby, but I also want to scream and run away. Today I enjoy being a parent, but I am mourning my old life when I could go out with my friends when I wanted to. There’s so many things that we can hold that are this and that, and not this or that, and I think that’s really hard to navigate for new parents. So letting them know that there’s space for all of these emotions.

Dr. Sarah (00:39):

We hear so much about preparing for birth, what to pack in your hospital bag, how to create a birth plan, what to expect in labor, but what about what comes after the postpartum period is a massive physical, emotional, and mental shift. It’s so many new parents find themselves blindsided by just how intense and overwhelming it can be. I’m joined today by Dr. Jessica Vernon, a board certified OB GYN and associate medical director at Oula, a midwifery based women’s health startup in New York City. Dr. Jessica is also the author of the upcoming book. Then Comes Baby: An Honest Conversation about Birth, Postpartum and the Complex Transition to Parenthood where she candidly addresses the realities of birth and postpartum recovery, blending 15 plus years of clinical expertise with her lived experience. This book offers actionable insights and compassionate guidance for new parents and the providers who support them. So it’s definitely one you’re going to want to add to your reading list.

(01:40):

In this episode, we are shedding light on the full spectrum of postpartum mental health, why so many parents feel guilt or shame around their struggles, how the standard six week postpartum checkup came to be and why it only scratches the surface of the needs of new mothers. And also the shifts that Dr. Jessica made to the questions that she asks her patients that has created space for more honest and open conversations. Plus, we delve into one of my favorite topics, mires Essence, what it means and how it’s revolutionizing the way we think about early parenthood. So whether you’re pregnant, postpartum, or a professional working with new and expecting parents, this episode will give you valuable insights into the mental health challenges of early parenthood and the changes happening in maternal care.

(02:36):

Are you a mental health clinician looking to expand your skills and equip yourself with tools to best support mothers? I am so excited my group Practice Upshur Bren Psychology Group is going to be partnering with The Motherhood Center to offer a very special training called The Good Mom/Bad Mom Loop: Using Internal Family Systems to Support the Mental Health of Moms. This three hour experiential training led by Rebecca Geshuri, an IFS and Perinatal Mental Health certified clinician focuses on the unique mom parts that mothers navigate as they juggle competing needs for themselves and their children. The training will help participants learn to identify and work with components of their client’s inner system that perpetuate these challenges and support moms in finding self-trust and joy in mothering. The workshop is being offered both in person at The Motherhood Center in Manhattan and live streaming virtually on Thursday, February 27th, making it accessible no matter where you’re located. And for clinicians in New York State, this training is approved for three continuing education contact hours for eligible mental health counselors, psychologists, and social workers. But space is limited, so make sure to go to upshire.com/ifs training or just click the link inside the episode description wherever you’re streaming this podcast to secure your spot now to learn this truly transformative approach for supporting maternal mental health.

(04:00):

Hi, I’m Dr. Sarah Bren, a clinical psychologist and mom of two. In this podcast, I’ve taken all of my clinical experience, current research on brain science and child psychology and the insights I’ve gained on my own parenting journey and distilled everything down into easy to understand and actionable parenting insights so you can tune out the noise and tune into your own authentic parenting voice with confidence and calm. This is Securely Attached.

(04:29):

Hello, we’ve got Dr. Jessica Vernon here. Thank you so much for coming on the show.

Dr. Jessica (04:37):

Thank you so much for having me. I’m really excited to talk to you. I’ve loved your episodes that I have listened to so far and I think there’s a lot that we can add to this conversation.

Dr. Sarah (04:48):

I agree. I feel like we have a lot of parallels in our experiences, personal and professional, but especially personal. So maybe we could start just by, can you share a little bit about your own experience in your postpartum journey, but also as a OB/GYN, kind of navigating these two paths is both a doctor working with pregnant women and a mother emerging into this motherhood?

Dr. Jessica (05:17):

Of course. So I have been an OB/GYN in New York now for about 10 years, and I’ve worked with very diverse patient populations from a New York City city hospital to a big academic center. Now I work at ulo, which is a midwifery led collaborative care with OB/GYN, so more holistic care. And when I had my first child about five years ago after she was born, I struggled with severe postpartum anxiety and OCD that eventually led to depression because I just thought that was my new normal and I had no idea that that’s what I was dealing with any of it because my training hadn’t set me up for it. My work with pregnant and postpartum people at that time between my residency and my practice had been about 10 years in total. I hadn’t elicited a lot of that information from them in training.

(06:16):

Were only taught at the time that I was training, which was a little while ago now, we were taught to kind of look out and be clued in for keywords around suicidality or severe depression where people basically were so depressed they couldn’t get out of bed, they couldn’t do anything that they had enjoyed before. We weren’t even taught about the rest of the spectrum of perinatal mental health disorders. And so I didn’t even know about the anxiety. I thought it was just hypervigilance of a new mom. So I was about a year and a half, closer to two years postpartum when covid hit in New York, and that kind of brought my mental health level to a new low. I still didn’t know what was going on fully, but I knew that when I’d had anxiety in the past, an SSRI had helped. So I went to my primary care doctor and got on Zoloft and that gave me the perspective to kind of be like, oh my gosh, I’ve been dealing with this for the past couple years. And I started reading and looking into postpartum depression and anxiety more. I read a book called Ordinary Insanity and I could relate to so many of the things and my mind was blown. I was so shocked that I’d been dealing with this for so long as an OB/GYN and had no clue.

Dr. Sarah (07:36):

And did the, I mean hindsight’s 2020 because when you’re in it, and I’ve had this very same experience even knowing about PASI with my second, my first, I had mild postpartum anxiety and I could place that I knew what it was. And then with my second, I wasn’t expecting anything else different than that. So I got really kind of the rug pulled out from under me when I had pretty significant postpartum depression.

(08:07):

And I wasn’t expecting it. And I did know prior to having kids what those signs and symptoms were, but I was so in it that I wasn’t even the one that was like, something’s wrong. My husband was the one that was like, something is not okay. And then I was like, oh my goodness, I didn’t even realize I was in this. But the reason I share that is because even knowing the signs and symptoms, sometimes when you are in it, your sense of reality is sort of distorted and you’re not able to get that perspective, that step aside and look at the problem because you’re so deep in it. But I’m wondering because what you’re sort of alluding to is that even as a highly trained OB, GYN who works with pregnant and postpartum parents on a very daily basis where you weren’t even aware that there was such a thing as postpartum anxiety.

Dr. Jessica (09:02):

Correct.

Dr. Sarah (09:03):

Okay. Yeah.

Dr. Jessica (09:06):

The training was very minimal and training in this area is supposed to be part of residency. Now. We are coming a long way. I feel especially in the past few years, there’s a lot more awareness and breaking the stigma. But because OB-GYNs have very limited time with their patients, especially postpartum, we do one visit at six weeks, you see your doctor for maybe a couple minutes during that visit and they’re basically clearing you physically to return to normal activities and ask if you want birth control and are like, great, you can go have sex again. You can work out often in a year. Often other conversation was like, oh, how’s the baby? And especially, we’re getting babies back again now post covid, but for a little bit we didn’t see them, but typically it was like, oh, here’s the baby. They’re so cute. How are you doing?

(10:00):

And it was very upbeat and rushed and I think it made a space where it was hard for people to even come forth and talk about these things and we also just weren’t asking the right questions. So I really had no clue. But once I went through my experience and started changing the questions I asked and creating this non-judgmental safe space for people to open up, I routinely was getting people just starting to cry to me in the office because they had no other place to talk about these things or no one was asking them about how they were feeling.

Dr. Sarah (10:35):

What were the shifts? How did you change the space and the tone of the sessions and what questions would you start to ask that would open this floodgate in people.

Dr. Jessica (10:51):

Even during prenatal visits and postpartum visits, everything. I think watching psychiatry colleagues that I worked with, reproductive psychiatrists when I was at the big academic center really helped me learn how to just sit there, look people eye to eye, not be standing over them, not be at the door, you’re ready to run out of the door and really ask people, how are you feeling? How are you doing when addressing things like breastfeeding instead of saying, are you breastfeeding? Which is a very judgmental question for a lot of people and they feel like they have to defend their choices. If not, I say, how is feeding going? How are you feeding the baby? And if it seems like there are struggles, be like, that must be really hard. Tell me how you’re feeling about that as far as recovery, if they had on plan, how are you feeling about your birth or if they had a vacuum or some other emergency? It sounds like you went through a lot with a birth. How are you processing this? How are you feeling about your birth experience? And just really letting them open up about these things. Before that wasn’t really a part of the conversation and there wasn’t really a pause where the people I was talking to felt like they could take time to discuss these things.

Dr. Sarah (12:20):

It’s impressive how such a small shift as I’m listening to you ask these questions, I’m like, oh God, I have a physical reaction to hearing you ask those questions. It’s small, but there’s room for a lot more emotion and I think we all want to be the good patient. We all want to be like, yep.

(12:44):

And I don’t know, maybe it’s me, but I’m always like, I’m aware of how stressed and pressured doctors are and how overpacked their schedule is, and I don’t want to take up more time than is allotted to me like, oh God, I know that I’m going to ruin your entire schedule if I ask three more questions. And so I think that when doctors actually slow down and sit down and look at you and talk to you, it allows that anxiety to sit back a little bit and be like, no, no. This is your time. I am here. I’m not halfway out the door. I’m not staring at a screen and typing everything as you go because I have to get out of here. It makes a difference.

Dr. Jessica (13:25):

And I think the other big part of it is starting from early on in pregnancy, even preconception when I’m seeing people, if they have risk factors for anxiety or depression, talking to them about that and saying either you have a history of anxiety, depression, or you’ve gone through fertility treatment or you have other things that are just flags for me that you’re at higher risk for this. So if you start ever having any of these feelings, let me know. And giving them resources upfront. It’s always great to have a therapist. It’s always great to join support groups, making sure you’re making time for self-care, whatever that is for you. Setting boundaries, all of these things that are important to address early on. And then again, postpartum. As soon as someone’s delivered, I’m often rounding on the postpartum floor and talking to ’em about these things before they even go home so that they are aware this is what baby blues is versus this is what anxiety and depression are.

(14:21):

You’re at a higher risk for this. Let me know if you want to go ahead and set up some follow up so we can check in with you. If not, here’s some resources and here’s a number to call if you start developing any symptoms. So it kind of gives people permission in advance to know it’s okay if this happens to me. There’s nothing wrong with me. I’m not a failure, I’m not a bad mom. This is just part of what happens sometimes because this is a very intense and pivotal time in our life and so many things can go different from we expected. Even if they go beautifully, you can develop PMAD. So there’s just so much to open up that space for people to ask for help.

Dr. Sarah (15:00):

Yeah, I think that pre-education so important. It’s so important because like you said, it’s important so that they know to flag it if it happens. But also just like there’s so many things I feel like that we are taught when we’re pregnant, especially when we’re brand new parents. And this is like, oh, I have no idea. Teach me everything please, because I have no idea what’s going on in my body. But it’s very commonplace to be like, Hey, gestational diabetes, here’s what could happen. We’re going to do a glucose test, we’re going to do these things. And so that way if it does happen, there’s this sense of, well, I was prepped for this. And the shame that occurs if it occurs, if you get gestational diabetes, obviously for some people that we can have a lot of internal stuff around that.

Dr. Jessica (15:49):

Definitely.

Dr. Sarah (15:50):

There still can be feelings of shame or guilt for having complications in your pregnancy, and hopefully we can dismantle that for people. But when you’re not told about it and you’re not prepared that hey, this is something that could happen. This is something that is normative to certain degree in the population of pregnant people. So if something’s not on that list and it happens

(16:14):

That sense of like, oh my God, did I do something wrong? Why is this, no one told me this could happen. Does this not happen to other people? Then there’s this, I don’t know, there’s this shroud of I messed something up. And I think giving people that, okay, these are gestational diabetes is a risk, preeclampsia is a risk. These are the look out for these things, look out for these things. Maternal mood and anxiety like perinatal mood and anxieties are a risk. So here are what you look out for. It just puts it in the category of all the other things. And historically, I feel like mental health was set aside that it wasn’t part of these medical conditions, but in reality, IADs are a medical, biological, hormonal neurochemical. They’re very much medical in a lot of ways.

Dr. Jessica (17:06):

Right, and we know that obs get so much training in things like postpartum hemorrhage and high blood pressure and hypertensive emergencies. We could handle those in our sleep, but more people die from suicide and overdose in the perinatal period than either of those. And so it is just a big shift that we need to have in our conversations and how we broach these topics because it is so important. And besides just mentioning ps, even talking to pregnant people and postpartum people to say, your feelings matter and your feelings are valid, it is not just about the baby because as well as I do, as soon as someone even starts trying to get pregnant, they’re thinking about everything that they need to do to grow a healthy baby and have a healthy birth and a healthy child. They’re not focusing on their own mental and emotional state, which is just as important for the child as what you’re eating and if you’re exercising and any of those other things.

Dr. Sarah (18:11):

Because we know and it’s chemical, it’s not just a woo woo, well, if you’re happy and zen, your baby is going to be fine. It’s like, no, when you are stressed, your body creates stress hormones like adrenaline and cortisol, and that’s going into the system. And we know we track these things and we know that high stress levels in pregnancy can trigger epigenetic responses in a fetus. So sometimes I’m like, I don’t want to add one more worry to a parent’s plate because worrying about being worried is great for anxiety.

Dr. Jessica (18:45):

A hundred percent. I know anytime I have someone who had a miscarriage, the first thing I say is, you did not cause this. It was not your stress. It was not what you were doing at work or any activities you did because that’s the first thing they jump to is…

Dr. Sarah (18:56):

Yes. But I also think that those moms who are like, okay, I got laser focus here. I’m just doing whatever the baby needs. Sometimes adding to that list, regulating your stress levels and getting support and having breaks and rest for yourself and your body, put that on your list for, it’s good for my baby because sometimes women are just very myopic in that. And so while I would love for the bigger conversation to be how can we focus on both of us? And even in parenthood, I feel like, oh man, women and parents get a lot of support. Probably not as much as they could benefit from, but they do get more support. I feel like in the postpartum or the stages of pregnancy, they see you how many times in the course of a pregnancy.

Dr. Jessica (19:49):

At least 10 times is common.

Dr. Sarah (19:51):

And then once after maybe twice, and it’s all really quickly in the first six weeks, two months. And then there’s a really big cliff that we fall off of in terms of support. And I think early parenthood, which is where I really focus on a lot, is it’s just not supported at all and stress levels go way up and support goes way down, which is a really bad combo. So I’m excited when I hear about programs that are medical ob, GYN midwifery programs that are extending the support well past the six weeks and looking at the health of the mother and the baby in the long term as part of the whole package. You don’t stop after the baby gets born. You’re just getting started.

Dr. Jessica (20:47):

And that’s another thing that we always talk about and when I’m in visits with patients and the midwives I work with are incredible about this too, is reminding people after their six week visit that your postpartum for life, but especially the first year, there are so many changes still going on with your hormones. Your brain is literally reforming itself and making new connections and physically you are not back to baseline physically at six weeks even though we’re clearing you for normal activities. So just keeping the door open and saying, call us, reach out anytime. It’s really hard for a lot of providers to offer that to their patients, and a lot will be like, I’ll see you at your annual, otherwise you’re out of OB practice because insurance doesn’t cover any additional visits and it’s really hard to make time for people outside of that. So being in a place where we really focus on that was important to me. And I think we’re just starting to have those conversations too in society because we know there’s no infrastructure, there’s no support when people return to work, when they need lactation support, when they need anything else like physical therapy. We just don’t have any of that built into the system already. And it’s a huge conversation that some countries are tackling more than we are, but definitely conversations we need to keep having and bringing to the forefront.

Dr. Sarah (22:14):

And I think on a hopeful note, I think it has changed a lot in the last couple years. I feel like we were talking earlier that you had even gotten a grant to train psychiatry residents and other, can you talk a little bit about what you’re seeing change in terms of funding and resources being allocated to expanding just getting this information to more people, not just moms, but all the people who work with parents and how that’s changing kind of the global understanding of, okay, even the trence is the concept that’s I think becoming more well known, which is like…

Dr. Jessica (23:04):

Right. A lot of people have still never heard that word, but it’s becoming more known and I think maternal child health has gotten a lot more interest and especially post covid mental health has really come to the forefront. We know anxiety and depression in general went up like 25% post covid and with that studies post covid showing up to like 30% of people endorsing PA ds, so we know this is so important and we know the cost to society of a mom and her baby if the mom is struggling with PAS, so there’s a lot more funding. I’m on the board at Postpartum Support International and they have the big HRSA grant from the government to run the maternal mental health hotline, which is amazing. You can speak to a counselor any day who has lived experience for free. The work that I got a grant through the Gold Humanism Society for was to create a curriculum.

(24:08):

This was in part with one of my colleagues for resident education for OB/GYN residents because you were saying before as far as screening and offering resources, OB/GYNs often don’t have the comfort or knowledge to really have these conversations. Even though we’re primary care providers, they often aren’t comfortable prescribing first line medications that are safe in pregnancy and postpartum for anxiety and depression and knowing how to follow up and how to increase the medications as needed and know how to escalate and what patients need to go to the psychiatrist. And so basically giving them that fundamental knowledge so that instead of doing a screener and trying to find a mental health specialist who are all overwhelmed and might have wait lists that are for months or they don’t take insurance or they don’t take your patient’s insurance, the OB-GYNs can have those conversations and start treating patients when needed and know who is really high risk, who needs to be referred out. Like patients who have a history of bipolar OB-GYNs should not be treating those. They should be sending them to the psychiatrist because they are at such high risk for postpartum mania and psychosis. So we know these things and we can empower the younger generation to do this as a frontline top of funnel way to decrease the weight to get to the specialist and only send people to specialists who really need it.

(25:41):

So that’s been a really exciting part of the work that I’ve done and the big thing we see in trainees and in residents is they love this. They are really into holistic care and they’re still idealists. They haven’t been out long enough to have lost that sense of I really want to care for people in a really good, inclusive, holistic way. And I’m even seeing OB-GYN residents who are interested in doing kind of a combination training or fellowship where they do get that psychiatry training from the beginning to be more of a frontline provider and even do the special care for substance use disorders and complex mental health issues, which is amazing.

Dr. Sarah (26:26):

That’s so good. That’s makes me so happy. I feel like I had worked for many years in the hospital system as a psychologist alongside psychiatrists, and I felt like the hospital that I was at did a really amazing job of interdisciplinary care and I think that it has seemed that that was not as common outside of psychiatry and psychology. Collaborating is not uncommon, especially in big hospital systems, but the idea of psychiatry and obstetrics collaborating or other types of mental health and medicines, being able to, medical specialties, being able to work in tandem because so many of these things, medical and psychiatric are layered on top of one another and they can’t just be disentangled and can’t when all these medical practices are so siloed, it’s like we lose as patients the ability to have synergistic care from our providers. So that’s really cool to me to hear that.

Dr. Jessica (27:44):

It helps and it brings it to light. For instance, emergency room providers are often seeing people who are postpartum, who are having symptoms of panic attacks or severe anxiety, and unless they’re asking the question, have you recently had a baby? They don’t even know to look out for that. And so you’ll see, and this is one of the costs to society, is that people go into the emergency room for these physical symptoms of mental health issues and you have to have people who are aware of PA Ds and who know to ask the right questions and get the right help for new parents present, otherwise they’re just still getting lost in the system.

Dr. Sarah (28:28):

We were talking a little bit earlier about Mitre essence, and I do, our point was that it’s becoming more well known, but I bet you there are plenty of people listening. What was that term you said? What was that? Can we talk a little bit about Trence and this, it’s a newer field I would say. I mean it’s not a new field, it’s a newer way of studying this field, but can you share a little bit about, can you introduce people to this idea if they haven’t heard it before?

Dr. Jessica (28:58):

Sure. And there’s a really good new book called Mires written by a British journalist. I don’t know if you’ve seen it, but it came out recently and is wonderful, and Mires essence is like adolescence only. It’s the time period of becoming a new parent or a mother. I try not to use mother all the time since some people don’t identify as a mother, but that period where you’re undergoing so many rapid changes, physically, mentally, emotional, your brain is changing, your body’s changing, your hormones are changing drastically, and just like adolescence, you need a lot of extra support during this time. And unlike adolescence, it’s not recognized in society. And so while I would, from my experience, rece is much more intense and at the end of it, you have a new little human being to take care of while you’re going through this process versus adolescents, a lot of people don’t even know that their body is going through so many different changes. Their mind is going through so many different changes, and so they’re not getting the support from the community and they’re not being given that space to talk about their experience and process it in a way that this time really deserves.

Dr. Sarah (30:23):

Yeah, and I think the idea of using a term rece, which is basically using developmental language, it’s saying, Hey, our developmental timeline, we have infancy, early childhood, we have latency, which is school age, the easy time, it goes up and down, right? Early childhood, childhood, it’s like, oh my god, so many brain changes. They’re reconstructing everything up there in the prefrontal cortex and it’s chaos, and then there’s latency and it’s like, oh, the slide we go down a little bit and then there’s adolescence and it’s right back up again, and it’s so much brain changes and construction. That’s why I joke that adolescents and toddlers are not so different sometimes when you look at how they show up and how they problem solve and their impulse control, but then it cools off again in young adulthood and hey, guess what? When you enter trence, you go right back up to that brain changing construction zone, everything’s getting rewired, and then it cools off again as your child moves through latency. And then they’re starting to talk a little bit about this idea that we have a trence that moves kind of in a spiral. We sync up with our child, so as they go through adolescence, there’s another peak to our own reconstruction, and you go through trence with every single child, but just this idea of putting the experience of moving into motherhood or parenthood or fatherhood because there’s also patresence, moving into paternal, the paternal developmental timeline, but putting it on a timeline like a developmental timeline allows us to say, one, this is normal, and two, you can anticipate this. We can give you a map of your development because it doesn’t stop in young adulthood. Our development doesn’t, we don’t plateau in young adulthood and change not at all until geriatric age. We are constantly ebbing and flowing and our brains really are changing and adapting and modifying and rewiring and pruning and doing all these cool things. Were not static. And I think thinking about matress in this way is like, oh, so permission giving to be a human who evolves.

Dr. Jessica (32:49):

Totally. And I think it’s so important for people to know. I talk to new parents all the time, and when I’m with their partner as well, their partner, they’re just often, we can’t communicate in the same way. We can’t talk to each other in the same way. I’m like, she’s literally a different person right now. Things are changing so rapidly that maybe the ways you were communicating before aren’t effective right now. And so just even holding space for that, yeah, you’re right. You are noticing something’s different because it is different is so important.

Dr. Sarah (33:24):

And you talk a lot about how this disconnect between the expectations that we have of what parenthood is going to feel like from both partners, not just the birthing one. I think a lot of parents who aren’t having the baby are like, I have this vision and ooh, this doesn’t feel like what I thought it was going to be. My partner’s really different. You’re describing I can’t talk to her the way I used to. She’s reacting so differently than what I had expected or for the person who’s going through it themselves, when we have this really big disconnect between what we are expecting something to be because these are the messages we’ve been told forever that idealize parenthood and motherhood as this like angelic blessed time, that’s so wonderful and we need to be so grateful. And then that is hit with the reality of what so many people really, it’s messy. It’s messy. Our bodies are totally flipped upside down, and we have to care for some other human being that needs more than of us than we could possibly give the stakes feel so high. How do you help people manage that discrepancy, ideally before, but if they’re in it, what are your thoughts on that?

Dr. Jessica (34:54):

Right. It’s so much about first having the conversation that so much of this is out of our control, and so there are the mental and emotional things that go differently than we anticipated. There’s also the physical parts of it. A lot of people I’m speaking to their birth went very different than they thought it would, and they think that they or their body were failures. The same with feeding their baby or the postpartum depression or other things going on. It just went so differently than they anticipated. But letting them know that none of that means they’re a bad parent. None of it is wrong, that people can have every sort of emotion and you can hold multiple things that seem to conflict in the same space. I really love my baby, but I also want to scream and run away. Today I enjoy being a parent, but I am mourning my old life when I could go out with my friends when I wanted to.

(35:55):

There’s so many things that we can hold that are this and that and not this or that, and I think that’s really hard to navigate for new parents. So letting them know that there’s space for all of these emotions, and I really strongly encourage community. Some people not on social media, that’s not the best place to go for community. You might see a lot of this idealized version that makes you feel bad about how you’re thinking or feeling or how your body’s responding to New Parenthood. But support groups where people are honest and authentic and will share what they’re going on. Often when I have new parents go there, even if they’re not speaking in the groups at first, they just hear other people and feel so validated that they’re not alone. It’s nothing wrong with them. They’re not a failure. And finding people in your local community as well.

(36:49):

Not every new parent is going to share about all of the parts that are messy and not pretty and go against how society thinks you should think and feel, but you can find people who will be there and be the ones that you can text at two in the morning and be like, oh my God, we’re having a terrible night. And they’re like, yeah, me too. It really sucks sometimes. And sometimes you get that despair when nighttime’s coming because what’s up ahead? And so having people prep with those sort of things, but also holding for them from early on that because so much is out of our control, things are going to go off course from what we expected, and that’s okay. We just need the support and resources in place to get through that.

Dr. Sarah (37:34):

Yeah, I think that’s such good advice. I think that moms groups, they’re such a valuable resource. I used to do, I still do this every once in a while, but I used to do a lot of drop-ins on mom groups, friends of mine who’d run moms groups, and I would come and do a drop-in session and ask me anything on maternal mental health or child development or raising toddlers or whatever. And I still will get messages from those moms years later being like, oh, I remember this thing you said. And it just still sticks with me. And at the time, I wasn’t trying to be memorable. I was just like, oh, let’s answer questions. But sometimes having a space to just ask the questions that you’re afraid to ask in front of other people who aren’t then like, oh, that’s your question, but are like, oh, thank God you asked that question. I have the exact same question, so just so safe. It feels so good. I really think any question you could possibly have as a parent, a thousand other parents had that question, I can guarantee it.

Dr. Jessica (38:47):

And anything you felt or thought someone else has felt or thought that as well. And so I think that’s so important because we often are in situations where we feel judged or criticized even by our own friends and family for the decisions we’re making or how things are going. And being able to say the way that things are for me is okay as well, and this works best for me and this is what we’re going through and this is right for my family. Without feeling the pressure and the need to conform to what other people think it should be for you is really a hard space to get to. And going to groups like this can help get you there easier, I think.

Dr. Sarah (39:31):

Yeah, and I think they can help with our relationship with our kid because I think it can be really difficult when you have these conflicting feelings, when you have these competing experiences where you do genuinely love your kid and you are genuinely overwhelmed and frustrated and overstimulated and tired and want to break. And sometimes when those two things feel like they can’t exist at the same time that they’re mutually exclusive, we then feel this conflict and we can feel like it could just create this sense of I have to separate myself completely from this conflict, which then can create. I think one of the very common symptoms of postpartum depression and postpartum anxiety is a difficulty feeling that sense of bondedness or connection with their baby. Because really I think what’s happening is that I’m defending against this overwhelming conflicted feeling or cascade of conflicted feelings by disconnecting from it as a self-preservation strategy. But my baby’s in there, so I’m getting disconnected from my baby too. And so when we can stay in the conflict and tell ourselves like, okay, this makes sense. There’s a reason why I’m feeling these two things. And actually no, it is okay, and it’s counterintuitive, but it’s possible to feel these two it competing feelings at the same time, and no one doesn’t undo the other or cancel out the other. And that I can love my child deeply and need a break from them or resent them for waking me up at four in the morning and needing my body when I need my body. And that can allow us to stay in that bonded space with our child even in its messiness. And I think that that is a very important thing to protect for parents. And so I think these conversations that you are promoting and sharing are really powerful in doing that.

Dr. Jessica (41:44):

Thank you. Yeah, I think it’s important for all of us to just have a space where we can go and I do that one-on-one with my patients. I know you do that one-on-one as well or in groups, but trying to normalize these conversations in broader spaces like you’re doing are so important as well, because a lot of people don’t have that capability to meet with us and get that validation.

Dr. Sarah (42:12):

And this book that you wrote too, I mean, I think that’s another, when we talk about how do we get this information out to more people, how do we help people have these conversations with themselves if they can’t go meet one-on-one with a therapist or a doctor? I mean, hopefully there’s groups people can find because I think that that is one really accessible entry point, but books are a really great resource too. Could you talk a little bit about the book that you wrote?

Dr. Jessica (42:40):

Yeah, absolutely. And real quick, before I do that for free support groups, people can go to Postpartum Support International and they have tons of free weekly support groups for all different types of things that you might be dealing with or all different groups that you belong to. So I encourage people to go and check that out if they need a group that’s free. The book is called, Then Comes Baby: An Honest Conversation about Birth, Postpartum and the Complex Transition to Parenthood. And I wrote it for the people giving birth. So it’s not about your baby, it’s not about how to best take care of your body through pregnancy or for the baby. It’s really about the mental, emotional and physical aspects of this hugely transformative and pivotal time that people often feel they were unexpecting, they were surprised it happened to them, things they didn’t even know existed or could happen.

(43:38):

And it leads people to feeling like failures, like they’re alone. They weren’t meant to be parents. And it’s really the book that I needed after I had my first child, and that when I’m talking to my patients and my friends and people who tell me their stories all the time, the topics and the stories that I hear over and over again. So bringing a lot of this to light so it can be part of the conversation and the knowledge beforehand, since we know that so many things go different than anticipated, and that’s because we really don’t have control over a lot of this, but bringing to light why things might go certain ways and also how to treat yourself with grace when these things happen.

Dr. Sarah (44:24):

Yeah, I think that’s so valuable. I feel like even someone who’s already on the other side of it of pregnancy might feel really validated in hearing some of these things just so that they know, oh, that was okay for me to have gone through that. I feel like that could be very healing.

Dr. Jessica (44:43):

Totally. I mean, I see, I have friends who had their babies five, 10 years ago ago, and they still feel like, oh, my body is still different and your body’s always different postpartum. Some things may go back. Six weeks is just not even physically possible.

Dr. Sarah (45:03):

How did that become a framework?

Dr. Jessica (45:05):

So the six week postpartum is really when your uterus has involuted or gone back to its normal size in the pelvis and you’ve healed from the surgery or for vaginal stitches that you have, and so you’re being cleared to return to normal activities, but that in no way means that your body is the same as it was before, and there is just still so much occurring physically that even if you were in amazing shape before and during pregnancy, it still takes a lot of work and it’s still really important to start with things like breathing properly and proper alignment and basic skills to get your body starting to get to its new normal. But yeah, it’s become this thing in culture where people want their bodies to look like they never had a baby and they want to be able to go back to work and look like nothing happened. And it’s really hard and causes a lot of shame and guilt for a lot of people. They feel like something’s wrong with them if they still have, your abdominal muscles are still going to be relaxed. Your pelvic floor is still going to be relaxed. You’re not going to have the strength you used to, and so…

Dr. Sarah (46:23):

Your breasts are also like…

Dr. Jessica (46:25):

Oh my gosh.

Dr. Sarah (46:26):

All kinds of things, whether you’re breastfeeding or not at six weeks, even if you decide to completely formula feed your baby at six weeks, your body is still doing all kinds of stuff. There’s no six. Yeah, that’s helpful actually. I didn’t know that. The six weeks is really about simply the uterus and nothing else, and there’s the timeline for other parts of our body functioning. To get back to homeostasis is not six weeks.

Dr. Jessica (47:04):

And also, even though your doctor says it’s safe for you to have sex again, that does not mean that you want to have sex again or you are any way ready to have sex again. And I think that’s important not just for the birth parent, but for the partner as well who often feels like, all right, we’re cleared to go, let’s do this. And that can be really difficult to have those conversations and reset expectations be like, let’s focus on regaining intimacy in a different way while I have so much else going on right now.

Dr. Sarah (47:35):

Yeah, we did an episode of, it was a while back, but we did I think two episodes kind of back to back on Sex After Baby, and I think we have this really amazing person come on and talk about it. And then I literally did a follow up episode by myself just being, just so you know, all of this is true and you might just not want to, and there was a whole episode just on all the reasons why you might emotionally not be interested in that anymore and that that’s also okay. Yeah, I might be able to link those in the show notes so people can go back and listen because that needs to be said.

Dr. Jessica (48:12):

100%.

Dr. Sarah (48:15):

Well, this is amazing. I’m really excited about this book. I think it’s going to be a really, really helpful resource for parents. If people want to connect with you, learn more about the work that you’re doing, how can they stay connected and where can they get this book?

Dr. Jessica (48:30):

Sure. So the book is available for presale now at all major booksellers. You can also find links to pre-order on my website, Dr. Jessica Vernon, and I’m also on Instagram, LinkedIn, Facebook as @drjessicavernon as well.

Dr. Sarah (48:48):

Amazing. Just a little inside information about the book industry that I’m learning as I interview all these amazing authors. When you buy a book on presale, it really, really helps actually get the book picked up more. So if you like this and you think you want to buy the book, go get it now. Don’t wait.

Dr. Jessica (49:10):

Yeah. Thank you so much for that.

Dr. Sarah (49:12):

Yeah, no problem. I feel like people are always wanting to support and then they don’t know that presale orders are actually very important in the book.

Dr. Jessica (49:21):

Yes. The Amazon algorithm will push your book higher in the search if you have more presales and more comments.

Dr. Sarah (49:28):

Yeah, so thank you so much. The work you do is amazing, and thank you for being so candid about your own experience as well. I that’s I think when people who are sort of in this space of this professional space of giving out this information when they can also be humans who have gone through it as well and are willing to share that and step off that pedestal, I think it is beyond valuable for people because it really lets people feel like, oh, I’m allowed to have this experience. I’m not just being taught about it.

Dr. Jessica (50:01):

Thank you for that. That’s exactly how I describe it to people too, and like doctors, providers, we’re all humans too, and we still struggle too. And so if I can go through it, then anybody can go through it. Considering all my training and expertise.

Dr. Sarah (50:18):

You’re not immune to it either, and it’s not like a, oh, if you get enough knowledge on something, you’ll be spared.

Dr. Jessica (50:24):

Nope. You cannot ace the test of parenthood. That’s for sure.

Dr. Sarah (50:28):

No way. Well, thank you so much. We’ll talk soon.

Dr. Jessica (50:31):

Thank you so much for having me. Bye.

Dr. Sarah (50:40):

If you enjoyed listening to this conversation, I want to hear from you, share your thoughts and your feedback with me by scrolling down to the ratings and review section on your Apple Podcasts app or whatever app you’re listening on, and let me know what you think of this episode or the show in general. Your support means the absolute world to me, and just a simple tap of five stars can make a real impact in how this show gets reached by parents everywhere. So thank you so much for listening and don’t be a stranger.