Power of Postpartum #064

We are diving into the world of postpartum again in this episode.  Because, frankly, we don't tend to give it the attention it deserves in the perinatal care space.

There are so many ways that we are failing folks throughout the postpartum period. Our guest, Kayla Bitten, also known as The Southern Midwife, is a wealth of information about how will we make shifts in the cultural narrative around postpartum healing. How will we address the stigma that is so often present as folks make this transition and work to align their physical, mental, emotional, spiritual, all aspects of their health?

Join us for this really frank conversations about how much pressure we put on postpartum people.   You were going to leave this conversation with more ideas about how to switch your language with folks that you care for during birth, and also those you support in any other aspect of your life.

Themes include:
~Black perinatal mortality rates and postpartum care access
~Adjusting our mindset to view postpartum as equally transformative as pregnancy
~Recognizing our validity outside of being a vessel for the baby
~Creating stronger postpartum support networks
~Examining our relationship with nutrition & body image
~Countering toxic familial and cultural postpartum traditions
~Busting postpartum myths

... And so much more

Learn more from Kayla in her guest profile.

Transcript

Maggie, RNC-OB  0:03  
Welcome to Your BIRTH Partners, the podcast identifying gaps, acknowledging biases, and co-creating a trauma informed standard of birth care with change agents across the spectrum of birth work. I'm your host, Maggie Runyon. I'm a birth nurse, educator and advocate who has been searching since 2010 for the answers to how to provide better care during pregnancy, birth and postpartum. Through my own pregnancies and supporting births in home and hospitals around the country. I've seen firsthand many the systemic flaws that exist in perinatal care. Through these conversations, I'm thrilled to share with you insights and inspiration as we work collectively to transform birth care.

I am so thrilled to be sharing the topic of postpartum again with you all on the podcast. This is something we have talked about several times already. And it is something that just needs more of our attention. There are so many ways that you know, we are failing folks throughout the power postpartum period. And I am really excited to share a conversation with you with Kayla Bittens, better known as the southern midwife on Instagram and the creator of the postpartum clinic. She is a wealth of information about how we make shifts in the cultural narrative around postpartum healing, how we address the stigma that is so often present as folks make this transition and work to align their physical, mental, emotional, spiritual, all aspects of their health. We are having really frank conversations about how much pressure we put on postpartum people. And you are gonna leave this conversation with more ideas about how to switch your language with folks that you care for during birth, and also those you support in any other aspect of your life. So that folks know that they are encouraged to have personalized support to ask for what they need, and that they have folks who are ready to walk that journey with them onto the show. 

Oh, well welcome Kayla. I am so excited to have you joining us on the podcast today. Thank you so much, if you want to just share a little bit with our audience about yourself and your work.

Kayla, Student Midwife  2:16  
 Oh, well, again, my name is Kayla. I'm also known as the seventh midwife, and I am the founder of the postpartum clinic, which is Alabama's first black on lactation and postpartum centered clinic or wellness space at May. I am a 10 year birth worker doula in all aspects of douladom, and I'm also a student midwife.

Maggie, RNC-OB  2:38  
Fantastic, you bring such a breadth of experience to this topic, I'm really excited to dive in. So we wanted to really center this around postpartum care what really drove you to focus your work on that,

Unknown Speaker  2:50  
I decided to specialize in postpartum care at the height of the pandemic. So immediately when the lockdown was started in 2020, at the time, I was running a community organization called coloring between the lines, breastfeeding support for mothers of color, and it was breastfeeding group for mothers of color in North Alabama. And when the lockdown happened, we couldn't meet, it was a little harder. And even if we met virtually, it was still hard because we were also trying to navigate what in the world was happening. But when we did get an opportunity to have conversations, where to meet virtually, it was this sense of panic, right and them not knowing how they're going to gain support when it came to lactation, but also how to gain support when it came to them being currently living the postpartum period. So when that happened, I really was like, okay, something needs to happen, what's going to happen. So at the time, I was working at a job, not necessarily doing birth work with it, that's it. And I decided, I'm just gonna create this thing. And so the postpartum clinic came to be, and I always wanted to open a clinic, I'd always wanted to specialize in something specific, it just kind of happened organically. Unfortunately, it had to happen on the back of like something as tragic as you know, the pandemic. But yeah, that's kind of how I started to really hone in on the postpartum period and realize and all the things that were happening, also realizing, I want people to realize to and to see that when it comes to maternal and infant mortality, specifically in the Black community is not necessarily birth or labor. There's like this huge part of it that's happening in the immediate postpartum period, and then in the postpartum period beyond and that can include a year or two. So that's depression, anxiety, psychosis, and they have actual physical issues or medical issues that are not being attended to because of bias.

Maggie, RNC-OB  4:54  
Yeah, yes. Yeah. I want to like pull that thread a little bit with you because I think there is a I don't know there's that hesitancy in I feel like sometimes when talking to other birth workers when we talk about birth care, you know, at large as something that encompasses pregnancy, birth through postpartum, that we still kind of make it seem as if postpartum doesn't matter. As much as pregnancy and birth. I've heard people kind of talk about the way other people work maybe like, oh, oh, like she just does postpartum as a doula or making it seem as if somehow caring about folks during the postpartum period is like a lesser calling? And I don't know. Yeah, if you've experienced that, if you have anything to touch on with that.

Unknown Speaker  5:32  
Absolutely. And definitely, I don't know what it is the buzz around how we all feel like let's not act like we don't all feel like this heightened, beautiful feeling when it comes to labor and birth and, and the processes in between and seeing the the body change and shift and then like, knowing that the fetus is growing and like all these things are really, really exciting. And, you know, I think, because you can tangibly actively see things shifting, people get more excited and put more emphasis on that. But we really are doing like, we're not doing folks justice when we don't realize that postpartum is also this metamorphosis happening as well. Not only for the newborn, but for the postpartum person as well. And I think it's because we put so much emphasis on the newborn and the baby. Right? How's the baby developing, you go in, they check you like, no one really asks you what's going on with the birthing person. So yeah, I found out too. I think that's what it is, like, we get so excited when we can physically see the tangible changes and shifts that's happening with the birthing person then with the fetus and or baby. But when it comes to the postpartum period, it's just kind of like, Oh, it'll, you'll be fine. I mean, the baby's out the baby's good, the baby gonna get their checkup, you'll be fine. I mean, you have a husband or you have a partner or life continues, you were delicate and valid for a certain amount of time. But once it comes to the postpartum period, what's your problem?

Maggie, RNC-OB  7:01  
Oh, yeah, it's a crushing, you know, like hearing it spelled out that way, like, what a disservice we do to people who just had a baby, when we still make it all about the baby. And also this assumption that people you know, the whole snap back bounce back kind of culture piece of just like, Yeah, well, that was like you did the hard part of pregnancies. And I used that to kind of like, move on with with life.

Unknown Speaker  7:27  
Yeah, general, because like, it's not just in pregnancy. It's crazy. Because it's kind of like embedded in the system period. Like, if you think about if you're sick, if you try to tell someone you say that you're working for us, or you work for a corporation or a nonprofit, whatever the case may be, it's okay, how long are you going to be out you only a lot at this amount of time to be out, if there's a death in the family, or if you literally just burnt out or tired or whatever the case may be like, the idea of healing and wellness and rest. And you know, and that's a very cultural thing. It's embedded in, you know, Black and brown culture, rest and that idea of rest, and that you deserve wellness, and you deserve healing, and you deserve time to you know, reset and all that it's just not part of this culture. The hustle and bustle of this culture is just, it's crazy. So yeah, this idea of like snapback or you will be fine once you have the baby, because that was our main concern. It's just embedded in all different aspects, you know, the percentages of the different races that go back to work before they should is insane. So I just find that isn't the entirety of the system, and we just allow that to bleed into like, pregnancy and childbearing. And that's crazy to me.

Maggie, RNC-OB  8:48  
Yeah, obviously, so much to say about our overall terrible and particularly inequitable distribution of like paid parental leave and how we treat people after they have gone through this major, like you said, it's the physical level, it's the mental emotional life spiritual, all pieces of yourself that makes so many shifts through pregnancy and birth. And then we do just expect people to get back on the grind. I wonder to what I feel like that's definitely a big one. What are the big myths that you maybe see kind of perpetuated or that we've kind of internalized about the postpartum period

Unknown Speaker  9:26  
That depression and anxiety don't exist in the postpartum period? I think that's the number one thing is just baby blues. The amount of folks that experience postpartum depression, anxiety, where that lands on the scale is subjective to the person, but still the amount of people that experience that is insane. And it's completely different than baby blues is completely different than, you know, oh, you're just sad because your hormones are shifting. Yeah, that's totally what it is. But like it can develop into other things. I think that's the biggest and most ridiculous myth. That's and then also when you get into like the nourishment and or the nutrition aspect of it, you don't need a salad like nuts, berries, juices and leaves, like, great if you just want all in the mix, but like you need nourishment. And that's another myth that, you know, nourishment should look like this westernized idea of health or bounceback culture. And it absolutely should not. So those are the two things that I think are myths that and you don't have to plan for postpartum. It'll just be fine. It'll just happen. You'll figure it out as you go. And that's absolutely not true.

Maggie, RNC-OB  10:36  
Yeah, yeah, I know, we've talked before about like, how much how much effort we put into like the, you know, planning for, again, planning for baby, making sure baby has the clothes and the stuff they need, whether that's a nursery or space for them, and they have all of their, you know, kind of their, their stuff, the tools and tricks that you're gonna have like for baby. And then, on the other hand, how much we like actually planned for the postpartum period, like, what support will look like during that and for most of us is drastically different pales in comparison how much we think of like that actual time versus the stuff, the gadgets, and what we think like baby will need for that. I also believe that nutrition piece like oof, it's a whole thing. I remember being a nurse, nursing student and caring for folks on postpartum. And there was this one woman who she would walk a lap around the unit. And then she would stop at the scale that was there, like just you know, on the side of the unit, and she would weigh herself and she would walk another lab, and she would get on the scale...heartbreaking

Unknown Speaker  11:36  
Oh, eating disorders are like a more unit, they happen a lot more than people think even within my experience with my clients and things that I've experienced just within the last few years, especially during the pandemic. Eating disorders are definitely part of the postpartum period when it comes to that anxiety, depression and that psychosis, body dysmorphia, like all those things, and again, like people are so uneducated about it, and it's not people's fault, necessarily, again, it's all these systems that make up this idea of what you have to look like in order to continue to function as a robot within society. But yeah, I'm not surprised to hear that that was your you know, what you've experienced, and you saw definitely been there the whole, I need to, like lose weight, or like, I need to diet, I'm taking this diet to eat and I'm like, What in the world? Are you doing six weeks postpartum? Yeah,

Maggie, RNC-OB  12:30  
yeah. Yeah. And I feel like, unfortunately, I think we've seen like, I mean, it shows up in all aspects of that. And I feel like disordered eating is encouraged by so many, so many different elements of our society. And for every time that, you know, I've been in some sort of, you know, new parent, new mom group, and someone is hawking some MLM product. And everyone's commenting like, Oh, is that still safe for me, even though I'm pregnant, even though I'm breastfeeding, even though whatever. And so often the quick response like, Oh, of course, yeah, it's totally natural. And it's safe, essentially, to deprive yourself while you are growing and nourishing another person, because then you can get back to whatever your ideal weight is it that matters more.

Unknown Speaker  13:15  
I would love to see like, parenting mental health specialists are like in the postpartum period, it should be first of all, it should just be part of folks care plan in general, and I make sure that it is when they come to the postpartum clinic, or even if they like, adopted me as a postpartum care, yes, it's part of it, we need to make sure we do even at that scale is a joke, but like, it still gives me something that I can like look at. And so we can figure out a better way to like kind of gauge where you are mentally and emotionally. But like, I think that talking to like, I guess you can call a food therapist, because I feel like saying any other word makes it a little scarier than it should be. Food therapists that people should be able to talk to you about like those things, because food therapists will more than likely tell you that we're going to worry about you losing weight or whatever later, let's talk about your relationship with food and like your idea of what nourishment is, because guess what's happening with your body? I think actually someone is is that love supposed to hear? Yeah, that's helping folks out and they also are like a therapist when it comes to food and like eating disorders, they're up on game, and they're helping people get better, you know, with understanding what nourishment should look like, and we're worried about dieting and all this other crap.

Maggie, RNC-OB  14:29  
Yeah, I feel like I'll share a little bit I feel like I know there's a couple of people and I think douliciousnutrition I want to say that their handle on Instagram I feel it is like definitely in that space as like a doula and nutritionist trying to bridge that gap. And I'm sure there are other people but I would love to see that as like someone who was leading that charge particularly that is like a reliable resource to send people to to refer people to because I think it is. I think it touches on everyone. I don't know that I can think of a postpartum person I've known who has not, at some level, consider like, Alright, when does my body get back to being who I thought I was, how much my identity was tied into what my body felt like look like all of that, like, I think it is just it's so ingrained in our society. And so it's impossible. I think that the vast majority, people aren't going to have those thoughts, those sensations and start doubting themselves or doubting their journey, their healing, and throw off their postpartum recovery, by focusing on that instead of focusing on all of these other pieces of ourselves that actually do have greater importance than the amount of space that we take up in the world. And then the other piece of it, obviously, postpartum mental health is it is a crisis. And I think, as you said, certainly the last couple of years, going through a pandemic that has obviously had a colossal, like collective grief that we are, I don't feel like we are acknowledging in deep in slightly the way that we need to as a greater society in our country, and how beyond difficult that has been for people having babies and parenting super young children with so much isolation and unknown. When we've talked with a couple of therapists on the podcast, they have just shared, I mean, obviously, we see the rates of depression, anxiety in particularly postpartum just, I mean, they're skyrocketing. And it's been really hard for people to find support services and access therapists, what have you seen, that has been helpful for folks as they're navigating that as you're working through the postpartum clinic.

Unknown Speaker  16:31  
So this like, this burst of virtual spaces rate that can like help, and support folks who are feeling the way that they are feeling what they feel like they can have these conversations and meet with people. So that includes like Postpartum Support International, where I had the pleasure of leading a group there, but also in any way, shape, or form that I can lend over extra support, I feel like has had some type of cushion there. But to be quite honest, I haven't seen anything really happen. I liked the idea. And I liked seeing that there was this burst of like online resources of therapy. Yeah. But there's, it's just, it's a lot going on there like, white folks are more likely to say, Okay, I need support, and I need help, then communities of color, especially Black communities, are just not as likely to seek out help when it comes to the mental and the emotional aspects of anything, let alone postpartum versus white folks who are a little bit more like, yeah, I need support, I need help. This is just what I need, like, whatever that looks like, whether it's me going to see a psychiatrist or a psychologist like that. So I would like to say I've seen things. And I would like to say I've seen a lot of you know, things shift and change or whatever, but I haven't. But yeah, that's how I try to kind of throw some support in the mix is by joining PSI, so Postpartum Support International, and then also about offering more of a intimate virtual space for us to have group that also a one on one where we can talk, and they can get it out. I'm not a therapist, and I tell them that all the time, but I can totally listen and then refer you to the right resources, which is why I have perinatal mental health specialists on my staff, to where I can say, Okay, you check it off all the boxes, look course they don't know, but I'm saying yeah, you have all the boxes, like I'm have, like this person that's here that I really, really love. And I work with them. Side by side, I've worked with a lot of my clients, and I would love for you to meet them. And it'll make you more comfortable, I can sit in with you if you want. It's just the initial meet, we can just all chat and have a conversation and see how you feel. And I kind of find I found that to be great. People reach back out and say, oh my god that helped somewhat, but as a whole, so as a society as a birth worker community, or as nurses or as doctors and midwives or whatever, I have not seen anything shift. I have, like you said barely seen any real research on the postpartum period in general, let alone the depression and anxiety and psychosis rates that have been happening since the pandemic let alone before.

Maggie, RNC-OB  19:10  
Yeah, yeah, such a hole there. So I feel like what you discussed doing in your clinic, it addresses both kind of the destigmatizing and the accessibility concerns for other folks who are listening and trying to be like, Okay, how do I make change and shifting in my community? Do you feel like it's it is one of those the stigma piece or the access piece more of the issue? Or is it really just there hand in hand and both need to be addressed at the same time?

Unknown Speaker  19:34  
They both go hand in hand, but I don't want to say access priority. If someone has access to something, it becomes the norm, right? So shift the perspective and society of what is accessible for somebody or what is right for someone or what is supposed to be part of said community. And so we kind of like decolonize those ideas or whatever, and we also kind of take away or start to chip away at least at those stereotypes. So I do think it's access. You know, I've seen a lot more folks of color, specifically Black folks feel comfortable coming to a place where they see like the postpartum clinic or just my work in general and say, and I asked them hey, it's and it's always a part of my stuff. As a doula as I became a season doula anyways, but to ask about their mental health, do you have a history of depression, anxiety or anything like that? You know, they feel more comfortable all of a sudden answering those questions because A, no one asks, and B, I have access to this thing. And I tell them that they have all these, you know, these choices. So I have perinatal mental health specialists kind of put your contact with I give you the information, you can still tell her look at her website, but we'll get there when we get there. And we'll we'll talk about that a little later. And then so we're just want to have some candid conversations, how are you feeling and like really changing how we approach it, while also making sure that it's accessible as possible. So if that looks like virtual, it needs to be virtual, while also simultaneously being a person. And then accessibility also means like, how much are you charging people, if anything to access basic needs, especially during the postpartum period where you don't care about them after six weeks anyways? 

Maggie, RNC-OB  21:08  
Yeah, yeah. Yeah, there's a lot that I feel like, whenever we have these conversations, like it's heavy, there is just so much that is not working, that we are not doing well. And so I wonder if you can share maybe, how do we talk to folks about this? How do we talk to and prepare people who are pregnant for some of these just like, in some ways, harsh realities of postpartum without fear mongering, I know, I've had babies myself, I have been doing this work for, you know, over a decade, and I still haven't found that way to, to try to share these conversations in a way that feels like I am lovingly supporting, preparing you for this. And I'm not just like, scaring you, while you're already pregnant. And it's coming, whether you're prepared or not, I feel like there's like, it's really hard to, to balance that line, and especially watching a couple of folks who had their babies over the last couple of years, especially like, first babies, and it's, it's been really hard to watch out just how challenging this is for folks. 

Unknown Speaker  22:05  
Well, there are a couple of things. One is, believe it or not, nine times out of 10, they know exactly what's possible. Yeah. When it comes to the postpartum period, when it comes to childbirth, when it comes to labor, like the negatives, right, or the extreme possibilities of this may happen nine times out of 10, there were and I think that we need to get that out of our brains that they just don't know, they may not be thoroughly informed and educated so that they can make the best decisions possible. And that's why they are looking to you. But no, so you don't necessarily have to reiterate those things in a way that does come off as fear mongering, that's number one. But two, I would say, see, so now it just depends. Because when I'm approaching postpartum when it comes to Black and brown folks, I'm approaching it from a modern standpoint, because we live in a westernized society, of course, but also from a standpoint of cultural traditions, right? So it makes sense for me to talk about and to bring those cultural traditions to my clients who are Black and talk about all the things that are considered nourishment, all the things that we do, you know, support has looked like in our, in our culture like to have those conversations because it's relatable, so then I can go into so we need to make sure we're planning and so I want to talk about that our next appointment, like what that's going to look like and thought about that do you even know like, I kind of go into it like that, because traditions are very important. And when it comes to traditions, within communities of color, we need that in order to connect in order to feel nurtured in order to feel like okay, I'm gonna heal and be well, and all of those things. But yeah, that's just what I would say like nine times out of 10, they already know, trust me, they're coming to you letting you know their fears, but also you ask their fears. And you can learn how to have these conversations and share your knowledge while also giving the support in a way that yeah, doesn't add to those fears. That's the only way I can say that. I do it. That makes sense.

Maggie, RNC-OB  24:03  
Yeah. Yeah, absolutely. Being prepared with those resources with the things that maybe they're going to have some of those answers, like the typical questions that you've seen the typical fears people share and being able to have something to provide to fill that gap. That's a great way to think about it. I also wonder, like pulling onto that, that cultural piece and obviously as a white woman, it's gonna look different from you know, the communities that you're primarily serving. But I I wonder if you have answers for folks who feel like they don't necessarily have like strong cultural traditions to pull from or the the traditions that have been like handed down from their families are feeding into kind of some of this like negative perceptions about postpartum I remember talking to my grandmother when I was very pregnant. And she was very concerned about whatever number she asked like, she was like, Oh, how much weight have you gained, and I don't remember what number I shared with her and whatever it was, she was horrified. And she was like, That is way too much way to gain like, how are you going to get rid of this and I had other support that other resources in it. didn't bother me that I can think through like so if that is my, if that's my tradition if that's what everyone in my family has been focused on kind of some of these like negative behaviors in postpartum where do we look to maybe to pull other other more supportive traditions that also isn't like, appropriate anything?

Unknown Speaker  25:20  
Okay? So when it comes to the postpartum period, and like looking at these traditions are sometimes these traditions can be a bit toxic, right? It can make you feel, you know, ways that don't feel good and postpartum. In the postpartum period, whether you're Black, brown, or white, doesn't really matter, they're always going to be you know, something that's part of our culture, that's going to be like it doesn't apply, this does not apply. And I can't deal with this. So I can just give you an example. So if I'm talking to a client, I recently have a client and we're talking about the postpartum period. And they have, you know, given over some information about how they have felt about family members, very similar to what you just told me saying things or feeling ways about pregnancy, let alone postpartum. And so the only advice that I can give, I think that's subjective. And there's just a lot of moving parts to that, because we all have different family traditions, let alone cultural traditions, right. And those traditions sometimes can be toxic and those traditions sometimes can be really amazing and beautiful. And so like, the first thing I would do, just to kind of like, let's paint a picture here, is meet with the person prenatally. And so even if I'm just their postpartum support person, I'm still want to be with the prenatally and I'm asking those questions, because I want to know what those traditions have been throughout your family edition where we don't breastfeed, we just pump and if you breastfeed, it's just not good. Or there's a traditional where, no, no, you're not supposed to go back to work before six weeks, or you need to make sure you go back to work, or you need to make sure you're still cooking and like model submissions, if that's been part of your family's tradition and for like, however long, but that's the first thing I would ask is just like, I want to know your fears. And then I want to know, how your family has felt about postpartum in their experiences, I want to know your mom, your grandmother, your aunt, your sisters, I want to know all those things. So we can kind of navigate those things when it comes to the family idea of what has been traditional, or what have we have just done in our family. And take that. And then also, if there is a cultural piece to it, bring those two things together, then I could bring like evidence to it. So again, let's take a client, for instance of my who have had that experience, like I said, very similar to what you're explaining. And so I have all that, and I know, okay, so that's something that's been like, we iterated within your family, that's something we're gonna have to unpack and hopefully, so like, let me bring this cultural piece to it. So in our culture, whether you're on the continent, or you're in the south, which we are as Black folks here, like resting is like what we're supposed to do, right. And it's part of the culture where, you know, you have the grandmother is taking care of the mom, a birthing person and their partner and making sure you're nourished and they're coming together. And it's this whole thing. So like, then I explain it, like I understand we live in a society and like, don't be upset with like your family and their traditions and their ideas of what postpartum should look like, unfortunately, what we've had to adapt to and like adapt into within the society, but also know that there's this evidence, and there's like these traditions, and it's a cultural aspect to it that we've always done, as well as Black folks and folks part of the diaspora, so that's kind of how I approach it, and it shifts and those conversations start to change. And I think that that's just all it takes, like I said, it's subjective. And so you have to really hone in on the personalization of the postpartum period, and the person's experiences, reproductively lead on on when it comes to obstetrics, and then their mental and then their emotional. That's my tagline for the clinic like personalized care for the fourth trimester. What does that gonna look like for you outside of your family, even though I know that's going to have an effect on how you observe let alone look at your body, your experience, your baby, all those things? 

Maggie, RNC-OB  29:08  
Yeah. Okay, I love that, I think, really, us like really internalizing that piece that like it's going to be personalized, it's going to look different for people and it doesn't have to be the same and then feeling confident both and how we embracing which traditions resonate with us and fit us now and also then feeling that confidence that like, we are in quotes we are "allowed," we are encouraged to find a different path through postpartum it doesn't have to look the way it looked for your sister or your friend, your mother or your whoever you know, in your world like it is okay. It is good. It is normal to need and want different support than other people needed and wanted and we don't have to make it fit into like a perfect box. We should feel comfortable asking for things that that we need, even if no one else around us understands that or needed that themselves. That is, that's just a part of like being our own individual humans and maybe letting go of some of that, that pressure to fit into a mold, whatever that might look like. 

Kayla, Student Midwife  30:10  
That's the name of the game is just like personalizing it and let it folks know. And like we were talking about my destigmatizing a lot of things because it is very much so personalized. It's personalized to the person's lived experience. So that can include ethnicity, race, sexual orientation, it can include all those things. It's personalized to understanding that some things like shouldn't be stigmatized, but they are normal. So intrusive thoughts. So anxiety, psychosis, depression, like, I know, it sounds weird for people to think that but like, it's normal. There's the shift that's happening within you and around you. How could you not on a day, and it's been interesting to me how people can't understand that when it comes to folks in the postpartum period. And then we turn around and we see these ridiculous percentages of like suicide or the opioid usage, or narcotic, all these things. And it's crazy to me, because before we have a baby, before we get pregnant, we freely talk about how we are burnt out and losing our frickin minds. And we're having intrusive thoughts, and I need a therapist, or I'm coping in the latest not great, or I need to exercise this great kind of mental health. But the moment someone has a baby or become in the postpartum period, you're deemed "Are you serious?!" Yeah. Well, that makes absolutely no sense. That's always been my, are you crazy?

Maggie, RNC-OB  31:42  
It's kind of bizarre how much like we put on this baby to somehow, like, fix anything else that's going on? Like, obviously, especially for folks who have like, you know, a very wanted pregnancy, like, you know, for folks, I think I can think of so many friends who've gone through like, you know, fertility journeys, so hard. Such a desired pregnancy, they finally get there. And then like, it's flippin hard, you know, and there is this, like, guilt that like, this is what I wanted, this is what I worked so hard for. And we put so much pressure on ourselves and on on this baby to like, fix everything else was going on in society, everything else that had our mental health all messed up before we got pregnant. And we expect that like if we can't somehow just be settled into this next phase of our life and like, happy with everything that goes along with it, that somehow we have, like we failed. And like we're not, we're not even worthy of, of like this experience that we that we wanted, that we like, or navigating through, like, there is so much guilt, to acknowledging that life isn't perfect. It was never perfect and never going to be perfect. But especially in that like, new postpartum time when gosh, like the way we talk to people, you know, like the way we focus on like, how happy you must be with the baby here, you know? And then you're like, if you're not happy, you're like, Well, what do I say now? No, I'm flippin miserable. I'm terrible. I'm crying myself to sleep all the time. I am crying when the baby sleeps, I am not sleeping, you know, like, there is no space to have that conversation. When the cultural narrative is like, *glowing*

Unknown Speaker  33:15  
The whole the white is out and the what is it? 

Maggie, RNC-OB  33:21  
The halo, the halo right around the new postpartum person

Kayla, Student Midwife  33:25  
literally gets under my skin, you must be so happy. So eww no. Are you kidding me?  Let someone come to me. First of all, because of all of these things, I decided not too long ago that I didn't want to get pregnant, right? And I didn't want to have a baby. And I'm turning 30 This month, right? And that is the number one question that people are asking me and I'm like, I'm going through things mentally about 30. Or you're asking me about having a baby, but like, You must be so happy at it becomes this this thing? And it's like, no, like, so tell people that I didn't want to have a baby and I'm approaching 30. Right? And I'm looking around and deciding that like, No, this is not what's for me because I can't even imagine being a black woman. A clear black woman having a baby in this society with the idea of what motherhood should look like, what postpartum should look like, right? And someone asked me You must be so happy. Absolutely the freak not because every time I go to the hospital or I go to the birth center, or even see my midwife, I'm frickin scared found that I'm having a baby boy, let's say assuming that they'll attach to that gender, but I'm having a baby boy, I'm scared he's Black. So I'm looking at my nice little newborn, you know, who has been assigned as a boy at birth? And I'm like, Oh my gosh, and then I know I'm not happy. I'm scared. I'm petrified. So like you said, I'm crying at sleeping. Or if I have you know Well, a girl or a daughter, I'm thinking about the fact that you know, if she ever need in any type of abortion care, that's probably gonna be out the window. I'm like, No, I'm not happy. am I grateful? That's even another question that I think is a little, too has it been an interesting journey and like, it's just complicated. And again, like you were saying, I love that you said that it says, I ask that really grinds my gears and it gets like, under my skin, when even in the room with people they're feeling like, Oh my God, how do you feel? Are you so happy? And I'm like, Isn't that funny?

Maggie, RNC-OB  35:34  
You gotta laugh instead of cry sometimes, right? You know, like, this ridiculous.

Unknown Speaker  35:39  
What's happening right now. But yeah, these ideas are really, really, really crazy. Especially when it comes to the postpartum period. It's It's insane. Like, one postpartum people to be normal. And like you said, this baby, you're having a baby, so I kind of fix them as well. Good. 

Maggie, RNC-OB  36:07  
Yeah. Kayla, that's the whole thing. Thank you for sharing your your experiences and your story. And wonder as we wrap this up, like you've probably touched on a little bit, but what would you give us the the three things you would change about the postpartum period tomorrow, if you had a, you know, a magic wand,

Unknown Speaker  36:23  
I would change. Number one, I would change this idea that the CDC put out about how often postpartum people should be seen because let's be honest, a lot of people in the postpartum period utilize insurance because it makes sense it's accessible. It's financially feasible. Whatever the case may be hospitals on every corner westernized medicine, right medicalized shit, right. So I would change that, like the idea of how often you should be saying what that care plan should look like. And then I would change the idea of collaborative care within that space. So perinatal mental health specialists should not be something that you say you go off on your own and do it now it should be made sure that this person has the care that they need. You see, that's number one. Two: I would change the education that people get as providers as support people, whatever the case may be, because it's going to start with us, we can assume that again, kind of goes back to what I was saying, you can assume that nine out of nine times out of 10 that they do know their risks or whatever word you want to use this not to triggering, but also fits the bill have this conversation that they know what's going to happen. But the point is, is that they're not looking to you to kind of like fear monger, right? They look into you to give them more information than education so that they can make informed decisions and know that this is normal. This is okay, and destigmatize that so I would change how much education that these folks are receiving when they go get their PhDs or when they go get their doctorates or when they go, you know, get their certifications as doulas I would or certifications as midwives, I would change what that education looks like because there is so much emphasis. And it's crazy to me on the anatomy and birth and labor of a person with a uterus. And there's absolutely no or not enough education on the postpartum period, hormones, hormonal imbalances, mental health, emotional health, nutrition and nourishment and then the cultural piece that should be attached to that in order for people to feel okay and support it fully. And whole body to be honest, I don't even feel like there should be a birth and postpartum doula. I think it should just be a doula that is well versed in both. And that's it, because it doesn't make sense for me to then leave you as a birth doula after maybe two, four or even six weeks, I extended it to six weeks. If you are my client as a birth doula, it still makes no sense for me to then never like really check in on you or talk to you or chart you or whatever, after that and expect you to get the care that you need. I am so afraid of that. I was so afraid of that when I first started out as a doula like, okay, so I'm just supposed to like it just be that that doesn't make any sense. So I would change education piece look like. And then number three: I would shift the amount of research that's happening around the postpartum period. And I would divide that up into Black postpartum people, Asian postpartum people, Hispanic and then white. And because we need personalized research for it to make sense, because there is no one size fits all idea of postpartum looks like and that's for all research when it comes to the maternal and infant health. It should be personalized to groups of people, not this woman idea of what you know, a person looks like, what their height is skin color. Like that doesn't make any sense. So when we start there, see that's foundational those three things are foundational, they're not like fluffy and on the surface, like I would change how we you know, do nutrition like all that should have come if work on the foundation like our foundation is shitty And that's why, you know, the other piece is solid nutrition and like, postpartum planning seems so like, whatever it's up in the air and like, it's fine. If you get it, it's fine if you don't, because our foundation is so Rocky. Yeah, that does nothing for anyone. So essentially what I'm saying is by doing those three things, we are then shifting the actual system, which is the umbrella, right? Yeah, all the shit underneath. It's just going to shift all underneath earthquake, right? Yep. The plates to start to shift. And then it just is what it is. And it creates beautiful thing. It's like the freakin Grand Canyon. And that is. So that's what I would do.

Maggie, RNC-OB  40:40  
Oh, yes, Kayla, thank you so much. Those are all so powerful and totally fits into, you know, this theme all season, we just worry about like change agents. And we started out talking about systems change. Because each of these are things that like, yes, huge shifts in our foundation in that it has to change. It has to change what we have built as a system is not it's not sustainable. It's not caring for folks. It's not meeting what people need. So I love those. I love that. The big, big picture. Thank you so much. Well, can you just share with our audience where else they can can find you and follow your work?

Unknown Speaker  41:12  
Yeah, you can find me at thepostpartumclinic.com, or at the postpartum clinic on Instagram, and honestly, just all other social media spaces so much to keep up with. You can also find me at the Southern midwives.com and also at the southern midwife on all social media spaces. And yeah.

Maggie, RNC-OB  41:33  
Oh, thank you so much. Is there anything else you want to share with us before we head off? No,

Unknown Speaker  41:36  
I'm just excited. Thank you so much for thinking of me. And thank you so much for having me here. 

Maggie, RNC-OB  41:40  
Oh, yes. It's such a powerful conversation. I appreciate you, Kayla. Thank you.

Kayla, Student Midwife  41:43  
Thank you.

Maggie, RNC-OB  41:46  
Wow, well, just such a powerful conversation with Kayla, I'm so grateful for her sharing so many insights that she has gained as she looks to examine what needs to change and happen as we need to create a system that actually is supportive of folks as they transition through postpartum and into parenthood. As you all are reflecting on what is available in your community what you can do in your practice. We'd love for you to share your ideas with us over in the your birth partners community our Facebook group. We know we can do so much better, and we're so excited to be along on this ride with you all. Till next time.