Do you feel the pressure to get everything “right”? We know the scientifically proven effects stress has on parents. And what’s more, how this parental stress can negatively impact our children. And yet, we still lack proper support systems for caregivers and families.
Joining me today is Dr. Christine Sterling, a board-certified OB/GYN who has made it her mission to provide comprehensive support to people undergoing the physical and emotional challenges of pregnancy and postpartum.
We’ll talk about the mental load of pregnancy and parenthood, strategies moms and dads can use to combat burnout and stress, share stories of our own experiences with symptoms of postpartum anxiety, and offer tips for how you can lean into your own personal strengths to help you more fully enjoy your parenting journey.
Dr. Sterling (00:00):
It’s not so much that if I make all the right decisions, I’m a good mom. But if I believe I am a good mom and I lean into my strengths as a human being and I lean into the fact that I am good and I love my children, I will make the right decisions.
Dr. Sarah (00:23):
Parents are stressed out, and this pressure doesn’t just begin the moment that that cute little bundle of joy is placed in our arms. Actually, the making of parental burnout and overwhelm often starts during pregnancy or even for some the moment we start trying to conceive. And that is where Dr. Sterling comes in. Dr. Christine Sterling is a board certified OB-GYN mom of three and the founder of The Sterling Life. After observing the holes in the healthcare system and the effects of the mental load of pregnancy and parenthood on her patients, Dr. Sterling left her clinical practice and began creating accessible resources to help those who were expecting. If you’re feeling overwhelmed, stressed, and rushed, it’s not your fault. It is the result of a failing system. But in the meantime, while we are living in this system, what can you do to combat that? That is exactly what we’re going to talk about today.
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.
Hi, I’m so excited guys. We have Dr. Christine Sterling on the podcast today. Thank you so much for being here.
Dr. Sterling (02:01):
Oh, thank you. I’m so excited to chat with you.
Dr. Sarah (02:04):
I’m so excited. I’ve, I’ve been following along on the work you’ve been doing for so long and I’m just really excited to have a conversation with you.
Dr. Sterling (02:11):
Oh, thank you.
Dr. Sarah (02:13):
So for people who aren’t familiar with your work, can you share a little bit about what you do and why you’re doing it?
Dr. Sterling (02:22):
So I’m a board certified OB-GYN, but I felt very, very incredibly constrained by our current healthcare system. We are typically allotted about 10 minutes for prenatal appointments, and then don’t even get me started on postpartum, right? There’s like the standard appointment is one appointment at six weeks, again for 10 minutes. And I felt like I was just not able to adequately address not only the questions that my patients had, but the incredible life transformation that they are going through and about to go through. And after I went through it myself, so my oldest is about to turn six this year. After I went through that experience, I felt a moral obligation to talk to people about postpartum and about that transition to parenthood and all the things that come up because I had such a difficult time and there were so many privileges that I had in that experience.
I mean, I’m an OB/GYN, I knew that everything that was going on with me physically was okay. My husband’s an ER doctor. I had a, if anything went wrong with our child, he was right there. He couldn’t do it. You know what I mean? So yeah, I had so many advantages and it was still so hard. So I was in these 10 minute appointments, how am I going to prepare people for what it’s about to happen? And I just could not live with the fact that they were going to be there postpartum and say Dr. Sterling didn’t say anything. So I started doing this with my patients, started educating them about what it’s like postpartum, how you can prepare during pregnancy, motherhood, all of it. And it was bananas trying to fit that into 10 minutes. I would just, oh, yeah, I felt like I was just giving monologues every appointment.
Dr. Sarah (04:20):
And it’s probably very stressful, I imagine to know I can’t do what I feel needs to be done in this time. I feel that, and I get 45 minute sessions. I mean, not always. That’s why I do so much psychoeducation because I’m like, I can’t get everything in a therapy session that you need to know. It’s better for me to give you some other stuff to study outside of the session so that we can move things along faster.
Dr. Sterling (04:49):
A hundred percent. And to me, it felt like to know what it should look like and to not provide, that felt like it was a moral injury to me, and I felt like I was tearing my soul apart. I know that this isn’t enough and yet this is what I have to do. And I’m so glad that there are people in the system fighting within the system to make it better. But personally, I had to exit the healthcare system and solve the I, I’m just too impatient. I was like, I can chip away at this system and be 80 years old and be like, I made a difference. But I have friends and there are people right now who are currently pregnant going through this, and I just can’t wait to a lifetime to make a dent. So I left my clinical practice in 2019 and moved online. And so now I do health education and support people through this 24 7. That’s my full-time job.
Dr. Sarah (05:45):
And you’re good at it. I love watching your stuff because a lot of it speaks to me. It’s so interesting because I know you focus so intently on pregnancy and postpartum and supporting the transition into parenthood. And I work a lot. I work in that space a little bit, but I also do a lot of work with people kind of later on as they’re in the thick of parenting. But a lot of the themes are very similar. The pressure that we put on ourselves for it to be a certain way, for it to feel a certain way for it to look a certain way, the fear of judgment, the fear of making one wrong move and everything’s destroyed that I’ve been working on, it’s scary. And I don’t know that it has to be that scary. So a lot of the work I do is helping people understand what’s noise and what’s actually worth paying attention to. And it’s a lot less than you think.
Dr. Sterling (06:41):
And that starts the reason why it’s the same that it feels like the same messages is because it is all of this pressure and stress, and we talk about the load, the mental load of the primary parent. All of that starts from trying to conceive and for some people even before that. So the reason why it’s the same is because it is the same. And that is what I will be shouting from the rooftop until I’m a little old lady. Actually, I’ll never be little. I’m five 10, but until I’m an old lady who’s probably shorter than I am now, I’m going to be shouting this from the rooftop. Let’s pay attention from the very beginning to how we navigate this mental and emotional load. Let’s be aware of it. Let’s talk about it. Let’s just bring it out of the shadows and just acknowledge that just because you can’t physically see me doing the work, it’s just like pregnancy. A lot of the work that we do in pregnancy you can’t physically see. It’s incredibly important also in it drains our energy and time and energy. These are the most precious resources that we have.
Dr. Sarah (07:55):
Yes. So what do you see as the biggest impediments for feeling that sort of groundedness and confidence and equity in when you’re a parent?
Dr. Sterling (08:11):
How much time do you have?
Dr. Sarah (08:12):
Dr. Sterling (08:13):
Okay, so let’s start. I think we should start with the healthcare system to begin with. Okay,
Dr. Sarah (08:18):
Dr. Sterling (08:19):
So one of the things I am, I’m addicted to the big picture. So one of the things that just drives me bananas is that we talk a lot about like, okay, don’t eat unpasteurized soft cheeses and pregnancy. Don’t eat this, don’t do this. There’s all of these rules, which they all make sense and there’s all reasons for them, and that’s a topic for another time. But we have all these rules because we care about pregnancy outcomes. Well, one of the elements of our lives that we have the most data on in pregnancy and its implications for pregnancy is stress. We have robust data that stress increases the risk of blood pressure issues, low birth weight, preterm birth, and you’re probably aware of this. There is lots of emerging evidence about the role of stress in our health outcomes, health outcomes, including their mental health. So we know that this is a real thing, and it’s much more present than say something like listeria, which is the reason why we don’t eat pasteurized soft cheeses in pregnancy.
So we have a healthcare system that has so many gaps in it in the preparation and moving through pregnancy, we’re just like, what if you have a question, a pregnancy question, you’re just going to have to figure that out on Google. You don’t have access to an expert. There’s so many different sources of information. So that’s what happens. We have a healthcare system with all of these gaps in the support as people move through the reproductive journey. So they’re going onto the internet to fill these gaps. But the internet to fill gaps in your healthcare is almost like using scotch tape on a bridge.
Dr. Sarah (10:08):
It’s more dangerous than it is helpful.
Dr. Sterling (10:11):
And I love scotch tape. Google’s great, but for these gaps, it just oftentimes increases the stress. And so people are looking for a relief in the stress. They’re looking for the right answer, but then they just get overwhelmed with information and it’s this vicious cycle. So that’s one of the main things. We have a healthcare system that just says, you know what? We’re going to just basically make sure that your blood pressure, your weight, we’re going to address the bare minimum and all of the other stuff is kind of a that’s a you problem, but that just increases stress. And we know that stress, we supposedly care about pregnancy outcomes. So it’s just a system problem. So that’s one of the main things, but there’s a lot of other stuff.
Dr. Sarah (10:58):
Yeah, it’s interesting because I don’t know if you’re familiar with Dr. Beatrice Beebe, but she does a lot of research on infant attachment, like parent attachments and parental stress and infant temperament. And she just came out with a study that talks about how when you looked that she was looking at maternal covid related postnatal stress.
And also just whether you had covid or not, there was a bunch of different variables. I’m probably going to botch the study, but I’ll pull link to the show notes. But this idea that they looked at having covid versus basically being stressed because of the pandemic and having covid did not impact infant temperament, but parental stress did. And it’s like, we know this, but we also, we need to look at the fact that, okay, this is probably true before pandemic, but after definitely during and after a pandemic too. This idea that we have so many stressors as parents that, I mean, we always have, because there’s a systemic problem with lack of parental support. It sounds like not just in postpartum, but really during the pregnancy. I mean, I think people feel as though they get more care in pregnancy than they ever do postpartum for sure, but it’s still not adequate.
Dr. Sterling (12:21):
And that’s still not enough. The thing is it’s you do get a lot of visits, but it’s still not enough.
Dr. Sarah (12:26):
But they’re short. And it’s more about just is it feel like it’s more checking certain things off of a list than it is about meeting the patient where they’re at.
Dr. Sterling (12:37):
You know, there’s certain things, there are certain things that need to be done at each visit. And when you only have 10 minutes, oftentimes the necessary stuff that’s just like, we just need to make sure you’re okay. That takes up the entire 10 minutes. And you have to understand that some people are going to 100% require more than 10 minutes because they have something really devastating happen. And so that means that you have to make up that time somewhere else. And so some patients will be like, why my doctor just rushed in and rushed out. You had the unlucky experience of being the one that they needed to catch up because they were two hours behind. It’s, it’s just an awful system. And it really, at the end of the, it’s not any individual person or providers lack. It’s an entire systemic lack that then is just a reflection of why do we have a lack of parental support afterwards? It’s all a reflection of the same thing. We just don’t really care. Or the people in power, especially in the United States, don’t care enough to address.
Dr. Sarah (13:42):
These issues. And it’s like they say they do, but then when they actually have to, you know, enact legislature to support it paid family leave and childcare being somewhat universal, and this are the stressors that are leading to poor mental health outcomes in parents, but also challenges for child development because we are interconnected our kids and parental stress is a predictor of poor outcomes in the family system and in the children, because we’re not siloed. We are an interconnected unit. And so when one person in the family is under some type of distress, everybody is to some degree. And similarly, if you support one, a parent through a postpartum experience, yes, you’re supporting the whole, everyone benefits. So just as much as…
Dr. Sterling (14:50):
It’s a good news, bad news situation. Exactly. And that’s why to me, it’s like if we aren’t addressing stress in trying to conceive and pregnancy by the time you are in it with kids and you’re, you’re drowning at that point in just in this stress and this lack of support. So it’s a real problem. And at the same time, we’ve got everybody saying, just engage in self-care and Oh, yeah. Like I find it can be so frustrating for people who are like, what do you want? What do you mean? A lot of it just ends up being more stress on, again, oftentimes that primary parent, it’s like, oh, you need to find a solution to this. And we’re not looking at the bigger picture of why are be people being put in this situation? Can we address it sooner?
Dr. Sarah (16:01):
And I think you bring up, but also very good point. So, okay, we have this broken system, but it’s not going to change any time soon. So what can we do beyond asking every individual person to try to figure it out themselves and patch up the gaps with scotch tape or a bubble bath because it’s not going to do it.
Dr. Sterling (16:27):
Yeah. Well, I can only address the, there’s a big pie here, and I can address my piece of this pie in the way that I see that I can help. And so what I did when I left the healthcare system is I said, okay, let’s look at what’s the mental load of pregnancy look like? Let’s get it all onto a piece of paper and just write out, okay, you’re worried about birth, you’re worried about taking care of your baby. You’re worried about what do I actually need to buy? You’re worried about if you have other children, are my children going to be prepared for this? There’s the quiet worries. Am I good enough? Am I going to be a good enough mom? So I got all of those. I kind of mapped out the mental load of pregnancy, and then I said, okay, how do I design a system that directly addresses these components of the mental load, these questions and concerns.
In a way that not only addresses them once they get there, but hopefully actually prevents them from ever being added to the mental load? Because I’m going to answer the question before it gets there. So that was the inspiration for my membership, Sterling Parents. So we take people from the beginning of trying to conceive and we say, Hey, here’s like, this is all the emotional stuff and the physical stuff and all this stuff that comes up in to conceive. We’re going to guide you through that. And then the same thing happens in pregnancy. So an example is people get really nervous about that. What genetic screening option should I choose? Oh, my fetal anatomy ultrasound is coming up. What does that look like? I have to do my gestational diabetes screen. And what we do is we send you the content, say, Hey, you’re 22 weeks, your gestational diabetes screen is coming up.
Watch this video. We’re going to talk about what it’s going to be like, what you can do to prepare. So they don’t even ever have to go, oh, maybe I should Google that and look that up. That never gets added to your mental load. And then as you get closer to delivery, we have all of the birth preparation built into the membership. And then we have a lovely pediatrician who comes in and teaches you about your newborn. And we have our lactation consultant who teaches you the basics of breastfeeding. Then we have a course that follows you that entire first year. And each month you get new content saying, Hey, you’re probably getting your going to start teething. There’s a sleep regression. Let’s talk about this stuff. So it all comes to you before it actually gets added to the mental load. And we have live community too. The Sterly Pearls are a community. So we get together on Zoom and we have happy hour, and we just share our life experience as moms and as pregnant people and all of it. So that’s how I have addressed my piece of the pie, and it’s so much else that goes into that child. Having actual childcare for people and the stuff boots on the ground is important, but that’s the solution that I found.
Dr. Sarah (19:33):
Your not going to go take on every single thing.
Dr. Sterling (19:35):
I really want to.
Dr. Sarah (19:38):
But you got to do one thing well, right? Yeah, yeah, yeah. And I think that that’s kind of very, in keeping with the message I kind of share with parents, just don’t just focus on doing one thing at a time. You can’t do everything.
Dr. Sterling (19:54):
I love that advice.
Dr. Sarah (19:55):
And it’s kind of true.
Dr. Sterling (19:56):
I love that advice. Yeah.
Dr. Sarah (19:57):
For you and me too. I think we need to do that.
Dr. Sterling (20:00):
I have something that I think that might be helpful to your listeners that it’s advice that I give to my pregnant members, but I use this as a parent all the time too. So I have this little bowl, I call it my becoming bowl. And I have these little attributes that I hope to live up to as a parent. So patience, presence, those kind of things in a bowl. And when I’m having a difficult day, I will pull a word and I’ll say, this is the thing. I’m just going to focus on this one word today. So today it’s a difficult day, and I feel like I want to fix the situation. I have a almost three year old who was having trouble at school, and we had to move his, and it was really a very challenging experience. And so it’s pulling that word and saying, okay, you know what?
Today I’m just going to focus on, I have fun in there. I have an adventure in there, just going to focus on patience, and another day I might pull fun. And so that’s what I lean into that day, and I’m like, I’m going to be 2% better at the fun today. I’m going to be 2% better at the patients today. And so that just allows me to think, you know what? I don’t have to worry about all the other attributes that I want to be as a mom. This is the one I’m going to focus on.
Dr. Sarah (21:18):
I love that. And I think that really speaks to this, okay, we could sit here and talk about all the mental low, we can list all the horrible things that we have to keep track of and why it’s so terrible. But we also want to balance that with, okay, so what do we do about it? Exactly. And this is a very good example, both because it’s grounding and centering and validating, but from a total cognitive standpoint, you can’t focus on 17 things if you’re focusing on one thing.
Dr. Sterling (21:48):
Dr. Sarah (21:49):
It’s when we’re working with anxiety. When I’m treating anxiety, and you get these really intense ruminative, like, oh my God, my head, my break. The thoughts are racing, and what if a lot of times, we’ll, what we’ll do if you’re experiencing that is we teach you to, okay, focus on a word, a thought, a thing, focus on a glass, look at all the different qualities of this. You just look at to focus really intently on one thing, and that mindful focus on a singular object or thought or feeling or texture, whatever. It doesn’t matter what it is. It’s putting your mind on someone thing. It turns out just you can’t do both.
Dr. Sterling (22:34):
Yeah. The power of our attention.
Dr. Sarah (22:39):
Dr. Sterling (22:40):
The brain, I nerd out on the brain because that’s what I studied in undergrad.
Dr. Sarah (22:46):
Love, love, brain.
Dr. Sterling (22:47):
I nerd out. I always thought I was going to go into psychiatry or neurology, and then I just fell in love with OB-GYN. It’s just so funny how things work out, but it’s that attention. That’s the thing. This is something that a little pearl that I talk about all the time with my members is intention plus attention is what I fall back on as a parent. My intention is to make my children feel heard, and I’m just going to pay attention to when I do that. And when I don’t do that and have some curiosity about myself and when I’m able to do that and when I’m not, and then it’s like, I love that it’s the trial and error scientist perspective of parenting. It makes it so much more fun. You be like, Hey, we’re going to go to the park and we’re going to see how this goes. Is this going to work out? I don’t know. Let’s try it out.
Dr. Sarah (23:42):
Yeah, I love that. It’s really funny, but I, I’m thinking too, okay, so one of the things that we can do to sort of challenge the mental load is notice what we’re focusing on. Notice what we’re putting our attention on. What you were talking about earlier is preparation. How do we anticipate things that could become stressors or worries or feel like a load? And so if we can forecast a little bit and sort of look ahead of ourselves a little bit, not in a, I’m obsessing about the future, kind of stuck in the future kind of anxiety way, but a, okay, I’m right here right now. Tomorrow I will likely be here in a couple weeks. I’m going to be here. What do I want to anticipate, prepare for? Yeah. We know that preparation reduces anxiety. What are other things that we can do either as perhaps the primary parent or maybe more on a societal level that can reduce the mental load, whether it’s in trying to conceive a child in parenting a family?
Dr. Sterling (25:02):
So I, one of the things, and again, you’ll see the addicted to the big picture thing is a theme. So one of the things that I think is a perspective that can help the primary parent is sometimes we think that in order to be a good mom, we have to make all the right decisions. So we put a lot of pressure on the decisions, and that’s where the researching comes into play a lot. The person who is the researcher in the family, family who looks things up and whatever, that is a significant job. Yes. Trying to figure out, read the parenting books and find the parenting experts and all of that, that’s a significant job. So the research is important, but understanding that it’s not so much that if I make all the right decisions, I’m a good mom. But if I believe I’m a good mom and I lean into my strengths as a human being and I lean into the fact that I am good and I love my children, I will make the right decisions.
Dr. Sarah (26:14):
I love that so much. That is such an articulate way of trying to describe my whole goal as a parenting support person is to be like I, because I feel like I get so many requests for people to be like, well, what do I say in this situation? What do I say here? What do I do here? And I frustrate people a lot when I’m like, well, it depends. I don’t have a script for you but I can give you some kind of context for how you might think about how to make sense of what you’re seeing. And that might inform your decision and might inform what you say. But I’m a big fan of frameworks over scripts because totally for this exact reason is because I think when we feed parents a ton of answers and a ton of scripts, what we’re doing is we’re reinforcing this messaging.
Dr. Sterling (27:04):
Dr. Sarah (27:05):
The right answers are out there. You just have to study enough and memorize enough of them, and you’ll get it right eventually. Yes. Instead of saying there are no right answers. What you really need is to feel like you have a way of connecting to your kid and understanding the cues that they’re communicating most of the time, some of the time, and that you don’t have to get it right all the time.
Dr. Sterling (27:29):
So I love that you said that. And here is an example that kind of illustrates that point from my own life. So I have a kindergartner, and she’s a classic first child. I’m a first child, so I recognize a lot of myself in her. She gets really stressed out in the morning doing all of the things. And I am not a detail-oriented person. I’m not even a particularly organized person. So I would see a lot of people talking about all of the things that they do to organize and get ready, their kid ready for school. And I’m like, well, that is really hard for me. What am I good at? Okay. I’m really good at, I’m great at entertaining and creating special moments. I, I’m the one who does the vacations for the family and the birthday parties, and I can craft really special moments.
So what if I look at our morning time in her getting ready for school as a special moment? And the theme, the vibe is it’s calm. How can I craft the morning as a moment thinking of it like an event? And then that utilizes my creativity to say, oh, I can do this before she wakes up and I can have her breakfast made when she wakes up and I can do this. And so I’m not putting this pressure on, gosh, everybody else, Christine is or more organized than you are and has all these checklists and you don’t do it that way. So I lean in to my strengths as a human being when I’m faced with parenting challenges. And I also have this fundamental belief that our children are our soulmates. So if I lean into my strengths and my values as a human being, I’m going to be in alignment with them. And it really has been the thing that coming from somebody who was very determined work ethic type a person before I kind of entered parenting, that belief, my children are my soulmates. I just have to lean into my strengths, has been the biggest weight off shoulders.
Dr. Sarah (29:42):
Yeah. I love that. That’s such a beautiful way of thinking about it. And to me, it kind of reminds me of this idea that if we trust, we can trust our kids are who they are from the minute that they’re born. We are not filling up an empty vessel. There’s such a huge pressure on us if we think that that’s our job, think our job is to craft a human being and we better not mess it up. Geez, what a responsibility. But no, our kids are exactly who they’re supposed to be. Our job is to be a detective, not a sculptor. Like a curious observer. Ooh, tell me who you’re going to be. Tell me who you are today. Yeah. Take so much pressure off. Our job is really to create a safe environment for them to show us who they are. Exactly. And that’s a lot easier to do.
Dr. Sterling (30:32):
Exactly. I love that you said that. And our job is not to fix them. They are not problems to be fixed, but it feels like that. And I really think that sometimes social media really makes it feel like, oh, you better fix the potty training issue. You better fix all of this. And at the end of the day, if your child is having a challenging time, you are a consistent support. And you may kind of mold the way that they interact with the world over time, but it’s not in this moment, I have to fix this issue. It’s like, okay, they are shy. And so over time, I have to consistently model to them that you’re safe, et cetera. You know what I mean? Just even this pressure on each tantrum to fix them is, yeah, it’s so overwhelming.
Dr. Sarah (31:31):
And it’s not accurate. It’s just really not accurate. That’s not how child development works. We’re not that fragile. If we were that fragile as human beings, we would be pretty screwed, right? Yeah. That if our parents said one thing wrong or did one thing wrong in a single interaction, that our attachment systems would be completely derailed. We wouldn’t be a robust species.
Dr. Sterling (32:02):
Dr. Sarah (32:03):
But we are. We’re doing okay.
Dr. Sterling (32:06):
Dr. Sarah (32:06):
Not fantastic sometimes. But I think feel like people are starting to learn a little bit more about attachment relationships and the power that they hold and the priority we want to make them. But I do think people misunderstand, they misperceive a fragility about attachment systems that I don’t think is actually there. Is it important that we learn about them and understand how to support secure attachment? Absolutely. That’s like the whole reason I have a podcast about it, because I want to teach people how to know what’s important and how to do it, but it’s not that fragile. We don’t have to beat ourselves up for every single decision.
Dr. Sterling (32:50):
And the brain is constantly adapting and learning and changing both our children’s brains and our own.
Dr. Sarah (33:00):
Dr. Sterling (33:00):
So the idea that there’s, of course, there’s certain things that can happen in life that can set off trajectories, major traumas, et cetera. But really major traumas aside, a lot of it is just consistent, a consistent environment that is not always perfect, that our children’s brains are so adaptable. And I mean, it’s just the development of the human brain both in children and adults is just the most fascinating topic I think that is on the planet.
Dr. Sarah (33:40):
I agree. We could do a whole other episode, and maybe we should about the way the brain changes in pregnancy, because I love that. I’m so obsessed with talking about that because I think a lot of pep, we talk about preparation for things that are coming down the pike. A lot of parents are really thrown. They know they’re going to have hormonal changes and their body’s going to change, but they don’t realize how much their brain changes. And it’s profound in a good way, but it’s also really challenging. You have to adapt really, really quickly. It’s almost like a third. I always say toddlers and teenagers are very similar because their brains are under construction. So are new moms. Yes. It’s the third brain recon, brain construction time in our life.
Dr. Sterling (34:31):
And the interesting thing about the brain is that we give ourselves that we are in control of our thoughts and so much more than, I mean, we think that we are under conscious control of the things that we think and where our attention goes. And so much of that is subconscious. And we have a moment once it arrives in our consciousness where we have more agency, but we are so hard on ourselves about just the random things that fire off in our brain. And oh my gosh, I can’t believe I thought that. What kind of person thinks that happens all the time with scary thoughts postpartum? Yes. And it’s like, oh my gosh, must there must be something wrong with me. We assigned so much weight and we don’t understand that our brain is so much more complex than even than we understand that we’re aware of.
Dr. Sarah (35:34):
Yes, yes. No, it’s interesting. I think it’s also, I mean, I didn’t even know postpartum anxiety and postpartum OCD people don’t know as much about those PMADs and PMAD is a perinatal mood and anxiety disorder. But people just think, oh, postpartum depression. But there’s eight, maybe, perinatal mood and anxiety disorders that you could have maybe more. It’s not just postpartum depression. And I think people don’t realize that those scary thoughts, those intrusive images of, you know, dropping your baby down the stairs or really, I to remember when my son was born, I had postpartum anxiety and I would get these, I’d be walking down the street and I would literally picture in my head someone grabbing him and running away. I’m not an anxious an person at baseline. I’m a pretty low anxiety person. And I was so anxious when I had my son, and I was like, where is all of this anxiety coming from? I get it. I’m a new mom, but why are these, it wasn’t like, oh, I’m worried. It was like, really intrusive thoughts that were disturbing.
Dr. Sterling (36:48):
I had the same thing. And I also, I’m not an anxious person either. I made, we live in San Diego, we live by some cliffs on the beach, and we went for a walk. And with my husband and I, my second had just been born and my oldest and my husband were over closer to the water, and I could not get out of my head that Celeste was going to fall into the water and that I was going to forget I was wearing all Oliver and jump in after her. I couldn’t get it out of my head. And I was like, this makes no sense, hun. No sense. But we have to leave because I cannot, can’t be this close to the cliffs. And it was this strange, it was such a strange experience. And that’s the thing is it’s not like none of us want.
You didn’t want to think about that. I didn’t want to think about that wasn’t very much. Our brain is going through such massive changes because in order for you to go from really just focus on your own survival to now focusing so much of your time and energy and resources on another person’s survival, your brain has to change in order for that to happen. So oftentimes the brain really overshoots it and says, I’m going to make you think that you’re dying, this child cries so that you’ll attend to this child’s cry. So our brain overshoots. And then for when it goes accordingly, we’ll then kind of reel it back in and then we’ll find a steady state. But boy does our brain overshoot a lot of the time. Right?
Dr. Sarah (38:24):
And I think it’s very important for parents to understand that that’s really normal. It’s nothing wrong with it that’s happening. We can diagnose it. Sometimes it’s not even clinical, it’s subclinical postpartum anxiety, but sometimes it’s clinical postpartum anxiety, and that’s treatable. And whether it’s going to therapy or medication management or simply just getting support, right? Yeah. Doesn’t always layers. You don’t have to go take meds if that’s not what you want to do.
Dr. Sterling (38:57):
No, we have a mindfulness program, and that’s where I love to send people who are like, yeah, I talked to my doctor. We’re thinking about medication, but we’re going to hold off for now. And we’re like the go take, go to the mindfulness program. Just that alone, there’s such good evidence on mindfulness for depression and anxiety. Yes. I’m a huge, I love mindfulness and meditation. It’s a superpower as a parent.
Dr. Sarah (39:22):
Yeah. It’s so funny. I prescribe it, I’m saying in quotes, prescribe it to my patients all the time as a treatment, adjunctive treatment for their anxiety and depression. And I’m sitting at home being, I know I’m so supposed to meditate. I never do it. And this is my, we’re recording this January, 2023. I’m like, this is my New Year’s resolution is, I hate news resolutions too, but I’m like, I’ve got to build in time in my schedule to actually meditate because I just know how good it is for me. I know. I’ve got the data.
Dr. Sterling (40:01):
The data is so cool. I mean, data on mindfulness, a decrease in all cause mortality, what? Decrease in cancer, longer lifespan, what, this is what I’m saying, we are ignoring the fact that we have all the data on stress that it’s bad for our health, blah, blah, blah. But then look at things like mindfulness and this, if there was a pill that did this, improved satisfaction with parenting, there was a pill that did this, y’all, we would be paying a thousand dollars a month for this pill. But I get it. It’s like it’s time. It’s time. It’s a difficult habit to get into. But yeah, I love, and that’s why programs that are kind of set up, that you don’t have to figure it out on your own are so nice. The apps and books and all of that.
Dr. Sarah (40:52):
Yeah, no, I love it. I think mindfulness practices, and it doesn’t need to be sitting in zen meditation either mindfulness, you could mindfully take a shower. In fact, I always tell people, my favorite, this is my starter mindfulness exercise is mindful toothbrushing, because you’re going to do it every day. Yeah. It’s only three minutes, maybe not even. And there’s such a sensory rich experience that it’s a really easy thing to kind of do with full mindful awareness. So I just say, get into the habit of doing, even if you only do one of your toothbrushing sessions mindfully. Yeah, that’s three minutes a day. That’s really actually pretty good.
Dr. Sterling (41:41):
That’s incredible. And it’s it’s habit. It’s building a habit. I do it with, I do mindful mindfulness meditations when playing with my kids. So I will set a timer for 15 minutes. I will then put my phone in another room and I will get on the ground. I have little kids, obviously. If you have a 13 year old, they might be like, okay, mom, you can, I get on the ground with them where they’re playing, and I just try to be in the present moment, and I just soak them up. I watch their little mannerisms. I notice things like their eyelashes and the color of their eye and their hair, and just like, oh my gosh does. And this is why I think mindfulness is such a parenting superpower and why we emphasize it inside Sterling Parents so much. Because the hard stuff in parenting is so freaking loud.
It’s like the blowout diaper, the screaming tantrum, the attitude from the kindergartner. You know what I mean? But the beautiful stuff is oftentimes so quiet. And when you’re in that present moment, you notice their little fat on their wrist, their little chubby wrist. And I, I’ll notice my toddler, the way he puts his hand, rests his hand on his face. And it’s those moments where I’m like, oh my gosh, I’m being filled back up. So the loud stuff drains me and I, I’m a very sensory, auditory person, so I get really easily overwhelmed with noise. And so that can be really draining. But when I then say, okay, I’ve had a really draining day with the kids, and sometimes I just want to book it and it’s throw ’em in bed and go upstairs. But sometimes what actually helps is being present with them, because then I just get all of this love and beautiful oxytocin flowing when I just observe them. And that’s a mindfulness meditation that is your meditation practice.
Dr. Sarah (43:48):
Yeah, it is. And what’s kind of amazing about that, because actually tell my patients to do that too. I tell them to watch their hands, watch their child’s hands for 10 minutes while they’re playing. And it’s this amazing exercise in not, you have to sit on your own hands, so you have to watch your child hands. So you just, for 10 minutes, you’re just going to kind of, and your mind will wander, but then you try to bring it back to the hands. But watching them solve problems with their hands.
Dr. Sterling (44:18):
I love that.
Dr. Sarah (44:19):
It is like, you are going to feel so much, I don’t know, you feel so connected to your kid and when you do that, but here’s the reason why I tell parents to do it obviously, because of all the reasons, it’s good for the parent, but it fills up the kid. And it’s a way to fill up your kid without entertaining them. Parents are like, I’m so tired. I don’t want to play with my kids at the end of a long day of work. And I’m like, I don’t want to play. I do that either. I don’t blame you. I don’t never tell you. Right.
Dr. Sterling (44:51):
I’m only observing.
Dr. Sarah (44:52):
I’m the worst about it. But what I do do is I sit with them.
Dr. Sterling (44:57):
Dr. Sarah (44:58):
And I watch their hands, or I will, but it’s, it is an exercise in meditation. It is really hard to do. Yes. But am my wine totally wanders. It wanders to all the mental load to the Amazon list that I have to make sure I, oh, I got to add this. Oh wait, we’re out of that glue. I need to put that on the list. And then what’s, what do we have to get at the grocery store and what am I packing in the, so I will go to those places, then I bring it back to, okay, just notice, observe without judgment, and then bring it back to the hands. And it fills up your kids too. And which is going to reduce the power struggles and the testing behaviors. And the agitation.
Dr. Sterling (45:45):
You see me. I don’t have to scream. You see me. Yeah. Yeah.
Dr. Sarah (45:49):
So it’s a double twofer.
Dr. Sterling (45:51):
It is. It’s a twofer. And I think one of the things that really scares people away from meditating is that they think that it necessarily doesn’t necessarily feel good while you’re doing it, when you’re doing it with kids. Oftentimes it does. But sometimes you’re going to be really distracted. And then you have to make sure that you’re not going to the shame spiral of like, oh, I can’t even pay attention to my kids. Because the whole point of mindfulness meditation, really mi and meditation in general, which is focused attention, is that some of the meditations in which you are the most distracted are the most powerful. And building that muscle. Because when you bring your attention back to that singular focus 30 times or more in a 15 minute period, you are exercising that muscle so much. So you might not feel great during the meditation, but your brain will benefit from that exercise. It’s the same thing as getting on a bike or going for a run. It doesn’t, always feel good while you’re doing it.
Dr. Sarah (46:53):
It’s like you did 30 reps.
Dr. Sterling (46:54):
Dr. Sarah (46:55):
If you bring your attention back 30 times, you can look at it as, oh God, I got distracted 30 times. Or you can look at it as, I just did 30 reps.
Dr. Sterling (47:04):
30 reps. Exactly. Exactly. I love that way of, I’m going to use that. I love that way of looking at it. It’s 30 reps.
Dr. Sarah (47:10):
Yeah. It is.
Dr. Sterling (47:11):
Look at how strong you are now.
Dr. Sarah (47:12):
Yeah. You know, just did a high intensity train. It was a HIIT. That was an exercise kind of like a HIIT meditation, long, slow walk. I love it. That was really easy. It’s funny, it’s funny because I did an episode with Diana Winston who does a lot mindfulness research at UCLA. And we talked a lot about the metaphor of mindfulness and exercise and how they’re like you. They’re really similar concepts that Yes, just like a exercise for your brain and that endurance and that building up that the ability to go for longer periods of time. And it’s a muscle.
Dr. Sterling (47:53):
It’s a muscle and it’s an an incredible gift as a parent to work that muscle and just in life in general. But so much of our children’s brains brain is really modeling for their brain at when you get down to it, the way that our brain is wired is the way that we are going to teach our children to wire their brain. So if we can wire our brain and do these exercises for ourselves, we are also going to be instilling that in our children. So when I’m driving the kids to school, we have a long drive to school, which isn’t the greatest, but I’m always pointing out, oh, you know what a look at these big puffy clouds. Look at this. I’m bringing myself into the present moment because I like to do mindful driving and not get into, oh my gosh, driving can be so stressful when you start thinking about all the things.
Dr. Sarah (48:59):
Oh God, especially with kids in the back.
Dr. Sterling (49:00):
So I do mindful driving. And I do it out loud with my kids. So I’m like, oh, look at this. Oh, look at this. And we’re Jewish. So we say baruch Hashem, thank God. Look at all of this. And it’s really just a lovely way, it’s having a family value of presence and mindfulness. It’s just a lovely way to be and feel in your life.
Dr. Sarah (49:26):
Yeah. All right. So kind of recapping, we talked about the need to prepare, how having, not getting crazy anxious about the future, but having a little bit of a preview. So it’s coming.
Dr. Sterling (49:39):
Like a half step ahead.
Dr. Sarah (49:40):
A couple steps ahead, but that you feel confident and prepared and also that you can tolerate some of the uncertainty as well. Cause I think that there’s a piece that, there’s two sides to that coin, right? Yes. Preparation for what we can prepare for and tolerance that there’s going to be a lot, we won’t be able to, and that that’s okay.
Dr. Sterling (50:00):
100%. And then we’re going to, just going to trial and error it. We’re going to be curious about what’s going to work.
Dr. Sarah (50:06):
Right? Which is the second thing we talked about, which is not needing everything to be perfect, not putting so much pressure on ourselves to have every single answer, to make every moment a teachable moment or whatever. Sometimes it’s messy and that’s okay. But that if we understand the big stuff, it’s going to guide us in the little stuff. And versus being obsessive about the little stuff because we’re so worried that we’re going to mess up all the big stuff. I love the way you put that of leaning into who you are as a parent and what your strengths are and letting that help you make the decisions versus the other way around. And then we kind of landed on this huge piece of mindfulness and presence and just slowing down and paying attention to what we’re paying attention to. And I love that. And I think those are all in very, very different ways. Things that do combat the mental load of parenthood and buck the system a little bit and say, you do not need to be a pawn or a, what’s the word? You don’t need to be dependent on this system to save you. You can do things.
Dr. Sterling (51:14):
It should be better, but it’s not. So we’re going to just deal with it as it is. But I think that understanding that it’s not your fault. It’s not your fault that you have this incredible mental load. It really shouldn’t be this way. I think that we, it’s so easy to imagine a much better system, but that’s not what we have. But at least just acknowledging the reason why I think it’s so important to acknowledge that the system itself is broken is so that we don’t put the pressure on individuals like, oh, this is a you problem. No, you are existing in a very broken system that does not adequately support you. Okay, not your fault, but let’s talk about what you can do to actually live a joyful life in this broken system.
Dr. Sarah (52:07):
And I think finding the right support system, finding access to vetted information. I do think the parenting space, the, it’s saturated. There’s a lot of noise out there. It’s really overwhelming. So, and a lot of people have really good information that’s not, that contradicts it, the other person’s really good information. So it’s like, it’s okay to just find one or two voices that feel aligned to you. And just turn the rest off. You don’t need all of the information. You just need what you need right now. And you need to feel, just like our kids, we were talking about how our kids don’t actually need us to be perfect all the time. They just need someone to be this sort of stable Yeah. Reassuring anchor. Yeah. That is trustworthy. We need that. Yes, we as parents need that. So we just need to find a safe place where we know we’re going to get reliable information. And we don’t have to have 50 of those.
Dr. Sterling (53:12):
No, no. I mean that you’re going to get into analysis paralysis and decision fatigue.
Dr. Sarah (53:19):
And that’s the problem with social media is you, your feet is going to throw 50 different people at you. Yes. And you have to figure out how to get off of that, that it’s not a windmill. What is the word I’m looking for? That carousel?
Dr. Sterling (53:34):
Well, it’s this idea that we have to, in order to make a good decision, we have to gather all the information and then arrive at a decision. But we get stuck in the gather information too much. So one of the things that we teach inside Sterling parents is something called the combatant decision framework, which is how physicians, physicians we, you notice, we don’t just like order Pan CT scans and all of the labs and everything on everybody. You can’t do that or else you, you’re get lost with all the information. You can’t prioritize what’s important. So what I tell the my members to do is, okay, first just ask yourself the question. When you ask yourself the question, you’ll identify a missing piece of information that you need. And that’s the missing piece that you go and you find the evidence-based, expert based resource that can fill that missing piece if it happens to be a piece of knowledge that you’re missing. And you don’t have to listen to your neighbor and their parenting advice or your mom and her parenting advice or an influencer and how they do it, you can just listen to an expert.
Dr. Sarah (54:51):
Yeah. So speaking of experts, if people want to learn more about what you are doing and how to get your expertise, how can they do that?
Dr. Sterling (55:02):
Dr. Sarah (55:13):
Awesome. Well, we’ll link all that in the show notes, but I’m, ugh, it was delightful talking with you. I really love, I love, it’s so cool when I meet people who are in a different field, but obviously different but adjacent. But our training is so different, the things that we studied in graduate school so different. And yet here we are kind of in such alignment on these things that like, cause it’s just cool. It’s just so much fun.
Dr. Sterling (55:41):
Yeah. It’s different. It’s different angles and perspectives looking at the human condition, right? Yeah. We’re both addressing the human condition and we just do it from slightly different angles. But there’s so much overlap too.
Dr. Sarah (55:51):
I know. It’s really cool. It’s really cool. So thank you so much for taking the time.
Dr. Sterling (55:56):
Dr. Sarah (56:03):
As we were just discussing, being able to anticipate what’s coming and feeling prepared can significantly reduce our anxiety and stress when you are already in the thick of it. Sometimes it can feel daunting to take that first step. And that is why I advise expecting parents, in addition to creating a birth plan to create a postpartum plan as well. And that’s exactly why I created a mental health postpartum checklist and made it completely free because I want all new and expecting parents to have access to it.
(56:33):This interactive checklist and workbook will walk you through everything you need for establishing your personalized, physical, and emotional support systems throughout your postpartum. You can feel more confident and relaxed knowing you have all your ducks in a row and have a game plan for whatever your new little duckling brings. So to download my mental health postpartum checklist, go to my website, drsarahbren.com and click the resources tab. That’s drsarahbren.com/resources. This is also a great resource to share with any friend you have or a family member who’s expecting now. Thanks for listening and don’t be a stranger.
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