mood disorders

Transformed by Postpartum Depression Podcast Episode Zoom Interview Screenshot

Transformed by Postpartum Depression: Podcast Episode #110

 

 

Alyssa:  Hi.  Welcome to the Ask the Doulas Podcast.  My  name is Alyssa Veneklase.  I am co‑owner of Gold Coast Doulas, and today, I have Jessica Kupres, one of our postpartum doulas, with us, and we are both so excited to talk to Dr. Ladd.  She is the author of a book called Transformed by Postpartum Depression.  Hi, Dr. Ladd.

Dr. Ladd  Hi, guys!

Alyssa:  Hi, Jessica!

Jessica:  Hi!

Alyssa:  So, it’s still COVID.  We’re still in a pandemic.  We’re recording via Zoom, so if we hear any — you know, I have a dog and who knows what else.  Bear with us, right?  So, Dr. Ladd, I have to start — so Gold Coast Doulas is a doula agency, and I read that you were a birth doula.

Dr. Ladd  That’s correct!

Alyssa:  Are you still actively working or not?

Dr. Ladd  No.  I miss it.  I miss parts of it.  I decided to become a doula — I had a doula for my first birth, and she was wonderful.  And after I had my experience with a traumatic birth and then postpartum depression, I decided that I wanted to be a birth doula and did the DONA training.  And when I did the DONA training — this is all related, I swear – I saw in the syllabus, and Jessica, you can probably relate to this.  This was back in 2000ish – 2001, 2002.  So I was doing the training for birth doula certification, and I saw on the syllabus that there was nothing about perinatal mood and anxiety disorders.  Nothing.  And at the time, it wouldn’t have been even called that, but we didn’t – there was no training about depression or anxiety or any sort of mental health other than this kind of vague emotional support.  So I asked the trainer if I could bring in my own materials and do a presentation at the doula training.  I was so obnoxious.  And I took the PSI information with me and some basic statistics and basic, you know, what I had been through and shared my story.  And so my doula practice ended up being – I got breast cancer shortly after I was certified, so I took a hit in terms of how many I was able to do, but I did specialize in working with moms and partners who had had some sort of a trauma.  Either previous birth trauma or other; military.  I worked with some military couples.  And I absolutely loved being a doula.  It was hard physically.  I don’t think people realize how hard it is in terms of sleep deprivation and physical stuff.  But yes, I was a birth doula.

Alyssa:  Yeah.  I thought that was amazing.  Well, and it’s really amazing that you – they let you do your own presentation on mood disorders at that time, and I almost wonder if maybe you were a catalyst to adding some of that stuff to the DONA training, I wonder.

Dr. Ladd  Well, I’ve since been lucky enough to know Penny and Phyllis and work with them.  I was the founding president of PATTCh, which is dedicated to preventing traumatic childbirth.  And I’ve had many conversations over the years with Penny regarding whether or not doulas, birth doulas, should have what she would consider, I think, a scope of practice issue, because her amazing vision and belief was that anyone should be able to get the training to be a doula.  And along those lines, she felt that anything that kind of went into mental health needed to be handled by a professional.  So she and I have had those conversations throughout the years, and I’m hoping that the more the doulas nudge, that we can handle the statistics.  We can wrap our head around how to help somebody get to the Edinburgh Postnatal Depression Scale.  It’s fairly straightforward.

Alyssa:  Yeah.  I think we’ve come a long way in 20 years, right?  It’s been almost 20 years since that training.  At least we’re talking about it more.  I mean, that’s a step; a huge step in the right direction, that mothers are talking about this.

Jessica:  Yeah, getting the word out there so they don’t feel alone.

Alyssa:  Right.  So one question I had about even just the title of your book, Transformed by Postpartum Depression,  I was wondering – you know, that word “transformed” is so powerful.  And then I read in one of the chapters that you had – you were reading a book yourself about – I forget who the author was, but it had something to do with mental illness and mental health for mothers, and you read that word and it just, like, hit you.  So I’m guessing that’s why that word is so powerful to you and why you used that for the title of your book?

Dr. Ladd  Partially, yeah.  I mean, the title – that word did jump out, and it was Jeanine Driscoll, and this was a book that I had been given in my clinical training as a therapist.  And her story of postpartum – at the time, this was, for her, in the ’80s – she used the word transformed, and it’s the first time, I think, I had aligned the idea of transformation with perinatal mood disorders because I felt so different.  And when I, years later, went forward to do research in this area, the original title of this study was Changing instead of Transformation.  It was Changing Depression.  And my thought there was that what I was finding from the women’s own lived experience was that there’s a certain nature to postpartum depression.  Like, it has its own entity, and it is a changing kind of depression.  It’s so forceful.  It’s so sudden and comes on so strong, like a trauma, that it has its own sense of power.  It can change you.  And then I came back to the word transformation, and I think now, to be honest, I still grapple with that word a little because I think it has – I don’t want it to only be seen as a good thing or a bad thing.  It’s just that, gone untreated, these disorders change women.  They change women.  And for some, that change can be powerfully positive, and that’s where I got more – you know, I got involved with posttraumatic growth, but not everyone.  Not everyone.  So, yes, it’s a transformation, but I’m also kind of hinting at – which I don’t think I’m quite there yet.  I want to keep working on it.  I want to transform postpartum depression itself.  I mean, in the very back, I put together that graphic at the back page, which shows what we’ve called postpartum depression since the beginning of time, and we haven’t really gone very far.  It’s around birth.  It’s always related to some sort of reproductive event.  So I want, like you guys, to transform not only the experience that women have, but what we say about it, what we know about it, and the language that we use.

Alyssa:  Yeah.  You had mentioned that your husband at the time just kept telling you, this is all in your mind.  You’re making this choice.  Right?  And I think, you’re not the only one who hears that.  And maybe even if we as mothers aren’t hearing it from someone else, we’re hearing it from ourselves.  Why don’t you just do this?  Why can’t I just be that?  So I think you’re right in transforming not only what we call it but what we think about it and what we know about it, and I still think we don’t know enough about it, even though we’re talking about it.  It’s very surface level.

Dr. Ladd  Why do you think that is?

Alyssa:  You know, I didn’t know about it when I had my daughter.  I didn’t really know what it was.  And I would say, oh, no, of course I didn’t.  But then I think back, the more I learn, I’m like, oh, my gosh.  I remember sitting in the nursery just in tears in the rocking chair, and breastfeeding was so much harder than I imagined, and your hormones and your emotions are all over, and, you know, granted, for me, it slowly got better, but I don’t know.  I guess, was I in a depression?  Did I just have some anxiety?  Was this all just normal?  It’s hard to put a name on something.  And then the stigma of that is also what hinders a lot of mothers.  And, Jessica, I think you had a question specifically about postpartum depression, too.

Jessica:  Yeah.  But to go along with what you guys were just talking about, I think that part of it is, a big piece is that stigma, and going with my question in just a second, is that moms are afraid.  If they speak up and say something, their baby will be taken from them.  I did have postpartum depression pretty severely, and I didn’t seek help for eight months because I was, like, these horrible thoughts, which I now know were intrusive thoughts: they’re going to take my baby.  I don’t want to lose my baby.  And I think that that’s a big message that has to get out there, is that seeking help doesn’t meant that you’re a bad mom, and it doesn’t mean they’re going to take your baby.  It just can help.  And so I think that is a big piece of it.  But talking about this and this language, I wonder – you’re predominantly saying postpartum depression and focusing on the depression.  Why don’t you include more of the other things that go with it?

Dr. Ladd  Good question.  And I do, but it’s all because of language.  What we’ve known in common society – I think postpartum depression is the most identifiable.  So anybody who’s a possible reader or a clinician who hasn’t full training in the full spectrum of perinatal mood and anxiety disorders might identify postpartum depression.  And I also use it as an umbrella for all of the disorders because the language hasn’t filtered out to – I mean, we’re talking, all three of us this morning, about not knowing what to call our own issues when we have them.  So somebody with intrusive thoughts is not necessarily going to know that they might have postpartum OCD or postpartum panic disorder.  So I use the language that we’re most familiar with.  And I want to tag team on something you said about stigma.  You know, stigma – I did a study about how women who are diagnosed with bipolar disorder in the first year of postpartum, how they experience stigma.  And, basically, for all of us, any sort of the way we make decisions about the world is we observe how people are behaving, and if we perceive something to be outside of the norm – this is based on Goffman’s stigma theory – we kind of mentally categorize them as different.  Right?  And that different space is over, away, from what we’ve come to recognize as everybody else being normal.  Right?  So that different space lingers, and if we perceive them as either physically different or behaviorally different or emotionally different, we’re going to put them – our habit is to put them over in the “different” space.  And gone unchecked from just basic knowledge, that “different” group of people, we will build assumptions and beliefs about what they are capable of or how they fit in society, and it’s usually negative.  That creates the prejudice.  A prejudice; a preknowledge belief that, okay, that person who is behaving or looking different is going to potentially do things that are unpredictable.  And then if that goes unchecked, we can actually unconsciously build this implicit bias where we will discriminate.  We will discriminate in micro ways against or away from people that we perceive to be different.  So let’s take a mom who is crying a lot, and in the book, one of my participants referred to it as leaking.  You know, it’s like this kind of leak.  It’s like an involuntary crying.  Like the stomach flu, but you’re crying.  There’s no control over it; it’s just coming out.  So let’s say this mom is crying.  She feels that those symptoms are out of – they are out of the range of normal for her, and all of the baby stuff that she’s seen, from the minute she peed on the stick, didn’t show anybody crying inconsolably.  So when she goes out into the world, if it’s to Walmart, if it’s to the care provider, if it’s to the postpartum doula, there are no representations of that as normal.  So she moves herself into that “different” space and can start to believe that maybe there’s something seriously wrong with her.  And if that goes unchecked and she is at a family event crying, it gets validated because everyone’s like, why are you upset?  You have a new baby.  Everybody’s great.  So that process of stigma happens for women constantly.  And we unfortunately do it to each other.  When I was a doula, I once had a mom ask me to go to the supermarket for her to get formula because she was so afraid that some of her neighbors would see her buying formula instead of breastfeeding.  So that’s just one example.  So that stigma piece is – and the media certainly doesn’t help.

Alyssa:  Right.  And I had a question about one excerpt from your preface, and maybe I’ll just read it, because it stuck out to me.  Again, it’s the whole stigma, and it’s the idea of what do we call this.  So it says: “I reject the notion that objective truth is inherently real or measurable but rather constructed by multiple entities, including society, culture, history, and individuals, all coexisting.  So from this perspective, the reality of postpartum depression can’t be known, defined, or quantified.  By definition, it is constructed in real time, every time, in multiple ways, by multiple people.”  So it’s dynamic and changing, and to me, this pinpoints exactly why this is so hard to define, because postpartum depression, for one, doesn’t look – you know, for you doesn’t look like it does for me, and a lot of how we feel about, you know, if I had it, maybe it’s the way my family’s talking to me about it.  Maybe it’s, you know, not going to the grocery store for fear of my friends finding out I’m buying formula.  Or maybe I don’t care about that, but I have to post all the beautiful Instagram photos.  There’s just so many different layers and levels that I think you just hit the nail on the head with why this is so hard to define and then so hard for others to understand.

Dr. Ladd  Exactly.

Alyssa:  So when a mom has it, I feel like she’s – you know, maybe her partner doesn’t understand.  So like you, getting the whole thing about well, just change your frame of mind.  Just do something different.  Get your head out of the hole and, you know, you have a baby who’s beautiful, so what are you so sad about?  If people don’t understand, then we just dig ourselves into a deeper hole.  Well, I know I feel this way.  I shouldn’t feel this way.  I don’t want to feel this way.  But now they’re making me feel worse, so now I’m probably digging a deeper hole, and it’s just getting harder and harder to get out.

Dr. Ladd  Yes.  And part of what you’re saying, really, it speaks to how do we fix this, and I think the more we can normalize that – we have no trouble talking about a clogged milk duct.  No trouble.  We’ve made that okay.  And women have said, I need help.  So there’s been this agreement between science and society to allow women to talk about things like sore, cracked nipples, for God’s sake.  We can do that.  We can talk about how to care for an episiotomy repair.  I think maybe if we could talk about the range of that for every birth, there is a range of physical and emotional recovery and experience, and within that, I mean, we do know that 80 to 85% of all birthing women will experience postpartum blues, that kind of – you know, shortly after birth, two or three weeks.  It lasts for a few days and then moves out.  But we’re not even comfortable talking about that, and when I say we, I mean all of us.  But predominantly care providers.  So when you’re discharged after having a baby and you have all those pamphlets about how to lactate and breastfeed but there’s nothing in there about how you can identify if you’ve got some things going on with your brain, there’s a miscommunication.

Jessica:  So what would you suggest?  And this – I just really am interested.  What would you suggest as care providers that we do to get the word out?  How do you think we could improve that so more moms would know about it ahead of time and can be better prepared for it so it doesn’t just hit them like a ton of bricks?

Dr. Ladd  I think there are a couple of things, one of which is public health.  And on the public health level, we need more support for mandated screening.  And ACOG is close, but not there with the mandate to screen.  And even asking a woman about her family history, we’re not – if it’s not on the checklist for an intake for the OB nurse, for any sort of prenatal or perinatal care provider to say, so, tell me about your family history with any sort of mood or anxiety disorder.  If that’s not on the list, that’s something we could add quickly.  We’re not shy, and ACOG is not shy, about saying that we need to test your urine.  We need to test your blood.  We need to test your blood pressure many times to screen.  But yet even though we’ve got these validated screening tools, it’s not mandated, and that sends a message.  I’m not even sure that would fix it.  But on the public health level, organizations like National Perinatal Association, NPA, PSI, who are saying, we have to change it by asking women.  That’s one way.  And then I personally believe, and that is my personal belief, that the more women can talk about how they’re feeling, regardless of what they think might be happening in response to that, the better.  So in my research, all 25 women ended up having to get themselves treated because providers failed, even when women were saying flat out, I’m not sure I want to be here, or I think I shouldn’t be my child’s mom, or I can’t sleep.  And providers miss it.  And I don’t want to bash providers; I really don’t.  I want them to get the support from their certifying bodies that it’s important; important enough to take 5 minutes out of the 15 minutes that they’re given with a patient and ask.  So that’s part of it.  And I think as the birth community, the mom community, that’s so huge now online.  Maybe we just need to lighten the load on the language.  I mean, the women in my book speak very frankly, and I think all women speak very frankly when they’re not under the – you know, when they’re not being analyzed.  We all have those private Facebook groups where women are throwing down.  So when a participant will say to me, I don’t know why we don’t just tell each other.  It sucks, man.  That resonates on a level to any mom, regardless of their perinatal mood or anxiety disorder.  Why don’t we tell each other it sucks?  And that’s the last piece.  And it seems to be that we have a lot of trouble allowing – I’m going to use the word allowing – women to be ambivalent about motherhood.  You’ve got to love it all, or you’re horrible.  Every moment of it, every diaper change, every ear infection, all of it.  And that’s – who loves all of anything?

Alyssa:  Right.  That’s not fair for anything, let alone a screaming toddler or a sassy teenager, right?  With each new stage, I feel like – you know, I always tell my postpartum clients that every developmental stage, you lose something that’s so hard, and then you go onto something that’s easier, but then this new hard thing is going to come.  Like, there’s always going to be this new hard thing, and you won’t be prepared for it, and it’s okay.  It will suck for a while.  But yeah, I think it’s hard to – you know, I have whole days that I’m just like, oh, my God.  This is awful.  What in the world?  Why?  I read something the other day where this mom said she had one kid, and it was – you know, the pain of it and just the exhaustion.  It was, like, a two-day induction or something.  She goes, my only thought was, why in this developed world where contraception is available do we have so many humans?  Like, why are people doing this again and again?  And she was so real.  I loved it.

Dr. Ladd  Yes!  And the last piece of this, and not everyone – you know, I will just share that I think Bowlby and attachment theory has done a number on us for six decades because, on some internalized level, guys, we are buying the notion that maternal deprivation will harm the thing that we love more than anything.  That if we sneeze in the wrong direction or have a thought about, God, I’d really like to not be doing this right now, we will harm our child.  Not only once; for their lifetime.  And while we do have, you know, years of science about maternal attachment and development, we have yet to really clear the debris of what attachment theory can also do, which is to shame women out of their reality.

Jessica:  Yeah.  I feel like that’s a lot of mommy wars type of stuff.  There’s so much information on how to be a good mom, and whichever way you choose, every other way is going to say you’re wrong, and I think that’s just really hard, that we just don’t – I mean, it’s all this pressure to be this perfect mom.  Yeah.  I think that’s a big piece of it.  And then we have, on that, that if you have depression, if you’re not happy, if you don’t enjoy every minute of every day, now you are destroying your child for the rest of their life.  Now you’ve not only given them depression because you have depression genetically, but now you’ve given them depression because you’re depressed and you didn’t bond with them appropriately.  And so let’s just add a little more stress and anxiety to someone who’s already stressed and anxious.  And I just think that’s – I mean, it’s good to know.  Like you said, it’s research.  We know that there’s not that – it’s not going to be as much bonding and that it can cause more depression, but I feel like sometimes it just adds more.  It’s another way to feel like you failed.

Alyssa:  Well, and I think – I have the same thoughts about the attachment.  You can always go too far.  You know, and of course the oxytocin that you can get from the skin to skin, but sometimes even now, and my daughter’s 8, I just feel touched out.  Everyone just needs me all the time, and if I were a depressed mom with a newborn baby, and everyone’s saying, oh, you’re feeling depressed.  Just hold your baby all the time.  Wear your baby all the time.  Breastfeed more.  That’s just more touch when I need my own space.  And then sometimes babies – I see this a lot because I do sleep consultations, and I get those depressed moms who haven’t slept for months.  They are so sleep-deprived, and then they think, I’ve been holding my baby to sleep for three months straight or all these things.  They don’t know that their little babies are developing these personalities, and they might not want to be touched all the time.  Just because you’ve been told that they need to be picked up every time they cry – your baby doesn’t always need that.  So really listening and being in tune with what you want as a mother and what your baby is actually asking for – I think we’re just getting – like you said, the attachment thing.  We’re just getting too touched out.  We don’t necessarily need that all the time.

Dr. Ladd  This is such a great conversation, and it makes me think about how it loops into the stigma.  It loops into what we said about needing to let women speak to their own experiences.  And I think there’s something about redefining attachment as – or this idea of motherhood as, you can communicate to your baby and to your child: Mommy’s struggling, and I’m right here.  I had a conversation with a mom this week, a colleague of mine, who’s got a boy who had to have a tooth extraction.  And as anybody listening can imagine, a child having a tooth extraction is incredibly anxious, and it was long and very difficult.  And I said, you know, it’s okay to tell him that you – it was hard for you, too.  And that you went through it together, and that you’re okay.  Yeah.  I was there, and because it validates to your child, yeah, that was pretty crazy, wasn’t it?  That was pretty hard.  It was hard for me, too.  And I’m okay.  And maybe we can allow each other to say, you know what?  I see that you’re an amazing mom, even though you have these experiences that tell you that you’re not.  And we can start to say to our children, you know, I went through this, and I rock.  It didn’t screw me up in terms of my connection to my child.  It actually made it stronger.  And I’ve had women, lots of women, tell me that, that the connection with that child with whom they went through a mood disorder is unique and tight.  In other words, I think women – we love our kids, no matter what.  It just doesn’t have to always be positive.

Jessica:  I love that you said it doesn’t always have to be positive, and I think that’s really important for moms to know, that it doesn’t always have to be positive.  That there will be ups and downs, and it’s the hardest job in the world.

Dr. Ladd  And we’re able, in other areas of society, to really honor struggle in a way that’s noble.  Veterans: we’ve gotten our heads around honoring the nobility of somebody who’s sacrificed and paid a price emotionally, physically, et cetera.  And yet we’re not able to do that for moms in terms of honoring their suffering nobly.

Alyssa:  I love this conversation.  Two more things.  We’re going to end with how people can find you and your book and tell us anything else about your book, but let’s say not everyone is going to be able to read your book.  What’s one thing you think every mother, parent, would need to know going forward, either about motherhood or mental health or…

Dr. Ladd  I would say about any woman who is of childbearing years should be talking, should be telling, their provider about their sleep, their appetite, whether or not there’s a history in their family of mood or anxiety disorders, and for women of color, it is so much harder to get the message across, so I would say we all need to support our women of color to have an ally, to possibly go with them to the provider.  Without a doubt, we need to be telling – because they’re not asking right now.  They’re not saying.  They’re just not asking.  For a number of reasons; put COVID on top of everything else.  So we need to be encouraging.  I would love to see – there’s this concept called a reproductive life plan where doctors could be asking young girls and young men about their emotional and mental health very early on.  So a pediatrician who’s doing a well‑check for a kid who’s 11 could be planting the seeds that that’s a safe space to say, I am not sleeping.  I’m having intrusive thoughts.  Or I can’t stop thinking about this, or I’m any of the symptoms that would come forward.  So to wrap that one up, I would say – and for anyone who’s pregnant and/or just had a baby, I would say, know the language of mood disorders to be able to say it to your provider to get help, and that would be how your sleep is affected, how your appetite has been affected, and how your sense of hope or interest in life, anhedonia, has been affected.  Just being able to say, I’m not sleeping.  I’m not eating.  And I feel like I don’t want to do this.

Alyssa:  Yeah.  I think that’s beautiful.  Well, thank you so much for doing this.  It’s such a pleasure, and I look forward to finishing the book.  We got quite a ways into it.  But tell people about your book; maybe say your name and the title again and where they can find your book.

Dr. Ladd  Sure.  So my name is Walker Ladd, and you can go to my website.  And the book is Transformed by Postpartum Depression: Women’s Stories of Trauma and Growth.  And that’s on Amazon or at my publisher, Praeclarus Press.  And I also wanted to give a shout-out to anybody interested in the book to think about – I was able to get interviews with amazing experts, so a part of the book is dedicated to – I ask, you know, Karen Kleiman and Jane Honikman.  I had such a great experience interviewing these leaders to see what they think about the idea that untreated postpartum depression or any disorder could be experienced as a traumatic life event, and it was a very interesting response.

Alyssa:  Great.  Well, thank you so much!  We’ll talk to you soon.

 

Transformed by Postpartum Depression: Podcast Episode #110 Read More »

Kristin Alyssa Gold Coast Doulas Owners

Podcast Episode 100!

It’s the 100th episode!  Alyssa and Kristin, co-Owners of Gold Coast Doulas, talk about what the past two and a half years of podcasting has looked like, how the podcast has changed, how the business has changed, how services have pivoted in the midst of the COVID-19 pandemic, and how they are playing their part in supporting other local businesses.  You can listen to this complete podcast episode on iTunes or SoundCloud.

Alyssa:  Welcome to the 100th episode of Ask the Doulas Podcast!  I am Alyssa, and Kristin’s here via phone because it’s COVID-19.  We can’t even see each.

Kristin:  Right.  It changes everything!

Alyssa:  I know!  We haven’t seen each other in forever, and I actually came into the office for the first time in weeks, and it feels so good to be not working in my house.

Kristin:  Yeah, it certainly changed so much about the way we do business.  But 100 episodes — I can’t even believe it, Alyssa!

Alyssa:  I know.  It seems wild that in two and a half years, we’ve done 100 episodes.  What is that even — I should do the math on that.  Let me do it real quick while you talk.

Kristin:  Yeah.  I mean, we started this podcast as a member of the Radio for Divas team.  It’s a radio show with women experts in the community.  And then we transitioned to the podcast format, wanting to really keep our clients as the central focus and information that they would want to hear, and then also thinking about what other listeners, whether it’s regionally or across the US, might be interested in.  Capturing more information from experts on anything related to pregnancy and newborns to even toddlers and parenting in general.

Alyssa:  So the math, by the way: two and a half years is 130 weeks, so in two and a half years, there have only been 30 weeks that we did not put a podcast out.

Kristin:  Wow!  Yeah, I know when we started out, we had more frequent podcasts and then have slowed it down a bit.  And Alyssa is the editor and producer.  How has that changed for you?

Alyssa:  It’s a role that I don’t particularly love, but I think, actually, COVID has increased because — you know, I think for the first year and a half of it, I was cranking these out once a week, and then it slowed, just because it is so time-consuming and so much work.  We covered a lot of topics already, and we had a lot of changes in the business happening and I wanted to focus on other things, other than the podcast.  But now that we’re home, the last few weeks I’ve actually been putting one out every week.  And the fact that I can’t meet with someone in person — it’s kind of easier to do it over the phone.  The sound quality obviously isn’t as good, but it’s allowed me to — you know, I’ve got three podcasts recorded now with Laine Lipsky, who’s in California and is a parenting coach, and we’ve had just a ton of stuff to talk about.  But the virtual, like able to do that virtually, it doesn’t matter that she’s in California.  She can coach a parent in Michigan, and same with my sleep.  I can do sleep consults for families anywhere.

Kristin:  Yeah, it’s been amazing to see the locations that some of your sleep consults have been from.

Alyssa:  Yes, my last ones from Colorada and New Orleans, I think, and then somewhere in Florida were my last three.  So they haven’t even been local.

Kristin:  That is one thing with COVID.  We’ve taken things more globally as far as now offering classes online and being able to expand our base outside of the 50-mile radius that we serve.  And your work hasn’t changed much because a lot of what you do is virtual anyway, so you haven’t had to pivot all that much as a sleep consultant.

Alyssa:  Right.  I just don’t do it in person, obviously, but everything else is exactly the same.  And then we can’t offer postpartum doula support.  Well, I mean, I suppose we could for a newborn, but I’m not doing sleep consults for a newborn, so that doesn’t come into play, either.

Kristin:  So, Alyssa, let’s talk about some of the episodes and highlights of what we have gone over in the last two and a half years that we have been producing the podcast.

Alyssa: The topics have been all over the place.  You mentioned a few, but I know you in particular, you like to reference a few of them for your birth clients, like the episode, #54, What to Pack in your Birth Bag that you did with Dr. Rachel from Rise Wellness.  You know, a lot of our topics, we choose because they’re questions that we get asked often, so why not do a podcast on it, give them all the information, and then just allow them to reference that all the time.  So it’s a lot of the reason why we choose certain topics.

Kristin:  I also love the dad perspective.  We’ve done a couple podcasts of what it’s like to work with a doula and how a partner feels about their role in the birth with having another support person in the room, and even some of our students in the classes we’ve talked, talking about their person experiences, have been really fantastic because it’s a better testimonial to hear it from someone outside of our agency than us telling, you know, our audience all of the features and benefits of everything we offer.

Alyssa:  Right, and I think for somebody who doesn’t quite understand the role of a doula, even after researching, sometimes just hearing the personal story from one of our clients makes something click.  We love hearing personal stories of clients.  Like you said, either birth support, postpartum support, any of our classes.  We’ve done a lot on nutrition and diet, babywearing, pelvic floor stuff.  You know, that’s a big question for parents after a baby is born.

Kristin:  Especially because we happen to work with a lot of athletes, especially in the birth doula role, and they want to be able to get back to running marathons or whatever their particular sport is.  So, yeah, pelvic floor therapy and physical therapy in general has been very helpful for our clients.

Alyssa:  Right.  And then our friends at Rise have given us lots of information on different chiropractic topics.  Obviously, I’ve got quite a few on sleep.  I love talking about sleep.

Kristin:  And tongue ties and lip ties and working with breastfeeding.

Alyssa:  Yeah, breastfeeding.

Kristin:  Yeah, a lot of breastfeeding-related questions and feeding in general.  And certainly anything related to mood disorders and postpartum depression with different experts.

Alyssa:  Pediatric Dental Specialists of West Michigan is one of our partners, and Dr. Katie has been on a few times to talk about, you know, her special laser beam for tongue ties and lip ties.  And she just had a baby of her own!  We should probably check in with her and see how they’re doing.

Kristin:  Yeah.

Alyssa:  Cesarean births; we’ve talked a lot about Cesareans and what is a doula’s role within that, and we’ve got some actual birth stories about what that looked like for the birthing person and the family.

Kristin:  It’s been a lot of fun to have different guests in and try to find new and fresh content.  I mean, after 100 episodes, there are only so many topics you can cover, so…

Alyssa:  I know.  You kind of have to redo topics with different people.  But I’d love for our listeners to email us, too, and just let us know, like, what haven’t we talked about, or what did we talk about but you would like more coverage on?  Or do you know somebody who would be a great person for us to speak to?

Kristin:  And recently we’ve done some COVID-related podcasts, but that is ever-changing with policies in the hospital and specific states, of course.  We have had personal client experiences, birthing during COVID, as well as how our agency has adapted to this time and what precautions we cake.

Alyssa:  Maybe we can talk — do you want to talk a little bit about, just in case people aren’t up to date?  So as of May 21 when we’re recording this, 2020 — what the role of a doula is right now, like how we can work in hospital settings, and our postpartum doulas.

Kristin:  Yes.  So for those of you listening in other states, in the state of Michigan, we are following the governor’s stay at home orders.  So as Alyssa mentioned earlier, we’re not in our office working together, and we are seeing our clients and students virtually.  So all of our classes are done virtually via Zoom, so still very interactive.  We recently had our Saturday Series class, which is interesting, because for me, the comfort measures class that I teach is so hands-on and interactive.  To do that virtually without even a helper or model to demonstrate positions, I’m trying to describe things and show diagrams and videos and how to do a hip squeeze and counterpressure, for example.  So that’s been really interesting, and I know you taught your newborn class several times virtually.  And our lactation consultant had the breastfeeding class.

Alyssa:  Yeah, I think it’s hard for her, too, the breastfeeding, because to show different positions and — I mean, same with me.  Mine’s not as interactive as yours, but even moving the computer into the right spot so I can show my different swaddling methods or, you know, paced bottle feedings, things like that.  It works, and I always ask, did everyone see that okay?  Is everyone getting it?  Do you need me to do it again?  It’s just different.  I miss being able to meet the students in person.  But it’s just where we’re at right now.

Kristin:  But at the same time, it’s more convenient for them because they can be at home and, you know, not have to travel.  It gives everyone more time in their day, but as far as how we’ve adapted, other than classes, right now with the stay at home order, our lactation visits are all done virtually.  So, again, for our two registered nurses and IBCLCs, that has been different than hands-on or more engaging support.  But our clients have found it — I’ve had personal birth clients that I’ve worked with who have told me that Kelly was very helpful virtually, so that’s been going better than we had hoped.  And with birth support, things are, you know, ever-changing for us, but we’re doing all of our prenatal visits and even the initial consultations before hiring and certainly the postpartum visits after the birth — all of that is done virtually.  And different hospitals have different policies related to whether or not a doula can be in the hospital.  We’re fortunate that our governor has an executive order that includes a doula and a partner in the hospitals.  The doulas are not considered visitors, and we have access.  But every hospital, again, has the ability to make their own policies surrounding doulas, and we are right now working in Spectrum Butterworth and all of the regional Spectrum hospitals like Zeeland and Gerber and Pennock and Hastings and Greenville, and so that has been really fantastic.  St. Mary’s Mercy Health is currently not allowing doulas but encouraging virtual support, and Metro is allowing doulas.  Holland Hospital is not.  I was just informed that Mercy Muskegon, who was not allowing doulas up until very recently, and as of — I want to say it was this week — doulas are now being admitted to the hospital and able to support birthing persons.  So that has been fantastic since we do serve a 50-mile radius of Grand Rapids.  So as doulas, we are monitoring our symptoms, and if we have any symptoms of Coronavirus, then we send in a doula who is symptom-free.  Right now, all of the hospitals in our area are requiring doulas to be certified, so if a doula took a two-day or four-day training and chose to never certify, they are not able to work during this time.  And if a newer doula is working toward that, then that would be an option in the hospitals.  They could certainly attend homebirths.  So that has been interesting.  We worked with our lawyer and consultant to work on a COVID questionnaire and have included COVID language in our contracts that our clients sign so that our doulas are able to feel comfortable and confident, as well as our clients, in potential exposure during stay at home and what each household is doing as far as going to the grocery store versus having groceries delivered, or is a partner working outside of the home as an essential employee.  And then our clients and doulas are able to choose each other.  Some of our doulas are not working during COVID or only working with completely isolated clients.  So we’ve done a lot of focus internally on what our team wants to do and how we’re able to pivot during this time.  So we’ve been able to, you know, have conversations with the governor’s office and make sure there are no gray areas in the doulas role during stay at home and got some confirmations about what a postpartum doula can do, because a lot of that language was focused on our work in the hospital.  During the stay at home order that is set to expire at the end of the month — it may or may not be extended — we are only offering essential postpartum support.  So since we are working with clients normally through the first year, and they don’t need to have an urgent reason to have us there — they don’t need to be struggling with postpartum depression or a mood disorder — and they don’t need to be healing from a birth.  We can work with them until their child is one year old or until their multiples are.  So we have stopped working with some of our existing clients during the stay at home and plan to resume work with them.  We’re focused only on those first six to nine weeks of healing, depending on the type of birth that our client had, or those struggling at any point in their postpartum time with mood disorders or depression.

Alyssa:  So, to clarify, before this, we worked with people up to — we worked with families up to a year old, but now we can only do essential work which is, like you said, the six to nine weeks after someone just had a baby or with someone suffering from a perinatal mood disorder.

Kristin:  Yes, or if they don’t have a partner, that is essential, if they need support, since obviously grandparents cannot be involved during this time.  Families that have other kids are not able to take them to daycare if they’re not essential workers, so that has been interesting.  Obviously, we can work with triplets and multiples because they need more of a hand around the house especially during healing.

Alyssa:  So the moral of the story for postpartum is, we can’t just work with anyone right now until the stay at home order lifts, but we can work with you if you have a newborn, if you are suffering from a mood disorder, and/or have had multiples; twins or triplets.

Kristin:  Exactly.  Yes.

Alyssa:  And we can do day or overnight, and that would involve you, again, virtually meeting the doula.  You would both fill out this COVID-19 form that we created so that you and the doula both know what your risk, your exposure risk, is.  Who’s leaving for the grocery store?  Is someone in the home leaving for work?  And as long as you’re both comfortable with it, you can work together.

Kristin:  Exactly.  Yeah, and our doulas are taking every precaution and following what the family wants as far as, you know, sanitation and wearing gloves.  We’re all wearing our own cloth masks in the home, but if a client wanted surgical masks and has those or needs us to get them, then we work around their needs, and our doulas are bringing in a fresh set of clothes and taking their shoes and any coats that they may be wearing off immediately.  So that has been a pretty seamless process transitioning over for the doulas who are comfortable working with our clients.  And we’re so busy in postpartum pre-COVID.  You know, that has been some growth that we’ve seen since we started the podcast and very intentionally focused on educating our community and what a postpartum doula is and the benefits of it.  But now that is obviously slowed during COVID.  But we’ve seen an increase as far as, you know, our students, and being that many hospital classes have closed or not all educators are offering virtual classes, and certainly our birth clients have increased more recently.  It slowed for a bit initially because, you know, some doulas in our area are not offering in-person support, and we are.  So that has also been a change in our business.  Focusing on supporting local businesses is so key.  So for any of our listeners, support the local shops in your community.  I know, Alyssa, you order from Rebel, and I’ve been getting juice from different local businesses, whether it’s delivered to me or pick up, and just trying to keep our local businesses afloat, because as Local First members and a B-corporation business, we know the importance now and don’t want to see more businesses close down due to COVID.

Alyssa:  I know.  It’s so sad.  What’s the statistic; like, 50% of small businesses aren’t going to make it through this?  And luckily, Gold Coast will.  We’re doing what we can.  We’ve changed our business model a bit.  We’ll be good; we’ll make it through this.  It’s going to be a tough couple of years, I think, for everybody, but we’re going to do what we can in the midst of this to continue to help other small businesses and to keep all of our subcontractors.  They’re their own small businesses.  We want to keep them working and support them as much as possible, too.

Kristin:  Yeah.  And it’s been really sad even seeing other doula agencies that started at the same time as Gold Coast, which we’re nearing our five year anniversary.  You know, they’re closing their doors in bigger markets than we live in, and it’s due to COVID.  And that’s been very sad for me because they were peers of ours.  And so, yeah.  If you can support your local service and retail businesses and restaurants, do your part and think local.  And just thinking of our stores like EcoBuns with online ordering and Hopscotch, that we often partner with.  Supporting them, and the nonprofits.  We’ve actually given more during COVID since a lot of the fundraisers we would normally attend and support for some of the hospital foundations have been canceled.  We’ve given money to Mercy Foundation and we’re looking at what we can do within Metro and the Spectrum Foundation.  And we are analyzing what we can best do to help Nestlings Diaper Bank because let’s not forget that diapers are needed now more than ever, and it is not covered by your basic government assistance programs.  So that is something to keep in mind if you’re looking to help; if you have extra diapers or you’re looking at giving somewhere.  Nestlings Diaper Bank is in need, and they are running low in diapers.

Alyssa:  Yeah, the need is probably greater than ever right now, I would imagine.

Kristin:  Yes.  So, yeah.  Thanks to everyone for listening all of these years and supporting our podcast.  We would love to know what topics would be of interest to you and where we can go from here.

Alyssa:  Yeah.  Please let us know.  You can find the podcast on iTunes and SoundCloud.  We also have on our website a blog section.  If you hover over that, we actually have a listing of all the different podcasts.  There in order by date.  I don’t think you can search by topic, but you can probably Google it and find a certain topic.  But we appreciate you listening, and obviously, if you can subscribe, if you can like it, if you can rate us.  We’ve never really asked people to do that.  It kind of started out as just like — I don’t want to call it a hobby, but, you know, something fun to do to give our clients something; a resource for our clients.  But the more people we can educate, the better.

Kristin:  We’ve gotten some recognition in Grand Rapids Magazine about being a local podcast, and also through a national organization that rated us in the top ten podcasts that are birth-related.  So that was pretty exciting!

Alyssa:  Thanks for listening, again!

 

Podcast Episode 100! Read More »

Woman laying in a hospital bed

Hyperemesis Gravidarum

This post was written by Lauren Utter, a ProDoula trained Birth and Postpartum Doula with Gold Coast Doulas.

Finding out you are pregnant can bring an array of emotions – planned pregnancy or not. Maybe you’re excited because you have been waiting for this day. Maybe you are surprised because a baby wasn’t on your radar. Maybe you’re fearful – of what your pregnancy will be like, how you will look, if the baby is going to be okay, or how you’ll feel.

All of these feelings are normal. Being pregnant causes your body to change. Not just a growing belly, but new hormones, cravings, thoughts, and illnesses. 70-80% of women suffer from morning sickness. At least 60,000 cases of extreme morning sickness, also known as Hyperemesis Gravidarum (HG), are reported (the number of cases is actually higher as many are treated at home). Perhaps you wonder if this is how all pregnant women feel or is it just you? Or maybe you question your ability to handle nausea and pain. Do you feel as though others minimize how you are actually feeling- giving you tips that you have relentlessly tried?

Morning sickness is difficult to deal with; it’s exhausting and frustrating, but there are many differences between HG and morning sickness. Women with HG lose 5% or more of pre-pregnancy weight. Morning sickness doesn’t typically interfere with your ability to eat or drink, whereas HG often causes dehydration from the inability to consume food or drinks. Morning sickness is most common during the first trimester, while HG lasts longer – sometimes through the whole pregnancy. A woman with HG is more likely to need medical care to combat symptoms.

HG is often described as debilitating, making everyday activities like working, walking, cooking, eating, or caring for older children hard to do. Not only are women having difficulties eating and drinking, but taking their prenatal vitamins is often difficult, too, which results in a lack of proper nutrition. Because of severe dehydration and insufficient nutrients, headaches, dizziness, some fainting, and decreased urination can present as greater symptoms of HG.

On top of all the physical signs of HG, secondary depression and anxiety may also be present. There are potential complications that arise when HG is present. We talked about malnutrition and dehydration, but some others include neurological disorders, gastrointestinal damage, hypoglycemia, acute renal failure, and coagulopathy (excessive bleeding and bruising). Fortunately, with effective treatment these complications can be managed or even avoided completely.

While there is no cure for Hyperemesis Gravidarum, there is a variety of treatments including medications and vitamins, therapies (nutritional, physical, infusion), bed rest, alternative medicine, chiropractic care, massages, and more. Not all women and cases respond to treatments in the same way. Caregivers typically believe early intervention, even prevention, is most effective.

Medical providers work with each woman to discuss which treatments work best for them. Common medications offered to women suffering from HG are antihistamines, antireflux, and metoclopramide. Because HG can be traumatic and highly stressful, 20% of mothers experience Post Traumatic Stress Disorder (PTSD) and Perinatal Mood and Anxiety Disorders (PMADs). Early intervention proves to be effective, and your OB/GYN, primary care doctor, or a mental health specialist are fantastic resources for mothers experiencing symptoms of any mood disorder. Along with medical professionals there are many forms of support and resources. There are several Facebook groups of women who are suffering or have suffered from HG. This is a great way to feel supported by knowing you are not alone.

The website Hyperemesis.org is equipped with resources, facts, and blogs from other sufferers and their organization, HelpHer, are leaders in research for HG. The HER Foundation puts on events throughout each year for women and their families to come together.

Another great support system is hiring a doula. Doulas offer support through pregnancy, birth, and postpartum. Through pregnancy we can be there for bed rest support, informational, and emotional support. We provide you with evidence-based resources, and factual information. With this information, women suffering from HG can self-advocate for proper testing and treatment that best suits their pregnancy journey. During the postpartum time, not only do doulas help with infant and family care, but doulas are trained to notice signs of PMADs and will provide you resources that can assist you through recovery.

Doulas want to see you be successful, confident, comfortable, and healthy. I know I can’t be the only one who pushes aside her feelings, physical and emotional, and says “Oh, I’m fine” or “It’s nothing.” Our bodies are designed to “tell” us when something is wrong. Here is a tip: start logging your symptoms, from a single headache to daily nausea and vomiting. This will help your medical provider reach answers. Trust your body and trust your intuition, strive for testing that you believe is necessary, and find your people.

Photo by Andrea Piacquadio from Pexels

 

Hyperemesis Gravidarum Read More »

Dr. Gaynel headshot

Mental Health Awareness Month: Podcast Episode #97

Dr. Nave now works with queens through her virtual practice Hormonal Balance.  Today she talks to us about hormones and how they affect our mental health, including the baby blues and postpartum depression.  You can listen to this complete podcast episode on iTunes or SoundCloud.

Alyssa:  Hi.  Welcome to Ask the Doulas Podcast.  I am Alyssa Veneklase, co-owner of Gold Coast Doulas, and today, I’m excited to talk to Dr. Gaynel Nave, MD, and she works at Hormonal Balance.  Hi, Dr. Nave.

Dr. Nave:  Hi, Alyssa.  Thanks for having me.

Alyssa:  Yeah.  It’s been a while since we’ve talked, but we were emailing a while ago, and we realized that it’s Mental Health Awareness Month in May, and then this week is Women’s Health Week.  So you wanted to talk about baby blues and postpartum depression.  So before we get into that, why don’t you tell us a little bit more about Hormonal Balance because last time you talked with us, you worked for — you were at a different place.  So tell us what you’re doing now.

Dr. Nave:  Okay.  Awesome.  So as of this year, I’m in my own practice, as you said.  The name of it is Hormonal Balance.  And so I am an Arizona licensed naturopathic physician, and here in Grand Rapids, I operate as a naturopathic educator and consultant to women, with all gender identities, to basically reconnect to their — who they are and directing their own health, hormonal health concerns.  And that’s the reason why I went with Hormonal Balance, because our hormones affect almost every single aspect of our health, including when we wake up, our mood, our sexual health, all of it.  And for us who are women or female-identifying, the medical community sometimes doesn’t listen to our concerns or minimizes our experience, and so I want to be a part of changing that and, you know, helping women be advocates for themselves and learn more about their bodies, basically.

Alyssa:  Yes.  Awesome.  I love it.  And then you can do — so even though you’re here in Grand Rapids, Michigan, you can do virtual visits, so technically, you can work with anybody anywhere?

Dr. Nave:  Yep, yep, yep.

Alyssa:  Cool.  Well, we’ll tell people how to find you at the end, but let’s talk a little bit about the mental health aspect of, you know, bringing some awareness to it this month.  And then, obviously, you know, baby blues and postpartum depression is something that we deal with on a regular with our clients.  So how do you help your patients?

Dr. Nave:  I call them clients.

Alyssa:  Clients?  Oh, you do?

Dr. Nave:  Yeah, because here in Michigan, because my — there is no regulation for naturopathic physicians, even though I have my license.  I function more as a consultant, so I call the people that I work with “clients.”  And so the way in which I assist them is basically gathering information about their concerns as in-depth as possible because I’m not just going to look at you from the perspective of, oh, I’m experiencing this particular symptom, because nothing occurs in a vacuum.  And so looking at you as a whole, how does what you’re experiencing affect you mentally, emotionally, and physically.  And so we do the full assessment, and then a part of that is talking about and educating you on labs that are pertinent to you.  So there are different types of hormonal labs that are available.  There’s salivary.  There’s urine.  There’s blood.  And so, like, making sure that the one that’s best and indicated specifically for you is what we talk about.  It’s very individualized because each person has a different experience, even if we have the same diagnosis.  Does that make sense?

Alyssa:  Right.  So you’re saying if somebody comes in, you do a pretty thorough — kind of like with my sleep clients, I do an intake form.  Right?  There’s no, like — you’re saying there’s no one blood lab for — oh, there goes my dog.  I should have mentioned that we’re recording at home on speakerphone, and — okay.  So what I was saying is with my sleep consults, I do an intake form because there’s no right answer for every family, so if somebody comes in and needs blood work done or — well, like you said, labs.  Blood work might not be the right lab for them?

Dr. Nave:  Yeah, because there’s — let’s talk about female hormones, for example.  So the female sex hormones — and when I say female, I’m using the medical terminology for it, not like — so, like birth sex.  You have ovaries — versus the gender identify.  I’m still working through how to talk about these medical things and still be cognizant and respectful of the different gender identifies, so please forgive me if I say anything that’s offensive.  So the female sex hormones — estrogen and progesterone — but these hormones don’t just occur in women.  They also occur in men.  So all gender identifies have these hormones involved, but specifically for those who can give birth, estrogen is involved in the building up of the uterine lining of the uterus so that implantation of a fertilized egg can happen.  Progesterone is important for maintaining that uterine lining as well as maintaining healthy pregnancy so that you don’t lose the baby.  Obviously, there are a lot more factors involved.  These hormones, based on how the body breaks down balance specifically as it pertains to estrogen — we have three different types of estrogen, so it’s not just one form that’s in the body, and depending on what lab is done, you’re able to verify all three at the same time.  The one that I’m thinking of right now is the urine test called DUTCH test.  I really enjoy that one.  I’m not promoting it right now, but I’m just explaining why I like it.  So that particular type of analysis looks at all three of those types of estrogen in the body as well as how the body breaks them down.  Is it able to get rid of it effectively, which gives information on the metabolic pathways.  So there’s a lot more information that can be gleaned from — depending on what type of lab is utilized and depending on your specific concern and the way in which your symptoms are presenting; a more investigative or information-bent lab analysis might be indicated, and so being able to speak with someone like myself who is well-versed on the different approaches and all the different options can be really beneficial because then you don’t end up having to do multiple tests, you know, all that kind of fun stuff, or having to get blood drawn if you don’t have to.

Alyssa:  Right.  So what hormones are you looking for when somebody comes in and says, gosh, I think I have postpartum depression?  Is it just hormonal, or do I really have — I guess, where do you as a naturopathic doctor, say, “I think I can help you with hormones,” versus, “I think you need to see a therapist”?  Or do you do both?

Dr. Nave:  So I will probably tell them to do both because postpartum depression, as with any mental health condition, is on a spectrum.  So you have mild, moderate, and severe.  Before we go into that, I think it would be important for us to define a couple things.  Baby blues is feeling down or feeling a shift in your mood, like feeling more weepy, more exhausted, after giving birth, and this can last anywhere from a couple days up to two weeks.  If it extends beyond that time or it’s interfering with your ability to function, then it would be classified as postpartum depression, and postpartum depression can occur in that same time frame as the baby blues, like soon after childbirth, within three to five days, up to a year after giving birth.  And I’m going to read a couple of stats, so bear with me.

Alyssa:  Go for it.

Dr. Nave:  Just for a frame of reference.  So postpartum depression affects up to 15% of mothers, and shifting to 85% of moms is that they get the postpartum blues, so that — these statistics may provide some form of comfort that you’re not alone.  Please don’t suffer alone.  If you’re feeling more down and you need more assistance from your family and friends, please reach out.  If you’re a single mom, I’m sure that there are different groups, like single moms groups, or talking to your doctor or your friends who can be there to provide some emotional support for you during that time.  Please, reach out to people.  It’s not anything to be ashamed of.  A lot of women go through it because our hormones, as I said previously, affect a lot of things, including our mood.

Alyssa:  Right.  I feel like mothers are getting a little bit more comfortable talking about how hard it can be and how maybe bad they feel or these thoughts that they’re having.  You know, you talk to the older generations, like our mothers and grandmothers, who said, well, we didn’t talk about those things or we didn’t need help.  And we’re slowly getting to the point where we’re seeing more and more families look for and seek out postpartum support, which is one of my favorite services we offer because they can work day and night.  When a mom is suffering from any sort of perinatal mood disorder, having that in-home support that’s judgment-free can just be crucial to healing.

Dr. Nave:  I totally agree with you.  I’ve seen it in practice and the research back it up.  Just being pregnant, much less giving birth, is hugely taxing on our body and increased your risk for feeling down.  Some of it has to do with the hormonal changes.  I’m going to go really science-heavy because I’m a nerd and I think it’s fun and interesting…

Alyssa:  Do it!  Teach us!

Dr. Nave:  As I said, estrogen is responsible for the building up of the uterine lining, but it also affects things like our serotonin production, which you might know as the neurotransmitter involved in depression.  Like, if you have low serotonin, then you might get depression.  So the thing with estrogen is that it increases the production of serotonin by affecting a particular enzyme called tryptophan hydroxylase that is responsible for processing an amino acid that we get from our food called tryptophan into serotonin.

Alyssa:  Isn’t tryptophan the one that makes us sleepy?

Dr. Nave:  No.

Alyssa:  Tryptophan isn’t the thing that we eat that makes us sleepy?  What am I thinking?  It’s in turkey and stuff?

Dr. Nave:  Tryptophan is in turkey.  Serotonin and melatonin have the same precursor in terms of amino acid but the thing about their bodies is they use similar substrates or building blocks to make stuff, and just because we have the same building blocks doesn’t mean that we’ll get that particular product.  Does that make sense?

Alyssa:  Kind of, I guess.  In my sleep work, I talk about serotonin and melatonin a lot just for, you know, sleep cycles and feeling alert and then feeling sleepy, but I didn’t realize that a lack of serotonin can cause depression.  I’m trying to, in my brain, you know, the science of sleep, then — it makes sense, then, that people who are depressed sleep a lot, right?  Am I going down the right path here?  Because if you don’t have enough serotonin to make those hormones makes you feel awake and alert — sorry, I’m getting you totally off track by asking these questions.  Sorry!

Dr. Nave:  No, no, no.  I don’t think you’re going off track because sleep is very much an important part of the postpartum depression process.  If Mom isn’t sleeping, she’s at a greater risk for experiencing postpartum depression, and we know that the hormonal changes affect our sleep.  Also having a baby, a newborn baby — if the baby’s up crying, and they’re getting their sleep regulated; you’re adjusting to waking up and feeding the baby, feeling exhausted during the day, and your sleep is thrown off in terms of it not going or being matched up to when the sun rises and the sun goes down.  You’re more trying to sync to the baby, and that can lead to fatigue, which then exacerbates your mood, which makes you then more susceptible to feeling more down.  And then it’s like — one of the things that they mentioned is that babies who have a hard time sleeping — there seems to be a relationship between moms who have postpartum depression — so the baby isn’t sleeping; Mom tends to have a higher likelihood of having postpartum depression, but then the opposite is also true.  So if Mom has postpartum depression, it seems that the baby also as a result has a hard time regulating their moods and being more colicky and all these other things.  So taking care of yourself also helps the baby; it’s important to support Mom, which is why I’m so grateful that you guys have the postpartum doulas, and you guys do a lot of work with supporting moms post-baby.  Sometimes people focus so much on the baby that they forget the mother.

Alyssa:  Oh, absolutely.  It’s all about the baby.

Dr. Nave:  Yeah.  Yeah, yeah, yeah.  So the hormonal mood connection is very complex, and it’s not just A + B = C, you know, because, yes, estrogen influences serotonin production, but there are other factors that then influence, you know, the mood.  Does that make sense?  Specifically, when it comes to the mood changes or the hormonal changes in early pregnancy and postpartum – early pregnancy, we see the estrogen or progesterone levels are shifting because you’re now pregnant, so the body doesn’t have to produce as much of those hormones.  And when we have lower estrogen, which is what happens when you get pregnant, and since estrogen is responsible — or, rather, plays an important role in serotonin, which helps you feel calm when it’s at the normal level — if it’s particularly high, it can lead to anxiety-type symptoms.  If it’s really low, depression-type symptoms.  During those times when the estrogen is lower, there’s this lower mood that can also be accompanied by it.  Are you tracking?

Alyssa:  Yeah.

Dr. Nave:  Yeah.  So that’s the estrogen portion.  So estrogen affects serotonin production and also directly affects the neural networks in your brain.  Now, we have progesterone.  So progesterone: I like to think of it as our calm, happy hormone.  And so when you’re just about to have your period, usually it helps you sleep.  It helps you remain calm.  But if it’s really low, that can lead to insomnia, feeling really agitated and grumpy, and those kind of symptoms can also happen postpartum and early pregnancy.  And so that’s how the hormonal fluctuations can then manifest with the depression.  For the reason, at least in the postpartum stage, that these hormones might drop is that you give birth.  There’s a huge change because the body doesn’t have to maintain the hormones to keep the baby inside.  The baby is now outside of you.  And it really drops off really quickly, and that huge shift can then lead to the baby blues.  Then if it prolongs, your body having a hard time regulating, then that’s when we shift from the blues to the depression.  In terms of what I would do, I would assess what exactly is going on for you.  Do you have physical and emotional support?  Do you have a history of depression or any mental health condition prior to being pregnant?  Have you had postpartum depression before?  How is your sleep?  You know, sleep is really important.  If we can get you sleeping, I think that goes a long way.  Good quality sleep.

Alyssa:  You’re preaching to the choir here.  I think it’s one of the most important things!

Dr. Nave:  The other thing that they mention, the American College of Obstetricians and Gynecologists, is that if Mom has any feelings of doubt about pregnancy, that can also influence her feeling depressed because it can get, like, amplified during that time.

Alyssa:  So you’re saying, like, maybe doubting if they wanted to become pregnant?

Dr. Nave:  Maybe, or doubt that she’s capable of being a good mom, because there’s a lot of pressures on moms, you know?  Like, oh, someone will mention, like, oh, my baby’s sleeping through the night, or my baby — you know, they started eating at this time.  So there’s a lot of pressure to meet certain milestones that are from society, and that can amplify feelings of inadequacy that Mom might have had prior to becoming pregnant.  And so addressing that piece with a therapist or someone like myself will be a very important part of supporting her with the postpartum depression and getting her out of the state.  For some women, medication might be what they need to do, and their healthcare provider will be able to assess that.  But it’s not the only thing that’s available.  There’s therapists; there’s hormonal intervention, because if it’s a hormonal issue, if you address imbalance, then women get relief pretty quickly.  There’s having a doula, if that’s something that’s accessible to you, or if you have family members who are close by, asking them to help out some more.  Having people provide meals for you so then you don’t have to cook; having your partner be a part of taking care of the baby and asking them to step up some more to give you additional support.  Basically, asking for what you need is — I know it can be really vulnerable and scary if you’re not used to asking for help, but that can really be important in terms of getting what it is that you need because no one is in your exact position and knows exactly how you need to be supported.  Does that make sense?  Because I can talk about, like, a doula and a therapist and a naturopathic doctor, but you know what you need, and I want you to trust yourself in that knowledge.  You know what you need!  And here are all these different options to provide that.

Alyssa:  So you mentioned something a bit ago, and I don’t know what made me think of this, but how — let’s say a mother came to you pregnant and had postpartum depression before and knew that she — you know, her hormones are all over the place.  How much can you actually do in regard to hormones while pregnant?  Is there any risk to Baby?  You know, risk of miscarriage?  What does that look like for a mom who’s pregnant but knows she needs some help from you?

Dr. Nave:  So in terms of working with me specifically, I wouldn’t want to mess with her hormones during that time.  I would employ other tools, one of which is homeopathy, which basically supports the body’s own ability to heal and regulate itself.  As well as putting a plan in place — basically, working alongside her other healthcare providers to create a plan to support her and make sure that the transition is as smooth as possible.  What does she do if she notices that she’s trending from green and happy, healthy, thriving, into, I’m not doing so hot — what are the resources available to me when I’m at that place?  Who do I reach out to?  Who do I talk to?  What supplemental intervention needs to happen?  Do I need to talk to my doctor about starting me on medication?  There are so many different options, and prevention is always better than cure.  We would talk about what her issues — so she’s coming and she’s had it before — we would talk about what was her previous pregnancy like; when did the symptoms start to occur; what did they look like; what sort of things — what sort of red flags occurred during that time; what was the intervention utilized at that time; what were her hormone levels like?  What else; what were any medications that she was on; what medications is she on presently?  And, basically, maybe even talk about how that pregnancy is different than this pregnancy.  Like, does she feel more supported now?  What were the things that weren’t present in the previous one that she does have presently?  You know?  And basically coming up with a plan.

Alyssa:  Yeah, I like that.  So it’s kind of like what we do, you know, throughout birth.  It’s talking about all those what-if scenarios and what plans do you have in place for if any of these happen.  And then, like you said, once Baby comes home, nobody plans for that.  They’re so worried about the pregnancy and the labor and delivery part that they come home and go, oh, shoot.  What do I do now?  So it sounds like that’s a really healthy way to plan during pregnancy, if you do have any sort of mood disorder, to find a professional like yourself to sit down and say, hey, let’s go over all these things and put a plan in place, and then I’ll be here for you postpartum.  And then we’ll talk about what we can do then.  I like that.

Dr. Nave:  Right, because, as I said, there’s so many different options.  For one woman, maybe hormones, just giving her the hormones, is what she needs, and then I would, you know, work with her other — because I can’t prescribe hormones at the level that would be therapeutic, but I would be able to recommend, okay, that’s what you need.  Let’s talk to your doc.  Hey, Doc.  This is the plan.  If this happens, this is what we’re going to do so that she doesn’t have to suffer.  You know?  Or maybe it’s something else.  Just being able to work with someone who — again, like myself — who is savvy on that in terms of knowing — yeah, it definitely needs a collaborative approach, which is what I’m about.  In my head, in my dream, everyone would have a health team, you know?  People, health professionals, who are all in communication with each other who are just there to support you and help you thrive.  But I think to wrap up, it would be sleep, health, get your hormones evaluated.  If you’re thinking of getting pregnant and you have any mood disorders or any mental emotional concerns, as part of your pregnancy plan, you should be working — ideally, you would be working with a mental health professional as well, just to insure that you have the support that you need and you’re processing stuff effectively, because those concerns, those mental health concerns, can be substantially amplified once you become pregnant, as well as after giving birth.  If you have a mental health condition or if you’ve had postpartum depression before, you are at significant risk for developing it again.  And this applies to — postpartum depression can also occur if you have a loss of a baby, so it’s not just if you’ve given birth, but any form of baby loss can also result in postpartum depression.

Alyssa:  Yeah, I can imagine it would probably be even amplified with that because you still have the hormonal shift, that drastic hormonal shift, and then grief on top of it.  So it probably takes it to a whole new level.  Well, thank you for all of your expertise.  I always love talking to you.  I would love for people to know how to find you at Hormonal Balance, if they want to reach out.

Dr. Nave:  Yeah.  I am on Instagram and on Facebook as @drgaynelnave.  I’m in the process of getting my website up, so I’ll update you on that afterwards, or you can call my clinic at 616-275-0049.  If you have any hormonal or mental health concerns and you want to optimize your health team, you want a second opinion, or you just want some additional support — that’s what I do!

Alyssa:  Thank you!  During this Covid pandemic, can you see people in person, or are you choosing to do virtual only right now?

Dr. Nave:  I’m choosing to do only virtual at this point.  I see clients virtually most of the time Wednesdays through Fridays, actually, from 8:00 to 5:00 p.m., and in person at 1324 Lake Drive Southeast, Suite 7, Grand Rapids, Michigan 49506.

Alyssa:  So once the stay at home order lifts and things get a little bit more back to normal, you’ll be seeing people in person again?

Dr. Nave:  In person, yes.  But for now, we will see each other virtually!

Alyssa:  Thanks for your time!  Hopefully we’ll talk to you again soon!

 

Mental Health Awareness Month: Podcast Episode #97 Read More »

Perinatal Mood Disorders: Podcast Episode #91

Today we talk with Elsa, a therapist at Mindful Counseling in Grand Rapids, Michigan who specializes in perinatal mood disorders.  Learn what postpartum anxiety and depression look like, how they are different, and signs to look out for.  You can listen to this complete podcast episode on iTunes or SoundCloud.

Kristin:  Welcome to Ask the Doulas with Gold Coast Doulas.  I’m Kristin, and I’m here today with Elsa Lockman from Mindful Counseling.  She’s here to talk to us a bit about postpartum anxiety.  Elsa specializes in the following areas: perinatal mood disorders, which includes postpartum depression, anxiety, OCD, grief and loss, eating disorders, and body image issues.  She also works with clients dealing with relationship problems, coping with medical illness, trauma and abuse, women’s issues and self-esteem, and mood disorders and anxiety.  So obviously, you’re a natural fit working with clients who struggle with everything from eating disorders to anxiety and depression, transitions in their relationships, and expanding their family or having their first child.  So today, Elsa, let’s focus a bit on the difference between postpartum depression and anxiety and what women can do if they’re interested in seeking treatment and getting help.

Elsa:  Yes, postpartum depression and anxiety can go together.  Sometimes women will struggle with anxiety with depression.  Sometimes it is separate.  Postpartum anxiety and depression can look very different.  People classically think of postpartum depression as mothers who don’t connect with their babies, moms who are checked out and can’t get out of bed all day.  That’s actually not always the case.  Often, women with depression are exhausted and often can’t stop crying.  They can’t look, maybe, on the positive side or think rationally.  As far as the anxiety, it can come out more in not feeling necessarily down but feeling like you can’t relax; feeling that something bad is going to happen at any time.  Having thoughts of something happening to your baby; scary thoughts.  Sometimes even flashes of images of very violent things happening or the baby falling, and moms often feel guilty for those, actually, and don’t tell anybody, but they’re actually really important to talk about.

Kristin:  I had a friend who was afraid of driving in her car or anyone driving her baby.  There can be a lot of, like you said, those intrusive thoughts.

Elsa:  Yes, and it’s obsessive sometimes and you can’t get it out of your head.  So rationally, you can say, I’m not going to drop the baby going down the stairs.  I have the baby in my hands.  But it keeps going; it gets hooked, the idea or the image, and then they’ll struggle with almost a loop where it just can’t get out of your head.  Or anxiety can present sometimes in something around sickness.  No germs.  Thinking that my baby is going to get sick; I can’t take her out to the store, and I can’t take her to this house.  And how far that goes; I mean, some of these are common sense, and you want to take care of your child, but then how far does it goes?  Does it prevent you from doing things that you want to do, or do others notice that maybe this is being a little unreasonable?  It seems to be causing you even more anxiety to be thinking some of these things.  Another part is that sometimes anxiety can come out as anger.  Feeling just angry and irritable; feeling tense.  That can come out, obviously, with partners, and they can notice it.  Being different, a marked change from before for women.  Those are some of the symptoms that come that people can notice with anxiety.  Another one would be sleeping; when moms can’t sleep when the baby is actually sleeping.  That’s another sign of postpartum anxiety for people to watch out for.

Kristin:  Sure.  That makes sense.  I know even with postpartum doulas in the house, some women still struggle with fully sleeping even though their child is being care for by someone else. And sleep is so essential.  There are so many studies on how, if you’re not getting enough sleep, it can lead to mood disorders and anxiety and so on.

Elsa:  Yeah, it just leaves women very vulnerable, and now it’s become so normalized that part of the postpartum world is just not getting sleep.  And I think it’s also expected that women are also just supposed to go on with their lives and do all the normal things that they’re supposed to do even when they’re running on little to no sleep, and this goes on for weeks or months.

Kristin:  Yes!  So what resources would you suggest if they’re looking for help?  Obviously, we can talk about how to reach out to you!

Elsa:  For sure!  You can definitely contact Mindful Counseling GR.  You can contact Pine Rest.  They actually have a mother baby unit, so they actually have therapists that have specialized training, like I do, to work with women postpartum.

Kristin:  And now Pine Rest even has the ER when you can —

Elsa:  Oh, the urgent care center?

Kristin:  Yes, the urgent care center.  They can go in at night and not have to go the hospital.

Elsa:  yeah, they can go to the urgent care center and get assessed and get attention or treatment a lot quicker.  OB offices have a list of therapists who are trained and specialize with postpartum or perinatal mood disorders, which includes anxiety and depression in pregnancy and postpartum.  So there’s a list that you can ask for from your OB, as well.

Kristin:  Great!  How do they directly reach out to you?  Are you accepting new patients, Elsa?

Elsa:  Yes, I am!  You can reach out to me by contacting me through our website.

Kristin:  Perfect!  Thank you for coming on today!

 

Perinatal Mood Disorders: Podcast Episode #91 Read More »

Postpartum Depression

Supporting a Postpartum Mother: Podcast Episode #79

Elsa Lockman, LMSW of Mindful Counseling talks to us today about how partners, family members, and other caregivers can support a mother during those critical postpartum weeks to ensure she seeks help if needed.  How do you approach a new mother and what are her best options for care?  You can listen to this complete podcast episode on iTunes or SoundCloud.

Kristin:  Welcome to Ask the Doulas with Gold Coast Doulas.  I’m Kristin, and I’m here today with Elsa Lockman.  She’s with Mindful Counseling, and we are talking about how partners and other caregivers and family members can support a woman who has potential signs of postpartum depression or mood disorders.

Elsa:  Yes.  So postpartum is going to be an emotional time, so tears, some anger, sadness, are all part of the experience.  After about two to three weeks out, if spouse or a friend or a mother is noticing maybe a mom is crying more than usual, isn’t really looking forward to things, has these unusual fears that they can’t seem to let go of.  Another sign would be not seeming to eat very much or either sleeping a lot or not being able to sleep when the baby is sleeping.  If they’re noticing those signs, it would maybe be a sign that they could go talk to somebody as far as a therapist or go see their doctor.  Approaching Mom would be in a way to not criticize mom as if she’s doing anything wrong.  She’s not doing anything wrong, so start off with validating, actually.  She’s doing a great job with how hard it is; validate how hard she’s working, and try to tell her that it doesn’t have to be this way.  She doesn’t have to do it alone.

Kristin:  How does the caregiver know if it is baby blues or if it’s something that she needs help for?  Because, of course, there can be that hormonal fluctuation.  They may be teary.

Elsa:  Baby blues usually stops after three weeks postpartum.  So after that would be maybe a sign that there’s more going on.  But I would say, is it getting it the way of functioning?  Is it getting in the way of relationships?  Is it getting in the way of their working in the home or outside of the home, getting those things done?  To a degree, that is expected postpartum; not everything running smoothly, but are relationships being affected?  Those would be signs that it’s more than just baby blues.

Kristin:  How can a spouse, partner, or caregiver be supportive in order to empower her to get help?  Is it best for them to directly reach out for help for her if they’re seeing signs, or what do you recommend?

Elsa:  I recommend the mom reaching out, so that would be encouraging Mom to reach out herself.  And maybe she needs to talk to a friend and have more time with friends or more time to herself; maybe that would help.  See how that works.  If that seems to help and is enough to alleviate whatever stress is going on, then that works, but maybe if it’s not working, then take it to another level, which would be contacting a therapist or your doctor.

Kristin:  And since, obviously, women have multiple doctors — they’re seeing their OB or midwife and family doctor and their pediatrician — does it matter who they’re speaking with about getting help?

Elsa:  No, it wouldn’t matter who you see.  Usually the OB would be the person that they’ve seen most recently, but they can even bring it up to the pediatrician, since moms see the pediatrician very often.

Kristin:  And as far as getting help for our local listeners and clients, they can reach out to you directly?  How do they access you at Mindful Counseling, Elsa?

Elsa:  They can go to the website, and they can contact me through there.  Another resource would be Pine Rest, and through your OB’s office, there also is a list of therapists who specialize in perinatal mood disorders, which includes postpartum depression and anxiety.

Kristin:  That’s so helpful.  And in past conversations, you had mentioned that women can bring their babies to therapy; that you allow that with clients you’re working with, and I know Pine Rest encourages that with their mother-baby program?

Elsa:  Yes, for sure.  Bring your baby to the session; you can feed the baby, breastfeed, anything.  Coming with your baby is welcomed and encouraged, for sure.

Kristin:  Do you have any final thoughts or tips to share?

Elsa:  Just that it doesn’t have to be going through this alone.  It’s very normalized for women to feel that anxiety is just part of the postpartum experience or feeling depressed and stressed is part of it, and while it might be a new phase and there’s a lot going on, it doesn’t have to be that women are just suffering through it.

Kristin:  Great point.  Thanks so much, Elsa, for being on!

 

Supporting a Postpartum Mother: Podcast Episode #79 Read More »

Working Mom

HOW TO TAKE A SOCIAL MEDIA BREAK ON MATERNITY LEAVE

We are so very excited to share this guest blog with you because not only is the author an amazing mother and entrepreneur, but she is also a past client. With over 10 years experience in social media strategy and digital marketing, Chris found her purpose after having her daughter. Pre-baby, she was a self-proclaimed “hustle-a-holic” with no intention of slowing down. Because of her failure to plan a proper maternity leave, she entered motherhood with all the grace of a knock-kneed baby giraffe. Biz Babysitters is the outcome of this struggle. Chris made it her mission to prevent as many women as possible from going through what she went through by supporting them postpartum.

The average person spends 142 minutes on social media every day. Seem low? Remember, this count includes your Grandpa who doesn’t know what a DVR is. For the average business owner, it’s not surprising that this number is higher by, um, a lot. And here’s the catch – for most of us, the amount of time we spend actually in our social apps pales in comparison to the amount of time we spend thinking about what to post. With such a huge importance and energy suck in our day-to-day lives pre-baby, it’s imperative for pregnant (or planning to be pregnant) business owners to consider what the heck they’re going to do with their social media in their postpartum before it arrives.

Just like every other step of the entrepreneurial journey, there’s no one perfect one-size-fits-all solution. Rather, it’s a customized series of decisions, based completely on your own preferences. You’ve got the power and you know yourself and your business best.

Today, I’m going to walk you through three options for logging off of social media in your postpartum time, as well as the potential pros & cons, and some recommended resources for taking action.

By now, we’re all becoming more and more aware of the negative effects of social media on our mental health. We’re also becoming more aware of perinatal mood disorders. With the two of these worlds overlapping postpartum, there’s a strong case for taking your business’ social media off your plate in your maternity leave.

Ready to get started? Here are your three options for logging off…

1. HIT PAUSE.
This is the most straightforward – it’s literally just stopping.

It’s a beautiful option for those whose businesses don’t rely on social media for lead generation or marketing. If you decide to go this route, I recommend giving your audience a heads up ahead of time and letting them when to expect you back. No one likes to be ghosted. A potential downside here is that an inactive account cannot build business and can start to gather dust (i.e. lower visibility) from your absence.

*Recommended resource: You

2. OUTSOURCE IT.
Hand off the reigns.

Outsourcing works well for those who want to keep a thriving social presence and continue garnering leads, but are unsure what their own capabilities will be in their immediate postpartum. When outsourcing, I recommend investing in an expert with a vetted system for onboarding to minimize the stress and time investment on your end.

*Recommended resource: Biz Babysitters

3. AUTOMATE IT.
Schedule it and step away.

This involves some legwork ahead of time, but keeps an active presence while freeing up some mental hard drive. For scheduling, I love the Later app, which can handle both Instagram and Facebook. It gets bonus points because you can use it from both Desktop and your iPhone. Automation is great for business owners who want to DIY it. The potential downside of automation is overwhelm and an increased temptation to “check in” (which is a slippery, slippery slope).

*Recommended resource: Later

The cool thing is that there is no wrong answer – just an array of selections that can all be customized to fit your exact, unique desires. The important part is to take your business’s social media, which can be an ever present monkey on your back, off your plate so you can focus on what’s important – your own healing during this important transitional time.

No matter which route you choose, you’re not alone. If you want support in your decision making, I’d love to chat. Reach out to me via DM on Instagram as @bizbabysitters.

In the comments, tell me… which of these three options calls to you most?

 

HOW TO TAKE A SOCIAL MEDIA BREAK ON MATERNITY LEAVE Read More »

Ask the doulas podcast

Podcast Episode #68: Overnight Doula Support

Many of our clients and listeners don’t fully understand what overnight doula support looks like.  Kristin and Alyssa, both Certified Postpartum Doulas, discuss the kinds of support their clients look for and how their team of doulas support families in their homes.  You can listen to this complete podcast on iTunes or SoundCloud. You can also learn more here about overnight postpartum doula support.

Kristin:  Welcome to Ask the Doulas with Gold Coast Doulas.  I’m Kristin.

Alyssa:  And I’m Alyssa.

Kristin:  And we’re here to chat about what an overnight postpartum doula does, as that is a question that we get asked often by our clients and our podcast listeners.  So, Alyssa, my first question to you is, as a postpartum doula and sleep specialist, what do you see as the key benefits to a family in hiring overnight postpartum doula support?

Alyssa:  Whether they hire for sleep or not, it helps the parents get sleep.  So let’s say they’re not even hiring me for a sleep consult.  Parents don’t understand what sleep deprivation means until their in the midst of it, probably at least three weeks in.  Like, our bodies are designed to survive a couple weeks of this, sometimes even three or four, but after that, our systems start to shut down.  So if you think about overnight support being this trusted person who sleeps in your home to take over all those overnight responsibilities so that you can get a good night’s rest.  Even a six-hour stretch or sometimes even a four-hour stretch makes you feel like a whole new person the next day when you’re used to only sleeping maybe one- or two-hour chunks.  A four-hour stretch seems amazing in that moment, whereas right now if you told me I could only have four hours of sleep tonight, I would cry.  I would be miserable the next day.  And you, Kristin, as a birth doula, you know that feeling.  If you’ve had one night of no sleep, you’re just wrecked.  So you’re running on adrenaline.  You’re sleep deprived.  So having a doula come in and take over all that responsibility at night — obviously, she can’t breastfeed your baby, but you have a couple different choices if you’re a breastfeeding mom.  If you’re a bottle-feeding with formula mom, you can literally go to sleep at 10:00 PM and wake up whenever you want because the doula can just feed that baby every three hours.

Kristin:  Exactly, and clean the bottles and change the diapers and burp the baby, all of it.

Alyssa:  Yeah.  So if your partner is feeding in the middle of the night, you’re certainly not going to wake up to clean bottles and parts in the morning.  The doula does do that.  But for a breastfeeding mom, you can choose to pump instead of breastfeeding because it’s usually a lot quicker.  So you pump and you set those bottles out for the doula.  The doula wakes up when the baby wakes up; feeds the baby; burps the baby; changes the baby; gets the baby back to sleep — and Mom’s sleeping this whole time.  Or, if Mom chooses to breastfeed, the doula can bring Baby to Mom so Mom doesn’t even have to get out of bed.  I was just talking to Kelly Emory, our lactation consultant friend, and she was saying that when she was nursing, she would just side lie and her husband would bring the baby to her.  She would lie on her side, so she didn’t have to get up.  She didn’t even have to open her eyes if she didn’t want to.  She was still kind of in this half-sleep state, and then when Baby was done on that side, her husband would take the baby and she’d roll over and she would feed on the other side, and then the husband would take the baby away, change the baby, burp the baby, and do all that stuff.  So she said it was amazing.  She took over one shift of the night, and he took over the next, so she would get a six-hour chunk of sleep and would feel amazing in the morning.  So you’re able to tackle all those everyday tasks during the day because you didn’t have to also worry about those at night.

Kristin:  Yes!  And I’ve also had overnight clients who prefer to come into the nursery and sit in a rocker and feed their baby rather than have me come in and disrupt their husband’s sleep.

Alyssa:  Sometimes they’re sleeping in separate rooms, too, because they’ve become used to that.  So oftentimes, my goal as an overnight doula is to have both parents sleeping in bed together again, or wherever you were before this baby arrived.

Kristin:  Right, no more partner on the couch or in the guest bedroom.

Alyssa:  Right.

Kristin:  So as far as other tasks of an overnight postpartum doula, sleep is one.  So we can get Baby back to sleep and if they’re working with a certified sleep consultant, like you, then they can implement that.

Alyssa:  Yeah, I guess I didn’t answer that initial question.  So if they do work with me as a sleep consultant, you can hire an overnight doula in conjunction with.  So I offer this customized sleep plan for your family, and then our doula knows that plan, understands that plan, and implements that plan overnight.

Kristin:  That’s amazing.

Alyssa:  So you wake up again refreshed because you’ve slept, and then you have the energy to implement the sleep plan during the day.  And then the doula comes in at night and implements that plan overnight.  So it’s consistency because that’s always the key with any sort of sleep consult is that you have to be consistent.  You can’t just do it during the day and then give up at night because you’re tired.  Your plan will fail.

Kristin:  And so who hires a postpartum overnight doula, and how often do they use the doula support?

Alyssa:  Who hires them?  Tired families hire them!  You get to the point of exhaustion.  I don’t think when you’re pregnant you’re thinking about an overnight doula because you truly don’t understand what you’re in for.  But newborn babies sleep all the time, so they could sleep up to 22 out of 24 hours a day, so you’re thinking, well, of course, like, newborn babies sleep all the time.  I’m going to sleep when the baby sleeps.  They’re going to be feeding every two to three hours!

Kristin:  They get up a lot!

Alyssa:  Which means all day and all night, you will be up feeding every two to three hours, at least.  So your sleep becomes these little tiny chunks.  Because if you think if you have a newborn baby that’s eating every two hours, and it takes you an hour to breastfeed, and then after the breastfeeding session, you have to burp; you have to change the diaper; you have to get the baby back to sleep.  You’ve maybe got 30 to 45 minutes, if you’re lucky, to sleep before the baby needs to feed again.

Kristin:  And some clients hire us for one overnight to get a good night of sleep and catch up; other clients hire us every night, and we bring in a team, in and out, or have one doula consistently.  And some of our clientele have a partner who travels a lot, or I’ve even supported a family where the mother was going back to work from maternity leave and was traveling for her job, so as an overnight doula, I supported the husband as he cared for the toddler that was waking; I was caring for the baby.  And so there are a lot of unique situations, but a lot of our moms who have partners who travel a lot want that extra support, whether they have a new baby or other kids in the household that need support, as well.

Alyssa:  I think it depends on resources.   So if someone is sleep deprived and they’re like, I just need one night of reprieve, and that’s all we can afford and that’s what we’re going to do, then that’s what they do.

Kristin:  Exactly.

Alyssa:  Even if they don’t have the resources, oftentimes during pregnancy, if parents have the foresight to ask for postpartum support as a baby shower gift, they can have several overnights gifted to them by friends and family.

Kristin:  Which is better than all the toys and clothes they’ll outgrow.

Alyssa:  I always tell them, you’re going to get mounds of plastic junk that you’ll literally look at and say that’s hundreds of dollars’ worth of stuff I’m never going to use, and you could have had an overnight doula in your home so you could sleep.

Kristin:  Easily!

Alyssa:  So I think it’s just based on resources because, like you said, we’ve had people hire us for, you know, two overnights and we’ve had two months straight.  So I think it just depends.  I mean, I don’t know that it’s a type of client.  I think that’s just kind of based on resources available.

Kristin:  And we certainly support families who are struggling with postpartum mood disorders and anxiety, but that is not all that we serve as far as clientele.  But for moms who are being treated in therapy, then we certainly are able to give them much-needed support and rest as we care for their baby, and we do have a package where we are able to lower our hourly rate for clients who are in the Pine Rest mother-baby program or are seeking therapy.

Alyssa:  Yeah, sleep deprivation is considered to be the number one cause of perinatal mood disorders, so all these moms with anxiety, depression, up to postpartum psychosis — when you’re sleep deprived, you’re literally torturing your brain and your body, and it’s really hard to function.  So sleep is such an imperative thing, and for your baby, too.  If you’re not sleeping and your baby’s not sleeping, physiologically, that baby needs sleep in order to grow, for their brain to develop, for their immune system to function properly.  It’s so critical for both parents and children.

Kristin:  Agreed.  So, really, anyone can benefit from it.  Our shortest shift would be coming in at 10:00 PM and leaving at 6:00 AM, but a lot of clients extend that time.

Alyssa:  I’ve found that a lot of people like you to come a little bit earlier, especially if they have older children.  So if there’s older siblings, let’s say 6:00 comes around and you’re trying to get dinner on the table.  You have a two-year-old, a five-year-old, and a newborn.

Kristin:  That’s a lot!

Alyssa:  That overnight shift tends to, when parents say, yeah, yeah, come at 8:00 or 9:00 when I’m going to go to bed — that very quickly changes to 5:00 or 6:00.  So either that shift moves up, or it just lengthens.  So the doula can come from, a lot of times, 6:00 PM to 6:00 AM, and they do a lot of 12-hour shifts because they’re there for the hustle and bustle of getting dinner, wrangling toddlers, helping with the newborn, and then helping with bedtime routines for two or three children and then taking that infant newborn and helping them get to sleep.  Usually, it’s in that order.  Like, the doula will take the baby and put them to sleep, and then the parents get to spend some quality time with this toddler who is usually lashing out because they are used to being the only child, if there’s only one, and are really, really seeking that one-on-one attention that they’re not getting anymore.

Kristin:  Yeah, that’s the perfect time to bond, and they can read them a bedtime story and sing songs; whatever their nighttime routines were before Baby arrived.

Alyssa:  Yeah, and that’s one thing I stress, too, with my sleep consults is just having a really good bedtime routine, and even if I’m doing a consult for one child and there’s others in the household, I usually ask about them, too, because if you’ve got three kids who all have a different bedtime, and each bedtime routine is taking an hour, certainly whoever’s last on that list is going to bed at 9:00 or something, which is way too late for these little kids.  So trying to consolidate and have a system in place and just get a schedule that works for the family, for everyone in the family, is a really big goal.

Kristin:  Awesome advice.

Alyssa:  So you mentioned earlier that a doula sleeps when the baby sleeps, and sometimes parents wonder, well, what do you mean?  What does that look like?  Depending on the house, we’ve had doulas sleeping on sofas in the living room.

Kristin:  Yes, that’s what I’ve done.

Alyssa:  We’ve had doulas sleeping in a spare room.  We’ve had doulas sleeping in a spare room on the same floor, in a spare room on a different floor, and you can make anything work.

Kristin:  With monitors and technology now, you know the second a baby stirs.

Alyssa:  So parents are always like, oh, shoot, I don’t know how this is going to work.  How am I going to do that?  We’ve had blow-up mattresses in the nursery.  Ideally, you want the doula to be as close to the nursey as possible, so they’re the one, when they hear that baby, they’re up; they’re there.

Kristin:  No one else gets woken up in the household.

Alyssa:  Yeah, you want the parents to be as far away.  So sometimes I even tell them if you have a spare bedroom in the basement, go sleep there, because even with one of my most recent sleep clients, the first night we did the sleep consult, the doula was there overnight, and I contacted them the next day: how did you sleep?  And they were like, oh, I wanted to so bad, but I kept hearing this phantom crying.  Even when the babies weren’t crying, they hear it, anyway.  So it does take, as parents, who are used to not sleeping for week after week after week — it takes time for your body and brain to adjust back to, oh, I’m able to sleep again.  So it’s not instant.  It usually takes at least a couple nights to get your brain to say, I can sleep.  It’s okay to sleep through the night.  I don’t have any responsibilities tonight.  This doula is taking care of it.  And it’s just a matter of them getting sleep in two-hour chunks instead of the parents getting sleep in two-hour chunks.  So a doula can usually do two or three in a row before they’re too exhausted.

Kristin:  Just like a birth doula.  We can do a couple nights with a client in the hospital without sleep, and then we’re done.

Alyssa:  Yeah.  So for those clients of ours who we’ve had for two weeks straight or two months straight, it’s several doulas taking turns.  Otherwise, they’re just too exhausted.

Kristin:  Right, and that’s where we sometimes will bring in a team if it is continuous care.

Alyssa:  But I think ideally, with sleep training, I would love to see every parent have a sleep plan and then a doula for five nights.  That would just be — I don’t know; I think the mental well-being of these parents would increase drastically if they were able to do both.

Kristin:  I would have loved an overnight doula with my kids being 21 months apart; having a toddler and a newborn.  It would have been amazing.

Alyssa:  Well, and some people, too, think it’s weird to have somebody sleeping in your home.  I mean, always, when they meet the doula, they’re totally fine with it, but it is a weird thought to have this stranger come into your home who’s going to care for your babies.  That’s why I think we’re so adamant about talking about our training and our certification process, and we’ve done background checks for people who want us to.

Kristin:  Yeah, and we’ve shown immunization records and CPR certifications and so on and liability insurance.  We have all of that.

Alyssa:  Yeah, because especially with a mom with anxiety who needs to sleep and knows she needs this help, but now she has anxiety because a stranger is going to be sleeping in her home — we need to do whatever you have to, to make that mom feel comfortable to be able to sleep.

Kristin:  Yes, and we’re there to do just that.  So feel free to reach out to us if you have any questions about overnight doulas.  We’d love to work with your family! Remember, these moments are golden.

 

Podcast Episode #68: Overnight Doula Support Read More »

Technology and mindfulness

Technology and Mindfulness for New Parents

Technology is an amazing tool that we use daily for our work and personal lives, but it can also be the thing that drags us down. We need it, we love it, but we hate it.

It’s time we take a good look at our data usage and figure out what’s draining us. Why not find some parts of technology that are being used for good instead? They do exist. I’m going to give you several options for positive ways to use technology that can actually help you improve your mental health, whether you’re pregnant or not.

Mind the Bump

This is a free app that helps individuals and couples support their mental and emotional wellbeing while preparing for having a baby or becoming a new parent. It teaches brain education (the importance of mindfulness and meditation), the difference between mindfulness and mindlessness, and gives an overview of a child’s brain development.

Expectful

This is a guided meditation app for your fertility, pregnancy, and motherhood journey. Their team of licensed hypnotherapists, meditation experts, a psychologist, and a sound engineer have created 10-20 minute meditations customized just for you. This app offers a free trial then requires a paid monthly subscription.

Insight Timer

This free app claims to have the largest library of guided meditations in the world. Although it’s not specifically made for pregnancy, it seems to be a great app for meditations and sleep, and it is offered in 30 different languages.

Babies Help Mommies

This free app was created by a cardiologist. After having three children she couldn’t find an app for new moms that focused on health and wellness. This app is meant to improve overall health by focusing on fitness, activities that decrease heart disease, ways to be active with your baby and how to create new memories. It provides motivational feedback and highlights positive choices you can make throughout the day.

Enjo – Wellness for Parents

This app was created to offer new parents a positive way to interact with technology. The goal is to take a few minutes out of your day to reflect on something positive or that you are grateful for. The app leads parents through a positive and affirming conversation, but it will also notice when they are down and offer some reflections to support during struggles. Comments are not monitored by an actual person, so if someone is struggling with severe depression or anxiety this app is not meant to be a replacement for therapy or treatment for mental illness. It’s unclear if this app is free or paid.

Shine

This is a free self-care app that they call “a daily pep talk in your pocket”. You will set a self-care goal and get personalized audio challenges and self-improvement audio tracks to help you grow. You will receive texts with researched- backed affirmations to feel more confident.

Head Space

This app has hundreds of themed meditations on everything from stress and sleep to focus and anxiety. They are “bite-sized” to easily fit into your busy schedule. They also offer what they call “SOS Exercises” for sudden meltdowns. This app offers a free trial and then requires a paid subscription.

Using apps like these can be a great start to boosting your mood, lowering anxiety, or helping you sleep. Please do not substitute professional support for a phone app. If you are struggling with a mental health disorder, please seek the help of a professional therapist. We are able to give some trusted recommendations if needed. If you are struggling as a new parent and need in-home support, contact us about postpartum doula support. If you aren’t sleeping, contact us about our sleep consultations. We offer a discounted rate for postpartum support to anyone seeking treatment for a perinatal mood disorder.

Alyssa is Co-Owner of Gold Coast Doulas. As a Certified Postpartum Doula, Newborn Care Specialist, and Certified Infant & Child Sleep Consultant, she is passionate about the mental health of families during the fragile postpartum period. She is a member of the Healthy Kent Perinatal Mood & Anxiety Disorders Coalition and was recently honored as Health Care Professional of the year by MomsBloom.

 

Technology and Mindfulness for New Parents Read More »

Gold Coast Doulas Team

Podcast Episode #55: What Sets Gold Coast Doulas Apart?

 

What sets Gold Coast Doulas apart?  Today Dr. Rachel of Rise Wellness asks us why she should refer her clients to us.  She already knows she loves us, but why should everyone else?  You can listen to this complete podcast on iTunes or SoundCloud.

Kristin:  Welcome to Ask the Doulas with Gold Coast Doulas.  I’m Kristin, co-owner.

Alyssa:  And I’m Alyssa.  Today we’re talking to Dr. Rachel again of Rise Wellness Chiro.  Hey!

Dr. Rachel:    Hey, I’m back.

Alyssa:  Tell us a little bit about Rise.

Dr. Rachel:  Yeah, so I am co-owner of Rise Wellness Chiropractic with Dr. Annie, and we specialize in prenatal chiropractic care and pediatric care.  So we see a lot of pregnant women.  We are out in the community talking to a lot of pregnant women, teaching some different classes, and whenever we talk to anyone or any patient, we always recommend they have a doula at their birth.

Kristin:  Love it!

Dr. Rachel:  Yes, so we love you guys, obviously.  I used you guys.  So I just thought maybe you could tell us more about why we should refer to you.

Kristin:  Good question.

Dr. Rachel:  Because there’s a lot of doulas out there now.  You see it a lot more now, I feel.

Kristin:  Yeah, it is becoming more popular than when I became a doula about five years ago, and so we set ourselves up to the highest standards of care at Gold Coast.  As many people know, doulas are not regulated.  There’s no board certification.  So anyone could call themselves a doula, but our doulas are all trained or working towards certification.  It takes about two years to get certified for birth or postpartum, and our postpartum doulas are also current with all of the CPR, heart saver, AED certifications.  And so in order to work with us, you’re at that higher level.

Dr. Rachel:  What classes do the doulas take?

Alyssa:  DONA and ProDoula are two of the biggest certifying organizations.  Those are what most of our doulas come from.  There are a couple others.

Kristin:  Yeah, we have some Cappas, and we have doulas in other training programs, so we don’t select certain ones.  We do prefer that our doulas have had an in-person versus an online training, and the trainings can vary from two to four days, depending on the certification organization.  And then depending, again, on what program they’re going through, oftentimes an OB or a midwife would need to sign off on a certain number of births, as well as nurses in the room and clients.  And then there’s hospital research that needs to be done.  Books need to be read and essays and exams, and there’s a whole process, and it is different for every organization, but yet pretty similar in the structure.

Alyssa:  So a lot of our doulas are certified already, and the ones that are trained and working towards certification have a certain amount of time, and if they don’t fulfill those obligations within that 18- to 24-month period, then when it expires, they have to leave.  So we’re really, really adamant about that because if we’re saying that we’re a professional, experienced agency and these are our requirements, we have to stand by that.

Dr. Rachel:  So you guys offer a lot of other things besides just having a doula here at Gold Coast?

Alyssa:  Yes!

Kristin:  Yes!

Dr. Rachel:  Which I think is cool, because then you have your doula but then you’re also – then you can refer out to, like, oh, you want placenta encapsulation or help with breastfeeding or all these other classes.  So tell me about those.

Kristin:  Yeah, and with everything, again, trying to have the highest standards of care, there are a variety of lactation consultants, and our lactation consultants are the highest standard, so IBCLC, and they go through years of training in order to do that.  And HypnoBirthing; our childbirth education instructors are certified and maintain those certifications every two years, and our placenta encapsulator has gone through a certification program and is certified and keeps current with bloodborne pathogens and all of the other exams you need.

Dr. Rachel:  And weren’t you just telling me the other day that she comes and pick up the placenta?

Kristin:  Yes, from the hospital.

Dr. Rachel:  Which is nice, because not all of them do, right?  Sometimes you have to bring home the placenta?

Alyssa:  Sometimes, probably, but all of ours will come pick up at the hospital or home if they’re having a home birth.

Kristin:  One of our doulas is a certified placenta encapsulator, and her certification only has her do in-home, so some of our clients like to have that prepared in home and they actually bring the placenta home and then she does all of the encapsulation right there in front of them.

Alyssa:  The majority tend to want it picked up at the hospital and brought to the encapsulator’s work space and just dropped back off to them when it’s done.  But I think the reason we offer so many things is, you know, you find out you’re pregnant, and where do I go?  Who do I ask all these questions to?  And to know that you can come to Gold Coast and get evidence-based resources and talk to experienced professionals is invaluable.  Our response time is quick; we’ve noticed that if you don’t respond to somebody right away, they just assume that you don’t care or that to be unresponsive just gives a new mom a bad feeling.

Kristin:  Yeah, we work seven days a week.  We answer the Gold Coast line seven days a week and respond the day of, if not immediately.

Dr. Rachel:  How does it work?  So they’re, like, hey, they reach out to you, whether email or call, but you have 18 doulas; is that right?

Kristin:  Yes.

Dr. Rachel:  So how do you get matched with your doula?

Alyssa: Sometimes people ask for somebody specific.  “I was on your website, and I really love so-and-so.”

Kristin:  Right, or it could be location-based.  We have some lakeshore doulas, so we try to pair them with clients who are delivering in the hospital, but are Grand Rapids doulas, of course.  We serve a 50-mile radius, so we will travel, and some of our clients – Alyssa can attest to this – will only want a certified doula, so that would limit the pool, or are looking for a lower rate, and we do offer different pricing structures for birth based on where a client is looking for a certified or a pre-certified doula.   And so if they are looking for a reduced rate, we would give them our doulas who are experienced, but also working towards their certification.

Alyssa:  Right, even if they’re trained and working towards that certification, they could be twelve months in, and they could have had several clients and have done most, if not all, of their coursework.  They just have to get all of their clients.

Dr. Rachel:  Is there a test at the end or is it just –

Kristin:  It’s an exam, yeah.

Alyssa:  Yeah, and lots of reading and lots of clients.  And for births, they have to be qualifying births.  So they could have attended 20 and only 1 qualified because they went too quick or any number of reasons.

Dr. Rachel:  What’s a qualified birth?

Kristin:  It depends on the organization.  Most organizations require three signed-off births.  But again, it depends.  If you had three Cesareans, only one would count, or if it was a quick birth, it needs to be at least ten hours for some organizations in order to count.  And then again, with my first doula certification, Sacred Doula, before I went through the Pro Doula birth certification, I needed to have doctors.  So I might have gotten the nurse to sign; I might have gotten my client to sign, but if I couldn’t reach that doctor immediately after the birth to get he or she to sign, then that one didn’t count.  A lot of the birth trainings require auditing a full childbirth preparation class, so that could be anywhere from five weeks to twelve weeks, and also sitting in on a breastfeeding class so you understand how to support a breastfeeding mother.

Dr. Rachel:  When I took your breastfeeding class, I think someone was sitting in on it.

Alyssa:  Maybe one of our doulas?

Dr. Rachel:  Yeah, I took it through Shira, yeah.

Kristin:  So yeah, there’s a lot of preparation outside of that, and with my first certification, I also needed to take a business class, so I took a social media marketing-focused class as well to build my business.

Alyssa:  And one thing we haven’t mentioned is we are fully insured.  I know a lot of doulas aren’t, but we as a company are, and we have done background checks for clients or we can do drug screenings.  Anything that a client might need us to do, we’re able to do for them.

Kristin:  Yes, so we have – obviously in our classroom space and office, we have the full professional liability, but then we have the doula agency covered, and some of our clients have asked us to see our insurance.  And then we’ve also, for clients who are concerned about vaccinations, we’ve shown immunization records.  If they want doulas to have the flu shot, for example, then we would give them doulas and be able to prove that they have the current flu shot.

Alyssa:  And we keep all that information on file, readily accessible, so I know if a client calls and says I want to see someone’s immunizations; I want them to also have a flu shot, and I want to give them a drug test and a background test, I can look at my chart and be like, okay, this person, this person, this person.

Dr. Rachel:  That’s really awesome.

Kristin:  Yeah, especially for overnight doula support, they want to know that if you’re caring for their child, their baby, when they’re sleeping, that they can trust that individual.  So I feel on the postpartum end of things, the background checks, the screenings, are more rigorous than, say, for birth.

Alyssa:  Anything else you think that clients have questions on when you say you should hire a doula because you’re pregnant?

Dr. Rachel:  No, they probably just ask why.  I tell them because you don’t know what you’re doing.  You don’t know!  I mean, yes, your body can do it naturally, but if you’re not prepared for birth… I tell them to take a birthing class, too.  And have a doula there; they know what to do.  Like I said, when I sat down with you and Ashley, I was, like, oh, good.  You guys got this handled!  I’ll just listen to you!

Kristin:  Right!  We’ve got you covered, and we can also support the partner equally, and you know, regardless of how you’re preparing, whether it’s taking a hospital class or HypnoBirthing or Lamaze or Bradley, then we’re able to support and reaffirm what you learned in class and regardless – again, we pride ourselves on judgment-free support, so birth doulas, postpartum doulas – however you parent, however you choose to birth, it’s cool with us.  So if you want to get an epidural the second you walk in the hospital, let me make you comfortable and try to help things progress.  If you have a planned Cesarean, then we’ll help you along that way, as well as, obviously, an unmedicated birth experience.  Some doulas prefer to only support unmedicated births or only home births, but we will support everyone equally, and we’ve done specific trainings that are beyond the scope of a doula training to make us even more…

Alyssa:  More inclusive.  You know, we’ve had diversity training, an LGBTQ training.  We’re just looking at this community, saying, whoever approaches us and asks for support, how do we best support them?

Kristin:  Yes.  So we’ve done an empathy training.  A lot of our doulas went through the Mothership Certification program, which is a weekend-long training.  And also our lactation consultant and infant massage specialists, they both went through the training with me when it was first launched, and so that’s about empathy, working with healthcare professionals, with clients.  And so we did that training.  We did a disability training to be able to support clients both in birth and postpartum with various disabilities, and that was so helpful and nothing I ever learned at a doula training or a conference.  I go to conferences every year and some very specific niches, so we’re able to, again, serve more communities.  And one thing that Gold Coast does is that most of us work in the partner model.  How did you feel about hiring two doulas versus one doula?

Dr. Rachel: Yeah, it was great.  It’s nice to know that you always – well, it’s just nice to have two people to bounce ideas off, or like you said, once you hire your doula, they’re there for the whole pregnancy, so when I would text a question, you both would answer.

Kristin:  Right, and we have different backgrounds and experiences.  Ashley was your HypnoBirthing instructor, so you had her knowledge as well and my long-time experience, so yeah, that’s a benefit.  We only allow the option for certified doulas on our team to serve as a solo doula, and they still have the benefits of the team within Gold Coast if there’s an emergency or if the doula has the flu or if two clients deliver on the same day.  They would have a backup within our team, but they prefer to reduce their client load and focus on that individual connection.  So for a client who doesn’t necessarily feel comfortable with a team, we give that option, but most doulas in this area work in a solo model with a backup, and you may or may not know who that backup is.

Alyssa:  That’s why most tend to like our team approach.

Kristin:  And then in the postpartum time, we have some clients who want a lot of hours in a package, and so they may be working with five doulas or they may have one doula.  So Alyssa handles a lot of that scheduling.

Alyssa:  Yeah, that’s another thing that sets us apart, I think, is when you’re working with just a doula who does postpartum work, she’s limited in how many hours she can do.  But we have enough that when we have clients call and say I need somebody day and night for two months straight, we can cover those shifts.

Kristin:  It’s nice to cover inclusively with our team and their different skill sets.  Some of our doulas are also CLCs, so basic lactation consultants, so if they’re in the home postpartum, they’re able to support with basic breastfeeding needs.  If there are specific issues, we can bring our IBCLC there.

Dr. Rachel:  Yeah, it’s probably just nice to be, even as a doula at Gold Coast, to be able to reach out, like, oh, I have this going on; do you have any advice?

Kristin:  Yes, we can bounce situations or an induction question or how do you navigate this or trying to get baby in a better position.  So we have the whole team to run things by, and they can always call me if it’s a birth issue and a doula is uncertain how to handle a situation.  And then we’re so fortunate in that our infant massage instructor is also a licensed therapist and specializes in postpartum mood disorders and working with women in that time, and so we’re able to use her as a reference and a referral source.  She’s helped us process some experiences we’ve had where a doula sometimes needs therapy, needs help dealing with some of the emotions surrounding what we are holding space for.

Alyssa:  Yeah, I think our team – we can rely on each other.  We have a private Facebook group where we can ask all these questions of each other, support each other, give each other accolades.  We have meetings.

Kristin:  Yeah, and yearly, I set up a birth doula skill share, so we all spend half of a day together and go through just different comfort measures and things we’ve learned at conferences and other trainings, and just reaffirm each other and, you know, increase our skills.  If you don’t practice, then you lose it.

Alyssa:  Yeah, we’ve got a large enough team that we can cover everybody.

Kristin:  Yeah, we say from the moment a woman conceives through the first year of a child’s life, we’ve got most everything they need, and if we don’t, we have referral partners like you, like if baby’s having trouble latching and they need a chiropractor or they need to go see a pediatric dentist or they need to get some PT done during pregnancy.  Could be a variety of things.  We know everyone in the area as far as related practitioners to be able to refer them out.

Alyssa:  Well, if there’s anybody pregnant listening, why don’t you tell them how to find Rise, and we can tell them how to find Gold Coast.

Dr. Rachel:  You can find us at our website.  We are in the same building at Gold Coast.

Alyssa: We’re in the Kingsley Building in East Town, so we’re right above the restaurant Terra.

Kristin:  And besides our website, we’re also on Instagram and Facebook.  You can pretty much find us anywhere online.

Alyssa:  Thanks for joining us again, Dr. Rachel.

Dr. Rachel:  thank you!

Alyssa:  Remember, these moments are golden.

 

Podcast Episode #55: What Sets Gold Coast Doulas Apart? Read More »

breastfeeding

My role as a postpartum doula.

Our very own Jamie Platt, BSN, RN, CLC, CPST shares her personal insights on what it’s like to be a postpartum doula.

What is the role of a postpartum doula? What does it look like, and how might a doula support the breastfeeding relationship between mom and baby? A postpartum doula can take care of mom, baby, and the entire family. Sometimes mom needs emotional support, help around the house, or even just a nap! I’ve taken care of baby while mom takes a nice hot shower or has one-on-one time with older siblings. We’re also able to prepare meals and run errands. We help with newborn care; we serve a variety of moms from different cultural backgrounds and some families need help with bathing, breastfeeding, and diaper changes. Some of our doulas have had additional training regarding the care of multiples, or have multiples themselves!

I have completed special training in perinatal mood & anxiety disorders so that I am able to recognize the signs and symptoms of a variety of mood disorders. It’s important that mom receives help if she needs it, and the general Grand Rapids area has great resources that include therapists and community support groups. In fact, we have one of the few Mother Baby programs in the entire nation, which provides a day program where mom can bring baby with her while she receives treatment. It is critical that we recognize when a mom needs help, that we support her, and in turn reduce the stigma of postpartum mood & anxiety disorders. Postpartum doulas are right there in family’s homes and can be a direct source of help and information.

Doulas also provide overnight support, which can be so great for moms (and partners)! The entire family can get the sleep they need and mom can still breastfeed baby through the night. I like to think that when I show up to a family’s home at night, I am well rested and mom may be feeling tired- but when I leave in the morning, I leave with bags under my eyes and mom looks and feels like a goddess when she wakes up. That is my goal!

I also want to acknowledge the importance of breastfeeding while still respecting the needs of mom, which may include formula feeding. As a postpartum doula I provide nonjudgmental support, and I help mom reach the goals SHE wants – not me. I recently completed my Certified Lactation Counseling (or CLC) training. The CDC considers both CLC’s and IBCLC’s as professional lactation supporters.

So why is breastfeeding so difficult that mothers need help? Well, our culture has unrealistic expectations of what the newborn period is like. The fastest drop-off in breastfeeding rates occur in the first 10 days after hospital discharge. The main reasons mothers stop breastfeeding is because they believe they don’t make enough milk, the baby won’t latch, and/or mom has sore or painful breasts. Breastfeeding rates drop again when mom has to return to work or school between 8-12 weeks. It is so important that as a community we support mothers who want to breastfeed. As doulas, we can help mom gain the confidence she needs, give basic breastfeeding information, and make appropriate referrals if needed. Gold Coast Doulas offers lactation support through our IBCLC, Shira Johnson, who makes home visits. Gold Coast also has other doulas who have other breastfeeding-specific training, like the CLC training. We know that breastfeeding has amazing benefits for both mom and baby, so it’s time that we start normalizing it, and again, support all moms regardless of their feeding choice.

 

My role as a postpartum doula. Read More »

Prenatal Stress

Media – Friend or Foe?

In light of recent events, we have a special guest blog by Lindsey Zaskiewicz, LMSW. Lindsey is a licensed social worker currently employed as a clinician on a mental health and substance abuse crisis line. Prior to this role, she has several years of experience working in maternal-infant mental health, as well as direct practice with adolescents and young adults. Beyond her role as a social worker, she is also an expectant mother who is navigating this journey for the first time; this provides a unique opportunity to empathize and appreciate what other moms have experienced themselves.  

In an era when everywhere you turn things are being aired, tweeted, and live-streamed, it’s hard to dodge the media and celebrity updates that inundate our daily lives. Most recently, news and media outlets have covered the deaths of both Kate Spade and Anthony Bourdain, each dying by suicide. And while many people will take the opportunity to grieve those beloved public figures, media coverage of high-profile suicides can also negatively influence those at risk already.

It is important to take inventory of our own responses and internal triggers when confronted with the news of a death by suicide, especially for women who are currently struggling with perinatal mood and anxiety disorders.* You are allowed to give yourself permission to turn off TV reports or not scroll through news feeds in order to maintain a healthy separation. It is also critical to develop and/or use support systems when confronted with worsening depression or anxiety symptoms. Whether you yourself have experienced perinatal mood and anxiety disorders, or you know someone who has (or is at this time), please know that there is help and support available.

We tend to see the side of individuals on social media that they want us to see, and that is not typically an accurate representation of reality. While perinatal mood and anxiety disorders continue to feel somewhat stigmatized in society, there have been several brave women who have come forward to share their stories publicly. When high-profile celebrities can bring attention and shed light on what they have gone through, it can assist women to feel that they are not alone. Some of the most well-known women to speak out regarding their struggles are Brooke Shields, Hayden Panettiere, and JK Rowling.  They each had the following to say about their postpartum experience:

Brooke Shields: “I had gone through numerous attempts to have a baby and when I did finally have this perfect, beautiful, healthy baby it all but destroyed me. I couldn’t hold the baby, I couldn’t do anything for the baby, I couldn’t look at the baby.”

Hayden Panettiere received inpatient treatment after the 2014 birth of her child: “There’s a lot of misunderstanding- there’s a lot of people out there that think that it’s not real, that it’s not true, that it’s something that’s made up in their minds, that ‘oh, it’s hormones.’ They brush it off. It’s something that’s completely uncontrollable. It’s really painful and it’s really scary, and women need a lot of support.”

JK Rowling: “I have never been remotely ashamed of having been depressed. Never. What’s to be ashamed of? I went through a really rough time and I am quite proud that I got out of that.” 

When confronted with perinatal mood and anxiety disorders, or thoughts of suicide, it is crucial to reach out and receive support and/or treatment. You can’t tell that someone is struggling or feeling suicidal just by looking at them. If you are the loved one of a pregnant mom or mom with small children, it’s important to check in with them and ask how they are doing, even if things seem to be going well from the outside.  And if you are someone who is currently experiencing depression, anxiety, or thoughts of suicide, there is help available even if you don’t have an immediate social support network. Listed below are several resources that can be used to provide the essential support and encouragement that you need. Also remember, not all treatment is “one size fits all,” so if you don’t feel connected to a specific therapist or type of treatment, please don’t lose hope. Asking for help takes bravery – there is strength in sharing our story and letting ourselves be seen and heard.

Resources for depression, anxiety, and suicide support:

National Suicide Prevention Lifeline (24 hrs/day) 800-273-8255
Pine Rest Mother Baby Program 616-455-9200
Spectrum Health Postpartum Emotional Support Group (FREE) 616-391-5000

* Any type of mood or anxiety disorder from pregnancy through the child’s third year

 

Media – Friend or Foe? Read More »