Accessible Birthcare Communities #074

In this episode we explore how we connect more deeply past the complicated power dynamics and the hierarchy in health care.
How can health care providers really set themselves up to be in community with those who they care for?
How do we shift the way we deliver insights and education and information to ensure that it continues to center the patient?
What are some of the ways that we need to reconsider how we have been trained to share information with patients to speak to folks about the experiences that they are having in their body?
How do we push back when folks want to focus on efficiency rather than connection?
 
Our guest today is Dr. K Pregnancy Specialist found on Instagram @DrK_PregnancySpecialist is an expert in high risk obstetrics. She has practiced as an MFM around the country, and is currently focused on how we make medical education and relationships more accessible to folks. She has so many insights to share around how we create this reality, where birthing people can truly feel that their provider is part of their community that they are available and that they are there to serve their best interests. This episode is for you, if you too are interested in how we change these current dynamics that have been set up and how we can use the power of social media to actually create more connection, rather than isolation.

Join us as we uncover:
~The benefits of multidisciplinary care
~Unlearning as a physician
~Power of social media to get an "ear to the ground"
~Quality over efficiency in appointments
~Meeting folks where they are for health literacy
~And...remember: stop "meddling" in the vagina

 

Connect with Dr K and her work here.

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. 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.

On this episode of the podcast, I am really excited to dive into a conversation with you focused on how we connect more deeply past the complicated power dynamics and the hierarchy in health care. How can health care providers really set themselves up to be in community with those who they care for? How do we shift the way we deliver insights and education and information to ensure that it continues to center the patient? What are some of the ways that we need to reconsider how we have been trained to share information with patients to speak to folks about the experiences that they are having in their body? How do we push back when folks want to focus on efficiency rather than connection? Our guest today Dr. Kia Lannaman is an expert in high risk obstetrics. She has practiced as an MFM around the country, and is currently focused on how we make medical education and relationships more accessible to folks. She has so many insights to share around how we create this reality, where birthing people can truly feel that their provider is part of their community that they are available and that they are there to serve their best interests. This episode is for you, if you too are interested in how we change these current dynamics that have been set up and how we can use the power of social media to actually create more connection, rather than isolation onto the show. 

Oh, well welcome Dr. Lannaam. And I am so excited to have you joining us on the podcast as we dig into community and particularly thinking about how your work as a physician ties into how you foster community. So we would love to just hear a little bit about your background, your your journey within perinatal care and where you're at right now.

Dr Kia Lannaman  2:39  
Thank you so much for having me. I'm excited to be on this podcast and share anything that people will be interested in hearing whatever would be fun for the community. So I am a high risk obstetrician, also called maternal fetal medicine specialist perinatologist for so many titles, obstetrician gynecologist but I have been on this path for years actually, I was a little girl when I decided that I wanted to be an obstetrician just a little bit older than my toddler when I felt like it was something that God put on my heart to do that I grew up with family that taught me to pray and taught me to listen. And as a young child, I really had this inspiration. And when knew that that was what I was going to do not that I was going to be a physician in general. I'm Squinkie, an obstetrician. And interestingly now I questioned whether the word I was looking for with midwife. But the word I got was obstetrician. I asked my mom once you know, who is that doctor do that does, takes care of the baby. She's an obstetrician. And so that's what I will do. So been on this path my whole life, I never had any people in my family that were in medicine that were around me to draw any inspiration from or any kind of mentoring and what I was doing. And it really wasn't until I got into residency as an OB GYN that I was like, Oh, wow, this is actually a good idea for me. So I was in residency, I had the blessing to work with somebody that was very well published very involved in obstetrics, and in a significant name, and a name that had even been in some of my textbooks. And I was like, Oh my gosh, I can't even believe I work with this person. And they were just every time they spoke, I was just curious and curious and curious. And so I started to realize that the people that were really involved in the guidance of obstetrics, making recommendations, safety, understanding of what we know and obstetrics were all people that were publishing research or that we're now currently in what we call maternal fetal medicine that that was like the ultimate obstetrician. And so then I continued on in my pursuit to be an obstetrician and did training in maternal fetal medicine, and was able to train with the train Michael center in the premium Allergy Research Branch of the NIH and the Wayne State collaboration there. And that was also a really great experience for me also worked with key leaders in the field, which has taught me to learn, who taught me to investigate and to be curious, to read things for myself to form my own opinions, to respect the background information that previous generations had contributed to science and to give them credit for their work and to and then to try and build on it in a really responsible way. So thankfully, I've had some really good kind of mentors along the path that I think guided me to really to learn, I think they really guided me to learn. So I think that's been part of my journey. I'm working now in a non training capacity, and I've had the opportunity to work with all kinds of different colleagues have worked with physician assistants, nurse midwives, nurse practitioners, medical nurses, and so many people have taught me different things that I've been able to learn from or work well with them and listening different models of kind of work, collaboration between peers, my specialty works really closely with neonatology, we kind of hand off in certain situations, when there are changes in how babies are born, that are going to require intervention or immediate attention or a plan, a long term plan for how to help them best in have been able to work at kind of a fetal center where we an area of excellence for diagnosing changes in how babies were born, and then counseling families ahead of time on what to expect, you know, the unknowns who should be involved in the care of these children. And the particular center that I was most involved with was actually run in a Catholic facility. And that was also interesting to see the families that chose to keep their pregnancies and how that journey is, is uniquely different for them with just kind of the ongoing unknowns of what to expect. And then even some of the feedback afterwards when the journey has really kind of materialized. And when we see what the realities are just some of their experiences vary. I don't think they get as much attention sometimes in kind of the talk and the awareness, but it's quite brave and, and challenging at the same time. So it was I've had a lot of different very experiences are studied in in Miami, trained in New York, and in Michigan, worked in the Midwest. And so I've been a medical migrant. And every place that I've been every group that I've worked with, it's taught me something. So it's been it's been a great journey so far.

Maggie, RNC-OB  7:46  
Oh, thank you for sharing all that with us. Yeah, I think it's interesting. We've talked a lot, you know, we have we certainly have listeners from all around the world, actually. But obviously, much of us are US based, and, you know, paramount in Canada, as well. But so it's interesting. Hearing, you know, from folks who have been able to practice all around, you know, our country, there are certainly like vast regional differences in birth culture, in kind of expectations around relationships with our care providers, you know, all of that. And so, I want to switch gears a little bit. So it seems like you kind of were on this, this track of being very much you're MFM, you're you're doing the conferences, and you're publishing the work, and you're really kind of focused on the physician scientist piece of the program. And then I know about you from finding you on Instagram. So what led you to social media and start to really kind of form form a community form awareness there through through your work?

Dr Kia Lannaman  8:38  
Actually, the story starts in Canada. So I started a business with a partner at the businesses based in Canada, it's called accessible professionals. And it's an online community that we're growing, we recognized that there was a need for reliable information from relatable people working in a profession, and that sometimes when you are online, trying to get help for yourself trying to get answers to questions that you have, because you can't get into the doctor, or nurse practitioner, or you've gotten an answer that just doesn't seem to give you resolve, and you're searching things for yourself that sometimes you're struggling to figure out what's valid, and what's just someone's opinion from their experience, but both actually have training in the area that they're writing about, or that they're sharing about what they're sharing from their personal experiences. Not that that's not valid, but that's not always people are looking for. And sometimes it's really hard to weed out what's what. So my partner and I, we wanted to create an online forum to bring relatable health professionals, legal professionals, educational professionals, into a community where individuals can come could connect with them for individualized support, education webinars, and felt like it was a safe place to get valid information and And so that was what prompted me to get on social media as a professional was working with this business. And then I realized that I'm such a niche, like, pregnancy is my focus. And so I realized that my content would overwhem, what we were doing on social media, and that I needed to kind of have my own niche that I could just be me is Dr. Kia, the pregnancy specialist, and that those individuals that liked that content would not be overwhelmed by me talking about pregnancy and postpartum women, and being all the time, and then I could share some of that. And then when they came to our community, they would already know a little bit about me from things that I was sharing. So that was what prompted me, I don't think I really had any desire to be social media as a professional. And I found it actually quite fun. I definitely was pleasantly surprised by how fun it's been. And the people that have engaged with an eye on things that I've learned from other people, other accounts that I'm coming across, that are engaging, and they're asking really interesting, provocative questions. And like, wow, this is like a whole community. And so I'm personally enjoying Instagram. That was my first year of fun that I've been in. And now I'm starting to come alive to tiktok and and just see, I don't know how to use it fully. But, but I do think that it's a whole different arena of file. Yeah. And also, the threshold for people to engage you on tiktok seems to be really low. So people are like, really bold with questions and comments. And I'm like, Oh, wow, this is worse. The popcorn like this is?

Maggie, RNC-OB  11:40  
Yeah, so So funny. Yeah, we have not get on the tick tock game, because I have not had the capacity to do engage in that level. But I think that, yeah, you're experienced echo several of my friends who are on there. And there definitely is like, there is a different, much lower threshold for folks who just want to, like, let's do this, and, you know, dive into it, which I think is I mean, it's powerful. Like, obviously, there's the good and bad of social media, but having the opportunity to engage to hear diverse perspectives, and obviously, you're gonna get some that are just often left field and that's okay, too. But also knowing that I think it's one of the things that's interesting is, you know, what we've talked about it, sometimes it's hard to understand how much you want engage with someone who you think is maybe not really having a good faith conversation, they're just trying to be provocative are trying to, you know, whatever. However, it is interesting, recognizing like, that, they might truly believe that, like, having more insight into like, everyday nirthing people, people who are out there, this is like, this is the background or coming from this is the lens that they are viewing stuff, I think that piece of it is very interesting, just to kind of understand maybe the conversations that don't come up, if you're sitting in the office, talking to someone and it feels like a very formal kind of setting. So I don't know, if there were surprising pieces of that, or if that's been like a pleasant surprise, in some ways, have there been other like unexpected pieces of it? Or how is it? How was it felt,

Dr Kia Lannaman  13:02  
I definitely think that it's a learning opportunity for those of us that will be open, because everyone's sharing, and every one has a right to share. And so you're gonna get people that are going to share their experiences, and just the ability to hear more voices as people comment on certain things. And I think if you're open to it, you can really become receptive to maybe there's more than what I've been exposed to maybe there's more than what I've been taught, maybe the side effects that I thought were gonna be, you know, rare or not so rare from this intervention or or that. So I think it's a great opportunity, even as people that work in certain professions to get an ear on the street to what our experiences that people are having, what are sentiments that people are having, I think one of the things that I realized is that that I'm a little bit different than my kind of my style on social media is very similar to my style in the office. And I always kind of knew that I was a little bit different than some people in the office based on feedback that I was getting. I listen. I listen, I slow things down. I spend time with people I will use my full time with you in the office, even if I have to write notes after we're done even an evening. But I just really feel like that's your time for you and I to make sure that you are not overwhelmed by what's going on really tried to not over exaggerate concerns, but I don't want you to be overly alarmed. I just I need to tell you these things, you know, and but let's create a plan. I'm going to be participating with you on this plan. I'm going to be supervising some things. What do I think you need to do differently in your life? If there's nothing then there's just really responsibility for me to supervise things that you know I tried to take that burden off of what did I cause this is or something I need to do differently? So I find I spent a lot of time with people talking to them, asking them what's going on in their life, trying to help in areas that maybe wasn't what they it wasn't the main focus, but these are other things going on, you know, like, are you having frequent headaches? Well, that could complicate things downline, why don't we address that? You know, like, what, you know, are you having your skin is on fire and your itchy hair and it's falling out? Okay, let's address that, you know, and, and sometimes people are like, Oh, they didn't tell me that. I'm like, did you ask, you know, when people come out, and they say, oh, you know, I think that she's got a yeast infection, and we need to treat it. Oh, she didn't tell me that. Did you ask, you know, like, if they have conditions that make that more likely, did you ask, you know, if they had diabetes, their risk for yeast infections or at risk for urinary infections? Did you ask Hey, are you having any itching down there? Yeah, yeah. Could you? Okay, let's do that you really shouldn't be itching down there. So I think some people don't ask questions. And it's definitely more efficient to get in and out of the office appointment, you know, ask questions, but I'm here for them. You know, I'm here for the patients. And I will try and get my work done when I can get it done. But I'm there for them. And I And I've had people say to me, and you know, you're lying when it's talking to me, you're the only one that's explaining all my questions. Thank you so much. And, and even some of the questions that have come up in the office, I realized that we need to stop taking things for granted. And we definitely need to not talk to people, like we write our men have it. Or that they understand what we're saying and not make assumptions. Even if somebody's in the health field. I'm always like watching people to make sure that they're getting the takeaway. And I had a couple that I was talking with the other day, and I could tell right away that the pregnant person was in the health field, you know, she was like, connecting with me. And then the partner, I could tell he wasn't. And at one point, I stopped, I said, I'm talking to you, like, I'm making sure that I don't talk over your your head because I can tell your partner understands what I'm trying to say. But I don't want you to be left out either. Like, am I connecting with you? Is it making sense? Just like, yes, thank you, thank you. Because I was like, I'm looking at your eyes. And I'm seeing you from about the mess going like this and making sure that you're following me. I'm not talking over your head that that I want to make sure I keep it plain that I don't favor to one person that understands and can leave you out when you're, you know, this is your job, too. So I noticed that I communicate a little bit differently in this from my peers. And then I just brought that with me to social media and just some of the things that I just thought they were just like, simple posts have gotten way more attention than they should have for like my limit of account. Like I don't have that many people following me. But to have some posts that like, are exponentially doing better than the number of people following me. I'm like, oh, okay, interesting. Or, right. Yeah. Yeah, you know, or it's just how I had this one post. What are fibroids? What is a fibroid? You know, Next Level complications that come up the risks that and I was like, to people even know what a fibroid, you know, what is a fibroid? Do you know what it is? Yeah. And people like, I've never heard somebody explain what a fibroid is, is I've heard that people get fibroids and complications from fibroids. But nobody's ever said, what is it? And I was like, okay, there is a certain level of assumption that many people are making, as professionals, even when they come on to social media, and they're talking to their colleagues. And then they're, they're still missing certain people that are like, No, I need you to bring it all the way to the basics. And I don't want to feel stupid, but I really just don't understand what you're, you know, this, I want to hear it from the basics. You know, when I have a second time mom, who doesn't know how to read her lab tests or ultrasound reports, we need to bring this all the way down to the basics, like I need to not assume anything, and that's not your fault. That's our fault for not taking the time. These are information that we're gathering about you to help us, you know, give you better recommendations, supervise things well for you. And if you don't understand that, that means we're not doing our responsibility in educating you. And that was why I got into that business. I just thought that office time is not enough to really transfer information to build up the health understanding of the people that we're working with. They need more than that they need webinars that if they want to come and attend, they need a one on one engagement. And so that's what that mean to be accessible professionals with my colleague and then subsequently there's on social media so

Maggie, RNC-OB  19:52  
yeah, oh, yeah. Yeah, just three tears burning you just said I think that is like that, like it gets to the crux of the issue. And I think you know, we talked about As healthcare professionals, especially clinical workers, we can talk or feel angsty about poor health literacy. Right? It feels like people don't understand what's going on in their life. But ultimately, whose responsibility is that that like, Absolutely, people have the world of information out there, they can read books, they can get on stuff, but we are their health care providers. And a huge portion of our job is education. So like if they don't know, basic things about their body, okay, that's what it is. So let's make sure we're providing that let's like meet them where they're at, instead of being dismissive or talking down to them or acting as if like, we're better than them. Because we already know that, of course, we already know it. We went to school for like, we've literally studied this for years, we should know all of this stuff. But why, you know, why would they if they've never had this condition, if they've never heard of it, you know, and I've talked about, you know, stories before, like how saying, when I was pregnant, I obviously, I'd already been a labor and birth nurse for years, I had done a lot of my own kind of additional training and research and stuff. My husband didn't know any of that. Again, why would he be like he had never dove into it. And there were several times along the way, as we were doing stuff that I realized, like, Oh, I'm assuming this baseline, right knowledge that you do not? Right. You know, like, okay, let's dial it way back, then. I guess you didn't know about this. But, you know, I think you the way you speak about it? I you know, obviously you're you've been very keen on that. And it seems probably from early on in your career, this is something you've really fostered. I wonder if you can speak a little bit to kind of how that has had that as well? Has there ever been rub with other with other colleagues kind of within the system? Because like you said, sometimes it takes more time, right, like the way our system set up the way insurance policies reimburse us based on seeing X many people in this short amount of time like that those aspects, external aspects, they absolutely dictate, like, how care rolls out in the office, I do not believe that most physicians want to lead people lacking, I think they are just thinking, okay, great, did we kind of get to like check, you know, they're just kind of trying to check the box and get it because they know, they also have so many other people who also need to have at least a few minutes of their time, I don't know if you can speak a little bit about like how you kind of navigated that piece of it, especially as someone who, like you said kind of is at that high risk, Doc MFM has kind of been at the top of the kind of medical hierarchy that we have set up within, you know, within birth care.

Dr Kia Lannaman  22:23  
Honestly, I'm still navigating it. And I think there are a lot of factors that dictate to providers practitioners, on how they practice. And I'm not here for most of those things. I'm here for that pregnant person that I'm trying to work with, in that I'm invested in them having a safe pregnancy, good outcomes, compassionate care, and none of that comes rushed in so for and do my paperwork, when I can get it done. And definitely, you know, along the way, people thinking that I moved a little bit slower and maybe wanting me to move a little bit faster. And and I wouldn't say that even when it comes to paperwork, then the fastest person at doing that. But it's interesting, you know, that that's those are like the values, you know, like, gotta get it done quickly. Not okay. How are you communicating? Even when you're writing notes to colleagues? Is it worth reading? does it communicate to other people? I think we can all work on our efficiency. But I think what's been really important to me is working on communication. You know, a lot of times I work with clients who have a primary obstetrician, and I'm the high risk consultant for them. And so I spend my time with them in the office to make sure that we're transferring, understanding that we're putting over the things that I'm responsible for that I'm supervising, and then my note is to their provider, and I really just want to write something that's going to be worth reading, then I've noticed that if it's too long, I don't even want to read it, you know, if it's too involved, you know, I don't, I wouldn't leave I'm like glassing to them, like get to the point, you know. So even when I take time to communicate to colleagues, I really just kind of want to go over here are the salient points, these are the things you need to look out for this one I'm going to ask you to to work with me and doing I don't need to write this really academic discourse that you're not going to read about we let me make this something that you really will use as a resource. So I think it's just learning I think you need to learn your audience. And and that takes time for me. I have been around a lot of different types of people in my life. I've lived in different places. My family is from the Caribbean, from Jamaica, I've lived in Jamaica, I've lived in France. I've lived in Guatemala, to me here in the United States. I've been a student of language. I've been in places where English was not spoken. Well are, you know, I was the foreign tongue and had to fend for myself and I had to make sure that I was safe had to look at, you know, legal documents, signed contracts. And when you're on the other side of comfort, for language and comprehension, I think it really teaches you the value of words, it teaches you the value of understanding and communication. And even if you study something like I studied French, I was a French major, I went and I lived in France. And I still would want people please slow down, like, talk that fast. Like, I mean, I need to hear all the syllables in what you just said, and even then I might need a pause, second to process what you said. So I think you learn when you're exposed to when you're in that situation, where you're uncomfortable, when you're in the situation when you're around people that even if they're using your language, but they're using terms you've never heard, I was a little girl that when I would read a book, I would write definitions of words that I came across it didn't know at the bottom of the page, and like, couldn't get through a book without starting to write down these words. And, you know, sometimes I'll even watch the news, or I'll watch, listen, or I'll read magazine articles or different things. And I'm like, wow, there's a whole different jargon to the literary community like they, they're at another level, yeah, times, even when they tell stories, they have a certain assumption that you've been following all along. So some of my frustration, you know, from us a different community, but same concept, is this assumption of what I know. And so if I'm, as many medical professionals, sometimes we're in a medical bubble, we're paying attention to things related person, we're not always aware of what's going on in the world, or in our own country. And even if I want to come and catch up, there's like, I get to an article or I get to a new story. And there's so much assumption of that I've been keeping track of what's going on. And you know, in the last presidential cycle was such a soap opera, and I was full. I was like, Oh, the narratives are what, there's so many pieces every day is a new breaking news. Like, what is going on? Like, if you aren't paying attention from the beginning, you're like, Who are these people are talking about and my husband's like, oh, so and so and so and so. And I'm like, Ah, I need, like, the links to the backstory, like, who's gonna write? That's how medicine is right? Like, we can't assume that people know things. And we need to start from the basics. We need to keep it plain and, and get it you know, sometimes I'll go into a room for people that are in the hospital before labor. And they're, you know, they're not they're meant to be there laboring, whether they're for complications. And I'm not the first provider that they've ever seen. And I'm a colleague coming in and I say, what do you understand about what's going on? And you'll be surprised how many people don't even know why they're still there. What the plan is, what the concerns are, what do you understand about what's going on? I'm gonna be the first doctor you've seen, but I might be the first one to say, let's make sure you know why you're here. Yeah. Yeah. Why do we still want you to be here? Is that okay with you?

Maggie, RNC-OB  28:07  
Yeah, I think so much of those. Yeah. Like, I think, you know, we've talked at length about power dynamics that are present in birth care, which are generally not positive. You know, a lot of times we have, we have taken as the, you know, healthcare professionals we have taken and hold on to so much the power in those situations. And we often seem hesitant to return power to the person whose body whose baby is actually in the mix. And I wonder if so much of that, you know, that piece of it, where we kind of end up going to that, that base level, the stuff that leads to like coercion, and stuff like that, where we're just trying to get someone to agree with us. I think we cut out some of that stuff, instead of understanding like, what are you understand? What are your concerns? Do you even think this thing that we think is a pretty big deal? That could be a problem for you or your baby? Do you even understand what that is what we're looking at, you know, or do we just jump to being pretty much like, well, you just got to kind of do what I said. Because if that assumption of trust that assumption of, I don't know, I wonder

Dr Kia Lannaman  29:09  
how the assumption of trusts and assumption of who's in charge the authority in final say, you know, there's so much unlearning that needs to happen. And, and, and that's one of the things that I see, I'm learning more and more on social media is people are sharing their experiences. And some of it is it will make you cringe if you'll read the comments. And people share videos and I'm like, oh, and it should cause us to reflect on what we're doing and say, Are we doing this right? Can we get that up? You know, I've done some unlearning along the way and definitely, I am humbled when I see things and comments and experiences that there's more unlearning that I need to do. About what I've been taught is the way to practice obstetric care and what's not appreciated and what's not a value. I remember I had this one person along the journey that came in, shook things up. And you know, they had interesting personality. I wasn't a complete fan of them. But even people that you don't always check with can teach you something. I remember, I told that to my brother. I said, even a hater can teach you something. He was like, Ooh, they're not all wrong. You know, sometimes haters have something to teach you about yourself. That if you listen, you know, weave through the garbage, you might find a checkpoint. Oh, like, yeah, they're right about that. Like, they may not like me, but they're not lying about that. And my brother is like, I can't believe you said that. I'm like, you know, you can learn from anybody if you'll be open to learning. So it doesn't mean you have to be a friend with your hater. But you can learn from them. They might be honest with you about some things that you need to work on.

Maggie, RNC-OB  30:50  
I didn't It's so interesting. Like that defensiveness that comes up that blocks us, you know, you hate when someone tells you something that's true about yourself, you know that you're like not you haven't been ready to work through. So you say you're just like, No, yeah, yeah, not get engaged. We're not going to dive into that when really, that's sometimes the stuff that needs a little bit deeper self reflection. Learning like, right,

Dr Kia Lannaman  31:08  
you somebody you don't think has your best interests at heart, you know, like a true hater. Like, you're just here to attack me. Okay, maybe that's correct about them. But every now and again, they might actually say something that's, that applies to you. And that's not just shaded in their, in their vibe. You say something that, like, if you listen, you're like, Ooh, there's that stick. Okay. And so there was this one particular person in my, in my journey that presented some different examples of how to be involved in obstetric care. And there were some things I didn't like, but there was at least one takeaway that I got that we are meddling too much on vagina. And, and they would just ask us, What are you doing? What are you doing with your hands down there? What do you think you're achieving? And it connected to me? And I was like, You're right. We're just being busy bodies. We don't know what to do with our hands while we're waiting for the baby to come out, like, what are we doing? And then when you see people on social media, who are expressing how they did not like some of these things, and and for some people, it can guide them. Some people need tactile feedback, when they're pushing, especially if you have an epidural, and you don't really feel what you're doing as well, which I've been there, but some people do. And some people that's unwelcome touch. And they're like, What are you doing? Like just yeah, don't touch me so much. But there's this culture that has been passed down about doing all these different things. And if you're not doing something, what are you doing?

Maggie, RNC-OB  32:42  
That one, that one gets us, right? If you're not doing

Dr Kia Lannaman  32:45  
that there's no value in waiting, that there's no value in being patient, and waiting that you have to be doing something all the time that that busyness is expected. And so sometimes I find myself that's one one of the things that stuck from this particular person, that I would be in the delivery room telling people don't touch Don't touch her. Leave her alone, like the head will do that, you know, not yet Get your hands out. No, you don't need to do that. And everybody's looking at me like, What are you talking about? Like, this is why we've been talking, I'm like, no, no, you don't need to do that. Just let it come, just wait, wait for that and hit the ground like that. Welcome that whole crown. So I do think that there's an opportunity on social media to really learn from people sharing about what they didn't like, and if we will be humble, but you know, it takes every person because sometimes you're gonna just say, they just like, they just don't like medical care, or they're just, they're anti this anti that and then you miss the opportunity to learn from them you miss, you know, if we don't recognize each other's humanity and try to put ourselves in an empathy shoe, we're not going to, you're not going to have those connections, you're not going to have those experiences, you're not going to relate with people. I've lived a lot of life. I 40. And I have lived a lot of life. My husband doesn't believe me when I'm like, I've been poor. And he's like, No, you haven't. Yeah, like, Yes, I have been poor. I've not had food, I've had to struggle. And when you have different experiences, it should open your eyes to life. You know, I've been independent way. You know, I've been independent for a long time. And not that my family wasn't good to me. But, you know, sometimes immigrants come over and the struggle is real. You know, I've seen all kinds of things. And I thank God that even in the challenges that I experienced, that I've been saved, that I haven't been harmed by life, but all of that has allowed me to be human and to look for other people's humanity and to try to understand them and to relate to them, and not to judge them when they have disagreements or challenges, but to try to figure out how do we work together, you know, I have some concerns, I have things that I think I can recommend to you for your safety. How can we work together? What's going on in your life? That might make that difficult for you? Can I try to give you a hand, you know, with this or that? Or is it just the understanding piece of has nobody given you your true permission to be in charge, and you just need to make sure that we're communicating so that you can still be the adult autonomous over your own body here, but I think it's just trying to, it's just trying to connect with people see their humanity, and I don't know what it is about. A Howard that just seems easy. It just that's like, natural for me, maybe it's like, because I've freckles, and I've always been a little bit, you know, I've always been a little bit curious and a little bit, you know, outside and, and then I've been in places where I was an outsider and, and been in places where I was not necessarily favorite and and a disadvantage, but or, you know, tried to hear people and, you know, communicate with people that spoke differently. And, and all of that just adds it to I get you I see you Let's talk. Oh, gosh,

Maggie, RNC-OB  36:05  
yeah, I mean, so much good stuff you just put out there, I think you know, that piece of being able to just be with folks recognizing their humanity, we did a whole season around holding space. And I truly wish that that was, if not a whole course at least a whole lecture that everyone in the health care professions, just had some exposure that and understood the value of just being with someone and so much of what we're talking about here, right? Being in community, like how are you they're, you're accessible, you're available, you are there with them, but you're not doing something, it is not always about action, just that the power presence, how that can be so much a part of our role as people knowing that like we're here, you're here to support you. And that humanity piece to like it is I you know, we've again, there is so much to be said about the way that our healthcare education training, and particularly medical education, obviously, has historically been available to folks who have had more privileged upbringings. And how that absolutely shapes what we believe to be true in the world, as a as a culture. That is, you know, if 90% or more are coming from very privileged upbringing, they're not going to understand the other side, in the same way. And if they don't, they don't

Unknown Speaker  37:19  
always, yeah, they don't always have to, I think as we open up the medical arena to more people that are not traditional, that we will teach each other better. And I think we will be better to those that we're serving. Because there are things that you learn from people that are outside of your typical safe space of friends. And in your bubble of play, and exposure. There's so much to learn in a lot of medicine is legacy. At this point, there's a lot of multi generations, I had a lot of colleagues that their parents, their grandparents were, you know, in medical community, it's just different when you've come from different people, you know, when you're when you're not having conversations at home, you know, and staying in the jargon, even even when I come home, if I want to engage with my husband, what happened, I had to speak English. Yeah, I have to walk him through I have a non medical husband, my husband is very brilliant. But it's not in medicine. And so even when I come home, and I want to engage them on what challenges I've seen, or the experience I've had, or why I'm exhausted, I have to talk to him like a regular person, I have to practice the art of communication with someone who I almost have to narrate a book to them, so that they can follow the story so that they can see things the way I see them and not assume that I can skip steps by speaking to them, you know, in medical jargon, and I and that just does not get taught in medical school. It's where there's a lot of elitism that's taught, there's a lot of pride that's just kind of part of the culture, whether it's taught or whether it's just kind of assumed after all of this hard work. What am I late coach pulled out my lapels. And I'm finally in charge, you know, I missed out on my 20s. And I've finally arrived at the status of elevation and respect in my community and in my work. And, yes, I think there's a level of respect that you hope to get after all of what you sacrifice no matter whether your legacy or not like you bust your butt to be in that career, you can make a lot more money in a shorter amount of time and working with money. But ego doesn't help people. Pride doesn't help people. And being an elitist and not trying to connect with the people that you're serving doesn't help people, you know, and it's something that my husband helped me, where I kind of had this aha moment that like many of us in medicine, we learn from the underprivileged. A lot of training centers. Oh, yeah. Yeah, in areas of underprivileged. So we actually owe them. But we don't act like it. We owe the people that allowed us to learn with them, learn from them, learn on them. And then sometimes we don't act like we owe them. But if we only trained in areas of affluence, we would not be trained. Because, because not everyone wants people that are learning to participate in their health care. So in the medical community have built our profession and our understanding on the experiences of the poor, on the experiences of the underserved and the experiences of the medical, illiterate, we owe them.

Maggie, RNC-OB  40:43  
Yeah, we dive into like a whole other podcast episode about that, because that is like that is such a strong current. And it absolutely impacts the relationships that we have, you know, with folks, and again, as we're, I guess, you know, as we wrap this up, that, you know, what do you think community birth care can look like? What is like the vision you would cast for how we how we move forward holding all of these different elements? What could it look like?

Dr Kia Lannaman  41:08  
That's a great question. And I think, you know, in politics, we have different parties, because we don't always agree. And it's not, it's not necessarily a bad thing. Sometimes it's okay to say, you know, I actually see things differently. And I hear you, I respect you. But you're, I'm not going to join you, in this thing that you want to build. I think that maybe we need to have another party. And I question and I know some others that are questioning whether we can really build one tower that serves all better in, in a system that's been going on for, you know, a several, multiple decades, and may not, it's hard to change the course of a big ship. So I wonder if what is going to happen over time is there going to be different different options, different parties of community, the typical community that that's gonna survive, that doesn't have to change in order to continue doing what it's doing? And then a new wave of people that are saying, let's do this a little differently? Let's be okay to asking questions of ourselves that we haven't asked before. Let's listen a little bit more. Let's collaborate more with the people that we're serving, let's really let them have autonomy, but be uncomfortable and let that grow us. And, and so that community may involve more collaboration between midwives, nurse practitioners, physician assistants, physicians, I was at something the other day, and it was so invigorating, I went to a home birth office, like a center for a breech training course, I was the only maternal fetal medicine provider there was one of two OBGYN There the person the only other OB GYN was the person teaching the course. And for the most part was with all midwives, midwives assistants. And I walked away invigorated, and I just thought the courage these midwives have that do home births is applaudable and like even just being around them from a weekend, it transferred some courage to me to say, You know what, these are growing opportunities, I think the more that you are around other people that you can learn from, if you'll be you'll come off your your elite pedestal and just say, I can learn from this person, they have an area of excellence that maybe I don't have, and just all that exposure can grow everyone I've learned so much from a nurse practitioner that I've worked closely with for years. And I'm like, wow, she's excellent. Boom, boom, boom, boom, boom, she has so much knowledge and boom, boom, boom, boom. And the more I'm around her, I'm learning from her and she's learning from me, and we can share knowledge and it doesn't have to be competitive, and it really can just elevate the service that we provide. But I just thought to myself, Oh my gosh, some of us need to be around midwives sometimes, you know, there's your locks you up, like the things that you know, but not everybody there so I mean, there's some are learning that has to go into that to have you know, that you're not competing that some people are not practicing, you know witch medicine and, and that we're all here to serve and that that you can learn from someone who had a different career path and training path than you and that their experiences are still valid. So So I think what I think is going to happen is that another party is going to come up with their that there are going to be different communities of offerings of birth care work, and there's going to be the Traditional that will always be there. And that may change ever so slightly here and there. And then there are going to be other silos of options that people are going to start to realize as, as the world becomes more accessible to each other through the internet, they're going to realize the options that they have, whether virtual or in person, and in those that are interested in that are going to seek that out. And again, I find it

Maggie, RNC-OB  45:24  
hmm, yeah, well, obviously, I hold that same hope that folks are able to find the care that they want, that they can find supportive providers who, again, that fulfill any number of birth goals that folks have, you know, there is not some right side, you know, one size fits all, you know, perfect birth experience. And so, I think it's so valuable. I love how, you know, obviously, so much of our work here is collaborative, and I love having conversations where you see folks connecting, and we've had it several times on the podcast where someone shares it, we're having multiple guests on and the other guests is like, wait, what I didn't even know that I didn't know that was possible. Like, I've literally never heard that I've never learned that that was not part of my training. And there is so much that we can learn, both always going back and forth. And that is a beautiful piece for us as a community of birth care professionals to be able to have folks who who challenge our preconceived notions who like to help us to recognize those biases, who you know, say like, Hey, there actually is a different way. And you're like, oh, Ty genuinely didn't know. Okay, great. So, oh, thank you so much Kia for spending this time with us. I really appreciate you and you sharing about like your journey and I am confident it is inspiring other people to to consider the way that they communicate the way they connect the way that they are in community with others. So thank you so much.

Unknown Speaker  46:38  
Thank you so much. And shameless plug, we'd love for you to check it out. Please, Accessible Professionals Community @www.apcares.ca we're on social media. But thank you. It's been an honor for me to be here, Maggie, I've considered myself a small fish in the pond. So I'm honored to have had space with you today.

Maggie, RNC-OB  46:56  
Thank you so much. 

Well, I just found this to be such a powerful episode and I am so grateful to Dr. Kia for sharing her expertise with us to diving into how she has navigated these challenges in connecting and community through the haze and complicated power dynamics that are present in our current hospital birth care system. So thank you so much to her. I hope this has been enlightening for you all as well. As you think about how you can connect with folks more clearly and more deeply. As we all strive for better birth care. We would love for you to highlight and social media we are your birth partners across all platforms. Feel free to shout us out in your stories on Instagram. We would love to connect with you till next time