Transcrição completa de Beyond the Headlines: Postpartum Mental Health & Systemic Failure

children who passed away because that's terrible. 00:04:55.439 --> 00:04:56.079 It's awful. 00:04:56.160 --> 00:05:01.360 It's something that you never, I feel like in this work, that's like the last thing that you want to get to. 00:05:01.519 --> 00:05:01.839 Yeah. 00:05:02.079 --> 00:05:07.040 Um and I want to name that there's so much complexity to this. 00:05:07.120 --> 00:05:21.199 And I want to name that if you are someone who's experienced postpartum psychosis, um, if you're someone who has been helpful to someone who's experienced postpartum psychosis, you can probably name the nuance and the layers that come with this. 00:05:21.360 --> 00:05:25.759 It takes it takes time to get to that outcome that we hate. 00:05:26.160 --> 00:05:28.800 And I feel like this case really emphasized that. 00:05:29.040 --> 00:05:30.560 Like, how did we get here? 00:05:30.800 --> 00:05:39.600 And so one of the things I'll emphasize um is that Lindsay actually is a nurse, an LD nurse, labor and delivery. 00:05:39.759 --> 00:05:48.079 And a big part of this, and I think what made this case stand out, is that she actually sought out a lot of help and also had access to it, right? 00:05:48.399 --> 00:05:51.680 Not a lot of people have even have access to what she had access to. 00:05:51.920 --> 00:06:05.519 Um, so in between going to um psychiatrists, going to a mental health facility, um, utilizing medication, utilizing therapy, like there was a lot in the story that I think was unusual in that case. 00:06:05.600 --> 00:06:11.279 Usually we hear about at least the things that are publicized, we hear about a lack of that, right? 00:06:11.519 --> 00:06:18.560 What we may hear about is child protective services being involved, but still a lack of care, honestly, at least in my opinion. 00:06:18.720 --> 00:06:29.519 So this was this was new to see like this case where all these resources were put in place and we still had this really terrible outcome. 00:06:30.079 --> 00:06:38.240 Well, and on top of that, she also had social support within her family, her parents close by who were very attentive and helpful. 00:06:38.319 --> 00:06:42.879 She was a white woman, so we know she had access to a lot more resources. 00:06:43.040 --> 00:06:48.959 And she also had a nanny uh before allegedly he she was let go by the husband. 00:06:49.199 --> 00:06:55.120 But um she did have a lot of yeah, and that's like we've never I've never seen a case like that. 00:06:55.279 --> 00:06:57.680 I always see one, your name and Dr. 00:06:57.759 --> 00:07:00.319 Anna, the intersectionality of it all, right? 00:07:00.480 --> 00:07:08.879 Where it's like usually black and brown folks, especially if you're um poor or any of that, close to any of that, you don't get all of this. 00:07:09.040 --> 00:07:13.600 A nanny, a this, a that, like it's done, right? 00:07:13.920 --> 00:07:19.360 So I guess I'm gonna go into first, like one, I would just like to hear both of y'all's opinions. 00:07:19.439 --> 00:07:28.160 I said a lot about my thoughts, but I would love to start with you, Mary Nisi, on just a level of like what what you thought about as you were navigating this. 00:07:28.399 --> 00:07:29.279 Yeah, yeah. 00:07:29.519 --> 00:07:30.560 I really struggled. 00:07:30.720 --> 00:07:33.519 I really struggled like following through the whole story. 00:07:33.600 --> 00:07:37.120 Um, I had to pause, like I would stop, you know, kind of being on social media. 00:07:37.279 --> 00:07:42.959 Um, I think it was, and I'm I was trying to figure out like why was this really hard, right? 00:07:43.120 --> 00:07:46.800 I think it was the aspect of where it was highlighting someone, right? 00:07:46.959 --> 00:07:49.759 Again, that intersectionality, right, who is privileged, right? 00:07:49.920 --> 00:07:53.040 Someone who is white, like who has these resources. 00:07:53.199 --> 00:08:06.079 Um, and when I tell you the families and the folks that I've personally worked with or that I know of locally, right, who struggle in some way, maybe not psychosis, but like their stories are not, like you don't hear about it, right? 00:08:06.240 --> 00:08:10.000 So I think that like I was just like, oof, I don't know, this feels really hard right now, right? 00:08:10.079 --> 00:08:14.079 Like, I'm just like, I don't I don't know that I want to fully enter into this conversation. 00:08:14.240 --> 00:08:18.720 Um, the other part, as you already know, is that like, you know, not everybody's a birth worker, right? 00:08:18.800 --> 00:08:21.680 So like neighbors, like I was at a cabin. 00:08:22.000 --> 00:08:22.480 True story. 00:08:22.560 --> 00:08:32.399 I was in a cabin camping with a bunch of folks, and the one person who doesn't even know the work that I do was like very passionate about like how horrible Lindsay is. 00:08:32.480 --> 00:08:35.759 I can't believe she deserves, you know, what she gets, right? 00:08:35.919 --> 00:08:40.799 And I'm sitting here like, holy mother of grace, people are so opinioned about this. 00:08:40.879 --> 00:08:42.799 I'm like, you're not even educated. 00:08:43.120 --> 00:08:43.279 Right. 00:08:43.440 --> 00:08:46.399 Because I was just, I think it was just bringing out so many emotions for me. 00:08:46.480 --> 00:08:47.600 Like I didn't want to enter it. 00:08:47.759 --> 00:08:56.879 At the same time, I was very angry about this like extreme opinions of like just everybody around, you know, around me, of kind of like those like this two sides, right? 00:08:56.960 --> 00:08:59.600 Like polar opposites of like what she deserves. 00:08:59.759 --> 00:09:04.879 And I'm thinking, this is so much more complicated than like what you believe she deserves, right? 00:09:04.960 --> 00:09:08.639 So I think it was just like a very hard space for me um to enter in. 00:09:08.799 --> 00:09:14.720 And, you know, with all the hats that I wear, right, as a birth worker, you know, as a community member, as a black woman, right? 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00:09:20.159 As someone who's very much aware of like what this like postpartum season looks like as a mom. 00:09:20.399 --> 00:09:28.240 Um just felt like there was not a lot of conversation around the nuance of it all. 00:09:28.480 --> 00:09:33.840 Um so I kind of like was like, I'm like, we're camping right now. 00:09:34.240 --> 00:09:39.679 I can't really go into it, you know, like it might not end well, right? 00:09:39.840 --> 00:09:40.559 Um, yeah. 00:09:40.639 --> 00:09:41.600 So I think I really struggled. 00:09:41.759 --> 00:09:52.720 And I was like really, you know, I've been really looking forward to kind of like having this conversation together because I think this is honestly the first time that I'm actually like fully talking about all of this, you know, kind of like the nuances of it, right? 00:09:52.799 --> 00:09:56.240 Of like what that means, you know, for us, what that means for birth workers. 00:09:56.320 --> 00:09:57.679 Um, and really glad for you, Dr. 00:09:57.840 --> 00:09:58.799 Honor, to be here as well. 00:09:58.960 --> 00:10:00.559 So I'd love to hear hear from you. 00:10:00.879 --> 00:10:01.279 Thank you. 00:10:01.440 --> 00:10:04.480 Yeah, I um gosh. 00:10:04.799 --> 00:10:16.720 Okay, so I have to preface this by saying this this case happened for me adjacent to a completely uh uh brand new move across the world for me. 00:10:16.799 --> 00:10:21.120 I moved from San Diego to Barcelona, Spain for political reasons. 00:10:21.360 --> 00:10:33.200 Um and so navigating this really complicated move of extraordinarily stressful move that actually brought me back to a similar state that I felt when I was postpartum. 00:10:33.519 --> 00:10:34.720 That's how I've described it to people. 00:10:34.799 --> 00:10:36.000 And they're like, well, how are you? 00:10:36.320 --> 00:10:44.480 I feel like a new mom in some ways because I feel so confused and out of sorts and lost and just not myself, right? 00:10:44.639 --> 00:10:46.399 So I was kind of already in this state. 00:10:46.480 --> 00:10:57.919 And then I was, of course, tuning in to this trial because this is the work that I do, not the postpartum psychosis so much, but just perinatal mood disorders, right? 00:10:58.080 --> 00:11:02.320 And um working a lot with pregnant and postpartum uh people. 00:11:02.960 --> 00:11:09.679 And I I personally struggled with pretty severe postpartum depression with my second. 00:11:09.840 --> 00:11:11.200 I don't know if you knew that, Savia. 00:11:11.279 --> 00:11:15.600 I don't know if we had talked about it much, but it was pretty, pretty bad actually. 00:11:15.840 --> 00:11:27.840 And I I think that so much of that time of my life, I felt very alone in a lot of the ways that I was feeling, the things I was thinking, especially as an infertile person. 00:11:28.320 --> 00:11:41.120 It is there's even less space for you to voice any displeasure with being a mother because you were only allowed to be grateful and um, you know, enjoying every single second and these kinds of things. 00:11:41.200 --> 00:11:44.320 And I was just not feeling those things at all, and it wasn't my fault. 00:11:44.480 --> 00:11:54.480 Um and so I was I during this trial, I felt like an intense emotional experience for for weeks. 00:11:54.639 --> 00:11:56.879 I I was losing sleep because of it. 00:11:57.039 --> 00:12:04.960 I was remembering things with my my son that I had kind of let myself forget intentionally because they're so painful. 00:12:05.360 --> 00:12:11.519 Um and I was really, really aware of a couple of other things. 00:12:11.600 --> 00:12:17.759 So one is just the very few women that I have worked with who suffered from postpartum psychosis. 00:12:17.919 --> 00:12:20.480 And those thankfully happened when I was under training. 00:12:20.639 --> 00:12:25.360 So I was under the supervision of a licensed psychologist at the time when I wasn't. 00:12:25.440 --> 00:12:30.799 So I had a lot of support around navigating these really, really painful cases. 00:12:30.879 --> 00:12:40.799 But those are the ones that have stayed with me the most in my career in these really painful ways where I feel like I wasn't able to help in the ways that I wanted to. 00:12:41.120 --> 00:12:51.200 And I was also thinking about this white woman receiving all of this like love and I mean, she's also gotten villainized horrendously and it makes me sick. 00:12:51.279 --> 00:13:01.039 But there's also been this uplifting and all of all of these moms around the world that have, you know, that have supported her, which is beautiful and she deserves that. 00:13:01.120 --> 00:13:12.639 But I just think of how many black and brown women, like Latarsha Sanders, is, you know, one out of, I'm sure, many examples of names that I haven't even heard of, they don't even show up on my screen, right? 00:13:12.799 --> 00:13:16.399 And so I was just very aware of that piece of things too. 00:13:16.480 --> 00:13:24.399 And that's just it, it's to your point, it's so uh multifaceted and so nuanced and so complex. 00:13:24.480 --> 00:13:36.720 And so there's a million different feelings swirling around, but on a personal level, just as a woman, as a mother who had postpartum depression, this case just rocked me emotionally. 00:13:37.039 --> 00:13:37.600 For sure. 00:13:37.759 --> 00:13:49.600 I think definitely it's I can't emphasize enough how it is to be in the work and not just be talking around the work, right? 00:13:49.840 --> 00:13:55.919 Because I'm like, this sounds maybe more black and white if you're just around it. 00:13:56.159 --> 00:14:15.840 If you haven't sat with birthing people, you haven't been at the birth, you haven't been in their postpartum period, you haven't had those conversations, seen those difficulties, navigated what it what it feels like to have a have a child and also have other children on top of that. 00:14:16.159 --> 00:14:17.600 That's a whole nother thing, right? 00:14:17.679 --> 00:14:28.639 Like

it's one thing, granted, everything is a challenge and a journey, but wow, when somebody's bringing home a new baby amongst other children already, the demands of that, right? 00:14:28.799 --> 00:14:38.559 The relationship demands, right, between you and your partner, the way that things change, the way that you're trying to identify yourself, the way you're trying to identify your children, you're trying to identify your partner. 00:14:38.799 --> 00:14:40.240 Who were we at one kid? 00:14:40.399 --> 00:14:41.440 Who were we at two kids? 00:14:41.519 --> 00:14:43.279 Who were we at three kids, right? 00:14:43.440 --> 00:14:48.799 Like there's so many things that, like me personally, I've never had a child. 00:14:49.440 --> 00:14:55.679 And sometimes I'm like, being a doula maybe it made me even more clear about not being a parent. 00:14:57.679 --> 00:15:01.039 Because I'm like, I don't think I have the mental faculties, right? 00:15:01.200 --> 00:15:05.440 I'm like, I don't think I personally have the mental faculties to handle it. 00:15:05.600 --> 00:15:07.679 Like, and that's just being honest, right? 00:15:07.919 --> 00:15:16.320 But not many people, including birthing people, learn about postpartum mood disorders prior to getting pregnant. 00:15:16.559 --> 00:15:20.559 If anything, they learn about it in between, like when they're pregnant, right? 00:15:20.639 --> 00:15:24.240 If they go to childbirth education, if they go to something like that. 00:15:24.480 --> 00:15:32.000 But generally speaking, people don't learn about pregnancy, postpartum, this, that, and the other until they are already in it, right? 00:15:32.159 --> 00:15:37.440 And that's already like, I feel, uh a problem in our in our society to begin with. 00:15:37.679 --> 00:15:46.000 However, I want to move us forward and I think it's really important because a lot of what we're talking about, postpartum psychosis, depression, da-da-da-da. 00:15:46.480 --> 00:15:57.600 A lot of these things I learned are not even like in the official like diagnosis book for how we navigate mental health. 00:15:57.840 --> 00:15:59.759 Um, and so Dr. 00:15:59.919 --> 00:16:04.720 Anna, I would love to just hear about um one, what are PMEDs, right? 00:16:04.879 --> 00:16:10.320 And then two, why aren't they listed in the books and stuff? 00:16:11.360 --> 00:16:16.000 So I can't the systemic issues of my field. 00:16:16.240 --> 00:16:22.399 Uh we that's a whole separate episode of just the DSM in general. 00:16:22.559 --> 00:16:42.159 Um, to be fair, I I stopped going through that the way that I did in my training just because I think working with so many black and brown people, that book became a little less useful to me, unless you know I really needed it for more like clinical purposes or, you know, diagnosis-related issues that I was concerned about. 00:16:42.320 --> 00:16:45.279 But um, I mean, this is a controversial take. 00:16:45.360 --> 00:16:48.960 So people will listen to this and and have feelings about me saying that. 00:16:49.840 --> 00:17:01.600 But I I personally, I mean, people that have worked with me clinically know that I'm not, I'm not looking at them from the lens of that book so much as I'm looking at all of their circumstances. 00:17:01.840 --> 00:17:07.759 So I can't speak to why it's not in the DSM or why things are that maybe shouldn't be in the DSM as disorders. 00:17:08.160 --> 00:17:11.440 That's a whole episode on in and of itself. 00:17:11.680 --> 00:17:17.279 But um, what PMAD stands for is perinatal mood and anxiety disorders. 00:17:17.519 --> 00:17:20.480 And there's a multiple different ones. 00:17:20.640 --> 00:17:35.200 And what's tricky when you're seeing uh a clinician in this space, the the mistake that I see people make is they work with just their regular therapist, thinking that that particular person can help when they're pregnant or postpartum. 00:17:35.359 --> 00:17:41.039 And sometimes that's true, but it's very, very specialized training, extremely specialized. 00:17:41.200 --> 00:17:49.680 And even within that world, you have people that are specialists in part of that and people who are not experts in other aspects of it. 00:17:49.920 --> 00:18:08.880 So when you look at the array of disorders, I'm I'm using air quotes, um, in that there's there are some, for example, if I were to get a call from someone who was experiencing um postpartum OCD or postpartum psychosis, that would be an immediate referral out for me. 00:18:09.039 --> 00:18:15.440 I would be supporting as needed until I got them to proper care because I don't consider myself an expert in that. 00:18:15.680 --> 00:18:20.400 I consider myself an expert in depression, postpartum depression and anxiety. 00:18:20.559 --> 00:18:30.720 But those other two are they're just more, they're, they're some, I mean, postpartum psychosis specifically is a medical emergency, right? 00:18:30.799 --> 00:18:34.160 I mean, that's requiring medication, that's requiring hospitalization. 00:18:34.319 --> 00:18:44.960 And so if you don't have a lot of experience with psychosis, which I do not, then you could miss this and you could create and cause a lot of harm, right? 00:18:45.200 --> 00:19:03.519 And so that's the other piece is when you're looking for providers, you want to make sure if you're helping a loved one or one of your clients, for example, is dual is that you're actually looking for someone who says, I have expertise and really solid training in postpartum psychosis versus just general PMADs. 00:19:03.759 --> 00:19:13.039 So, like with that point that you're making right now, um thinking about the Lindsay Clancy case, yeah, I don't think people were making that distinction. 00:19:13.279 --> 00:19:13.599 Yeah. 00:19:14.160 --> 00:19:19.680 People were like, oh, okay, I've I've worked with postpartum depression, I can work with this. 00:19:19.839 --> 00:19:20.079 No. 00:19:20.240 --> 00:19:26.960 And like I think like what you're

speaking to is that there is a breadth and a depth to the two postpartum mood disorders. 00:19:27.279 --> 00:19:35.680 And not only do you have to or should be specialized, but the the provider should be able to name their limits. 00:19:35.920 --> 00:19:36.480 Yes. 00:19:36.720 --> 00:19:36.960 Right. 00:19:37.119 --> 00:19:42.480 And like if you don't name those limits, I wouldn't know that it's such a breath and a depth. 00:19:42.559 --> 00:19:44.160 I don't, you know, I'm not in it. 00:19:44.319 --> 00:19:44.480 Right. 00:19:44.720 --> 00:19:49.920 So I may not be even able to identify that maybe I'm not being treated necessarily by the right person. 00:19:50.319 --> 00:19:51.200 Correct. 00:19:51.519 --> 00:19:54.400 Yes, it's it is extremely specialized. 00:19:54.480 --> 00:20:08.160 And because postpartum psychosis is so rare, you can imagine that the training you receive, I mean, all of the residency program I did, the postdoctoral fellowship I did was specialized in women's health and in particular, you know, perinatal mental health. 00:20:08.319 --> 00:20:16.960 And even within that, out of all of those years, I only had two patients that landed on my caseload who had postpartum psychosis. 00:20:17.200 --> 00:20:23.599 And after that, in my you know, 10 years private practice, I have not had a single one, not one. 00:20:23.839 --> 00:20:26.160 So it is it is quite rare. 00:20:26.319 --> 00:20:50.720 So you would imagine then people's training in that, unless they really seek that out or they already had a really core good training in psychosis, which a lot of people don't, because it it is a harder, I think, area for people to go into because it is maybe not as warm and sunny as some of the other disorders, because there's not often like a happy ending. 00:20:50.799 --> 00:21:02.400 Um, not so much with postpartum psychosis, because that is more brief, but in like schizophrenia and some of these things, I mean, these are chronic conditions and they're they're really tricky to navigate and they're, you know, can be pretty exhausting. 00:21:02.640 --> 00:21:08.160 So um all that to say, yes, I mean, it's so important to find specialized care. 00:21:08.319 --> 00:21:19.440 Now, having said that, because it is such a tricky area of expertise and people already have difficulty with access to care, sometimes you live in cities where that's just not an option. 00:21:19.599 --> 00:21:21.200 You get who you get, you know. 00:21:21.440 --> 00:21:28.720 But as a as a patient or as a client, it's really important to know that you might be dealing with somebody who doesn't have that expertise. 00:21:28.960 --> 00:21:33.279 And that person should ethically be able to tell you that directly. 00:21:33.680 --> 00:21:48.400 Ethically, I think also too, one of the things that we work with, and I think this happens in any field from do list to whatever, is that we have to take our ego out of the work and be able to say, like, this is beyond me. 00:21:48.559

--> 00:21:49.279 You know what I mean? 00:21:49.440 --> 00:21:51.039 Like outside of my scope. 00:21:51.359 --> 00:21:55.920 Yeah, this is where I need some support and and also using technology. 00:21:56.079 --> 00:22:18.160 Like, we have so much technology where it's like, can I get someone who the expert in that to at least be in in in relationship to my psychiatrist, to my therapist, to whoever, to like work with me because they may be local, but this this support can come in, you know, from the computer, you know, like to help us out. 00:22:18.559 --> 00:22:19.440 So okay. 00:22:19.680 --> 00:22:36.720 One thing that I'm familiar with as a birth worker is we have baby blues, which I always like we talk about baby blues and they're like, it happens usually in the first two weeks and da da da I'm like who it's it's pure confusion and delirium. 00:22:36.880 --> 00:22:41.440 Like it's just like it's like you have this baby that came home with you. 00:22:41.680 --> 00:22:54.559 Y'all are trying to figure out sleep and and eating and relaxation and you know all these things like I completely understand why the the space would be blue for a while. 00:22:54.799 --> 00:22:54.960 Right. 00:22:55.519 --> 00:23:03.680 And then from there what we have learned is that can roll into something more clinical and deeper, right? 00:23:03.759 --> 00:23:11.599 So we may go into postpartum depression, postpartum anxiety, postpartum OCD, um things like that. 00:23:11.759 --> 00:23:16.319 And that's stuff that as a birth worker as a dual I've definitely seen, right? 00:23:16.480 --> 00:23:18.960 Having diagnosed, which we'll talk about that later. 00:23:19.119 --> 00:23:22.240 Yeah, but definitely have seen and been a part of. 00:23:22.480 --> 00:23:29.920 And then generally I see um I have seen at least like once like a role into postpartum psychosis, right? 00:23:30.079 --> 00:23:39.519 And so one of the things about that list that I just kind of put out there is most people I think have heard of postpartum depression. 00:23:40.559 --> 00:23:44.400 Most of them I feel like have maybe heard about postpartum anxiety. 00:23:44.640 --> 00:23:52.480 Postpartum OCD I think is like under talked about if that's what I want to put it by so much. 00:23:52.640 --> 00:23:53.759 And so Dr. 00:23:54.000 --> 00:24:00.559 Anna if you could please just explain postpartum OCD and especially intrusive thoughts. 00:24:01.680 --> 00:24:22.799 And and and also in the sake of normalizing it because I think as doulas we get to hear about these thoughts all the time but those thoughts don't usually reach the general population or even people's friend circles or family because they're like if I say this where I told them I had this thought, they're gonna think I'm in psychosis. 00:24:23.359 --> 00:24:28.240 And it's like no you're just having an experience is actually pretty normal. 00:24:28.400 --> 00:24:30.559 So I would love to hear about that from you Dr. 00:24:30.720 --> 00:24:43.440

Anna well I mean intrusive thoughts in general can arrive in any of the stages that you just talked about whether it's baby blues, whether it's postpartum depression or anxiety, whether it's postpartum OCD, postpartum psychosis. 00:24:43.680 --> 00:24:56.319 Now I am definitely not an expert in postpartum OCD, as I stated earlier, but I mean it presents is in so many ways similarly to just you know for lack of a better way to say it's like regular OCD. 00:24:57.039 --> 00:24:59.440 It is an anxiety related condition. 00:25:00.240 --> 00:25:04.400 It can start or worsen during pregnancy or after childbirth. 00:25:04.559 --> 00:25:11.119 It affects roughly like 15 to 17% of individuals within the postpartum period. 00:25:11.359 --> 00:25:17.279 That being said the number for black and brown women is likely higher. 00:25:17.440 --> 00:25:32.319 I don't know what the statistics are on that, but all of these stats like there's the general stats for women and then there's what those look like for black women or black and brown women and those numbers jump significantly when you look at them from that lens. 00:25:32.480 --> 00:25:33.920 So I will just say that. 00:25:34.160 --> 00:26:00.640 But essentially the symptoms that people have when when they do present with postpartum OCD are you know these unwanted distressing repetitive intrusive thoughts these kind of mental images or urges um usually these are around kind of like the baby getting hurt dropped contaminated experiencing some sort of harm right now I say that and I'm sort of laughing because I'm like I just have those thoughts all the time as a mom. 00:26:00.799 --> 00:26:07.279 I mean I've like witnessed in my brain just even I think this by this morning right just we have these windows here in Barcelona. 00:26:07.359 --> 00:26:09.920 They do not believe in screens in this country I don't understand it. 00:26:10.000 --> 00:26:14.640 But I mean I just have pictured my children that are older now like just falling out of these windows. 00:26:14.720 --> 00:26:18.400 It's like this is part of just parenthood I think but especially motherhood. 00:26:18.880 --> 00:26:28.000 So that's a little sidebar on that but what accompanies what what's different from just an intrusive thought with OCD is the compulsions that accompany these intrusive thoughts. 00:26:28.079 --> 00:26:35.599 So these are repetitive behaviors or mental acts and they're meant to reduce the anxiety that the intrusive thoughts cause. 00:26:35.839 --> 00:26:50.400 So some of these examples can include like constantly checking if the baby's breathing, excessive hand washing, repeatedly checking their temperature or the temperature of the house, seeking that constant kind of reassurance. 00:26:51.359 --> 00:26:53.680 It could also be an avoidance, right? 00:26:53.759 --> 00:27:01.599 So staying away from certain caregiving tasks, um like maybe bathing or holding the baby out of fear of kind of losing control. 00:27:02.160 --> 00:27:10.319 The intrusive thoughts are they go completely against the the parent's actual values and desires. 00:27:10.559 --> 00:27:18.480 So people with postpartum OCD are completely horrified by these thoughts right they're they're extremely unlikely to act on them. 00:27:18.559 --> 00:27:46.079 They think about them and then the compulsions help to reduce the anxiety of the fact that they had them whereas postpartum psychosis they don't have that it's the ego dystonic versus the ego syntonic nature right and for postpartum people with postpartum psychosis these thoughts just feel like natural to them right because they're not they're not they have experienced a total loss of contact with reality right and have like a severe functional breakdown. 00:27:46.240 --> 00:27:51.200 And that looks different than it does with postpartum OCD hopefully that makes sense. 00:27:51.440 --> 00:28:10.240 No that's super interesting because that was really good I was like yeah like the way you like broke that down into like these thoughts can happen in both of the people right but someone with postpartum OCD has more consciousness around that's not what I will ever do. 00:28:10.400 --> 00:28:13.680 That's not who I am that's not how I parent that's not how I care. 00:28:13.920 --> 00:28:19.759 Where someone with postpartum psychosis doesn't have the ability to recognize themselves anymore. 00:28:20.000 --> 00:28:26.480 So it seems like it feels like in a way like everything merges because they're they've broken away from reality. 00:28:26.799 --> 00:28:27.039 Right. 00:28:27.200 --> 00:29:08.240 So an example of this just in myself to I I never use examples of people I've worked with but for me I remember one night with postpartum depression I I looked at my baby and I thought what if what if my baby is is a possessed demon I mean it was just like I was exhausted clearly but I knew enough to know like no that that's not the case and I was able to you know pick my baby up and hold them but but just even that intrusive thought if I had been experiencing postpartum psychosis what that could have turned into is my baby is a demon and I need to kill the baby for the the sake of the baby and my other baby and the family right like that could have turned into something really dangerous. 00:29:08.400 --> 00:29:28.640 But because I was in still had you know my reality testing was intact, I was able to say wow I'm really tired and clearly I'm not well and wow this is a sign of like I probably need some support around here I just really need to get more sleep but the fact was I did have this intrusive thought of a moment of fear for a minute of like oh my gosh what if that is true? 00:29:28.960 --> 00:29:42.240 So an example but it's a cool example it's deep but it's my four kids ever hear this may they know that they are not demons and I I love them very much. 00:29:43.039 --> 00:29:47.680 Yeah it's like yeah that's that's that's deep. 00:29:47.920 --> 00:29:56.319

May I did you have anything to add because obviously you're a parent so no I think I I'm taking it all in and I'm definitely like speechless in this moment. 00:29:56.960 --> 00:30:38.720 I think you know that aspect of of um you know talking about intrusive thoughts that like that is something that like we experience like you said as a parent I'm a parent as well telling you guys about the morning routine I had to do to send them to school today right and that like those intrusive thoughts like you know do continue right they don't they don't stop and then like you know knowing that like they're you know like I can say back to myself like no like this is you know they're not gonna fall off the window right that that will be okay right I think that's even just being able to like recognize that that is normal right like having intrusives can be normal and you know and how you handle it I think tells us right in postpartum where someone is at and where they need support. 00:30:39.200 --> 00:30:50.640 And it can be protective right because in this case an example of that could be well maybe we need to put screens up on the windows or bars or whatever right and so it it it also is protective of your children and yourself sometimes to have these thoughts. 00:30:50.720 --> 00:31:00.880 I think people are like I wish I didn't think these things but what I always tell people is anxiety it's it's there to protect you right if if you're if you have a fear of rattlesnakes that's healthy. 00:31:01.039 --> 00:31:57.599 We we don't want you like seeing a rattlesnake and be like well what's that and pick it up there's a reason we have anxiety and it it is it's protective now obviously when it gets to to be extreme then it's no longer protective and it it impacts your general health and functioning and wellbeing we don't want that but um too like the the point that we don't often hear this and I think it's important to emphasize what you just said like anxiety can be protective right and like everything there's a spectrum to it right so because I'm thinking about anxiety because I'm like yeah you know your girl be anxious and some of it more so informs how I plan and how I do things accordingly because sometimes for me anxiety could just be am I going to have enough time to do this thing and then I'm like okay well if I plan it actually the way that needs to be planned where I get my ass up in the morning I'll be like don't do this. 00:31:57.920 --> 00:32:09.599 But I think too just like thinking about obviously I'm not a parent right but like you know when I'm taking care of the chickens and there's certain things I'm like I feel anxious about this and I feel like I'm annoying my partner about it. 00:32:09.839 --> 00:32:59.440 But really underlying is actually like a legitimate fear or concern that needs to be addressed right and I think like that's also as dualists I think we could do well with that thinking around sometimes you have clients who are who are anxious right and you're like what's going on here but really trying to differentiate like is there a true concern under this right and also is it something maybe the concern is something that is we've reached the other side of the spectrum right and maybe we need to start thinking about who we could pull in because this concern is is a little out there right so I'm just thinking about that and how we can just also normalize with parents like you're gonna have anxiety that's okay let's think about what the fear is or the concern is under it. 00:32:59.599 --> 00:33:12.079 If we start getting to fears and um concerns that are a little way past the spectrum then we can start thinking about what other things and people we can bring into this and making that more just a normal conversation. 00:33:12.319 --> 00:33:20.640 I think a key thing too with anxiety because we're framing it in the context of fear and it does present that way often but anxiety can also present as irritability. 00:33:20.799 --> 00:33:42.480 So can depression so when you're with a client or your partner or your friend whoever it might be and they're really irritable and angry and hard maybe harder to be around and maybe I'm talking about myself here but that's that is often a really major sign of that and and sometimes people present that way because they have a harder time being vulnerable and just saying I'm really scared right now. 00:33:42.559 --> 00:33:48.000 I'm really sad and they've had to learn to just kind of push people away with irritability or anger. 00:33:48.240 --> 00:33:56.960 And I think where this gets even trickier is for black and brown women where you have like the stereotype of angry black women or angry brown woman stereotypes, right? 00:33:57.039 --> 00:34:13.840 Which really like push people away from them and what that looks like in healthcare and medical care when a black woman presents to the hospital and they're showing their anxiety is irritability and they're being sent away is like oh she's just you know she's just difficult as opposed to she's really suffering right now. 00:34:13.920 --> 00:34:16.239 She's really hurting or they are really hurting. 00:34:16.480 --> 00:34:17.119 Yes. 00:34:17.519 --> 00:34:33.519 So one amen because I am definitely the irritable type when you said I was like I am definitely like my eyes are squinted I'm irritated I'm short tempered like get it done or get out of my way like that is for sure who I am and I'll also say too because Dr. 00:34:33.599 --> 00:34:53.599 Anna hinted to this a little bit when she said am I talking about myself yeah I remember when I first met Anna and she was like I'm not easy like basically she was like I'm not like I'm not I'm not the super I'm not gonna and I was like it's fine like we'll move through it you'll be angry and it'll be it'll be okay. 00:34:53.760 --> 00:35:02.719 You have an attitude I'll be right here like the reason I chose a black doula I mean I I sought out a black doula

because of that exact reason. 00:35:02.880 --> 00:35:15.199 I I knew if I had a white doula that she wasn't gonna be able to hang with it it was going to be like you know and so I was like I need someone in there advocating for me and you know and that is why I chose you. 00:35:16.480 --> 00:35:24.480 Well we we have some times there's some some specific times during our process that yeah it was we did our thing though it was good. 00:35:25.280 --> 00:35:42.960 So I want to kind of move a little bit off of Lindsay because right now Lindsay is uh like I'm like her friend right Lindsay but um she's in the process they are in the process of figuring what this next retrial is gonna be and I think it's gonna be very interesting. 00:35:43.039 --> 00:36:28.880 So my eyes are going to be very much on it especially when it comes to that husband and to that his new wife his new wife looked just like her very similar correct that lady looked just like her Mary I did not see this picture I've been like a side by side scary literally she looked just like this lady that's scary that's crazy and I was like he really tried see now I'm just gonna get into my conspiracy but I'm like he really tried to just like replace her like it just how I feel like it was just like let me just replace her and find someone that like looks just like her and then we and then we move along damn I'm trying to find I wish I could just that's how I do it. 00:36:29.119 --> 00:37:38.320 I'm gonna look it up after and see if yeah I'll put it I'll put it in your uh in the slack for you okay yeah so you could look at it hold on I'm gonna do it right now because we need your on screen reaction here we go hold up there we go with the picture okay I sent it okay go look mercy yeah girl copy and paste oh my god shut the front door I ain't shutting it girl it's open because that that is something's wrong okay something's wrong oh my god that's the whole thing okay but I want to open the conversation to just really start talking a little bit more generally um and I want to start with the fact that a lot of times when we're talking about doolacare specifically we're talking about filling gaps one of the gaps that we fill and I always say unfortunately because it's like we shouldn't have to um is a six week gap between someone having a child and being seen. 00:37:38.480 --> 00:37:45.199 So in between that time their child may be seen with them actually being seen is usually six weeks, right? 00:37:45.519 --> 00:38:28.159 In that six weeks there can be lactation issues there can be mental health issues there could be postpartum pre-eclampsia there can be all these things that like really frustrates me because it's like people especially like in our like in our current system we always do this emphasis on how duals are not medical professionals and I'm like and we aren't and we don't want to be and when you leave people there for six weeks without care I now have to say hey put this blood pressure cuff on because I want to make sure that you don't have postpartum eclipsia because you're saying you have a headache, you're normalizing it, but this could be something else. 00:38:28.400 --> 00:38:36.079 Right now I have to make sure that I'm there for for your lactation needs because it may not be an IBCLC in the area. 00:38:36.159 --> 00:38:53.679 I live rurally there's not a lot of IBCLCs I don't know if there's any IBCLCs where I live right like there's these things that we try to like catch as doulas that ideally wouldn't be our responsibility our responsibility because we don't want to be medical folks but there's this gap that is there. 00:38:53.840 --> 00:38:58.800 So one of the things I wrote about in my um blog was about that six week rule. 00:38:59.039 --> 00:39:05.280 And so what I learned is that it was an accounting rule because everything always gotta go back to money. 00:39:05.760 --> 00:39:24.079 So what I and I'll just read this um really quickly but a 15 minute appointment at six weeks exists because insurance companies build built a flat rate billing package that treats postpartum observation as a cost to minimize rather than as care to deliver. 00:39:24.719 --> 00:39:36.079 The American College of obstetricians and gynecologists ACOG suggests that postpartum parents be seen at three weeks and receive continuous personalized care at least by their 12th week. 00:39:36.559 --> 00:40:07.679 However, the financial system of health insurance penalizes clinics that provide care before six weeks therefore birthing people continue to begin receiving care at six weeks versus weeks sooner a time when we're able to catch things such as PMADs, infection, lactation issues and other complications because our healthcare system is fining providers for wanting to be proactive versus reactive what are our thoughts I mean that's just really crazy. 00:40:07.760 --> 00:40:08.320 Go ahead Dr. 00:40:08.400 --> 00:40:12.320 Anna that I just want to say that's really that's that yeah that's that's really crazy. 00:40:12.639 --> 00:40:39.840 Well I mean what you're speaking to is the absolute failure of our medical system in this country which I mean I mean I think that a lot of times our providers get villainized and sometimes for very good reason but honestly even some of the best of the best providers that I've ever known in all of my years and these people are truly miracle workers and wonderful they are burdened by a system that is not healthy. 00:40:40.000 --> 00:40:46.800 It is not a system that cares about the providers and their health and wellbeing it is not a system that cares about patients. 00:40:46.880 --> 00:41:15.199 It is especially not a system that cares about women's health and obviously those numbers look worse and worse for any other sort of marginalized folks right so it's all insurance it's all money it's all that that is the the purpose of all of this and and how these things even get decided how long an appointment can be,

when it can be scheduled right I mean none of this is done with evidence to support that it's in the best interest of the patient. 00:41:15.360 --> 00:41:25.199 So we have a very sick system and some people who have access to other resources that allow them to work around this system can fare better. 00:41:25.440 --> 00:41:31.360 But even for those of us with a lot of privilege it's still a system that just does not work. 00:41:31.519 --> 00:41:34.880 So you can imagine what these numbers look like for everybody else. 00:41:35.039 --> 00:41:52.400 It's abysmal and it really puts so much pressure on birth workers and doulas right um like how you said Savia like we we know these things right we know we have this intimate relationship and I know we'll talk more about that but we have this intimate relationship with the families that we're supporting. 00:41:53.280 --> 00:43:58.320 And so we're able we're in their houses right we're in their spaces and we're able to like recognize oh something feels off here right like we're paying attention to you know what is that interaction looking like with baby right we're in there for like multiple hours right like my first four spartan visit is at least three hours right because I I gotta have to kind of like there's a lot that we're figuring out did you eat do you do you need to shower right like you know there's always like oh look at my breasts are so engorged like what do I do right um that's a lot of pressure on on birth workers for us to be the ones who are you know able to recognize something some you know something is off and if we've had experience I have a doula right now I'm walking with she experienced something pretty intense with like her last family that she supported so now she's literally on the edge right I'm calling her I'm texting her like three three times a day and this was the conversation yesterday right and it's because she feels anxious like what if something goes wrong again in this specific family I'm supporting because she experienced it she saw what that looked you know what that looked like um yes absolutely absolutely I think we also get hypervigilant like we also right like we absorb that as much as we aim not to like in a perfect world we'd be like we could just leave it over here we can just drop it over here but it doesn't it doesn't land like that all the time um but I want to get back to so what you're saying Mary Nisi about um being in people's homes right like we're in their homes probably the only person that's in their home um and I also want to give a shout out to midwives who home birth midwives birth center midwives who are filling that six week gap but also are not being paid enough being you know like re cherished enough in all the ways um to continue doing that work in a sustainable way right and and then and the truth of the matter is not everyone's gonna have access to a home birth midwife or a birth center right so that's also the the matter is we're most in a

hospital or in a hospital like system. 00:43:59.119 --> 00:44:11.280 But I try To emphasize, like us being in their homes, I think like there's these um screening tools that we have that are built into the way that we practice. 00:44:11.519 --> 00:44:15.280 Um, like you said, looking and be like, how is the connection to baby? 00:44:15.360 --> 00:44:16.880 I've been in the house for three hours. 00:44:17.039 --> 00:44:18.559 What's the relationship here? 00:44:18.719 --> 00:44:20.880 Um, how messy is the house? 00:44:21.119 --> 00:44:26.639 Messy is good when we get to a certain level, we are like, hmm, there may be something else going on here, right? 00:44:26.800 --> 00:44:31.920 I'm looking at how's everyone eating, what's going on, what how is this person showing up? 00:44:32.079 --> 00:44:35.280 Like, there's like our own kind of assessment tools that we use. 00:44:35.360 --> 00:44:43.039 And there's also official assessments, like assessment tools, like the Edenberg post-natal depression scale is one. 00:44:43.280 --> 00:44:45.760 There's a few others that people utilize too. 00:44:45.920 --> 00:44:47.360 Um, and I would love, Dr. 00:44:47.519 --> 00:44:53.519 Anna, for you to speak on how we as per like we as dualists can utilize those things. 00:44:53.679 --> 00:44:56.400 Because a lot of times people are like, well, I can't use them. 00:44:56.480 --> 00:45:03.440 And I'm like, you can, but you want to head, you want to then move it where it needs to be moved. 00:45:03.599 --> 00:45:13.760 Because sometimes, honestly, our clients won't tell people how they are experiencing postpartum, they will only tell us. 00:45:14.000 --> 00:45:14.239 Right. 00:45:14.400 --> 00:45:14.639 Right. 00:45:14.719 --> 00:45:23.119 And that's like a big like weight to carry, but they're scared of like CPS, they're scared of all these other intersections that may happen. 00:45:23.280 --> 00:45:30.880 So yeah, I would love for you to talk about that, Doctor, and like what we can do, how we can work with someone like you to make something positive happen. 00:45:31.119 --> 00:45:36.000 Well, the Edinburgh is a fabulous, fabulous scale to utilize. 00:45:36.159 --> 00:45:38.880 It's it's got, I think it's 10 questions. 00:45:39.360 --> 00:45:47.519 If the person scores a 13 or higher, that is a definite referral to a psychologist or a psychiatrist or both. 00:45:47.679 --> 00:45:54.559 Um, if they endorse question 10, which is self-harm or harm to the baby, that is also an immediate referral. 00:45:54.639 --> 00:46:04.079 So even if they score under that 13, but they endorse that yes, they have thoughts of harming themselves or the baby, that is a sign that, okay, we need to get them to proper care. 00:46:04.239 --> 00:46:07.840 Um, so that's one way you can utilize that tool that's really, really helpful. 00:46:08.079 --> 00:46:29.360 The problem with self-report scales is that some people obviously don't answer them honestly because of fear, to your point, whether

it's, you know, fear of things like CPS, but also again, uh this this notion of motherhood in general is this glorified thing that you're just always supposed to be grateful and happy and loving every second, and it goes so fast. 00:46:29.440 --> 00:46:31.199 And and and that's true. 00:46:31.360 --> 00:46:44.480 I mean, the go so fast is true in some ways, but um, and you do miss certain stages, but it can feel really, really tricky to answer those questions honestly for a lot of people, right? 00:46:44.559 --> 00:46:46.800 They'd rather just kind of put their heads down and keep moving. 00:46:46.880 --> 00:46:53.519 So even in these self-report measures, you can't necessarily always assume that people are just completely answering them, honestly. 00:46:53.760 --> 00:47:03.039 So also that particular skill, I want to say, is assessing how the person felt within the last seven, five to seven days. 00:47:03.119 --> 00:47:04.079 I can't remember exactly. 00:47:04.159 --> 00:47:13.119 It's been a while since I've I've used the Edinburgh, but um so you also want to think about not just giving it once and then not giving it again. 00:47:13.199 --> 00:47:22.639 I mean, if you're gonna make it part of your work, then every time you see the person, especially, you know, a week later, make sure you're you're reassessing them to see where are they today? 00:47:22.800 --> 00:47:23.679 Are things getting better? 00:47:23.840 --> 00:47:24.960 Are things getting worse? 00:47:25.199 --> 00:47:30.400 And you know, you can kind of utilize it in that way to help inform next steps. 00:47:30.719 --> 00:47:36.000 And I think it's important to bring up that that timeline because things can change that quick. 00:47:36.880 --> 00:47:51.519 Like, right, Mary, we've been in houses where the initial time that we, you know, meet with this person, everything is great, everything is, you know, three days later, we could be in a completely different spot. 00:47:52.000 --> 00:48:04.000 Like, completely we have are we are all the way on the other side of the spectrum for whatever reason, whether it's lack of sleep, a trigger, or whatever the case may be, but like we are somewhere else. 00:48:04.239 --> 00:48:08.960 So I think it's important to like name, like it could really happen that quickly. 00:48:09.119 --> 00:48:12.159 Because people always think, like, oh, it's a slow, so people think it's a slow burn. 00:48:12.239 --> 00:48:14.159 It's like it's not always a slow burn, babe. 00:48:14.320 --> 00:48:16.320 Tomorrow we could be in a different space. 00:48:16.559 --> 00:48:16.960 Yes. 00:48:17.119 --> 00:48:23.599 Especially with things like postpartum psychosis, and you know, that's gonna be a more rapid onset. 00:48:23.679 --> 00:48:24.880 And that's also a sign. 00:48:24.960 --> 00:48:30.000 If you notice the person was really okay a few days ago and suddenly they're not, that's a red flag. 00:48:30.159 --> 00:48:35.199 Um, whereas some of these other things might have a

bit more of a gradual um presentation to them. 00:48:35.519 --> 00:48:36.480 For sure. 00:48:36.800 --> 00:48:54.639 So, one thing I also want to emphasize before I want to talk about something that Marinese brought up, but I also want to like emphasize this part around what is the role that we play when someone is showing extreme signs of something's wrong. 00:48:54.880 --> 00:49:06.639 And the thing that I'll say, and I'm speaking for myself, the thing that I have a hard time with is whether someone has postpartum psychosis or other things are happening with them, but they're in an extreme kind of space. 00:49:07.119 --> 00:49:10.559 And then we hear a story, you know, on the news about what happened. 00:49:10.800 --> 00:49:27.119 One thing that bothers me is like people will say, Well, yeah, they were saying something about um like some religious kind of psychosis thing, but we just, you know, we just kind of like let it go, or they did show up this way, and it really was like really weird and problematic. 00:49:27.280 --> 00:49:52.960 And we, but we they came in the house screaming and yelling, but we just and I'm like, no, I'm looking like I'm like, please stop, like, and I know like it's hard to call in people when they're not well, it's hard to be that person, but like sometimes I I think like what if that someone was just that person that said, hey, like, oh, so you think you're God now? 00:49:53.119 --> 00:49:53.760 Okay, cool. 00:49:53.920 --> 00:49:55.760 Let's um go see about that. 00:49:56.559 --> 00:49:57.599 Like, right? 00:49:57.840 --> 00:50:06.880 Like, it like it, it just like I know that it's awkward, I know that it's uncomfortable, but like that's how we have to care for each other, right? 00:50:06.960 --> 00:50:12.559 Like if Mary Nisi calls me tomorrow and says, I think I'm God, I'm calling Mary Nisi's husband. 00:50:12.639 --> 00:50:14.000 I'm reaching out. 00:50:14.400 --> 00:50:24.079 Like, like, like I'm doing something to be like, hey, like this doesn't seem within Mary Nisi's character, you know, but like, like, what do we like? 00:50:24.239 --> 00:50:30.960 We we have to be committed to doing that work as community members because only we can do that. 00:50:31.199 --> 00:50:39.519 By the time someone else interferes or interjects or becomes a part of that story, it's usually gonna be in a negative way. 00:50:39.679 --> 00:50:45.599 It's usually gonna be, you know, in some like level of incarceral way, right? 00:50:46.000 --> 00:51:03.280 And like, I don't know, I just wanted to emphasize this piece around like we have to do that community work because if we can step in earlier too, before we get to a Lindsay Clinty or before we get to these kind of cases, like how much better we can be in community with each other. 00:51:03.519 --> 00:51:04.079 Yeah, yeah. 00:51:04.239 --> 00:51:06.480 And you know, for birth workers, right? 00:51:06.559 --> 00:51:12.800 Like we talk about Postpartum being kind of like something that

we actually like plan in pregnancy, right? 00:51:12.960 --> 00:51:18.159 Um, and so for us, even just having, you know, hey, do you have my partner's number, right? 00:51:18.239 --> 00:51:20.079 Do you have my best friend's number, right? 00:51:20.159 --> 00:51:24.000 Like as you know, birth workers, like having those contacts of like who's your village? 00:51:24.079 --> 00:51:25.119 Who are your people? 00:51:25.440 --> 00:51:29.280 And having that information ahead of time goes a really long way, right? 00:51:29.360 --> 00:51:31.519 Because we know that like we don't live in silos, right? 00:51:31.599 --> 00:51:35.760 Even in pregnancy and birthing and after, like, who are your people? 00:51:36.000 --> 00:51:41.119 I had uh, I know COVID, you know, during pandemic, you know, people were not really connected to folks, right? 00:51:41.280 --> 00:51:44.559 And so I remember like thinking through like, well, how how else can we do this? 00:51:44.639 --> 00:51:46.159 Is there someone that you FaceTime with? 00:51:46.559 --> 00:51:51.440 Like maybe they're you know, they can't come, but like maybe they live like in another state, but that's like your person, right? 00:51:51.519 --> 00:51:55.519 Because we all have like our people that don't maybe like live in our vicinity, right? 00:51:55.599 --> 00:52:06.960 So getting really creative in what that support, you know, looks like for somebody because we know that people don't always have, you know, people that's you know, that can support them, and really getting creep you know, creative, right? 00:52:07.039 --> 00:52:10.159 Is there is there some like maybe groups that are going on? 00:52:10.239 --> 00:52:17.440 Maybe that's online that maybe you don't have access to transportation or you are bleeding and you don't want to walk out of your house. 00:52:17.760 --> 00:52:27.920 Well, is there other folks like around you, maybe some places that we can join to be able to be connected that can become your support system that like as a birth worker, some coming in to support you in your postpartum? 00:52:28.000 --> 00:52:30.960 I'm like, I know I'm not your only person because I can't be right. 00:52:31.039 --> 00:52:33.519 I can't be your only you know support person. 00:52:33.599 --> 00:52:41.440 But yeah, identifying those groups, those people, having their contacts ahead of time, that goes a really long way. 00:52:41.519 --> 00:52:45.440 Because when someone is going through it, you're not like, hey, what's your mom's number again? 00:52:46.719 --> 00:52:47.119 Right? 00:52:47.280 --> 00:52:49.679 Like that, you know, it doesn't it doesn't work that way. 00:52:49.760 --> 00:52:54.000 Yeah, so helping in planning ahead of time really does go a long way as well. 00:52:54.239 --> 00:52:55.440 But also sharing that, right? 00:52:55.519 --> 00:52:56.960 So you just said your mom's number. 00:52:57.039 --> 00:53:02.079 So if you if you state that from the get-go of working with someone, hey, here's my plan. 00:53:02.400 --> 00:53:07.360 Very rarely, but on occasion, people do develop these symptoms and they're an emergency. 00:53:07.599 --> 00:53:09.440 So what plan should we create? 00:53:09.599 --> 00:53:12.239 Who are some contacts I can call? 00:53:12.400 --> 00:53:14.960 Um, is your partner a safe person to speak with? 00:53:15.039 --> 00:53:21.119 Or do you have a sibling or a parent or right, a provider that you trust that I can call? 00:53:21.360 --> 00:53:31.440 Because yeah, there's a there's a reality here that as, you know, particularly when you're working with black or brown communities, you don't want to call the police, right? 00:53:31.599 --> 00:53:38.239 Uh that can create a bigger emergency and that could create the death of the mother or others, right, in the home. 00:53:38.400 --> 00:53:40.239 So that is a real problem. 00:53:40.880 --> 00:53:45.760 And we have to find creative ways to work around that and see who else is available in the community. 00:53:45.920 --> 00:53:50.239 Of course, this gets trickier when you're talking about rural communities, to Sabia's point, right? 00:53:50.400 --> 00:53:56.079 Living sometimes that is your only option, in which case, how do you want to navigate that phone call, right? 00:53:56.239 --> 00:54:00.960 And and having a plan in place of how you would do that if that's your last resort. 00:54:01.280 --> 00:54:14.960 Um, but I think if you talk about it in advance with the person when it comes time to that, it can be really helpful to actually implement that strategy because you've already discussed it with the person and their family. 00:54:15.199 --> 00:54:15.440 Yeah. 00:54:15.599 --> 00:54:18.159 One of the things that I forgot, oh my gosh, who was I with? 00:54:18.320 --> 00:54:20.159 Because I'd like to give people credit. 00:54:20.400 --> 00:54:22.079 Oh my God, I can't remember who it is. 00:54:22.239 --> 00:54:23.039 I'm sorry. 00:54:23.280 --> 00:54:30.559 But we were talking about like in those times when you have to call CPS or you have it was with from Elephant Circle. 00:54:30.719 --> 00:54:31.360 There we go. 00:54:31.440 --> 00:54:33.440 Hey Wit, hey girl. 00:54:33.679 --> 00:54:41.679 Um, but they were talking about like when they do have to call CPS, they call with the person right next to them. 00:54:42.079 --> 00:54:42.400 Right? 00:54:42.559 --> 00:54:51.199 Like, because if even calling, like calling CPS or calling police or calling whoever needs to be called, that in itself, when I've been in those circumstances, right? 00:54:51.599 --> 00:54:59.920 When that person is not involved, automatically whoever it is the police, CPS are coming, thinking that it's if it's them versus that person, right? 00:55:00.159 --> 00:55:11.280 And to at least have that person next to you, if this is something that y'all have chosen to do and they are informed about it, it does give a little bit more of a sentiment as like this person is going along with this, they understand the need for

it. 00:55:11.440 --> 00:55:17.599 And maybe there can be not so much, you know, like defensiveness coming into the space. 00:55:17.840 --> 00:55:39.199 Um, other things too that I try to promote um in Marinese as well, is when you're working with a client who is a birthing person who's about to, you know, have a baby, even if they've never been in like a therapy kind of space before, establishing care there before they have their baby, right? 00:55:39.360 --> 00:55:41.039 And I say that for two reasons. 00:55:41.360 --> 00:55:47.679 One, the US, especially in our healthcare system, is super like backlogged and backdated, right? 00:55:48.400 --> 00:55:57.199 So I would I would hate for my clients to be moving through something where a therapist would be a great option, but we now have to find one. 00:55:57.360 --> 00:56:00.400 And we got to find one that's available pretty soon. 00:56:00.559 --> 00:56:05.920 And now because we're doing that, we can't get into the specifics about what they may want in a therapist, right? 00:56:06.000 --> 00:56:11.920 So if we could do that beforehand, establish some care, maybe do one to two sessions just to like touch base. 00:56:12.400 --> 00:56:15.840 This is what I'm thinking, this is what I'm feeling, maybe help them plan some things. 00:56:15.920 --> 00:56:23.679 Maybe if they do have some mental health disorders, talk about what that may look like, medication, like do all those things as a preparation. 00:56:24.000 --> 00:56:31.679 And so that when they're in their postpartum time, if it's something that they need, there's quicker access to it because we're already established. 00:56:31.840 --> 00:56:46.559 And also, even if it's not a quote unquote need, like it doesn't have to be quote unquote, there's an emergency happening, but oh, this is a good maintenance for me to be able to talk to someone twice, you know, once a week about what's happening with me, so on and so forth, it's already available, right? 00:56:46.719 --> 00:56:58.079 And so I really promote like that as like postpartum plan while the person is still pregnant and plan for plan for what supports would be needed if anything was to happen. 00:56:58.320 --> 00:57:02.559 And if we don't need that, great, right? 00:57:02.880 --> 00:57:11.519 But I think like the worst thing is, and we've all been in this position where you're trying to figure out all these pieces in the midst of an emergency, right? 00:57:11.679 --> 00:57:22.639 And now they're being placed with providers that they don't relate to, don't feel comfortable with, and you're like, uh, is this helping or is it not? 00:57:22.719 --> 00:57:24.079 I'm not really too sure, right? 00:57:24.159 --> 00:57:25.679 Like, someone say that. 00:57:26.000 --> 00:57:28.880 Anyone else have any pointers about yeah? 00:57:29.199 --> 00:57:30.320 Well, a couple of things. 00:57:30.559 --> 00:57:34.719 So one one thing is just thinking about the birth of my son. 00:57:35.039 --> 00:57:37.920 You know,

obviously this was in the midst of the pandemic. 00:57:38.239 --> 00:57:44.239 So a lot of those are just those wild things that happen, but they do happen. 00:57:44.320 --> 00:57:50.400 And I feel like the world is getting seemingly just worse and worse and scarier and scarier in so many ways. 00:57:50.480 --> 00:57:53.280 And so there is an unpredictability to things. 00:57:53.440 --> 00:58:02.480 So some things you just can't plan for, but at least having some level of a safety plan with your the people that you're working with, I think is extremely helpful. 00:58:02.800 --> 00:58:27.360 As birth workers andor therapists listening or other people that that support um, you know, new parents, one thing just to be mindful of is if if worse comes to worse and it does involve authorities of some sort or hospitalization, um, one thing to prepare for as the worker, as the provider, is that that person may cut off contact with you after that has happened. 00:58:27.440 --> 00:58:38.639 And even in the case where you called with them present and you walked them through it and you did it with all the love and gentleness in the world, you could still be hearing later, you ruined my life and you're the worst, right? 00:58:38.719 --> 00:58:43.360 And and these things happen and it's so dysregulating. 00:58:43.440 --> 00:58:45.360 That's why some of these cases stay with us, right? 00:58:45.440 --> 00:58:47.360 Because you wonder, like, could I have done something different? 00:58:47.519 --> 00:58:48.800 Should I have made that call? 00:58:48.960 --> 00:58:50.719 You know, did I make things worse? 00:58:50.880 --> 00:58:58.960 And with the systems in place, sometimes it maybe does make it worse in some ways, but perhaps you also saved the life of the baby or them or the parent. 00:58:59.199 --> 00:59:08.480 So I think just preparing that even if you do things in like the quote unquote right way or the best way, you might also still lose that relationship. 00:59:08.559 --> 00:59:13.280 And that is really deeply painful and hard to sit with, but it is a reality of this work. 00:59:13.360 --> 00:59:24.239 I think, regardless of where you sit from a multiple sorry, multidisciplinary perspective, whether you're a birth worker or a psychologist or, you know, an OBGYN in this. 00:59:24.480 --> 00:59:24.719 Yeah. 00:59:24.960 --> 00:59:26.960 Thank you so much, like for naming that. 00:59:27.119 --> 00:59:28.639 That is so important, right? 00:59:28.719 --> 00:59:34.000 As birth workers or as people who do this work, we, you know, we come into this work because we care, right? 00:59:34.159 --> 00:59:36.400 Like we care so deeply, right? 00:59:36.559 --> 00:59:40.079 We remember each and every person we've ever supported, right? 00:59:40.320 --> 00:59:44.880 Um, and it can be, yeah, it can be really difficult to think about that. 00:59:45.039 --> 00:59:47.280 If I do this, this person might cut me off. 00:59:47.360 --> 00:59:50.239 And I'm very much connected to this

person now, right? 00:59:50.320 --> 00:59:56.880 And almost like really needing to remember like why we're doing what we're doing, and then also get support for ourselves, right? 00:59:56.960 --> 00:59:58.960 Like, I think as birth workers, that's also like our job. 00:59:59.039 --> 01:00:03.119 Like, that's my responsibility to have like doulas I can go back to, right? 01:00:03.199 --> 01:00:05.199 I can, you know, say this is what's going on over here. 01:00:05.280 --> 01:00:11.760 Like, have care for myself, knowing that like there is this aspect where I can be cut off from a family that I've supported. 01:00:11.920 --> 01:00:14.320 This might be the second time, you know, this might be the second baby. 01:00:14.400 --> 01:00:16.000 Like, I know where you live, right? 01:00:16.159 --> 01:00:18.880 We we got selfies on IG together, right? 01:00:19.039 --> 01:00:20.719 Like, that's real, right? 01:00:20.960 --> 01:00:23.199 Um, yeah, thank you so much for for naming that. 01:00:23.360 --> 01:00:24.159 Yeah, of course. 01:00:24.400 --> 01:00:24.719 For sure. 01:00:24.880 --> 01:00:39.679 And I think too, like, I know for myself, like I started off dual work with incarcerated people, formerly incarcerated people, people who are actively using, people who are in recovery, and Mary Nisi currently is doing very similar work. 01:00:39.920 --> 01:00:49.840 And when you're working with certain populations, it's like you have these big wins and these big highs, and you have some low lows. 01:00:51.519 --> 01:01:02.320 Some low lows, and like even talking about like we can aim to do the best that we can do, even if we have to include CPS or all of that. 01:01:02.400 --> 01:01:06.559 And I've also been in situations where it was an emergency and I had to call 911. 01:01:06.639 --> 01:01:13.280 Like, there was no, how can I make this more like not so like activated? 01:01:13.360 --> 01:01:15.840 It was like, there are kids in danger. 01:01:16.079 --> 01:01:18.239 I have to call who I have to call. 01:01:18.480 --> 01:01:20.719 Um, and I don't want to call. 01:01:20.960 --> 01:01:24.079 Like, let me be clear, I don't want to, right? 01:01:24.239 --> 01:01:31.679 But like I have to, because this is way out of my scope, and this is just, we have just reached the maximum of where we can go. 01:01:32.000 --> 01:01:33.760 Um, and it hurts. 01:01:33.840 --> 01:01:35.599 I remember that like that particular time. 01:01:35.760 --> 01:01:43.360 I remember like we got the situation somewhat, you know, de-escalated, everything, kids got taken care of, parent where it went where she had to go. 01:01:43.679 --> 01:01:48.079 And I was, I was drained for two days. 01:01:48.320 --> 01:01:51.519 Like I did not barely leave my room for two days. 01:01:51.760 --> 01:02:03.440 And it wasn't just the physical tiredness, it was the emotional, the mental, like like exhaustion that was like, what just happened? 01:02:03.679 --> 01:02:03.920 Right? 01:02:04.079 --> 01:02:06.880 Because when we talk about like, it could flip like this. 01:02:07.039 --> 01:02:08.880 Like literally that morning, we were cool. 01:02:08.960 --> 01:02:10.559 I was helping her clean up the house. 01:02:10.719 --> 01:02:11.760 I was doing this. 01:02:12.079 --> 01:02:13.039 I left. 01:02:13.679 --> 01:02:15.119 Hours later, her family called me. 01:02:15.199 --> 01:02:16.880 Like, she's saying this, can you get some her? 01:02:16.960 --> 01:02:18.800 You're the quickest one, right? 01:02:18.960 --> 01:02:25.599 And so it went from totally good morning to I'm having to call the police, not even two hours later. 01:02:25.840 --> 01:02:30.400 And so just wanted to name like how that hurts. 01:02:31.760 --> 01:02:48.639 And also, like, we would love to say, well, I would love to say as a as a birth worker, the trauma, you leave it at the door and you let it go, and you move along and you go see your other clients and you feel so empowered and whatever. 01:02:48.960 --> 01:02:53.679 But you know, you find yourself with the next client still in thought about the last one, right? 01:02:53.840 --> 01:02:56.800 You find yourself thinking, like, is this the work I need to be doing? 01:02:56.960 --> 01:02:58.480 Like, is this too much? 01:02:58.559 --> 01:03:03.039 I don't think I signed up for this part, but it's like you don't get to pick which part you sign up for. 01:03:03.920 --> 01:03:20.000 Like, if you're gonna sign up to help birthing people, whether it's in a the the level of being a psychologist, a therapist, uh, a this, a that, you don't get to just sign up for one teensy piece of it, the fun part, and not be there for the other pieces, right? 01:03:20.159 --> 01:03:22.000 And so you do carry it. 01:03:22.559 --> 01:03:27.920 Like, I will never say, like, I just dropped it all, I compartmentalized and it was great. 01:03:28.000 --> 01:03:30.079 It's like, no, I do carry it, right? 01:03:30.239 --> 01:03:36.000 And I do have times where if I'm interacting with other people, I'm like, is that a is that whoa, is that a sign of this? 01:03:36.159 --> 01:03:38.559 We will this this happened to me last time, right? 01:03:38.639 --> 01:03:41.119 Like, and so I have practices around it. 01:03:41.199 --> 01:03:43.280 Obviously, I go to therapy, okay. 01:03:43.519 --> 01:03:48.480 Um, but you know, I have my spiritual practices, I I do what I can, right? 01:03:48.559 --> 01:03:50.880 I also try to be really aware of my capacity. 01:03:50.960 --> 01:03:56.480 Um, and I also try to be really aware of like who am I great fit for, right? 01:03:56.639 --> 01:04:02.159 And I think how you measure that too, like if shit hit the fan, would I still be a good support for them? 01:04:02.480 --> 01:04:02.880 Right? 01:04:02.960 --> 01:04:04.960 Like, am I am I equipped? 01:04:05.199 --> 01:04:06.559 And I think that goes in and out. 01:04:06.639 --> 01:04:11.440 Sometimes you're like, I'm equipped, and other times you're like, I don't need to be taking no clients

right now. 01:04:11.840 --> 01:04:14.719 I'm not well, right? 01:04:15.039 --> 01:04:25.280 So I would just love to hear from y'all like how y'all are handling that part of the truth is we are going to absorb the work as we care about it, but also how do we move forward? 01:04:25.840 --> 01:04:43.519 I think too, there's there's the collect, so bringing it back to Lindsay Clancy or just some of these cases that make it into into kind of the mainstream media, uh, there's a collective trauma, I think, that happens here where people now have a strong sensitivity to working with new parents, right? 01:04:43.679 --> 01:05:08.320 So I've and I've seen this in some of my colleagues, where there's either this strong desire to take on a similar case and be excited about tackling it and they're not equipped to do that, or people that are equipped to do this, but they're being hyper-vigilant to the point of actually ruining rapport with their patient, because maybe they're working with a patient who has a history of bipolar disorder and they're pregnant for the first time. 01:05:08.400 --> 01:05:11.519 And now that's all that that provider can think about and talk about. 01:05:11.760 --> 01:05:37.039 So it's not quite answering your question, but as you were talking, I was just thinking about how these kinds of things, whether it's working with a previous patient where you just had this kind of trauma, and then how it can impact the way you show up in your work, maybe more armed with knowledge, maybe more thoughtful, but also possibly impacting rapport because maybe you're being a little paranoid, or now you're you're really sensitive, or you were quite traumatized by your previous experience. 01:05:37.119 --> 01:05:46.719 So you're going a little overboard in how you're managing this in another patient that is maybe better resourced or more um self aware, or whatever the case. 01:05:46.800 --> 01:05:48.639 So I don't think I really answered your question. 01:05:48.800 --> 01:05:51.760 I apologize for that, but I just wanted to comment on this. 01:05:52.239 --> 01:05:53.280 No, you brought up a point. 01:05:53.599 --> 01:05:59.599 I mean, we could have another whole conversation about this, but there are, and I would love Mary Nisi's thoughts on this too, like there. 01:06:00.159 --> 01:06:03.679 Are times where I like as a doula like teacher, right? 01:06:03.840 --> 01:06:09.039 I get to see different perspectives of why people do this work all the time. 01:06:09.360 --> 01:06:18.000 And sometimes it's based off of their traumatic event, and then they find themselves seeking out people with a very similar traumatic event, similar pattern. 01:06:18.239 --> 01:06:27.679 Um, or they have experienced a client who had a very traumatic event, and they find themselves seeking out that traumatic event as like their thing. 01:06:27.920 --> 01:06:30.400 And sometimes I'm like, it could be your thing. 01:06:30.559 --> 01:06:31.519 Sometimes I think it is. 01:06:31.599 --> 01:06:36.800 I'm like, oh, you found the thing that you are equipped to be to be doing, right? 01:06:36.880 --> 01:06:47.519 And then sometimes I'm like, I think, I'm like, I think you're trying to heal through this, but I think you actually need to get away from it, right? 01:06:47.679 --> 01:07:00.159 And I think like that's the work that we have to do internally, and we have to be open to hearing our peers say, I think you're kind of retraumatizing yourself every time you step into this. 01:07:00.320 --> 01:07:02.159 So maybe you need to back away. 01:07:02.400 --> 01:07:02.639 Right. 01:07:02.800 --> 01:07:11.679 So I really love that point that you said, because I think there's so many of us that find ourselves running into the pain, and we don't need to be doing that. 01:07:12.559 --> 01:07:13.360 Quite simply. 01:07:13.599 --> 01:07:14.400 But Mary Nisi. 01:07:14.800 --> 01:07:16.719 No, all of that, literally all of that. 01:07:16.800 --> 01:07:19.280 And I'm so glad you named that as, you know, as well. 01:07:19.440 --> 01:07:26.159 Like, um, I mean, I think the way I'm kind of, you know, walking into the space, you know, I'm in, I'm in therapy as well. 01:07:26.320 --> 01:07:30.159 Sometimes like Drew calls me out because he'll be like, when's the last time you are? 01:07:30.480 --> 01:07:30.719 Like, what? 01:07:30.880 --> 01:07:33.599 Because you keep saying it's not like, oh, wait, okay, hold up. 01:07:33.679 --> 01:07:34.559 It's been a few months. 01:07:34.639 --> 01:07:37.599 Um, but but just you know, I journal a lot because it's so important. 01:07:37.679 --> 01:07:46.880 Like I've learned that it's really important that whatever that I'm thinking or whatever that was really did affect me in, you know, supporting a family, even if I just did postpartum care, right? 01:07:47.199 --> 01:07:51.840 Like putting it somewhere, because I know that it's gonna, you know, take me to the next person I support. 01:07:51.920 --> 01:07:56.480 Like, you know, thankfully I've been doing this work longer to be able to like learn the pattern, right? 01:07:56.559 --> 01:08:02.559 I can tell when I'm very hyper-vigilant about something because I'm like, ooh, okay, this is going back to the to this thing, right? 01:08:02.639 --> 01:08:11.039 Um, because you know, when you've just seen so much, it's so hard to move in a way that is not hyper-vigilant, right? 01:08:11.280 --> 01:08:12.960 Um, because you've seen it happen, right? 01:08:13.039 --> 01:08:15.280 Like your anxiety has actually happened. 01:08:15.440 --> 01:08:22.319 Um, and how are you then going to trust that it's not going to happen to the next person or to the next family that you know that you support? 01:08:22.800 --> 01:08:28.720 You know, similar to you, say we're like walking alongside doulas, you know, I do like monthly supervisions with doula's. 01:08:28.800 --> 01:08:39.039 And so we're sitting down and I'm able to actually notice it a bit more, uh, which I

love being in this position to be able to like support doula's because I don't know that I had that when I was like starting off. 01:08:39.199 --> 01:08:43.199 So I love being able to notice it in a doula and kind of like naming it. 01:08:43.359 --> 01:08:51.359 Um, you know, yesterday was that I think I shared a little bit of what was happening with this doula who was supporting this was part of, you know, family. 01:08:51.600 --> 01:08:55.039 But she just experienced something really intense in September with one of her families. 01:08:55.199 --> 01:08:56.319 And I know it, right? 01:08:56.399 --> 01:08:57.279 Like I'm aware of it. 01:08:57.359 --> 01:09:04.079 And so as she's talking, she's like, yeah, I literally like, you know, I'm texting her every day, like three times a day, FaceTiming, just making sure that everything is okay, right? 01:09:04.239 --> 01:09:08.560 So she's talking like even the way she's telling me this story, it's very fast, right? 01:09:08.800 --> 01:09:12.159 Like she's very hyper-vigilant, even in our supervision, right? 01:09:12.319 --> 01:09:17.600 So being able to kind of like sit for a little bit and and you know, get, you know, deep breath. 01:09:17.920 --> 01:09:19.520 Like, what do you what are you noticing? 01:09:19.920 --> 01:09:21.520 What do you think is happening here, right? 01:09:21.600 --> 01:09:23.920 And I'm so grateful that again, I get to be able to do that. 01:09:24.000 --> 01:09:26.239 And like, hey, do you think there maybe there's like some triggers here? 01:09:26.319 --> 01:09:27.680 Is there some some fears? 01:09:27.760 --> 01:09:29.359 Like, what what does this look like? 01:09:29.520 --> 01:09:31.520 Um, can we do that differently? 01:09:31.680 --> 01:09:36.560 And you know, the advantage of this work is that we can be, do we need to transfer this person to another doula, right? 01:09:36.880 --> 01:09:43.199 Uh, which we have done, which we have done again, not every birth worker is in that position where they can transfer somebody. 01:09:43.359 --> 01:09:47.439 Not everybody works like in an organ in an organized kind of like doula program, right? 01:09:47.520 --> 01:09:48.800 So there's limitations there. 01:09:48.960 --> 01:09:53.520 But I think being able to uh find find folks who can speak into you, right? 01:09:53.680 --> 01:09:58.880 It might not be in a program, but find people who can say, you know, is there something else going on here? 01:09:59.039 --> 01:10:00.560 Um how are you taking care of yourself? 01:10:00.720 --> 01:10:04.560 You know, like I want everybody to be in therapy, and I realize like that might not be true. 01:10:04.720 --> 01:10:07.359 But like what are your spirit, what are your spiritual practices? 01:10:07.439 --> 01:10:09.760 Like, how are ways do you you know you care for yourself? 01:10:09.920 --> 01:10:15.359 Um, what are those ways so that you can actually be, you can support families well, right? 01:10:15.520 --> 01:10:19.279 Because when we come in with our own stuff, we're actually like not, we can't support folks well. 01:10:19.439 --> 01:10:19.680 Yeah. 01:10:19.920 --> 01:10:22.000 Yeah, that's go ahead, Anna. 01:10:22.239 --> 01:10:41.600 No, just thinking about the partners too here, because where where people have a partner and that's an option, that they also are getting support and having a place to go to, because sometimes that person, the actual, you know, uh postpartum parent might not um be in care or be speaking honestly to their provider. 01:10:41.680 --> 01:10:53.199 But if the partner is there, then their therapist or whoever they're speaking to might be able to red flag things and say, hey, that's sounding like maybe your partner's experiencing something that requires a little extra support. 01:10:53.359 --> 01:10:57.600 So it's just another part of the safety planning, I think, that can be helpful. 01:10:57.840 --> 01:11:03.680 Yeah, I definitely have had experiences with partners who, like in the beginning, didn't. 01:11:03.840 --> 01:11:11.279 I think a lot of times, obviously when the doula comes into the space, or the partner's like, okay, you're here for, you know, the birthing person, you're not here for me. 01:11:11.520 --> 01:11:21.520 Um, and there's also been a lot of times where after some time and some comfort has been built, the partner is like, Can I talk to you about XYZ? 01:11:21.600 --> 01:11:23.359 And I'm like, Yeah. 01:11:23.680 --> 01:11:26.399 Like, I'm like, I'm like, please tell me, right? 01:11:26.479 --> 01:11:27.840 I would love to hear your perspective. 01:11:28.000 --> 01:11:29.359 I would love to hear what's going on. 01:11:29.520 --> 01:11:41.279 And to be honest, like talking to the partner has both revealed where the birthing person is needing support, where the partner is needing support, and it's revealed abuse, right? 01:11:41.439 --> 01:11:46.239 Where I'm like talking to the birthing partner, and I'm like, oh, you're being abused here. 01:11:46.880 --> 01:11:47.199 Right. 01:11:47.279 --> 01:11:50.000 And I'm like, and you don't even know it, right? 01:11:50.159 --> 01:12:02.800 And so then I may get into like where they could be resourced and where they could go to talk to someone because it's not also the time for me to be like, this sounds like DV or this sounds, right? 01:12:02.960 --> 01:12:11.039 It's like I have to like, you know, also do this in a very intentional way because I don't want to rock the boat too quick on what's happening, right? 01:12:11.199 --> 01:12:13.359 So it's work, y'all. 01:12:14.239 --> 01:12:21.199 Like this work that we love to do, this work that calls to our soul, right? 01:12:21.279 --> 01:12:25.760 Sometimes I don't know about y'all, but sometimes I'm like, why can't I have a different soul calling? 01:12:25.920 --> 01:12:32.239 You know, a little, maybe a little something easier, a little something, you know, lighter, you know. 01:12:32.560 --> 01:12:34.399 Um, but that's just not the case.

01:12:34.560 --> 01:12:39.039 I feel like knowing both of you personally too, it's like y'all are not surface people. 01:12:39.119 --> 01:12:40.720 Like y'all have to go deep. 01:12:40.960 --> 01:12:45.439 So it's like we we we are where we are, so we might as well embrace it, right? 01:12:45.760 --> 01:12:50.880 So we have talked about many things today, and I'm really, really excited. 01:12:51.039 --> 01:12:53.359 I hope that people really have enjoyed our conversation. 01:12:53.520 --> 01:13:13.760 Um, we've talked about the Lindsey Clancy case, we've talked about postpartum mood disorders, we've talked about trauma for ourselves and our clients, we've talked about the intersectionalities of black and brown folks, we've talked about CPS, we talked about um six-week checks and why that's not enough in our broken system. 01:13:14.239 --> 01:13:17.039 We have talked about many, many things. 01:13:17.279 --> 01:13:24.319 However, before we go, I would love to hear one, how people can reach you. 01:13:24.640 --> 01:13:30.399 Two, one thing you would like people to know before we leave the space today. 01:13:30.640 --> 01:13:32.960 I will start with Marinese. 01:13:33.279 --> 01:13:36.159 I'll start with where you can find me because I know that part. 01:13:37.039 --> 01:13:42.720 Uh, so you can find me, you know, on social media on all platforms at Positive Birth Corner. 01:13:43.279 --> 01:13:48.319 And yes, positive yeah, we're everywhere, like YouTube, everywhere. 01:13:48.720 --> 01:13:51.520 Also, say a little thing about positive birth corner, what you do there. 01:13:51.760 --> 01:13:52.079 Yes. 01:13:52.239 --> 01:13:59.359 Okay, so positive birth corner is this corner that gets to highlight like positive birth experiences. 01:13:59.680 --> 01:14:16.640 And, you know, with you know, similar to what we were talking about today, you know, it has really just been so important that, you know, we highlight like it's yeah, we highlight kind of like this, like positive stories and experiences, um, especially from you know, black and brown folks, right, that are experiencing like this good things, right? 01:14:16.720 --> 01:14:20.880 It's this way of bringing hope back to this, you know, back to this work, right? 01:14:20.960 --> 01:14:22.159 Um, we know all of the stories. 01:14:22.239 --> 01:14:26.960 We know all of the the trauma and the heartache and um what folks are experiencing. 01:14:27.039 --> 01:14:29.119 And it's like we deserve joy too, right? 01:14:29.199 --> 01:14:30.640 And and where is that, right? 01:14:30.720 --> 01:14:37.119 And so you do have folks who are like, hey, over here, I I had I was in a hospital and I had a, you know, I had a positive birth. 01:14:37.199 --> 01:14:39.439 And let me tell you how it ended up being positive, right? 01:14:39.520 --> 01:14:40.159 Like what happened. 01:14:40.239 --> 01:14:42.159 So it's also a place to learn, right? 01:14:42.319 --> 01:14:45.359 How to really create because we have to create, like we have to make our own. 01:14:45.520 --> 01:14:47.039 Almost like nobody's coming to save us. 01:14:47.119 --> 01:14:48.960 So we we have to do this. 01:14:49.119 --> 01:14:52.399 Um, so yeah, so that's possible, you know, that's positive birth corner. 01:14:52.479 --> 01:14:54.239 Um, yeah, that's positive birth corner. 01:14:54.319 --> 01:14:54.720 What do I want? 01:14:54.960 --> 01:14:55.760 What's what's the last question? 01:14:55.840 --> 01:14:56.479 Like, what do I want to do? 01:14:56.640 --> 01:14:57.680 Yeah, what do you want people to know? 01:14:57.760 --> 01:15:03.520 It could be related to this topic, it could be whatever is pulling on your heart, you know? 01:15:04.399 --> 01:15:04.880 Yeah. 01:15:05.119 --> 01:15:12.560 So this word hope has been like my, I think this year, even last year, I it keeps like tagging, tagging on me. 01:15:12.720 --> 01:15:15.279 Um, that like in the midst of what we know, right? 01:15:15.439 --> 01:15:19.920 Especially just this conversation that we had, like that is very heavy, right? 01:15:20.079 --> 01:15:22.079 We we're like working with real people. 01:15:22.239 --> 01:15:25.199 Like, you know, this is this is not fictional. 01:15:25.439 --> 01:15:26.479 This is this is real. 01:15:26.640 --> 01:15:28.319 And that like there is hope, right? 01:15:28.399 --> 01:15:31.279 There is hope that we have providers like you, Dr. 01:15:31.439 --> 01:15:32.000 Anna, right? 01:15:32.079 --> 01:15:34.560 Who are able to like come in and support families. 01:15:34.640 --> 01:15:38.239 Like we have um we have midwives, right? 01:15:38.319 --> 01:15:41.279 We have people that we we know and we have a community. 01:15:41.359 --> 01:15:44.560 I think BADT is like that for me personally, right? 01:15:44.640 --> 01:15:54.399 Like it's a space where like we're learning, we're growing together and knowing that like there is hope for for families, for even for for us, for me first, right? 01:15:54.479 --> 01:16:01.199 And then for birth workers, for families, that like there we can there can be a new page to this work, right? 01:16:01.279 --> 01:16:04.000 We can we can have positive you know experiences. 01:16:04.159 --> 01:16:13.199 I think for me, that's just been the word that has been tagging on me and like reminding, you know, being reminded, even in the stories of like Lindsay's story, like it's like there is still hope. 01:16:13.279 --> 01:16:15.199 Like it is not all doom. 01:16:15.920 --> 01:16:17.119 It is not you know, right? 01:16:17.359 --> 01:16:23.359 In the midst of the political world that we're in, that you hit a bit a little bit at the beginning, that right? 01:16:23.439 --> 01:16:30.000 Like there is hope because there is there's us, like there's like a village, there's people that are coming up and saying, we're gonna do this differently. 01:16:30.239 --> 01:16:32.159 We're we're we're gonna support one another. 01:16:32.319 --> 01:16:34.239 We're actually like gonna be a community.

01:16:34.399 --> 01:16:40.479 Like I'm not just gonna run away with my own thing and try to, you know, I'm gonna be able to help other, you know, others. 01:16:40.640 --> 01:16:46.880 Like, yeah, there's like a remnant of folks that are that are rising, that are coming and saying, we're gonna do this differently, right? 01:16:46.960 --> 01:16:49.039 We're we're gonna we're gonna go against capitalism. 01:16:49.119 --> 01:16:51.359 We're gonna go against what it is that we have seen. 01:16:51.439 --> 01:16:55.520 We're gonna go against the six-week, the six-week checkup, right? 01:16:55.600 --> 01:17:00.399 Um, I was at a home birth and the midwife was back there the next day and the next day and the next day. 01:17:00.479 --> 01:17:02.560 And I know she did not get paid, right? 01:17:02.640 --> 01:17:07.439 I know that she has not been compensated enough, but she's coming in and saying, no, there is hope. 01:17:07.520 --> 01:17:09.359 We're gonna do this, we're gonna do this differently. 01:17:09.439 --> 01:17:15.680 So I think as we hear this really heavy and hard things, um, to be reminded that like there is hope and we are part of that. 01:17:16.079 --> 01:17:17.600 Thank you so much, Mary Nisi. 01:17:17.920 --> 01:17:22.880 Because it's been lovely just to hear you talk throughout this and to get to know you a little bit. 01:17:23.279 --> 01:17:27.359 Um, my uh how you can reach me is a little more complicated. 01:17:27.520 --> 01:17:30.960 Uh sadly, I like as I said, I moved across the world. 01:17:31.199 --> 01:17:40.239 Um and so right now, my license in the United States in California um is under an inactive status. 01:17:40.399 --> 01:17:44.159 I have it inactive for now while I kind of figure out what my next steps look like. 01:17:44.479 --> 01:17:47.439 So I'm not available for clinical work at this time. 01:17:47.600 --> 01:17:52.000 I'm available for things like podcasts and um other kinds of consulting. 01:17:52.079 --> 01:17:59.600 But at this time, um, yeah, unfortunately, I'm not taking on any clinical care, which I'm quite sad about. 01:18:00.000 --> 01:18:05.039 Um, but you can uh find out more about me just Googling my name. 01:18:05.119 --> 01:18:13.279 I'm on a lot of episodes speaking about uh women's health um and disparities, uh racial disparities uh in healthcare, et cetera. 01:18:13.439 --> 01:18:16.319 So you can see a little bit more of my work there. 01:18:16.560 --> 01:18:22.800 Um and hopefully uh I'll be able to bring some of this work to Spain in a meaningful way. 01:18:22.960 --> 01:18:24.960 Um, I don't know what that looks like yet. 01:18:25.039 --> 01:18:27.039 Right now I'm still surviving. 01:18:27.600 --> 01:18:40.880 Um, and as far as what I'd like to leave you with, I mean, I think for me, part of what I would like some of my impact to be is with my colleagues and helping to move the needle. 01:18:41.039 --> 01:18:46.399 I think in my work, uh my world is still such a white dominated world. 01:18:46.720

--> 01:19:01.039 And um I think there's such a difficulty in terms of access to care and work being able to work with black and brown therapists in general, and that looks even worse when you're like moving up the chain a bit to a psychologist or a psychiatrist. 01:19:01.199 --> 01:19:18.079 And so I just wanted to kind of leave this space encouraging any of our white listeners, particularly providers, um, with a Malcolm X quote, if I may, um, which is if you stick a knife in my back nine inches and pull it out six inches, there's no progress. 01:19:18.239 --> 01:19:20.640 If you pull it all the way out, that's not progress. 01:19:20.800 --> 01:19:23.119 Progress is healing the wound that the blow made. 01:19:23.199 --> 01:19:26.239 And they haven't even pulled the knife out, much less healed the wound. 01:19:26.399 --> 01:19:28.399 They won't even admit the knife is there. 01:19:28.640 --> 01:19:30.640 I think we need to admit the knife is there. 01:19:30.800 --> 01:19:47.520 And a lot of I think change in our healthcare system, whether it's insurance, whether you know, whether it's access to care, whether it's how we treat and and diagnose and take care of black and brown people, uh, birthing people, I think we have to start there. 01:19:47.760 --> 01:19:52.800 If not, none of the none of what we've talked about today, I think really truly gets better in the future. 01:19:53.039 --> 01:19:55.760 So that's what I'd like to leave us with. 01:19:56.079 --> 01:19:57.760 Now I have to follow up with that. 01:19:57.920 --> 01:20:01.039 Like, like that was so great. 01:20:01.119 --> 01:20:03.359 I'm like, uh, what am I gonna say? 01:20:03.680 --> 01:20:07.920 Um, to find me is Sabia Wade everywhere. 01:20:08.159 --> 01:20:10.319 Um, mostly on Instagram, though. 01:20:10.479 --> 01:20:11.920 I'm definitely a millennial. 01:20:12.079 --> 01:20:13.359 I do have my TikTok. 01:20:13.439 --> 01:20:13.920 It's up there. 01:20:14.000 --> 01:20:18.159 Y'all gonna see more like homestead content for sure when it comes to TikTok. 01:20:18.560 --> 01:20:20.399 Um, let's see. 01:20:21.199 --> 01:20:22.800 What would I want to say? 01:20:22.960 --> 01:20:28.319 I guess I would want to say that we all have a part in this. 01:20:29.279 --> 01:20:41.600 Um, Lindsay Killian C is one example of of a case, but a postpartum psychocasis case that obviously ended in the most terrible way. 01:20:42.239 --> 01:20:44.079 Um, and there's many others. 01:20:45.199 --> 01:21:10.560 And when we when I say we all have a part in this, when you see things getting strange, sound the alarm, you know, like talk to them, talk to their family, talk to whoever that you can before you get to a p uh, you know, 911 or all these things, but really try to be communal in our approach. 01:21:10.800 --> 01:21:15.760 Um, and I think it starts with saying, Hey, you seem a little off. 01:21:16.720 --> 01:21:20.880 Like, hey, you you seem to be like kind of boarding yourself up in the house. 01:21:21.119 --> 01:21:23.520 Like, hey, you seem to be, right? 01:21:23.600 --> 01:21:29.199 Like, whatever that looks like, and and letting people know that you're doing that with love, right? 01:21:29.359 --> 01:21:30.720 And not with judgment. 01:21:30.960 --> 01:21:39.439 Because everyone's scared to be judged, everyone is scared to parent wrong, where people are scared to be unwell, right? 01:21:39.600 --> 01:21:41.600 Because what does that say about me, right? 01:21:41.840 --> 01:21:44.800 So I really wanted to think about that and the parts that we play. 01:21:44.880 --> 01:21:52.319 You don't have to be a doula, you don't have to be a therapist, you don't have to be a medical professional to name. 01:21:52.399 --> 01:21:56.720 Like something's a little a little off, but how can I support you? 01:21:56.960 --> 01:21:59.439 Can I take you to your therapy appointment? 01:21:59.680 --> 01:22:02.880 Can I sit with you during a remote therapy appointment? 01:22:03.119 --> 01:22:03.840 Can I, right? 01:22:04.079 --> 01:22:07.199 Like, can I take care of the kids while you go see the doctor? 01:22:07.359 --> 01:22:14.239 Like, whatever that looks like, like it doesn't have to be these big, huge things. 01:22:14.560 --> 01:22:27.199 We can start with a lot of small things and really sometimes help someone who may have gone to the end of the spectrum, right, not get to that end because they have people holding them, right? 01:22:27.680 --> 01:22:38.479 And so I want to name that, and I also want to name just all the unspoken, unnamed work that goes into caring for birthing people. 01:22:38.960 --> 01:22:52.960 Um for all of us, Adula's medical professionals, like there's so much unspoken, unnamed work that we do in that process that no one can understand until you just do the work. 01:22:53.119 --> 01:22:57.039 And so just wanna thank everyone for doing everything that they can. 01:22:57.279 --> 01:23:05.600 And then lastly, I would like to say thank you to my guests, right? 01:23:05.760 --> 01:23:07.760 So, really doctor, and you're really the only guest. 01:23:07.840 --> 01:23:17.840 Mary Nisi is really a teacher, but you know, so we're gonna say thank you to you for being here, calling in from Spain, working, working with us. 01:23:18.000 --> 01:23:29.760 Because, like, you know, it's important, I think, for when we were planning this episode, I was like, it's important to have like a medical professional that is speaking the same language that we're speaking. 01:23:30.000 --> 01:23:34.239 Because a lot of times you can feel like, here's Doulas, here's everyone else. 01:23:34.479 --> 01:23:34.720 Right. 01:23:34.880 --> 01:23:42.239 And I'm like, it's important to show, like, there are people in the work at different levels, and we are all speaking the same thing. 01:23:42.319 --> 01:23:44.239 We are all here for the same mission. 01:23:44.479 --> 01:23:49.920 And we all also are noticing that the state of healthcare is terrible. 01:23:51.680

--> 01:24:00.079 So I just I really appreciate you bringing your personal experience, your professional experience, and also just yourself, because I know you're committed to this work. 01:24:00.319 --> 01:24:03.119 So I was like, it's easy if she's gonna come up here and talk about it. 01:24:03.199 --> 01:24:05.119 I don't have to prep her, I don't gotta do none of that. 01:24:05.199 --> 01:24:06.159 She knows what it is. 01:24:06.399 --> 01:24:07.520 So I appreciate that. 01:24:07.840 --> 01:24:09.439 Thank you so much for having me. 01:24:09.520 --> 01:24:11.039 I really appreciate you so much. 01:24:11.119 --> 01:24:15.840 And the work that you that you two are doing is so sacred. 01:24:15.920 --> 01:24:25.920 And, you know, Sabia, my first birth, the the part of that that I remember more than anything is is after my baby came out. 01:24:26.000 --> 01:24:30.399 And I felt like I was in like a black hole just by myself. 01:24:30.560 --> 01:24:36.079 And I just all of a sudden remembered hearing your voice right by my ear asking how I was doing. 01:24:36.239 --> 01:24:43.279 And that is the first moment I felt like safe and okay after what was a pretty long and scary experience. 01:24:43.520 --> 01:24:46.000 So thank you for the work that you guys do. 01:24:46.079 --> 01:24:58.319 I don't know if you hear that enough, but um after my experience with you, Sabia, I have recommended to all of my perinatal patients that they they seek out a doula. 01:24:58.880 --> 01:25:08.000 Um, it's I think it's so life-changing for for what is like the most vulnerable someone could possibly be. 01:25:08.239 --> 01:25:12.720 Um, so we was in there, we was making it happen. 01:25:13.199 --> 01:25:19.600 I remember one time too, during the during birth, like the midwife who we were in the hospital, but like a C and M. 01:25:21.119 --> 01:25:24.399 So we I think she she asked Anna something. 01:25:24.479 --> 01:25:26.720 She was like, Do you are you interested in it? 01:25:26.800 --> 01:25:30.000 And so like Anna looked at me, like let's like, you know, let's think about this. 01:25:30.159 --> 01:25:31.520 And she said something smart. 01:25:31.680 --> 01:25:34.800 And it was like, she's been here. 01:25:35.039 --> 01:25:53.760 I was like, oh I was like, oh, but also at that time, though, I will say too that like as a dualer, we know that we're stepping into spaces where people are gonna sometimes question, like, why we're there, or what's the big deal, or who is this person, or just sit in the corner and be quiet. 01:25:54.000 --> 01:26:00.399 So when our clients also come the same way that we come about them, it's like you heard her, bitch. 01:26:00.560 --> 01:26:02.560 Yeah, back it up. 01:26:02.880 --> 01:26:05.039 Okay, back it up, girl. 01:26:05.760 --> 01:26:07.279 We're having a conversation, right? 01:26:07.439 --> 01:26:11.920 And so I just really appreciate that moment too, because I've been in situations, I'm sure Mary needs too. 01:26:12.000 --> 01:26:14.720 Being a black birth worker, I'm still black. 01:26:14.880 --> 01:26:20.960 So when so when I come into spaces, they don't be caring what's going on. 01:26:21.119 --> 01:26:23.439 I I'm I'm still black. 01:26:24.960 --> 01:26:26.319 So I appreciate that. 01:26:26.640 --> 01:26:29.279 Marinisi, you know, you my boo. 01:26:29.840 --> 01:26:30.239 Thank you. 01:26:30.399 --> 01:26:30.960 Thank you so much. 01:26:31.039 --> 01:26:31.520 This was great. 01:26:31.600 --> 01:26:32.640 Yeah, it's so nice to meet you, Dr. 01:26:32.880 --> 01:26:34.000 Anna, and to hear from you. 01:26:34.159 --> 01:26:36.239 Um, yeah, just like really grateful. 01:26:36.560 --> 01:26:44.560 Marinisi is just a light, like she comes in and you're just like, it's like I feel like I come into a space and it's like gloom and doom a little bit, yeah. 01:26:44.640 --> 01:26:46.079 I feel like me and Anna both are like that. 01:26:46.159 --> 01:26:49.600 It's like a little gloomy doomy until you know we get into a good mood. 01:26:49.840 --> 01:26:51.840 I'm always in a bad mood, so yeah. 01:26:54.000 --> 01:26:57.119 But on that note, for everyone that's listened, thank you so much. 01:26:57.439 --> 01:27:01.119 Please, please, please like follow us wherever we are. 01:27:01.199 --> 01:27:08.640 We're gonna be on the YouTubes and the podcast places and the apples and the Spotifies and the wherever you find your stuff. 01:27:09.039 --> 01:27:11.439 Wherever you listen to podcasts, yeah, for sure. 01:27:11.680 --> 01:27:16.640 And then if you're interested in BAD, we not only train doulas, we train everyone. 01:27:16.800 --> 01:27:22.880 What we have learned is that people from different professions come into our space because of our approach, right? 01:27:23.119 --> 01:27:27.119 Trauma informs, inclusive, intersectionality, right? 01:27:27.279 --> 01:27:29.039 All these different levels of the work. 01:27:29.199 --> 01:27:31.520 So if you're interested, come through. 01:27:31.680 --> 01:27:33.039 We would love to have you. 01:27:33.199 --> 01:27:34.960 And again, thank you to my guests. 01:27:35.039 --> 01:27:37.520 And we will see you on our next episode. 01:27:37.920 --> 01:27:38.560 Later.